Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study.

BACKGROUND: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferior alveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predict neurosensory alterations from preoperative imaging. MATERIAL AND METHODS: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Prior to surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance. Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its contact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) were recorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-square test, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI) of 95%. RESULTS: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramic radiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more types of superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in only three cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations were observed in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed. CONCLUSIONS: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTM extraction by means of preoperative imaging did not show a significant statistical correlation with post-surgical incidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predict an increased risk of IAN injury.

Effect of the buccal fat pad in the prevention of zygomatic implant surgery postoperative complications: A pilot study.

BACKGROUND: Zygomatic implants have been used to treat severe atrophy maxilla. Since its description, the technique has been improved in order to reduce patient morbidity as well as prosthesis rehabilitation time. Despite the improvements in the procedure, zygomatic implant treatments still have complications related to the peri-implant soft-tissue; a probing depth greater than 6 millimeter (mm) and a prevalence of bleeding on probing of 45% have been described. The mobilization of the buccal fat has been used to manage different oral and maxillofacial soft-tissue pathologies. The aim of this study was to assess whether the buccal fat pad might prevent mucosal dehiscence and avoid potential postoperative complications when is placed covering the body part of the zygomatic implants. MATERIAL AND METHODS: In this pilot study, 7 patients were enrolled and a total of 28 zygomatic implants were placed and evaluated during a 12-month follow-up period. Surgical sites were randomly divided into two groups before implant placement: control group (A; in which no buccal fat pad was applied) and experimental group (B). Peri-implant soft tissue thickness difference, pain using a Visual Analog Scale (VAS), swelling, hematoma, buccal soft tissue healing and sinusitis, were evaluated. The implant survival rate was determined according the Aparicio success criteria and compared between the control and experimental procedure. RESULTS: A nonstatistical difference was found between groups regarding to pain. The experimental group showed higher soft-tissues thickness (p= 0.03) and the implant survival rate was 100% in both groups. CONCLUSIONS: The mobilization of the buccal fat pad to cover the body of the zygomatic implants increases peri-implant soft-tissue thickness, without increasing the postoperative pain.

Clinical performance of tooth root blocks for alveolar ridge reconstruction.

This systematic literature review set out to investigate the clinical outcomes of autogenous tooth root blocks used for ridge augmentation: survival rates, block resorption, implant survival, post-surgical complications, and histology findings. This review followed PRISMA guidelines. An automated search was made in four databases, supplemented by a manual search for relevant articles published before December 2020. The quality of evidence provided was assessed with the Newcastle-Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Seven articles fulfilled the inclusion criteria and underwent analysis. The articles included a total of 136 patients, who received 118 autogenous tooth root blocks and 26 autogenous bone blocks showing block survival rates of 99.15% and 100%, respectively. Tooth root blocks presented a mean bone gain that was similar to autologous bone blocks but showed less resorption. The implant survival rate was 98.32% for autogenous tooth root blocks. Reconstruction of alveolar crests by means of autogenous tooth root blocks appears to be a satisfactory option for single-tooth gaps and low grades of bone atrophy in terms of the survival of the bone block and the implants placed subsequently. More research providing long-term data is needed to confirm these findings.

Burnout syndrome assessment among Spanish oral surgery consultants: A two populations comparative pilot study.

BACKGROUND: The professional Burnout Syndrome (BOS) or Burnout is considered a professional disease made up of three interrelated dimensions (emotional exhaustion, depersonalization and lack of personal fulfillment). BOS has been documented to most severely affect the healthcare professions, especially dentists. On the other hand, its appearance has been documented at an early age, during dental training. However, there are no studies that analyze its incidence in professionals dedicated to Oral Surgery and Implantology, determining the age of onset and related factors. MATERIAL AND METHODS: The modified Maslach questionnaire was carried out anonymously among the professors and students of the Master of Oral Surgery and Implantology at the Complutense University of Madrid. A total of 36 participants were enrolled in this study and the results of the modified Maslach Questionnaire were established into four groups [1st year (n=6), 2nd year (n=6), 3rd year (n=6) postgraduate students and clinical teachers (n=18)]. The following variables were recorded: Age, sex, years of experience, weekly hours of work, dedication on weekends and scope of work. The statistical analysis performed included Pearson's correlation, analysis of variance, Student's t-test, F-Anova, Chi-Square and Gamma correlation. Statistical Significance of the tests was established of p≤0.05. RESULTS: 36 questionnaires were analyzed, of which 22.2% (n = 8) presented BOS, and 77.8% (n = 28) a medium risk of suffering it. The mean values and standard deviation ​​of emotional exhaustion (7.50 ± 2.43; 9.83 ± 4.12; 15.83 ± 6.21; 30.22 ± 7.86), depersonalization (5.50 ± 1.23; 50 ± 3.27; 11.33 ± 1.75; 17.56 ± 4.13), low personal fulfillment (39.67 ± 3.72; 39.33 ± 2.34; 43.17 ± 3, 55; 37.33 ± 5.51) and professional burnout (54.33 ± 2.66; 61.67 ± 2.88; 70.33 ± 5.43; 85.11 ± 9.05) in the four groups respectively. A significant association was found in the appearance of emotional exhaustion and depersonalization, years of experience, weekly work hours and the work environment. CONCLUSIONS: BOS is a disease that can appear from 30 years of age, after 5 years of professional experience and when there is a clinical consultation of 40 hours a week. Oral Surgery and Implantology seems to be a risk activity for the manifestation of depersonalization.

Dental implant placement through impacted teeth or residual roots as an alternative to invasive extraction surgeries: a systematic literature review.

This work systematically reviews dental implant placement through impacted teeth or residual roots, as an alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical, and prosthetic complications. The authors conducted an electronic search of four databases up to September 2020; also a complementary handsearch was carried out. The quality of the included studies was assessed using a protocol for assessment of risk of bias in exposure studies. Ten studies fulfilled the inclusion criteria and were analysed. A total of 44 patients received 62 dental implants and were monitored for a minimum of 12-months follow-up. An overall mean implant survival rate was 90.32%, reporting 97.56 % for dental implants through impacted teeth and 76.19% through residual roots. No surgical or prosthetic complications were reported. Placing dental implants through impacted teeth may offer a valid therapeutic option for implant-supported restorations in patients for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery. Moreover, additional caution is recommended when placing implants through retained root fragments, as this may involve long-term risk. Further research generating long-term data are needed to confirm these findings.

Accuracy of digital planning in zygomatic implants.

BACKGROUND: Zygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP. The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards. RESULTS: Fourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05). CONCLUSIONS: Zygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.

Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study.

BACKGROUND: Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was to determine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetate is effective in preventing surgical complications related to impacted lower third molar extractions. MATERIAL AND METHODS: A randomized, double-blind, split-mouth study was performed. Fifteen patients were recruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test or placebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply the gel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, and the opposite gel applied. The following parameters were diagnosed/evaluated and then recorded: alveolar osteitis following Blum's criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healing at day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesic pill intake. RESULTS: A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveolar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). No statistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consumption between two groups. But statistically lower postoperative pain during the 7 days after surgical extractions was found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effects were reported. CONCLUSIONS: The application of this gel may be effective in preventing alveolitis and thus reducing postoperative pain after impacted third molar extractions. More randomized clinical trials with larger sample are needed to confirm these results.

Efficacy of a topical gel containing chitosan, chlorhexidine, allantoin and dexpanthenol for pain and inflammation control after third molar surgery: A randomized and placebo-controlled clinical trial.

BACKGROUND: The aim of this study was to evaluate and compare the postoperative effect of a topic gel containing chlorhexidine, chitosan, allantoine and dexpanthenol versus a placebo for pain and inflammation control after third molar surgery. MATERIAL AND METHODS: A gel combining 0.2% chlorhexdine, 0.5% chitosan, 5% dexpanthenol, 0.15% allantoin and 0.01% sodium saccharin was selected for this split mouth randomized controlled and double-blind trial including 36 patients with bilaterally and symmetrically impacted lower third molars. The teeth (n=72) were randomly divided into two groups before surgical removal: control group (CG; in which a placebo was given) and experimental group (EG). Swelling, trismus, postoperative pain, wound healing and complications were measured and recorded in order to evaluate differences between the placebo and experimental product. RESULTS: Five patients suffered from an alveolitis in the CG (13.9%), and none in the study group (0%), but no statistically significant difference was found (p=0.063). From day 0 to day 7, trismus and swelling were significantly less pronounced in the EG, and wound healing was considered 'good' in 22.2% for the CG and 97.2% for the EG (p<0.001). Mean VAS scores during the seven postoperative days were statistically lower in the study (2.56±1,19) compared to the placebo group (3.25±1.6) (p=0.002). The mean consumption of analgesic pills during the first 92 hours was also statistically lower in the EG (0.26±0.51) in comparison to the CG (0.56±0.67) (p=0.003). CONCLUSIONS: The use of an experimental gel containing chlorhexidine, chitosan, allantoine and dexpanthenol seems to significantly reduce postoperative pain, trismus and signs of inflammation. Future studies should further evaluate, if the gel is effective in dry socket preventing after third molar removal.

Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts: A systematic review and meta-analysis

BACKGROUND: This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. MATERIAL AND METHODS: An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. RESULTS: Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. CONCLUSIONS: Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings

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Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts: A systematic review and meta-analysis.

BACKGROUND: This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. MATERIAL AND METHODS: An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. RESULTS: Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. CONCLUSIONS: Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings.

The osteocyte: A multifunctional cell within the bone.

The knowledge of bone biology has largely changed in the last few decades. Osteocytes are multifunctional bone cells that are surrounded by mineralized bone matrix and for decades it was considered that they might be relatively inactive cells. However, nowadays it is known that osteocytes are highly active cells which are indispensable for the normal function of the skeleton, playing main roles in several physiological processes, both within and beyond the bone microenvironment. This review highlights and updates the current state of knowledge of the osteocyte and focuses on its roles in bone remodeling and mineral homeostasis, and also reviews its recently discovered endocrine function. Osteocytes secrete sclerostin (a protein that works as a negative regulator of bone mass), and FGF-23, the most important osteocyte-secreted endocrine factor, since it is able to regulate the phosphate metabolism. Moreover, osteocytes can act as mechanosensory cells, transforming the mechanical strain into chemical signaling towards the effector cells (osteoblasts and osteoclasts). Therefore, the osteocyte plays an important role in bone biology, specifically in the remodeling process, since it regulates both the osteoblast and osteoclast activity. Finally, the paper discusses the clinical application of the bone biology, updating the new therapies against bone-loss disorders.

Effects of locally applied Insulin-like Growth Factor-I on osseointegration.

BACKGROUND: The aim of this study was to assess the effect of local application of IGF-I on osseointegration of dental implants placed in osteoporotic bones. MATERIAL AND METHODS: 16 rabbits were randomly distributed into two groups: eight animals were ovariectomized and fed a low-calcium diet for six weeks, in order to induce experimental osteoporosis, and the others were sham-operated and fed a standard diet. A titanium implant was inserted into the tibiae in both groups. In half of the rabbits, 4 µg of IGF-I was applied into the ostectomy, prior to the implant insertion. A total of 32 implants were placed. Animals were sacrificed two weeks after surgery and decalcified samples were processed for Bone-To-Implant Contact (BIC) and Bone Area Density (BAD) measurements. Analysis of variance (ANOVA) was used for statistical evaluation. P<0.05 was considered to be significant. RESULTS: Ovariectomy induced statistically significant lower BAD values (p=0.008) and a tendency towards lower BIC values when compared osteoporotic and healthy groups. The administration of 4 µg of IGF-I did not produce statistically significant differences neither on BIC nor on BAD values, neither in the osteoporotic animals nor in healthy. CONCLUSIONS: Within the limitations of this experimental study, local administration of 4 µg of IGF-I was not able to induce any changes in the osseointegration process two weeks after surgery, neither in healthy rabbits nor in the osteoporotic group.

Shelf life extension of mozzarella cheese contaminated with Penicillium spp. using the antifungal compound ɛ-polylysine.

Molds are one of the most important spoilage organisms on cheese which can lead to economic loss as well as raising public health concerns due to the production of mycotoxins. This study investigates the use of ɛ-polylysine as natural antimicrobial to inhibit fungal growth. The minimal inhibitory concentrations and minimal fungicidal concentrations of ɛ-polylysine were determined against Penicillium roqueforti, Penicillium nordicum, and Penicillium solitum. Then, polylysine was tested as surface antimicrobial for the preservation of mozzarella slice cheese inoculated with these Penicillium spp. and stored in plastic trays during 25 days. The minimal inhibitory concentrations calculated for the three fungi tested were of 60 mg/l whereas the minimal fungicidal concentrations detected were of 125-10,000 mg/l. The shelf life observed for the control experiments was of 15 days, and just using the ɛ-polylysine at 0.00625, 0.0125, and 0.025% was evidenced a shelf life increment in comparison with the control of 1-3 days.

Influence of short implants geometry on primary stability.

BACKGROUND: A correct design is needed in short implants to improve primary stability (PS) in low quality bone. This study aimed to compare PS of double thread and single thread short implants. MATERIAL AND METHODS: Thirty implants with single thread design (PHI/SHORT-I) and 30 implants with double thread design (PHIA/SHORT-I) (Radhex®, Inmet-Garnick S.A., Guadalajara, Spain) were placed in 30 randomly selected bovine ribs. PS was assessed in implant stability quotients (ISQ) and periotest values (PV) with Osstell™ and Periotest® devices, respectively. Computed tomographies of the ribs were taken and bone quality was evaluated in Hounsfield Units (HU) using Ez3D Plus software (Vatech Co., Korea). Only implants placed in low quality bone according to Misch and Kircos classification were selected (D3 bone: 350-850 HU; and D4 bone: 150-350 HU). Ten implants were not included in the study for being placed in D1 and D2 bone. Finally, 50 implants were selected: 17 and 9 PHI/SHORT-I in D3 and D4 bone respectively, and 15 and 9 PHIA/SHORT-I in D3 and D4 bone respectively. RESULTS: The one-way ANOVA showed statistically significant differences in ISQ (61.35 ± 4.77 in PHI/SHORT-I and 66.43 ± 4.49 in PHIA/SHORT-I, P<0.005) and PV (-2.76 ± 0.8 and -4.11 ± 1.24 respectively, P<0.005) between two implant designs in D3 bone, and statistically significant differences in ISQ (53.44 ± 3.34 in PHI/SHORT-I and 60.56 ± 1.53 in PHIA/SHORT-I, P<0.0001) and PV (1.13 ± 0.95 and -2.5 ± 0.61 respectively, P<0.0001) between two groups in D4 bone. CONCLUSIONS: Double thread design short implants resulted to have higher PS in comparison with single thread design short implants in D3 and D4 bone.

Maxillary sinus balloon lifting and deferred implantation of 50 osseointegrated implants: a prospective, observational, non-controlled study.

The aim of this study was to assess the effectiveness of minimally invasive antral membrane balloon elevation (MIAMBE). Twenty-seven patients with severe resorption of the posterior maxilla were treated by balloon catheter-assisted sinus lift procedure with deferred implant placement. Panoramic radiographs and computed tomography scans were obtained prior to surgery and at 6 months after surgery, before implantation. Data collected following surgery included inflammation, pain, bleeding, infection, and haematoma. Pain and inflammation were recorded using a six-point verbal rating scale (VRS). The patients were followed up for an average of 15 months. The initial sinus floor height was measured for each planned implant and compared with the height at 6 months post-surgery. The average bone height gain was 8.10±3.45mm (range 0.5-13.95mm). Inflammation on the VRS ranged from 0 to 3 (mean 0.97±0.85), while pain ranged from 0 to 4 (mean 0.87±1.19). There was a perforation of the Schneiderian membrane smaller than 2mm in one case. In another case, the balloon lift procedure had to be aborted and changed to the conventional Tatum technique due to breakage of the balloon inside the sinus. The results of this study show the balloon sinus lift technique to be an easy procedure to perform, with apparently low rates of inflammation and pain, and to provide sufficient quantity and quality of bone for the placement of osseointegrated implants.

Effect of α-tocopherol megadoses on hematologic parameters and antioxidant capacity of rats in an ultraendurance probe.

This study was aimed to analyze the effect of two different megadoses of α-tocopherol (vit E) in the antioxidant activity and red and white blood series of Wistar rats after a 180-min ultraendurance probe. Three groups of 10 rats were analyzed; VEAG: acute administration of a megadoses of 5,000 IU/kg of vit E the day before the probe; VECG: chronic administration of 1,000 IU/kg/day of vit E for 6 days before the probe; CG: placebo administration. VEAG presented white cells, red blood cells, hematocrit, hemoglobin values significantly higher than CG and VECG (p < 0.05). The mean corpuscular hemoglobin and lymphocytes concentrations were significantly higher in the VECG than in the other two groups (p < 0.05). Similarly, VEAG presented a significantly higher vit E blood concentration than VECG and CG (p < 0.05), and VECG than CG (p < 0.05). Finally, we found a significantly positive correlation between trolox equivalent antioxidant capacity (TEAC) and red blood cells concentration (r = 0.374) and a significantly inverse correlation between TEAC and blood lactate concentration (r = -0.365). Our findings suggest that acute vit E megadoses could protect against transitory sport anemia symptoms and increase the white blood cell count in comparison with the chronic dose and control groups after an ultraendurance probe.

In vitro comparison of primary stability of two implant designs in D3 bone.

BACKGROUND: Primary stability (PS) is a key factor for implant survival rate and depends on implant design or bone quality. The aim of this study was to compare different thread designs implants, evaluating PS with periotest values (PV) and implant stability quotient (ISQ) values through resonance frequency analysis (RFA). MATERIAL AND METHODS: A total of 60 implants (Radhex®, Inmet-Garnick S.A., Guadalajara, Spain) were placed in freshly bovine ribs in vitro. Two designs were used: 30 tapered body with single thread design (PHI) and 30 tapered body with double thread design implants (PHIA). Both designs were 4mm wide and 12mm long. Implants were placed according to manufacturer's guidelines. Osstell™ and Periotest® devices were used to evaluate PS by a blinded independent observer. Computed tomographies (CTs) of the ribs were made (BrightSpeed Series CT systems, GE Healthcare, Milwaukee, WI, USA) and bone quality surrounding each implant was evaluated in Hounsfield Units (HU) using Ez3D Plus software (Vatech Co., Korea). Bone quality was classified according to Misch and Kircos in D1, D2, D3 or D4. RESULTS: All implants were mechanically stable. Only implants placed in D3 bone (350-850 HU) were selected for the study: 28 PHI and 26 PHIA. The one way ANOVA showed significant difference (p < 0.005) among two implants designs in ISQ values (61,55 ± 6,67 in PHI and 68,94 ± 5,82 in PHIA). No significant difference (p = 0,171) was shown in PV between two designs (-4,47 ± 1,39 in PHI and -4,77 ± 0,87 in PHIA). CONCLUSIONS: Higher PS was found using Osstell™ device in implants with double thread design (PHIA) in comparison to implants with single thread design (PHI) in D3 bone.

The relationship between insulin resistance and periodontitis is not affected by Mediterranean diet in a Spanish population.

OBJETIVE: To examine the insulin resistance measured by surrogate indices in subjects with and without periodontitis and to find out any correlation among dietary intake with insulin resistance. DESIGN: Fifty-five patients were recruited to participate in this cross-sectional study. Insulin resistance measured by the homoeostasis model assessment (HOMA-IR) and the quantitative insulin sensitivity check index moreover glycaemia, creatinine, uric acid, high density lipoproteins, low density lipoproteins, very low density lipoproteins and triglycerides among others. True periodontal disease was elucidated through the examination of probing pocket depth, clinical attachment level, recession of the gingival margin and gingival bleeding. The statistical analyses used were the student's T-test for independent variables, Kolmogorov-Smirnov if variations were homogeneous; if not, the Mann-Whitney U Test was applied instead. Correlations between variables were assessed using Pearson's correlation coefficients. True periodontal disease was confirmed through the greater values of probing pocket depth, clinical attachment level, gingival margin and gingival bleeding in the periodontitis group in comparison with non-periodontitis group. RESULTS: Insulin resistance was evidenced by the greater values of HOMA-IR as well as by the lower quantitative insulin sensitivity check index values in the periodontitis group. Fasting insulin, glucose, uric acid, creatinine, low density lipoproteins, triglycerides and very low density lipoprotein levels were significant higher in periodontitis group. Pearson's correlations did not show any association among diet data and insulin resistance parameters in periodontitis patients. CONCLUSION: A putative systemic relationship between insulin resistance and periodontitis exists but it does not seem conceivable any effect of diet over such relationship.

Surgical complications in zygomatic implants: A systematic review.

BACKGROUND: The use of zygomatic implants in the prosthetic rehabilitation of the patient with severe maxillary bone atrophy is another therapeutic alternative, not exempt from complications. The main objective of this review is to analyze and describe the most frequent surgical complications associated with the use of zygomatic implants. MATERIAL AND METHODS: An electronic database search on PubMed, along with a manual search, without taking into account date nor language, was undertaken by two observers, selecting studies that comprised a study period from 6 to 12 months, any type of clinical trial, and series that included a follow-up and/or review period during the aforementioned margin, that mentioned at least two types of complications. RESULTS: Out of the initial search that yielded 455 studies, 67 were considered potentially relevant for the present study, out of which 14 were finally selected. Out of the most frequent surgical complications, sinusitis (3,9%) and failure in osseointegration (2,44%) are highlighted. CONCLUSIONS: The analysis of the results shows that the most frequent complications are sinusitis and failure in osseointegration of the zygomatic implant. However, a standardised data collection system for the data on complications is needed.