Assessment of Changes in the Outcome of Autogenous Tooth Grafts Over Time: A Clinical Study Evaluating Periodontal Healing in Bone Defects After Lower Third Molar Removal.

BACKGROUND: The removal of impacted lower third molars (ILTMs) is associated with bone defects in the distal area of second molars. Different methods have been described to minimize these defects. PURPOSE: The primary objective was to assess changes in probing depth (PD) over time (up to 36 months) between test (grafted) and control (ungrafted) groups; the graft was obtained from the extracted ILTM. STUDY DESIGN, SETTING, SAMPLE: This split-mouth randomized clinical trial was conducted at the Postgraduate Course in Oral Surgery of the Faculty of Dentistry of the Complutense University of Madrid. Adult patients requiring bilateral ILTM extraction with adjacent second molars were recruited, excluding pregnant/lactating women, patients in treatment with nonsteroidal anti-inflammatory drugs and patients with periodontal diseases. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The predictor variable was the graft technique. The bone defect after ILTM removal was treated with autogenous tooth graft (ATG) in the test group, leaving the control group ungrafted. MAIN OUTCOME VARIABLE: PD on the distobuccal, distomedial, and distolingual surfaces was recorded in both groups and averaged at baseline (T0), 3 (T1), 6 (T2), and 36 months (T3) postoperatively. COVARIATES: Sex, age, surgical time, ILTM situation and position between groups were assessed. ANALYSES: ANOVA repeated measures for comparisons between groups and the Friedman test for comparisons within the groups over time were applied. Statistical significance was established with a confidence interval of 95% (P < .05). RESULTS: The sample comprised 22 patients (6 males, 16 females) with a mean age of 21.68 ± 2.19 years; 44 ILTM extractions were performed. Statistically significant differences in PD average were found between groups (P < .001, 95% confidence interval) at 3 (1.63 ± 0.29), 6 (1.76 ± 0.3), and 36 months (1.74 ± 0.36). Reductions from T0 to T3 of 2.74 ± 0.28 (P < .001) and 0.54 ± 0.3 (P = .43) were observed in test and control groups, respectively. CONCLUSION AND RELEVANCE: ATG placed on the distal surface of lower second molars and almost completely filling the extraction socket improved PD 3, 6 and 36 months after ILTM. Furthermore, no significant changes in PD were observed over time; no major complications occurred. ATG appears to be a viable alternative graft material for this procedure.

Regeneración ósea guiada con dentina autógena tras la exodoncia de un premolar retenido en posición invertida: evaluación a 4 meses de un caso clínico / Guided bone regeneration with autogenous dentin after extraction of an impacted bicuspidin inverse position: 4-month evaluation of a clinical case

Introducción: el empleo de técnicas regenerativas tras la extracción de dientes retenidos ha mostrado su eficacia con diversos materiales de regeneración, al asociarse al empleo de membranas, pero en los últimos años se ha descrito el empleo de dentina autógena en procedimientos de regeneración ósea, mostrando unos resultados favorables. Caso clínico: se presenta un caso clínico de una mujer de 20 años, sin antecedentes médico-quirúrgicos de interés, que acudió a consulta remitida por su ortodoncista, para la extracción de un premolar maxilar retenido, en posición invertida. Tras la extracción del premolar y del tercer molar inferior retenidos, se obtuvo dentina procedente de ambos, para la regeneración ósea guiada del defecto resultante de la extracción del premolar, realizando revisiones a la semana y a los 4 meses de la intervención. Conclusiones: la dentina autógena demuestra ser un biomaterial biocompatible, adecuado para procedimientos de regeneración ósea guiada, tras la extracción de dientes retenidos, como alternativa a otros biomateriales. (AU)

Introduction: regenerative bone techniques after impacted teeth extraction have shown to be effective with different materials, when used in conjunction with membranes, but in the last few years, autogenous dentin has been used in bone regeneration procedures, having promising results. Clinical case: a clinical case of a 20-year-old woman is presented, with no interesting medical record, who went to dental clinic for removal of an inverse maxillary bicuspid retained. After maxillary bicuspid and lower third molar extractions, autogenous dentin was obtained from both teeth, to perform a guided bone regeneration of the bicuspid defect. A week and 4-month check-up were carried out. Conclusion: autogenous dentin has shown to be a biocompatible material, adequate for guided bone regeneration procedures, after extraction of impacted teeth, as an alternative to other biomaterials. (AU)

Anatomía de la arteria alveolar posterior superior (AAPS): estudio de 32 CBCT / Anatomy of the posterior superior alveolar artery: study of 32 CBCT

Objetivo: El principal objetivo es proporcionar información desde un punto de vista anatómico, evaluar la prevalencia, el diámetro y la posición de la arteria alveolar posterior superior (AAPS), su relación con la cresta alveolar y el suelo del seno maxilar utilizando imágenes radiográficas. Materiales y métodos: Se ha evaluado un total de treinta y dos imágenes de tomografías computarizadas de haz cónico (CBCT) (cuarenta y un senos maxilares en total) de pacientes parcialmente edéntulos en el tramo maxilar posterior, de los cuales veintitrés fueron mujeres y nueve hombres, que se presentaron en la Clínica Universitaria Odontológica de la Universidad Europea de Madrid. Se utilizaron tres tipos de escáneres CBCT que son el KODAK 9000, MORITA 3D y White Fox-Control D-00049. Resultados: La arteria alveolar posterior superior tiene un porcentaje de visibilidad de un 43,91%, se localiza a una altura de 15,9 mm de promedio desde la cresta ósea, en los grupos de 1-2 mm y <1 mm de diámetro se obtienen respectivamente 1,2 mm y 0,7 mm de valores promedio, y su posición es en un 21,13% intraósea y en un 22,76% extraósea. Conclusiones: En nuestro estudio, la AAPS presenta una distancia hasta la cresta alveolar, de mayor a menor altura residual, en primer lugar los segundos premolares, luego los segundos molares, y por último los primeros molares. Es decir, realiza un trayecto en forma de arco, haciendo la concavidad máxima a nivel del primer molar. (AU)

Objective: The main objective is to provide information from an anatomical point of view. To evaluate the prevalence, diameter and position of the superior posterior alveolar artery (SPAA), its relationship with the alveolar crest and the floor of the maxillary sinus using radiographic images. Materials and methods: A total of thirtytwo cone beam computer tomography (CBCT) images (forty-one maxillary sinuses in total) of partially edentulous patients in the posterior maxilla, of which twenty-three are women and nine men, that have been submitted in the University Clinic of the European University of Madrid. Three types of CBCT scanners are used: KODAK 9000, MORITA 3D and White Fox-Control D-00049. Results: The superior posterior alveolar artery has a visibility percentage of 43.91%, it is located at a height of 15.9 mm on average from the bone crest, in the groups of 1-2 mm and <1 mm in diameter they respectively obtain 1, 2 mm and 0.7 mm of average values and positioned in 21.13% intraosseous and 22.76% extraosseous. Conclusions: In our study, the PSAA presents a distance to the alveolar crest from higher to lower residual height, first the second premolars, then the second molars, and finally the first molars. In other words, it makes an arc-shaped path, making the maximum concavity at the level of the first molar. (AU)

Prevención de defectos periodontales tras la exodoncia de terceros molares inferiores con injerto de dentina autógena: evaluación a 6 meses de un caso clínico / Prevention of periodontal defects after lower third molar surgery with autogenous dentin graft: 6 month evaluation of a clinical case

INTRODUCCIÓN: El defecto periodontal localizado en la cara distal del segundo molar inferior es una complicación asociada al tercer molar inferior en posición horizontal o mesioangular. El tratamiento quirúrgico de estos terceros molares inferiores retenidos se acompaña del desbridamiento de la cara distal del segundo molar, no siendo esto suficiente para devolver la salud periodontal en esta zona. Por tanto, son muchos los autores que recomiendan la regeneración ósea guiada para conseguir una recuperación periodontal completa. CASO CLÍNICO: Se presenta un caso clínico de una mujer de 27 años de edad, sin antecedentes médico-quirúrgicos de interés, que acudió al Servicio de Cirugía Bucal e Implantología de la Facultad de Odontología de la Universidad Complutense de Madrid para la exodoncia de los terceros molares inferiores. Una vez realizada la Historia Clínica, se le realizó la exodoncia del tercer molar inferior izquierdo en posición horizontal con regeneración con dentina autógena, y el tercer molar inferior derecho de manera convencional, haciendo un seguimiento de 6 meses para comparar la evolución de ambos lados. CONCLUSIONES: la dentina autógena puede ayudar a la reducción de los defectos periodontales post exodoncia sobre el segundo molar tras la extracción de terceros molares inferiores mal posicionados

INTRODUCTION: periodontal defect localized in the distal surface of lower second molar is a complication associated to lower third molars in a horizontal or mesioangular position. Surgical treatment of these third molars is helped with debridement of second molar distal surface, not being this option enough to restore periodontal health. So, many authors suggest guided bone regeneration to achieve a complete recovery in this area. CLINICAL CASE: a clinical case of a 27-year-old woman is presented, with no previous registered medical records. This woman attended to the Oral Surgery and Implantology Service of the Dentistry faculty of the Complutense University of Madrid for removal of lower third molars. After the clinical and radiological examination, left lower third molar was removed, with regeneration with autogenous dentin, and right lower third molar in a conventional approach, with a 6 month follow up to check and compare the evolution. CONCLUSION: autogenous dentin as graft material in periodontal defects in the distal side of the lower second molar could be an effective treatment for surgical lower third molar removal

Comparación del Coeficiente de Estabilidad Implantaria ISQ entre implantes colocados en zona antral sobre hueso nativo frente a implantes colocados sobre hueso regenerado / Comparison of the isq implant stability coefficient between implants placed in the antral area on native bone versus implants placed on regenerated bone

El objetivo del estudio es comparar los valores del Coeficiente de Estabilidad Implantaria (ISQ) de implantes colocados en zona antral en hueso nativo frente a los colocados en zona antral en hueso regenerado, para saber si tras tres meses de osteointegración los valores aumentan, ver si son diferentes entre sí según el tipo de hueso y evaluar la relación entre: torque de inserción, tipo de hueso, ISQ obtenido y sus cambios después de la osteointegración. Se trata de un ensayo clínico de propósito analítico, cuya dirección temporal es longitudinal, el inicio del estudio en relación con la cronología de los eventos es prospectivo, existiendo dos grupos de estudio. Los resultados proporcionan evidencias de que los implantes colocados en hueso regenerado, al analizar valores ISQ iniciales, son iguales a los del hueso nativo y, tras la oseointegración, son mayores que los de éstos, pudiendo rehabilitarse esperando el mismo tiempo. CONCLUSIONES: El valor inicial de ISQ es similar en ambos grupos y después de tres meses de osteointegración fue mayor en implantes sobre hueso regenerado. El torque de inserción de implantes en hueso regenerado es mayor que en hueso nativo y existe relación positiva, pero no estadísticamente significativa, entre los valores de ISQ y el torque de inserción. La pérdida ósea marginal de los implantes es similar en ambos grupos y dicha pérdida no está relacionada con los valores de ISQ ni con el torque de inserción obtenido, aunque este hecho puede ser debido a la evaluación a corto plazo

The objectives of the present study are to compare the Implant Stability Quotient (ISQ) values of implants placed in the antral area in native bone versus those placed on regenerated bone, to know whether after three months of osseointegration period the values increase and see if they are different from each other depending on the type of bone and assess the relationship between: insertion torque, type of bone and ISQ obtained an its changes after 3 months of osseointegration.The study design is a Clinical Trial of analytical purpose, whose temporal direction is longitudinal, the beginning of the study in relation to the chronology of the events is prospective. The results provide some evidence in the fact that implants placed in antral zone in regenerated bone, when presenting baseline ISQ values equal to and after osseointegration greater than implants in native bone, could be rehabilitated waiting for the implant. CONCLUSIONS: The initial ISQ value is similar in implants placed in native and regenerated bone and after three months were higher in implants placed in regenerated bone. The insertion torque of the implants placed in regenerated bone is greater than those placed in native bone and there is a positive relationship but not statistically significant between ISQ values and insertion torque. The marginal bone loss of the implants is similar in those placed in native versus regenerated bone and this loss is not related to ISQ values niether to insertion torque obtained. This fact is due to being evaluated in a short period of time

Autogenous Dentin Graft in Bone Defects after Lower Third Molar Extraction: A Split-Mouth Clinical Trial.

Various biomaterials are currently used for bone regeneration, with autogenous bone being considered the gold standard material because of its osteogenic, osteoconductive, and osteoinductive properties. In recent years, the use of autogenous dentin as a graft material has been described. This split-mouth clinical trial assesses the efficacy of autogenous dentin for the regeneration of periodontal defects caused by bone loss associated with impacted lower third molar extraction. Fifteen patients underwent bilateral extraction surgery (30 third molars) using dentin as a graft material on the test side, and leaving the control side to heal spontaneously, comparing the evolution of the defects by evaluating probing depth at three and six months post-operatively. Bone density and alveolar bone crest maintenance were also evaluated six months after surgery, and pain, inflammation, mouth opening capacity on the second and seventh days after surgery. Probing depth, radiographic bone density, and alveolar bone crest maintenance showed significant differences between the test and control sides. Autogenous dentin was found to be an effective biomaterial for bone regeneration after impacted lower third molar extraction.

Epidemiological Features and Clinical Repercussions of Supernumerary Teeth in a Multicenter Study: A Review of 518 Patients with Hyperdontia in Spanish Population.

OBJECTIVES: The aim of this study was to establish the prevalence of supernumerary teeth (ST) in a sector of the population of Madrid, as well as possible complications associated with the presence of these teeth. MATERIALS AND METHODS: The study investigated patients (n = 28,114) who sought dental care at the Oral Surgery Service of three different centers between May 2005 and April 2018. Cases that did not present this numeric dental developmental variation were discarded, registering only those presenting ST. STATISTICAL ANALYSIS: Statistical analysis consisted of univariate analysis (mean, standard deviation, median, etc.), bivariate analysis applying the chi-squared test, whereby statistical significance was established with a confidence interval (CI) of 95% (p < 0.05), and multivariate analysis by means of classification and decision trees. RESULTS: The study found ST in 518 patients, representing a prevalence of 1.84%. The 518 patients presented a total of 726 ST. Distomolars were the most common, representing 37.7% of the sample, followed by premolars (20.1%). About 70.5% of the sample were located in the maxilla and 78% of ST were impacted. Radiographs revealed that 39.7% of STs were associated with disorders. Supplementary morphology appeared in 52.1% of the sample. CONCLUSIONS: Although mesiodens is considered the most common ST, the present study found distomolars and supernumerary premolars to be the most frequently occurring. Pathology was associated with 39.7% of the ST sample. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.

Clinical repercussions and epidemiological considerations of supernumerary canines: A 26 case series

Background: To establish the prevalence of supernumerary canines (SNC) in a sector of the population of Madrid (Spain), as well possible complications associated with this unusual developmental variation. Study design: This observational study was performed between 2005 and 2017, among 21,615 patients seeking dental treatment at the Faculty of Dentistry, Complutense University of Madrid (Spain), and at the Virgen de la Paloma Hospital, Madrid (Spain); 22 patients with 26 SNCs were diagnosed. These 22 patients underwent clinical and radiological exploration, registering patient data. Results: SNCs presented a prevalence of 0.10% of the study population. The supernumerary teeth (SNT) were located in the upper maxilla more frequently (61.54%) than the mandible (38.46%). 69.23% were found to be impacted, also causing the impaction of the permanent canine in 53.85% of these cases. In 15.38%, follicular expansion > 3mm was observed. SNCs were associated with other SNT in only four patients. Conclusions: Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological explora-tion, in the present study over half of them (53.85%) caused impaction of the permanent canine. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need

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Utilización de dentina autógena como material de injerto en Cirugía Bucal / Autogenous dentine as graft material in Oral Surgery

Las extracciones dentarias producen una pérdida ósea en sentido horizontal y vertical, que conllevan alteraciones funcionales para los pacientes, y dificultan la colocación de implantes dentales para los profesionales. Para minimizar esta pérdida ósea, se utilizan diferentes materiales de injerto, entre los cuales destaca el injerto autógeno, por cumplir las características de osteogénesis, osteoconducción y osteoinducción. En el año 2010 se describe por primera vez la utilización de dentina como material de injerto autógeno, demostrando que este material puede ser una alternativa terapéutica al resto de materiales de injerto, al permitir la osteoconducción y la osteoinducción, y mostrar la formación de hueso nuevo en un 46-87% del área con injerto de dentina autógena, 3 meses después de su utilización. La última revisión sistemática publicada en el año 2018, concluyó que los implantes colocados en áreas regeneradas en zonas en las que se empleó dentina como material de injerto, presentaron tasas de supervivencia del 97,7% después de 1 año de seguimiento, sugiriendo este nuevo material como una alternativa con resultados prometedores, aunque son necesarios más estudios al respecto

Subsequent to tooth extraction, a reduction of the length and width of alveolar ridge can be observed. It causes functional alterations to patiens, and problems to proper insertion of dental implants. In order to prevent this bone atrophy, different graft materials can be used, being considered autogenous graft the best because allows osteogenesis, osteoconduction and osteoinduction. In 2010 it was first published the use of autogenous dentine as a graft material, showing it could be an ideal graft material, as a material with excellent osteoconduction and osteoinduction. Besides, this graft material is slowly absorbed and replaced by new bone, in 46-87% of the áreas grafted with dentine, 3 months after regeneration. Last systematic review published in 2018 concluded dental implants inserted in regenerated areas with autogenous dentine had survival rates of 97,7% for over a year follow-up, so this new material is considered an alternative with good results, but there are necessary more studies with long term follow-up

Regeneración horizontal en sector anterosuperior con injerto en bloque vs particulado / Horizontal guide bone regeneration in anterior maxilla with autogenous bone block or particulated xenograft

La regeneración ósea horizontal tiene por objeto solventar las deficiencias de volumen óseo vestíbulopalatino o lingual, previa o simultáneamente a la colocación de implantes dentales. Hoy en día, existen diferentes técnicas para realizar una regeneración ósea, su selección depende de las características del caso clínico que se vaya a realizar. Los injertos óseos, se pueden clasificar según su origen y según su forma. Atendiendo a su origen, se distinguen en injertos autólogos, aloinjertos, materiales aloplásicos y xenoinjertos. En función de la forma se distinguen en bloque o particulados, siendo principalmente autoinjertos y xenoinjertos, respectivamente. Los primeros estudios sobre el tema preconizaban el uso de los autoinjertos en bloque como el Gold Standard en la regeneración ósea previa a la colocación de implantes. El propósito de esta revisión bibliográfica fue comparar los resultados obtenidos en cuanto a ganancia de hueso horizontal tras la regeneración del sector anterior de un maxilar atrófico, con injerto en bloque autólogo versus xenoinjerto particulado. Se realiza una actualización bibliográfica sobre técnicas de aumento de volumen óseo horizontal previas a la colocación de implantes, con el fin de comparar las dos técnicas más utilizadas hoy en día

The purpose of horizontal bone regeneration is to resolve the deficiencies/shortcomings of the buccal or palatal volume, prior or simultaneously to the placement of dental implants. Nowadays, there are different techniques to perform a bone regeneration, its selection depends on the characteristics of the clinical case that is going to be performed. Bone grafts can be classified according to their origin and their shape. Based on their origin, they are distinguished in autologous grafts, allografts, alloplastic materials and xenografts. Depending on the shape, they are distinguished in block or particulate, being mainly autografts and xenografts, respectively. The first studies on the subject, advocated the use of block autografts such as the Gold Standard in bone regeneration prior to implant placement. The purpose of this literature review was to compare the results obtained in terms of horizontal bone gain after regeneration of the anterior sector of an atrophic maxilla, with autologous block graft versus particulate xenograft. A bibliographic update is made on techniques of horizontal bone volume increase prior to the placement of implants, in order to compare the two techniques most used today

Comparison of peri-implant soft tissues in submerged versus transmucosal healing: A split mouth prospective immunohistochemical study.

OBJECTIVE: The present split-mouth prospective study involves an immunohistochemical evaluation of peri-implant soft tissue healing after the osseointegration period, comparing submerged and transmucosal approaches using two-piece implant systems. The null hypothesis was that both surgical procedures elicit a similar immune response of the peri-implant soft tissues. DESIGN: Thirty-one healthy patients were included in this study, in which two implants were placed in the right and left maxillary pre-molar regions. A total of 62 dental implants were analyzed, establishing a control side with 31 submerged implants, and a study side with 31 exposed implants bearing healing abutments. After a three-month healing period, a soft tissue biopsy was collected and prepared for immunohistochemical analysis of the proportions of different lymphocyte subpopulations. RESULTS: The comparative analysis between the submerged and transmucosal approaches failed to identify statistically significant differences in CD19+ B cells, CD4+ T cells, CD8+ T cells, CD25+ T cells or γd T cells. However, significant differences in NK lymphocytes (p = 0.012) were recorded with the submerged surgical procedure. CONCLUSIONS: Peri-implant soft tissue immune response with submerged or transmucosal healing protocols demonstrated comparable outcomes after the osseointegration period. There is sufficient evidence that the null hypothesis of no difference cannot be rejected. To the best of our knowledge, this is the first study of its kind. Further research is therefore needed to further clarify the role of these lymphocyte subpopulations in peri-implant soft tissues.

Masseter and temporalis muscle electromyography findings after lower third molar extraction

Background: The main clinical application of electromyography is to detect abnormalities in muscle function, to assess muscle activity for purposes of recruitment, and in the biomechanics of movement. Objectives: To analyze electromyography (EMG) findings for masticatory muscles during chewing following surgical extraction of lower third molars, and to determine any correlation between pain, inflammation, trismus, and the EMG data registered. Material and Methods: This prospective study included 31 patients. Surface EMG was used to study masseter and temporalis muscle function before lower third molar extraction and 72 hours and seven days after surgery. Clinical variables, pain, inflammation, and trismus were registered before and after surgery. Results: Studying the area and size of the masticatory muscles, higher values were found for temporalis than masseter muscles, regardless of the surgical side, which points to the greater involvement of the temporalis muscle in mastication. Comparing the side where surgery had been performed with the non-surgical side, a sharp and statistically significant reduction in amplitude and area were noted on the surgical side reflecting major functional affectation. One week after surgery, amplitude and area had almost returned to base-line values, indicating almost complete recovery. While pain decreased progressively after surgery, inflammation peaked at 72 hours, while mouth opening reached a minimum at this time, returning to normality within the week. Conclusions: Surgical extraction of lower third molars produces changes to electromyography activity that are more evident during the first hours after surgery and closely related to the intensity of pain suffered and the patient's inflammatory responses, although they are not related to mouth opening capacity (AU)

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Clinical and radiographic evaluation of implants placed by means of inferior alveolar nerve lateralization: a 5-year follow-up study.

OBJECTIVE: To evaluate clinical and radiological responses of implants placed in combination with inferior alveolar nerve lateralization, analyzing survival and success rates over 5 years functional loading. MATERIALS AND METHODS: This prospective, longitudinal, single-center study recruited 40 patients with mandibular atrophy in the posterior sectors, who underwent lateralization of the inferior alveolar nerve. Three months after surgery and implant placement, the implants were loaded by means of screw-retained implant-supported partial prostheses or fixed complete prostheses. Clinical and radiographic examinations were performed immediately after implant placement and at 12, 24, 36, 48 and 60-month follow-up visits. RESULTS: The 40 patients received a total of 129 implants (Phibo TSA™ , Phibo Dental Solutions, Sentmenat, Barcelona, Spain). Two implants were lost in the first month after surgery, generating an implant cumulative survival rate (CSR) of 98.44%. The success rate after 5 years of loading was 98.44%. No intra-operative or postoperative soft tissue or prosthetic complications occurred during the 5-year follow-up. CONCLUSIONS: Inferior alveolar nerve lateralization performed to allow placement of (Phibo TSA™ ) implants in patients with mandibular atrophy obtained predictable clinical and radiological results over five years of functional loading.

Dental considerations in diagnosis of maxillary sinus carcinoma: A patient series of 24 cases.

BACKGROUND: Maxillary sinus carcinoma is a rare entity with an incidence of 0.2% and a low patient survival rate due to the frequency of late diagnosis. METHODS: In this multicenter, transversal, retrospective, observational study, the authors analyzed patients who had received a diagnosis of maxillary sinus carcinoma, registering their oral symptoms, histologic type, treatment efficacy, and survival rate. RESULTS: Maxillary sinus carcinoma was diagnosed in 24 patients (15 men and 9 women), of which 75% were squamous cell carcinomas. All patients had dental mobility, and some had swelling, orosinus fistula, or some dental loss. Mean patient survival rate was 38.83 months. CONCLUSIONS: A history of pain or swelling of unknown origin, an unexplained widening of periodontal ligament space, or mobility of the teeth should be considered warning signs of maxillary sinus carcinoma. PRACTICAL IMPLICATIONS: Recognition of oral symptoms by the dentist would help in making an early diagnosis of maxillary sinus carcinoma, improving the patient's chances of survival and quality of life.

Does the postoperative administration of antibiotics reduce the symptoms of lower third molar removal? A randomized double blind clinical study.

BACKGROUND: To date there is little scientific evidence that clarifies the therapeutic effect of antibiotics for managing the postoperative symptoms of impacted third molar surgery. The aim of this study was to evaluate the efficacy of antibiotic treatment for reducing non-infectious clinical symptoms. MATERIAL AND METHODS: Patient data was collected from the patients´ medical records and the results were statistically evaluated with SPSS versión 21.0; SPSS, IBM; Chicago, IL, USA). This longitudinal prospective study consisted of a randomized simple-blind clinical assay of 293 patients attending the Department of Oral Medicine and Surgery, Faculty of Dentistry at the Complutense University of Madrid (Spain). The predictive variable evaluated was the effect of antibiotic treatment on non-infectious symptoms after third molar extraction. The variables evaluated were pain, swelling, and oral aperture. RESULTS: The 293 patients were divided into 2 groups: a control group of 147 patients treated with analgesics and anti-inflammatories after surgery and a study group of 146 patients, who were also administered antibiotics. Better outcomes were observed in the study group treated with antibiotics. Pain, swelling and oral aperture variables presented better results in the antibiotic group with statistically significant difference. CONCLUSIONS: The results suggest that antibiotic administration decreases the post-operative non-infectious clinical symptoms of impacted third molar surgery. However, the prolonged administration of antibiotics had no real medical indications to justify their use and can cause serious health problems in the long term. Key words:Antibiotic, post-operative, impacted lower third molar.

Hemofilia y sus repercusiones en los tratamientos odontológicos de la cavidad bucal / Hemophilia and its repercussions on dental treatment of the oral cavity

La Hemofilia A y B es un trastorno congénito de la coagulación catalogada como enfermedad rara debido a su baja prevalencia. El déficit de factor VIII y IX, que caracteriza a esta patología, constituye un factor de riesgo de hemorragia en los tratamientos odontológicos, especialmente en los quirúrgicos, que es necesario prevenir y manejar por el odontólogo responsable del paciente. Sin embargo las medidas a adoptar frente a un paciente hemofílico suelen ser desconocidas por la mayoría de profesionales, lo que conlleva una atención odontológica deficiente y por ende un detrimento de la salud oral de estos pacientes. El objetivo de este trabajo es exponer de forma sintetizada y actualizada las medidas locales y generales a adoptar en el tratamiento odontológico de los pacientes hemofílicos, sin olvidar la imprescindible colaboración con el hematólogo del paciente (AU)

Hemophilia A and B is a congenital coagulation disorder classified as a rare disease due to its low prevalence. The factor VIII and IX deficiency, which characterizes this pathology, is a risk factor for excesive bleeding in dental treatments, especially in surgical procedures, which are necessary to prevent and manage by the dentist. However the measures to be taken in front of a hemophilic patient are usually unknown by most professionals, which implies poor dental care and therefore a detriment to the oral health of these patients. The aim of this paper is to present in a synthesized and updated way, local and general measures to be adopted in the dental treatment of hemophiliac patients, not forgetting the essential collaboration with the patient's hematologist (AU)

Prosthetic hygiene and functional efficacy in completely edentulous patients: satisfaction and quality of life during a 5-year follow-up.

OBJECTIVES: The aim of this study was to compare satisfaction with function and hygiene maintenance in completely edentulous elderly patients rehabilitated with implant-supported fixed prostheses, overdentures, and conventional prostheses. MATERIALS AND METHODS: A total of 150 geriatric patients were divided into three groups: Group 1 (CD) patients rehabilitated with complete dentures; Group 2 (FP) patients with implant-supported fixed prostheses; Group 3 (OD) patients with overdentures. The patients responded to a questionnaire based on the Oral Health Impact Profile and the Dental Impact Profile to evaluate satisfaction with their prostheses. Data were analyzed using ANOVA F and the Kruskal-Wallis nonparametric test, with significance established as P < 0.05. RESULTS: Significant differences were found between the three groups. For oral hygiene, the group with overdentures showed better results, and the group with fixed prostheses was more satisfied with function. CONCLUSIONS: Satisfaction among these completely edentulous patients varied in relation to prosthetic type. The level of general satisfaction among patients with implant-supported prostheses was greater than the group using conventional dentures. Patients rehabilitated with fixed prostheses enjoyed a higher level of satisfaction than patients with overdentures.

Efficacy of platelet-rich plasma applied to post-extraction retained lower third molar alveoli. A systematic review

Dental retentions have a high prevalence among the general population and their removal can involve multiple complications. The use of platelet rich plasma has been proposed in an attempt to avoid these complications, as it contains high growth factors and stimulates diverse biological functions that facilitate the healing of soft and hard tissues. OBJECTIVES: To evaluate the available scientific evidence related to the application of platelet-rich plasma in the post-extraction alveoli of a retained lower third molars. MATERIAL AND METHODS: A systematic review of published literature registered in the Medline, EMBASE, Cochrane and NIH databases. The following categories were included: human randomized clinical studies. Key search words were: platelet rich plasma; platelet rich plasma and oral surgery; platelet rich in growth factors and third molar. RESULTS: Of 101 potentially valid articles, seven were selected, of which four were rejected as they failed to meet quality criteria. Three studies fulfilled all selection and quality criteria: Ogundipe et al.; Rutkowski et al.; Haraji et al. The studies all measured osteoblast activity by means of sintigraphy, and also registered pain, bleeding, inflammation, temperature, numbness as perceived by the patients, radiological bone density and the incidence of alveolar osteitis. CONCLUSIONS: Scientific evidence for the use of PRP in retained third molar surgery is poor. For this reason randomized clinical trials are needed before recommendations for the clinical application of PRP can be made

Satisfacción de los pacientes con tratamientos implantológicos. Revisión de la literatura / Patient satisfaction with implant treatments. Review of the literature

La pérdida de dientes, definida por la Organización Mundial de la Salud como una discapacidad, conlleva cambios físicos y psicológicos en el paciente. El profesional puede diagnosticar el estado físico, pero no puede analizar la situación psicológica si no utiliza instrumentos que midan la salud oral y la influencia que esta tiene en el modo de vida de los pacientes. Lo cual, ha derivado en múltiples estudios que analizan la calidad de vida relacionada con la salud oral. Se realizó una revisión bibliográfica de la literatura científica publicada sobre el tema. La literatura aporta un consenso entre los autores, en que la satisfacción de los pacientes tras un tratamiento implantológico, mejora sustancialmente. Entre los factores que pueden condicionar el grado de satisfacción de estos pacientes, están el tipo de prótesis, los años de rehabilitación, la edad, el sexo, el estado de salud general, factores socioeconómicos, la dieta y la ansiedad preoperatoria. El tratamiento implantológico de los pacientes desdentados, deriva en resultados funcionales, estéticos y psicológicos, altamente satisfactorios. El tipo de prótesis, así como las características de cada paciente, condicionarán el grado de satisfacción (AU)

The loss of teeth, defined by the World Health Organization as a disability, entails physical and psychological changes in the patient. The professional can diagnose the physical state, but he cannot analyze the psychological situation if he does not use instruments that measure the oral health and the influence that this has on the patient’s lifestyle. This has led to many studies that analyze the quality of life related to oral health. A bibliographical review was conducted of the scientific literature published on the subject. The literature provides a consensus among the authors, in which patient satisfaction after an implant treatment improves substantially. Among the factors that may condition the degree of satisfaction of these patients are the type of prosthesis, the years of rehabilitation, age, gender, state of general health, socioeconomic factors, diet and preoperative anxiety. The implant treatment of the edentulous patients leads to highly satisfactory functional, aesthetic and psychological results. The type of prosthesis, as well as the characteristics of each patient, condition the degree of satisfaction (AU)

Impact of prosthetic rehabilitation type on satisfaction of completely edentulous patients. A 5-year prospective study.

OBJECTIVE: The aim of this study was to evaluate the satisfaction of rehabilitated edentulous patients in relation to implant prosthetic type. MATERIALS AND METHODS: This prospective cohort study included 40 completely edentulous patients wearing conventional prostheses. They were divided into two study groups: Group A contained 20 patients rehabilitated with implant-supported fixed prostheses and Group B contained 20 patients with overdentures. Subjects were evaluated by means of a specially designed questionnaire before treatment and after 1, 3 and 5 years. RESULTS: Group A exhibited better results in terms of esthetics, function and personal satisfaction, although without statistically significant differences. However, statistically significant differences were found within parameters of oral hygiene after 1 year in favor of Group B. CONCLUSIONS: Overall satisfaction was seen to increase after implant rehabilitation, regardless of the type of prosthesis used. The satisfaction of edentulous patients differs depending on prosthetic type. Patients rehabilitated with fixed prostheses obtain a generally higher level of satisfaction than patients wearing overdentures.