ABSTRACT
Several regeneration techniques and materials have been proposed for the healing of bone defects after surgical endodontic treatment; however, the existing literature does not provide evidence on the most recommended techniques or materials. The aim of the present systematic review and network meta-analysis (NMA) is to summarize the clinical evidence on the efficacy of guided tissue regeneration techniques (GRTs). The PRISMA recommendations were followed. Four databases were searched up to December 2021. Randomized clinical trials (RCTs) with a minimum follow-up of 6 months were included. The risk of bias was assessed using the Cochrane Collaboration tool. A fixed effects model and frequentist approach were used in the NMA. Direct GRT technique comparisons were combined to estimate indirect comparisons, and the estimated effect size of the comparisons was analyzed using the odds ratio (OR). Inconsistency was assessed with the Q test, with a significance level of p < 0.01, and a net heat plot. A total of 274 articles was identified, and 11 RCTs (6 direct comparisons of 15 techniques) were included in the NMA, which examined 6 GRT techniques: control, Os, PL, MB, MB + Os, and MB + PL. The MB + Os group compared to the control (OR = 3.67, 95% CI: 1.36-9.90) and to the MB group (OR = 3.47, 95% CI: 1.07-11.3) showed statistically significant ORs (p Ë 0.05). The MB + Os group presented the highest degree of certainly (P-score = 0.93).
ABSTRACT
In the present retrospective study, we aimed to assess the replicability and reproducibility of a novel digital measurement technique for analyzing the volumes of the left and right maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift procedure using the lateral window approach, to provide an accurate measurement technique for easily applying in clinical practice and to allow pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable. MATERIAL AND METHODS: Thirty patients with partially edentulous posterior maxilla were selected and submitted to bilateral sinus lift using the lateral window approach technique, with grafting materials selected and submitted to cone beam computed tomography (CBCT) scans, both pre- and postoperatively. Then, datasets were uploaded to therapeutic digital planning software to measure the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex. Gage R&R statistical analysis was performed to assess the replicability and reproducibility of the digital measurement technique. RESULTS: The variability attributable to the novel digital measurement technique was 3.4% for replicability and 3.4% for reproducibility of the total variability of the samples. CONCLUSION: The novel digital method proposed is a replicable and reproducible technique for analyzing the volume of the right and left maxillary sinuses and the nasal and maxillary sinus airway complex after a sinus lift using the lateral window approach technique, allowing an accurate pre-operative assessment of maxillary sinus lift surgery, avoiding complications and making surgery more predictable.
ABSTRACT
La firma del consentimiento informado por parte del paciente es obligatoria antes de cualquier intervención. Objetivos: Los objetivos de este artículo original fueron: -Conocer el nivel de comprensión del consentimiento informado por parte del paciente. -Determinar el porcentaje de pacientes que rechazan el tratamiento al conocer los riesgos del mismo. Pacientes y metodo: Participaron en el estudio 385 pacientes a los que se les extrajo el tercer molar quirúrgicamente tras haber firmado el consentimiento informado. Posteriormente se les realizó una encuesta para comprobar si habían comprendido la finalidad del consentimiento informado y su opinión sobre el procedimiento. Resultados: Los datos se trataron mediante estadística descriptiva. Lo más destacable es que el 100 por ciento de los pacientes firmaron el consentimiento informado y se sometieron a la cirugía. El 99,74 por ciento entendió claramente qué le harían en la intervención. El 97 por ciento sabía que se podían presentar complicaciones y el 94 por ciento entendió que podía negarse a la intervención. Más de la mitad (61,56 por ciento) pensaba que el consentimiento sirve para eximir de responsabilidad al profesional. Al 98,96 por ciento les parece útil este tipo de información. Conclusiones: El consentimiento informado fue comprendido por la mayoría de los pacientes y ninguno de ellos se negó a la intervención (AU)
Subject(s)
Adult , Female , Male , Humans , Consent Forms/legislation & jurisprudence , Molar, Third/surgery , Oral Surgical Procedures , Intraoperative Complications/epidemiology , Postoperative Complications/epidemiologyABSTRACT
A study is made of 56 patients subjected to lower molar extraction, comparing the efficacy of the Akinosi technique as an alternative to direct or conventional mandibular nerve block in two groups of 28 subjects each. The parameters evaluated were pain in response to puncture, percentage positive aspiration, latency, pain during the intervention and complications. Patient pain in response to puncture was comparatively less intense and frequent with the Akinosi technique. The latency to anesthesia was briefer with conventional mandibular block than with the Akinosi technique (2.9 versus 3.8 minutes). Pain during the intervention and the duration of the anesthetic effect were similar for both techniques. The patients anesthetized with the Akinosi technique required more buccal nerve reinforcement infiltrations to complete the procedure. The anesthetic failure rates were 10.7% and 17.8% for the conventional and Akinosi technique, respectively. It is concluded that while the Akinosi technique can be used to extract lower molars, direct mandibular block offers superior anesthetic performance.
