La eficacia clínica de la carga convencional, precoze inmediata en sobredentaduras mandibulares con implantes dentales. Un estudio comparativo a cinco años / The clinical efficacy of conventional, early and immediate in mandibular overdentures with dental implants. A 5-year comparative study

Introducción. El estudio muestra la evaluación de los pacientes edéntulos totales tratados con sobredentaduras mandibulares con implantes dentales mediante diferentes tipos de carga funcional. Métodos. 33 pacientes edéntulos totales fueron tratados con 127 implantes en la mandíbula para su rehabilitación prostodóncica con sobredentaduras. Todos los implantes fueron insertados en la cirugía y fueron cargados de forma convencional, precoz o inmediata. Resultados. Después de un seguimiento clínico medio de 67,5 meses (rango: 36-108 meses), los resultados indican un éxito de los implantes del 96,9% porque 4 implantes fracasaron. El 100% delos pacientes fueron tratados con una sobredentadura implantosoportada, el 60,9% con retenedores de bolas y el 31,9% mediante barras .Conclusiones. El estudio indica que la rehabilitación oral de los pacientes edéntulos con sobredentaduras mandibulares implantosoportadas mediante su carga convencional, precoz o inmediata pueden obtener la oseointegración y representar una terapéutica odontológica con éxito (AU)

Introduction. This study reports the evaluation of edentulous patients treated with overdentures in the mandible by different loading protocols of dental implants. Patients and Methods. 33 edentulous patients were treated with 127 implants for prosthodontics rehabilitation with overdentures in the mandible. All implants were inserted in one-stage and were loaded with conventional, early and immediate protocols. Results. After a mean follow-up of 67,5 months (range: 36-108 months), clinical results indicate a success rate of implants of 96,9%. Four implants were lost. 100% of patients were treated with overdentures, 60,9% with ball attachments and 39,1% with bar retained. Conclusions. This study indicate that oral rehabilitation in the mandible of edentulous patients with overdentures supported by implants can achieve osseo integration and were loaded conventionally, early and immediately as a successful dental treatment (AU)

High prevalence of apical periodontitis amongst smokers in a sample of Spanish adults.

AIM: To study the prevalence of apical periodontitis in smoker and nonsmoker patients. METHODOLOGY: In a cross-sectional study, the records of 180 subjects, 109 smokers and 71 nonsmokers, were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all teeth, excluding third molars, was examined. Periapical status was assessed using the Periapical Index score. Statistical analyses were conducted using the Cohen's Kappa test, analysis of variance and logistic regression. RESULTS: Apical periodontitis in at least one tooth was found in 74% of smokers and in 41% of nonsmokers (P < 0.01; odds ratio = 4.2; 95% C. I. = 2.2-7.9). Amongst smoker patients 5% of the teeth had apical periodontitis, whereas in nonsmoker subjects 3% of teeth were affected (P = 0.008; odds ratio = 1.5; 95% C. I. = 1.1-2.1). The percentage of root filled teeth in smoker and nonsmoker patients was 2.5% and 1.5%, respectively (P < 0.05; odds ratio = 1.7; C. I. 95% = 1.0-2.6). CONCLUSIONS: In this study population, smoking was significantly associated with a greater frequency of root canal treatment and with an increased prevalence of apical periodontitis.

El tratamiento con implantes dentales postextracción / Treatment with postextraction dental implants

Introducción. El objetivo del presente estudio era mostrar los resultados de del tratamiento con implantes dentales insertados inmediatamente después de la extracción. Métodos. 22 pacientes con pérdida dental unitaria, parcial o total fueron tratados con 82 implantes Microdent® con superficie con chorreado de arena y grabada con ácidos. Todos los implantes fueron insertados inmediatamente después de la extracción correspondiente. Los implantes fueron cargados después de un periodo de cicatrización de 3 meses en la mandíbula o 6 meses en el maxilar superior. Resultados. Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 97,6%. 2 implantes se perdieron durante el periodo de cicatrización. El 73,2% de los implantes fueron insertados en el maxilar. superior mientras que el 26,8% en la mandíbula. Después de un periodo medio de carga funcional de 12 meses, no ha habido complicaciones tardías. Conclusiones. Este estudio indica que los implantes dentales insertados de forma inmediata después de la extracción pueden constituir una alternativa implantológica predecible y exitosa (AU)

Introduction. The aim of this study was to report the outcome of treatment with implant inserted immediately after tooth extraction. Methods. 22 patients with single, partially or totally tooth loss were treated with 82 Microdent® sandblasted etched surface implants. All implants were inserted immediately after tooth extraction. Implants were loaded after a healing free-loading period of 3 months in mandible or 6 months in maxilla. Results. Clinical results indicate a survival and success rate of implants of 97,6%. 2 implants were lost during the healing period. 73.2% of implants were inserted at maxilla while 26.8% were inserted at mandible. After a functioning period of 12 months, no late complications were reported. Conclusions. This study indicate that dental implants inserted immediately after tooth extraction may constitute a successful, predictable alternative implant treatment (AU)

High prevalence of apical periodontitis amongst type 2 diabetic patients.

AIM: To study the prevalence of AP in patients with and without type 2 diabetes mellitus. METHODOLOGY: In a retrospective cohort study, the records of 38 subjects with diabetes and 32 control subjects were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all teeth, excluding third molars, was examined. Periapical status was assessed using the periapical index score. Statistical analyses were conducted using the Cohen's kappa test, analysis of variance and logistic regression. RESULTS: Apical periodontitis in at least one tooth was found in 81.3% of diabetic patients and in 58% of control subjects (P = 0.040; OR = 3.2; 95% CI = 1.1-9.4). Amongst diabetic patients 7% of the teeth had AP, whereas in the control subjects 4% of teeth were affected (P = 0.007; OR = 1.8; 95% CI = 1.2-2.8). CONCLUSIONS: Type 2 diabetes mellitus is significantly associated with an increased prevalence of AP.

La carga inmediata de implantes transicionales en sobredentaduras mandibulares en adultos mayores / Inmediate loading of transitional implants in mandible overdentures of older adults

Introducción. La implantología oral constituye una importante modalidad terapéutica en el tratamiento prostodóncico de los pacientes con pérdida dental total. El estudio muestra la evaluación de los pacientes edéntulos totales tratados con sobredentaduras mandibulares mediante la carga inmediata de los miniimplantes de titanio con superficie grabada con ácidos. Métodos. 18 pacientes edéntulos totales fueron tratados con 72 mini implantes transicionales Sendax® en la mandíbula para su rehabilitación prostodóncica con sobredentaduras. Todos los implantes fueron insertados en 1 cirugía y fueron cargados inmediatamente en la misma sesión. Los hallazgos clínicos (implantológicos y prostodóncicos) se han seguido al menos durante 12 meses. Resultados. Después de un seguimiento clínico medio de 20,8 meses (rango: 12-48 meses), los resultados indican un éxito de los implantes del 97,3 por ciento porque 2 implantes fracasaron. El 100 por ciento de los pacientes fueron tratados con una sobredentadura implantosoportada con retenedores de bolas sobre 4 implantes. Conclusiones. Los resultados del presente estudio indican que la rehabilitación prostodóncica de la mandíbula con sobredentaduras implantosoportadas de los pacientes edéntulos mediante la carga inmediata de implantes transicionales de titanio pueden obtener la oseointegración y representar una terapéutica odontológica con éxito (AU)

Introduction. Oral implantology constitute an important therapeutic modality in the prosthodontic treatment of patients with total tooth loss. This study reports the evaluation of edentulous patients treated with overdentures in the mandible by immediate loading of titanium miniimplants with acid-etched surface. Patients and Methods. 18 edentulous patients were treated with 72 Sendax® transitional mini implants for prosthodontic rehabilitation with overdentures in the mandible. All implants were inserted in one-stage and were loaded immediately. Clinical findings (implant and prosthodontics) were followed during 12 months at least. Results. After a mean follow-up of 20.8 months (range: 12-48 months), clinical results indicate a success rate of implants of 97,3%.Twoimplants were lost. 100% of patients were treated with overdentures with ball attachments retained with 4 implants. Conclusions. Clinical results of this study indicate that prosthodontic rehabilitation in the mandible of edentulous patients with overdentures supported by transitional titanium implants can achieve osseointegration and were loaded immediately as a successful dental treatment (AU)

Periapical status and quality of root fillings and coronal restorations in an adult Spanish population.

AIM: To investigate the quality of root fillings and coronal restorations and their association with periapical status in an adult Spanish population. METHODOLOGY: A total of 180 subjects, aged 37.1 +/- 15.7 years, who presented as new patients at the Faculty of Dentistry, Seville, Spain, were examined. All participants underwent a full-mouth radiographic survey incorporating 14 periapical radiographs. The periapical region of all root filled teeth, excluding third molars, were examined. The technical quality of root fillings was evaluated in terms of length in relation to the root apex and lateral adaptation to the canal wall. Radiographic signs of overhang or open margins associated with coronal restorations were also evaluated. Periapical status was assessed using the Periapical Index score. Statistical analyses were conducted using the Cohen's kappa test and logistic regression. RESULTS: The total number of root filled teeth was 93, and 60 (64.5%) had apical periodontitis (AP). Presence of AP in root filled teeth was associated with inadequate adaptation of the filling (OR = 2.29; P = 0.06), inadequate length of the root filling (OR = 2.44; P = 0.048), and with poor radiographic quality of the coronal restoration (OR = 2.38; P = 0.054). Only 34.4% of the root fillings were adequate from a technical perspective. When both root fillings and coronal restorations were adequate the incidence of AP decreased to 31.3% (OR = 5.50; P < 0.01). CONCLUSIONS: The incidence of AP in root filled teeth was high. Many root fillings were technically unsatisfactory. Adequate root fillings and coronal restorations were associated with a lower incidence of AP; an adequate root filling had a more substantial impact on the outcome of treatment than the quality of the coronal restoration.

Prevalence of apical periodontitis and frequency of root-filled teeth in an adult Spanish population.

AIM: To estimate the prevalence of teeth with apical periodontitis (AP) and root-filled teeth in an adult Spanish population. METHODOLOGY: A total of 180 subjects, aged 37.1 +/- 15.7 years, presenting as new patients to the Faculty of Dentistry, Seville, Spain, were examined. All participants underwent a full-mouth radiographic survey (14 periapical radiographs). The frequency of root canal treatment and the periapical status of all teeth, using the periapical index (PAI) score, were assessed. An intraobserver agreement test on PAI scores produced a Cohen's kappa of 0.77 (substantial agreement). Results were analysed statistically using the Chi-square test. RESULTS: Apical periodontitis in one or several teeth was found in 110 subjects (61.1% prevalence), and 73 (40.6% prevalence) had at least one root-filled tooth. Among subjects with root-filled teeth, 48 (65.8%) had AP affecting at least one root-filled tooth. A total of 4453 teeth were examined, of these 186 (4.2%) had AP. The total number of root-filled teeth was 93 (2.1%), of which 60 (64.5%) had AP. Among non-root filled teeth, only 2.9% had AP. The prevalence of AP in connection with molar teeth was higher (5.5%) than for premolar (4.5%) and anterior teeth (3.2%; P < 0.01). More premolar and molar teeth were root-filled (2.8 and 2.7%, respectively) than anterior teeth (1.3%; P < 0.01). The prevalence of AP increased with age. CONCLUSIONS: The prevalence of AP in root-filled and untreated teeth, and the frequency of root-filled teeth were comparable to those reported in previous similar studies carried out in European countries. The prevalence of root-filled teeth with AP was found to be higher compared to that demonstrated in other epidemiological studies.

Comparison of modified Bass technique with normal toothbrushing practices for efficacy in supragingival plaque removal.

OBJECTIVES: This study was designed to compare the efficacy in supragingival plaque removal of normal toothbrushing practices and a particular toothbrushing technique, the modified Bass method. SUBJECTS AND METHODS: The research consisted of two identical experiments with two toothbrushing methods: the normal toothbrushing practices and the modified Bass technique. Forty-six secondary, non-dental students (10 males and 36 females) with ages ranging from 18 to 30 years were selected. Dental plaque was assessed according to the Turesky modification of Quigley-Hein Index. Subjects were requested not to brush their teeth 48 h prior to the baseline record of plaque index. Participants were instructed to brush twice daily during 3 min for the duration of the 3-week trial using their usual toothpaste. Plaque index was recorded at 2, 7 and 21 days. RESULTS: The modified Bass (Mod-Bass) technique was significantly (P < 0.05) more effective in removing supragingival plaque than normal toothbrushing practices both in all, buccal and lingual sites. After 21 days, the normal practices did not significantly decrease mean plaque indices compared to the scores calculated after 7 days (P > 0.05), but did so with the modified Bass technique (P < 0.05). The modified Bass technique was specially efficient at the lingual sites where it was 2.9-fold more effective than normal practices in reducing plaque scores (P < 0.01). CONCLUSION: The results show that a particular toothbrushing technique as modified Bass method is significantly superior to normal toothbrushing practices in supragingival plaque removal. The introduction of a specific toothbrushing technique, such as modified Bass technique represents an important improvement in the oral hygiene of the patients.