Long-term evaluation of quality of life and satisfaction between implant bar overdentures and conventional complete dentures: A 23 years retrospective study.

BACKGROUND: Dental implants have been used in edentulous jaws to improve the retention and stability of complete dentures. Attachment to the implants improves stability and function of the prostheses and increases patient satisfaction. PURPOSE: The aim of this study was to evaluate quality of life and satisfaction between patients with implant overdentures and complete dentures for more than 20 years. METHODS: Forty patients with overdentures and 40 patients with conventional complete dentures were included in this study. Both groups are carriers of their prosthesis more than 20 years. All patients completed an OHIP-14 and perception and satisfaction questionnaire related their implant prothesis. RESULTS: Follow-up mean in patients with overdentures were 23.27 ± 1.87 years and 23.20 ± 3.91 years for conventional prosthesis group. A worse quality of life was shown in the group of patients with conventional dentures in the 7 dimensions and in the total value, with statistically significant differences in 6 dimensions and in the total value (P ≤ .05). Patients with implants overdenture were more satisfied than patients with conventional dentures, with statistically significant differences (P < .001). CONCLUSIONS: Implant overdentures on cobalt chrome and gold bars offer an excellent long-term solution for edentulism compared with conventional denture.

Crestal bone loss around submerged and non-submerged implants during the osseointegration phase with different healing abutment designs: a randomized prospective clinical study.

OBJECTIVE: To evaluate peri-implant crestal bone loss during the osseointegration period, comparing submerged and non-submerged implants with healing abutments of different design. MATERIALS AND METHODS: A total of 90 Avinent®  dental implants (Avinent Implant System, Barcelona, Spain) were placed in 90 patients. All were sited in the posterior mandibular zone to replace teeth 3.6 or 4.6. Patients were divided randomly into three groups: submerged (n = 30), non-submerged with anatomical healing abutment (n = 30), and non-submerged with esthetic healing abutment (n = 30). Peri-implant crestal bone loss was evaluated in intraoral radiographs taken at baseline, 1, and 3 months after implant placement. RESULTS: Peri-implant crestal bone loss at the end of the (3-month) osseointegration period was lowest in the submerged group (0.11 ± 0.14 mm), followed by the esthetic non-submerged group (0.15 ± 0.06 mm), but without statistically significant difference between these groups (P = 0.234). The greatest bone loss was produced in the non-submerged group with anatomical healing abutments (0.37 ± 0.12 mm), with significant differences between this group and the other two (P < 0.001). CONCLUSIONS: On the basis of these findings, bone resorption during the osseointegration period using the non-submerged technique varied significantly depending on the morphology of the healing abutment used. The non-submerged technique with an esthetic healing post-produced an equally predictable outcome compared with the submerged technique.

A low dose of subperiosteal anaesthesia injection versus a high dose of infiltration anaesthesia to minimise the risk of nerve damage at implant placement: A randomised controlled trial.

PURPOSE: To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. MATERIAL AND METHODS: One hundred and twenty patients requiring the placement of a single implant in order to replace a missing first mandibular were randomly allocated to two groups: group A (awake hemilip) subperiosteal crestal injection equal to 0.9 ml of articaine with 0.5% epinephrine and group B (numb hemilip) infiltration equal to 7.2 ml of articaine with 0.5% epinephrine in the vestibular fundus. Intraoperative sensory control using sensory tests was carried out in all patients. Outcome measures were neurological complications, intraoperative and postoperative visual analogue scale (VAS) scores for pain and swelling, and a questionnaire evaluating patient satisfaction. Patients were followed for 1 week postoperatively. RESULTS: There were no cases of nerve injury. Seven days after surgery the postoperative VAS score for pain and swelling was lower in group A in a statistically significant manner (difference = -3.41%; 95% CI: -5.57, -1.26; P = 0.002 and difference = -3.33%; 95% CI: -5.41, -1.25; P = 0.002, respectively). CONCLUSIONS: No nerve damage occurred using either anaesthesia types, therefore the choice of type of anaesthesia is a subjective clinical decision, however it may be preferable to use a low dose (0.9 ml) of subperiosteal anaesthesia, since it is unnecessary to deliver 7.2 ml of articaine to anaesthetise a single mandibular molar implant site.

Salivary Concentration of Oxidative Stress Biomarkers in a Group of Patients with Peri-Implantitis: A Transversal Study.

PURPOSE: The purpose of this study was to know if peri-implantitis causes an increase in the total salivary concentration of oxidative stress markers. MATERIALS AND METHODS: Seventy patients, 28 men and 42 women, 60 of them with dental implants, 30 of which had peri-implantitis and 30 were healthy. The remaining 10 were the control group: healthy subjects without implants. The average number of implants per patient was 4.70 ± 2.29 in the peri-implantitis group and 2 70 ± 2.11 in the control group. Periodontal/peri-implant variables were assessed, including bleeding index, gingival index, clinical attachment level, probing depth, presence of pockets larger than 4 and 6 mm, pain to percussion, suppuration, gingival hyperplasia or granuloma, crestal bone loss (both mesially and distally), evaluated through periapical radiography. Saliva samples from the 70 subjects were collected for measurement of malondialdehyde high performance liquid chromatography (HPLC) and myeloperoxidase (enzyme-linked immunosorbent assay analysis) concentrations. RESULTS: Implants affected with peri-implantitis had an average follow-up of 26.40 ± 7.97 months. 4.12% of implants with peri-implantitis had a painful response to percussion. 2.06% showed suppuration; 25.77% had granuloma. The mean crestal bone loss in implants wtih peri-implantitis was 3.78 ± 1.17 mm. Total salivary malondialdehyde concentration in the peri-implantitis group (0.52 ± 0.37 µM/l) was slightly higher than that in the group with healthy implants (0.40 ± 0.16 µM/l) and also slightly higher than that in the group of healthy patients without implants (0.41 ± 0.79 µM/l), although the difference was not statistically significant, p value = .442. Myeloperoxidase concentration was slightly higher in the peri-implantitis group (12.32 ± 2.17 ng/ml) than in the group with healthy implants (11.54 ± 2.80 ng/ml) and the group of healthy patients without implants (11.86 ± 2.67 ng/ml), without statistically significant differences, p value = .584. CONCLUSIONS: The salivary concentration of oxidative stress markers in patients with peri-implantitis and without periodontitis is not higher than that found in healthy patients.

Periodontal disease as a risk factor of recurrence of venous thromboembolic disease: a prospective study.

BACKGROUND: In recent years, periodontal disease has been related to a large number of systemic disorders. OBJECTIVE: To study the possible relationship between periodontal disease and high levels of D-dimer in a group of patients with venous thromboembolic disease. MATERIALS AND METHODS: A study was made of 142 patients diagnosed with unprovoked venous thromboembolic disease. All patients underwent oral examination consecutively and randomly. Finally, two groups were obtained: (a) patients with periodontal disease (n = 71); and (b) patients without periodontal disease (n = 71). All patients were subjected to periodontal study, with evaluation of the number of teeth, bleeding index, gingival index, simplified oral hygiene index, community periodontal index of treatment needs, clinical attachment level, probe depth, number of pockets ≥4 mm, number of pockets ≥6 mm. The D-dimer values were evaluated in both groups. RESULTS: D-dimer values were higher in the study group than the control group, with statistically significant differences (p = 0.010). CONCLUSIONS: A relationship is observed between the presence of periodontal disease and high D-dimer levels. Patients with venous thromboembolic disease and periodontal disease could have more risk of a new thromboembolism episode.

High volume local anesthesia as a postoperative factor of pain and swelling in dental implants.

OBJECTIVE: To determine whether the administration of high-volume local anesthesia can influence postoperative pain and swelling, and the degree of patient satisfaction, following dental implant placement. MATERIAL AND METHODS: One hundred patients (45 women and 55 men) between 19 and 80 years old were divided into two groups: group A (n = 50, with placement of an implant using an atraumatic approach in each patient, with sub-periosteal injection of a volume of Ultracain(®) ≤0.9 mL [half a carpule]) and group B (n = 50, involving the same surgical procedure but infiltrating a local anesthetic volume of ≥7.2 mL [four carpules]). Visual analog scales were used in all patients to rate intraoperative pain and postoperative pain and swelling. After the first week, the patients completed a questionnaire evaluating satisfaction with treatment. RESULTS: The intraoperative pain scores were similar in both groups (p = 0.363), while the postoperative pain and swelling scores were significantly lower in group A at all time points. Patient rated satisfaction with the surgical treatment was higher in group A. CONCLUSIONS: Excess injected volume of local anesthetic in dental implant surgery has a negative impact upon both postoperative pain and swelling, and on patient rated satisfaction.

Association between periodontal disease and venous thromboembolic disease.

OBJECTIVE: In recent years, periodontal disease has been related to a large number of systemic disorders. The aim of this study was to find a relationship between periodontal disease and venous thromboembolic disease. METHOD AND MATERIALS: A total of 197 patients were included in the study, 97 patients with a diagnosis of venous thromboembolic disease and 100 healthy controls, in order to establish an association between these two conditions. All patients were subjected to periodontal examination, with evaluation of the number of teeth, Bleeding Index, Gingival Index, Simplified Oral Hygiene Index, Community Periodontal Index of Treatment Needs, Clinical Attachment Level, Probing Pocket Depth, number of pockets >= 4 mm, and number of pockets >= 6 mm. RESULTS: A high prevalence of periodontal disease was detected in patients with thromboembolic disease (P < .001). Bleeding Index, Gingival Index, Simplified Oral Hygiene Index, Clinical Attachment Level, and Probing Pocket Depth were higher in venous thromboembolic disease patients than in the control group (P < .001). CONCLUSION: A high prevalence of periodontal disease was detected in venous thromboembolic patients. There exists an association between periodontal disease and venous thromboembolic disease.

Keratocystic odontogenic tumor. Case report and review of the literature.

Keratocystic odontogenic tumor is an intraosseous benign tumor of epithelial origin that can appear as a unicystic or multicystic lesion. It is characterized most significantly by its high recurrence rate. This is why surgical removal is the chosen therapeutic approach in most cases. However, while surgery may be the safest technique to prevent recidivism, it may also result in numerous complications with large tumors. A number of authors have suggested a more conservative treatment for large keratocystic odontogenic tumors. The case examined in this article is that of a 48-year-old male patient who presented with a five-month swelling on the left side of his face, located in the mandibular area.

Topical tacrolimus and pimecrolimus in the treatment of oral lichen planus: an update.

BACKGROUND: The search for new drugs capable of controlling the symptoms and signs of oral lichen planus (OLP) with minimal side-effects remains an important challenge. OBJECTIVE: A literature review is made to evaluate the effectiveness and safety of topical tacrolimus and pimecrolimus in the treatment of OLP. MATERIAL AND METHOD: A review was made of the studies published between 1999 and 2008 in relation to the topical application of tacrolimus and pimecrolimus in OLP. RESULTS: The data obtained point to the need for larger randomized, placebo-controlled studies with carefully selected and standardized endpoints, to allow adequate comparison between treatments. The adverse effects were fundamentally of a local nature, and in particular included burning sensation in the application zone. All the studies consulted found the treatment to be effective over short periods of time, with lesion recurrences after suppression of the drug. The long-term safety remains to be established. CONCLUSION: There is need for larger placebo-controlled, randomized studies with carefully selected and standardized outcome measures.