ANALGESIC EFFICACY OF TRAMADOL/DEXKETOPROFEN VS IBUPROFEN AFTER IMPACTED LOWER THIRD MOLAR EXTRACTION: A RANDOMIZED CONTROLLED CLINICAL TRIAL.

OBJECTIVE: Impacted third molar extraction is associated with acute moderate-to-severe pain for up to 48 hours post-surgery. This trial was designed to compare the analgesic effectiveness, swelling, and adverse events after impacted third molar surgery following multimodal therapy with 75 mg tramadol hydrochloride plus 25 mg dexketoprofen or monotherapy with 400 mg ibuprofen. METHODS: Seventy-two patients were randomly assigned to receiving ibuprofen (n = 36) or tramadol-dexketoprofen (n = 36). Postoperative pain intensity and swelling were measured using a visual analog scale (VAS); pain relief experienced was reported using a 4-point verbal rating scale; the rescue medication requirement, adverse effects, and global impression of the medication were recorded. RESULTS: No statistically significant between-group difference in pain intensity was observed at any time point; however, pain relief was significantly higher in the tramadol-dexketoprofen treated-group at 6 and 36 hours. Self-reported verbal rating scale assessments showed significantly lower swelling in the tramadol-dexketoprofen group at 24 hours post-surgery but not at 48 or 72 hours, and VAS-swelling scores showed no significant between-group difference. The frequency of postoperative nausea and dizziness was significantly higher in the tramadol-dexketoprofen group. CONCLUSIONS: Multimodal therapy proved more effective to manage moderate-severe pain after impacted third molar surgery in comparison to monotherapy. However, the improvement in relief must be balanced against the increased risk of adverse effects when considering this multimodal approach.

Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study.

Implant stability is one of the main indicators of successful osseointegration. Although it has been measured in numerous studies, there has been little research on implant stability in regenerated bone. The study compares primary and secondary stability between implants placed in regenerated versus native bone and evaluates the influence of bone quality on the results. Sixty implants were placed in 31 patients: 30 implants inserted in native bone (non-regenerated) after a healing period of at least 6 months post-exodontia and 30 inserted in regenerated bone at 6 months after grafting with xenograft. Resonance frequency analysis (RFA) was used to obtain implant stability quotient (ISQ) values at baseline (implant placement), 8 weeks, and 12 weeks. Statistically significant differences were found between implants placed in regenerated bone and those placed in native bone at all measurement time points (p < 0.05). ISQ values were significantly influenced by bone quality at baseline (p < 0.05) but not at 8 or 12 weeks. Greater stability was obtained in implants placed in native bone; however, those placed in regenerated bone showed adequate primary and secondary stability for prosthetic loading. Bone quality influences the primary but not secondary stability of the implants in both native and regenerated bone.

Do perioperative antibiotics reduce complications of mandibular third molar removal? A double-blind randomized controlled clinical trial.

OBJECTIVE: The aim of this study was to compare the effects of different antibiotic prophylaxis regimens versus placebo in relation to possible postoperative complications derived from the surgical extraction of impacted lower third molars. STUDY DESIGN: The final study sample of this double-blind randomized controlled trial comprised 92 Caucasian volunteers. Patients were assigned to 3 groups by using a randomization table. Group 1 (n = 30) received 750 mg oral amoxicillin both before and after the surgery; group 2 (n = 32) received the same oral dose after surgery alone; and group 3 (n = 30) received placebo both before and after surgery. Infectious complications, postoperative pain, and inflammation intensity were measured. The requirement for and the timing of rescue medication were also measured. RESULTS: Postoperative pain and inflammation intensity were significantly higher (P < .05) in group 3 than in groups 1 or 2 at 48 hours, 72 hours, and 1 week. A significantly higher proportion of group 3 required rescue medication (analgesics and rescue antibiotics) (P = .013) compared with groups 1 or 2. CONCLUSIONS: Greater pain and inflammation were experienced by patients receiving placebo before lower third molar extraction than by those receiving antibiotics either before surgery or both before and after surgery. Other options, such as use of local antibiotics, should be considered to reduce the problems, including bacterial resistance, caused by overuse of systemic antibiotics.

Preoperative oral pregabalin for anxiety control: a systematic review.

OBJECTIVE: The objective of this systematic review was to determine the effectiveness of preoperative oral pregabalin for anxiety control, the most effective dosage regimen, its impact on postoperative pain, and its adverse effects. MATERIALS AND METHODS: A search was conducted of PubMed/Medline and clinicaltrials.gov (National Library of Medicine, Washington, DC), Scopus, Web of Science, and Cochrane databases for studies published between January 2009 and November 2018, with no language restriction. Based on PRISMA guidelines, the specific question was: is preoperative oral pregabalin effective and safe for anxiety control in patients undergoing surgery? The critical reading of retrieved studies followed questions prepared by the CASPe Network, and their methodological quality was evaluated using the Jadad Scale. RESULTS: Twelve randomized controlled trials were selected for review. All twelve studies were trials of high quality. A dose of 75 mg preoperative oral pregabalin has been found to reduce anxiety and stabilize intraoperative hemodynamics, although a more significant improvement appears to be achieved with a single dose of 150 mg pregabalin at least 1 h before the surgery. It is not associated with any severe adverse effects. CONCLUSION: Preoperative administration of oral pregabalin in a single dose of 150 mg appears to be effective to significantly reduce the anxiety of patients, intraoperative hemodynamic changes, and postoperative pain. CLINICAL RELEVANCE: These findings suggest that pregabalin is useful and safe for preoperative and intraoperative anxiety control in patients undergoing surgery.

Double-blind, randomized controlled clinical trial on analgesic efficacy of local anesthetics articaine and bupivacaine after impacted third molar extraction.

OBJECTIVE: The objective of this randomized controlled clinical trial (RCT) was to compare the effect of bupivacaine and articaine at habitual doses on pain intensity and the need for analgesics after lower third molar extraction. MATERIALS AND METHODS: The final study sample comprised 50 Caucasian volunteers (26 males and 24 females; age range, 18-30 years) undergoing scheduled surgical extraction of impacted lower third molar. A computer-generated random sequence was used to allocate participants to the articaine (4%) or bupivacaine (0.5%) group. Surgeons and patients were blinded by labeling the articaine and bupivacaine carpules with numbers (1 and 2, respectively). Postoperative pain intensity (primary outcome) was evaluated with a visual analogue scale (VAS), while the requirement for and timing of rescue medication and the quality of intraoperative anesthesia were also measured (secondary outcomes). RESULTS: VAS-measured pain intensity was significantly higher (p < 0.05) in the articaine group than in the bupivacaine group at all time points except for 8 h post-surgery (p = 0.052). Rescue medication was required by 13 (52%) patients in the articaine group and 8 (32%) patients in the bupivacaine group, although the difference did not reach statistical significance (p = 0.252). The groups did not significantly differ (p = 0.391) in the quality of the intraoperative anesthesia. CONCLUSIONS: Bupivacaine is a valid alternative to articaine in third molar surgery and may offer residual anesthesia as a means of reducing postoperative pain. However, further well-designed RCTs are required in larger study populations to verify the effectiveness of bupivacaine to achieve residual analgesia after oral surgery. CLINICAL RELEVANCE: These findings suggest that bupivacaine may be useful as a coadjuvant to control acute postoperative pain. TRIAL REGISTRATION: ACTRN12617001138370.

Oral pregabalin for acute pain relief after cervicofacial surgery: a systematic review.

OBJECTIVE: The objectives of this systematic review were to unify criteria on the effectiveness of oral pregabalin to treat acute post-operative pain after cervicofacial surgery, to establish the most effective dose regimens, and to determine its effect on rescue medicine consumption and its association with adverse effects. MATERIALS AND METHODS: PubMed/Medline (National Library of Medicine, Washington, DC), Scopus, Web of Science, and Cochrane databases were searched for studies in any language published between January 2000 and September 2016. The following question was posed, in accordance with PRISMA guidelines: Is oral pregabalin effective and safe for the relief of acute pain after cervicofacial surgery? The critical reading of the literature utilized a list of questions prepared by the CASPe Network, applying the Jadad scale for evaluation of the methodological quality of trials. RESULTS: Eleven randomized controlled clinical trials were selected. The 11 trials obtained a score ≥ 3, considered as Ib evidence level and high quality. A single oral dose of 75-mg pregabalin before or after cervicofacial surgery alleviates pain and lessens the need for rescue analgesia consumption, while the statistical significance of these effects is higher with a single dose of 150-mg pregabalin, either before or after the surgery. CONCLUSION: Oral pregabalin appears to significantly alleviate post-operative pain and reduce rescue analgesia consumption, with no severe adverse effects. However, the ideal dose and most effective administration regimen remain controversial issues that need to be addressed in further high-quality clinical trials. CLINICAL RELEVANCE: These findings suggest that pregabalin may be useful for acute pain relief after cervicofacial surgery.

Long-Term Survival of Dental Implants with Different Prosthetic Loading Times in Healthy Patients: A 5-Year Retrospective Clinical Study.

PURPOSE: To compare survival rates among dental implants restored with immediate, early, and conventional loading protocols, also comparing between maxillary and mandibular implants, and to evaluate the influence of implant length and diameter and the type of prosthesis on treatment outcomes. MATERIALS AND METHODS: This retrospective cohort study initially included all 52 patients receiving dental implants between July 2006 and February 2008 at a private oral surgery clinic in Granada (Southern Spain). Clinical and radiographic examinations were performed, including periapical or panoramic radiographs, and incidences during completion of the restoration were recorded at 1 week, 3 months, 6 months, and at 1, 2, 3, 4, and 5 years. After a 5-year follow-up, 1 patient had died, 3 were lost to follow-up, and 6 required grafting before implant placement; therefore, the final study sample comprised 42 patients with 164 implants. RESULTS: Variables associated with the survival/failure of the restoration were: number of implants (higher failure rate with fewer implants), bone type (higher failure rate in type III or IV bone), and type of prosthesis (higher failure rate with single crowns). No significant association was found in univariate or multivariate analyses between survival rate and the loading protocol, implant length or diameter, or maxillary/mandibular location. CONCLUSIONS: Immediate occlusal loading, immediate provisionalization without occlusal loading, and early loading are viable treatment options with similar survival rates to those obtained with conventional loading. Bone quality and number of implants per patient were the most influential factors.

Topographic characterisation of dental implants for commercial use

BACKGROUND: To characterize the surface topography of several dental implants for commercial use. MATERIAL AND METHODS: Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls (p< 0.05) tests. RESULTS: Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. CONCLUSIONS: The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use

Oral pregabalin for postoperative pain relief after third molar extraction: a randomized controlled clinical trial.

OBJECTIVES: The aim of this randomized controlled clinical trial was to evaluate the efficacy and safety of pregabalin administered pre- and postoperatively in patients with pain and swelling due to the surgical removal of impacted lower third molars. MATERIALS AND METHODS: The final study sample comprised 60 volunteers (23 males and 37 females). Group 1 (n = 30) received 75 mg oral pregabalin 1 h before surgery and 1 h after surgery. Group 2 (n = 30) served as a control group and received no pregabalin. Both groups were administered with 650 mg paracetamol every 8 h for 2 days. Postoperative pain intensity and swelling were measured using a visual analog scale (VAS); pain relief experienced was reported using a four-point verbal rating scale (VRS); the rescue medication requirement, adverse effects, and global impression of the medication were also recorded. RESULTS: No significant difference in pain intensity (VAS) was observed between the groups. However, fewer rescue medication tablets were needed by pregabalin-treated patients than by controls (p = 0.021). The frequency and intensity of adverse effects were significantly higher in pregabalin-treated patients (p < 0.001), although no serious adverse events occurred. No significant difference in the degree of swelling was observed in any measurement except that from mandibular angle to lip junction, which showed lesser inflammation in the pregabalin group at 24 h post-surgery (p = 0.011). The global opinion on the medication received was more positive in the pregabalin group (p = 0.042). CONCLUSIONS: The administration of pregabalin reduces the requirement for rescue medication after third molar surgery and results in a more constant pain level, with fewer peaks of pain intensity. CLINICAL RELEVANCE: These findings suggest that pregabalin may be useful to control acute postoperative pain. Adverse effects are known to be reduced at the low pregabalin dose used in our study.

Risk factors associated with early implant failure: A 5-year retrospective clinical study.

STATEMENT OF PROBLEM: The replacement of lost teeth with dental implants is a widespread treatment whose associated problems are also frequently encountered. Nevertheless, the factors associated with early implant failure have not been well documented. Further analyses of the factors influencing osseointegration establishment are required to maximize the predictability of the procedure and minimize implant failures. PURPOSE: The purpose of this retrospective clinical study was to explore the association between possible risk factors and early implant failure. MATERIAL AND METHODS: This retrospective clinical study evaluated 142 participants who received 276 external connection BTI implants between 2007 and 2011. Participant variables (age, sex, systemic disease, tobacco use, alcohol consumption, bruxism, and degree of periodontal disease), implant variables (type of edentulism, localization, area, diameter, length, and bone quality), intervention variables (expansion mechanisms, sinus augmentation techniques, bone regeneration, and implant insertion), and postoperative variables (presence of pain/inflammation at 1 week postsurgery) were studied. A multilevel logistic regression model (mixed effects-type model) was used to determine the influence of variables on early implant failure. RESULTS: Early implant failure was significantly associated with the male sex (P=.001), severe periodontal disease (P=.005), short implants (P=.001), expansion technique (P=.002), and postoperative pain/inflammation at 1 week postsurgery (P<.001). CONCLUSIONS: Early dental implant failure is more frequent in men and in individuals with severe periodontal disease, short implants, pain/inflammation at 1 week postsurgery, or bone expansion treatment.

Factors Affecting Dental Implant Stability Measured Using the Ostell Mentor Device: A Systematic Review.

OBJECTIVES: The aim of this study was to review the literature on factors that may affect dental implant stability as measured with the Ostell mentor device. MATERIALS AND METHODS: A systematic search of the literature was performed in Pubmed, Scopus, and Cochrane databases using dental implants, stability, and resonance frequency analysis as key words. RESULTS: The most relevant randomized controlled trials and clinical trials (n = 39) were selected from among 264 articles. CONCLUSIONS: Many factors can affect dental implant stability as measured with the Ostell mentor device. This may be a useful instrument for deciding the timing of implant loading, but additional research is required to establish the reliability and predictability of resonance frequency analysis for the future osseointegration of dental implants, which remains controversial.

Bacterial contamination levels of autogenous bone particles collected by 3 different techniques for harvesting intraoral bone grafts.

PURPOSE: The aim of this study was to compare levels of bacterial contamination of autogenous bone collected when using low-speed drilling, a back-action chisel, and a bone filter. MATERIALS AND METHODS: Bone tissue samples were taken from 31 patients who underwent surgical extraction of their third lower molars. Before surgical removal of the molar, bone particles were collected by a low-speed drill or a back-action chisel. Then, a stringent aspiration protocol was applied during the ostectomy to collect particulate bone by a bone filter. Processing of samples commenced immediately by incubation in an anaerobic or a CO2-rich atmosphere. The number of colony-forming units (CFUs) was determined at 48 hours of culture. RESULTS: No significant difference in the number of CFUs per milliliter was observed between the low-speed drilling group and the back-action chisel group in the anaerobic or CO2-rich condition (P = .34). However, significantly more micro-organisms were found in the bone filter group than in the low-speed drilling group or the back-action chisel group in the anaerobic and CO2-rich conditions (P < .001). CONCLUSIONS: Particulate bone harvested with low-speed drilling or a back-action chisel is safer for use as an autograft than are bone particles collected with a bone filter. These results suggest that bone obtained from low-speed drilling is safe and straightforward to harvest and could be the method of choice for collecting particulate bone. Further research is needed to lower the bacterial contamination levels of autogenous bone particles used as graft material.

Update on the use of corticosteroids in third molar surgery: systematic review of the literature.

OBJECTIVES: Third molar extraction produces inflammation, pain, and trismus, and different pharmacologic therapies have been evaluated for the minimization of postsurgical symptoms. The most frequently prescribed drugs are nonsteroidal anti-inflammatories, followed by steroids and opiates. MATERIAL AND METHODS: A systematic search of the literature was carried out in PubMed, Scopus, MEDLINE, and Cochrane using steroid and third molar as key words. RESULTS: The most relevant randomized controlled trials and meta-analyses (n = 28) were selected from among 72 articles. CONCLUSIONS: Administration of corticosteroids improves the postoperative experience of patients and has a significant impact on trismus and inflammation. Greater effects appear to be achieved by using the parenteral route and by administering the corticosteroid before the surgery.

Proliferation and osteogenic differentiation of osteoblast-like cells obtained from two techniques for harvesting intraoral bone grafts.

OBJECTIVES: The aims of our study were to verify the presence of viable osteoblasts in samples of bone tissue obtained by drilling or from cortico-cancellous bone blocks and to assess their growth and differentiation capacities. MATERIALS AND METHODS: Bone tissue samples were processed independently and cultured in Dulbecco's modified Eagle medium, in a CO2 incubator at 37 °C. The proliferative capacity of osteoblasts was determined by spectrophotometry (MTT) at 24 and 48 h of culture. Cell cycle was analysed by flow cytometry. Cell differentiation was studied by red alizarin staining of nodules formed in mineralisation medium and by analysis of alkaline phosphatase activity. RESULTS: In comparison to bone block-derived osteoblasts, the proliferative capacity was greater at 24 and 48 h of culture (P < 0.001) in the drilling-derived osteoblasts, which showed significantly increased G2/M (P = 0.014) and S (P < 0.001) phases in the cell cycle study. The number of mineralised nodules was proportional to the incubation time, with no differences between the two types of sample, which also did not significantly differ in alkaline phosphatase activity. CONCLUSION: Superior autograft material is obtained by harvesting particulate bone from low-speed drilling fragments than from a cortico-cancellous bone block. CLINICAL RELEVANCE: These results suggest that bone obtained from low-speed drilling is a simple and effective alternative to the classic procedure for obtaining bone tissue.

Dental implant stability is influenced by implant diameter and localization and by the use of plasma rich in growth factors.

PURPOSE: The objective was to analyze the factors that influence the stability of dental implants at 12 weeks after implant placement as measured by resonance frequency analysis using the Osstell system. MATERIALS AND METHODS: This prospective clinical study was performed in 235 implants placed in 93 patients at the Oral Surgery and Implantology Clinic of the University of Granada. The gathered predictor variables were grouped into patient variables, implant variables, operative variables, and baseline implant stability quotient (ISQ). All variables were analyzed in a multivariate model to determine their influence on the ISQ score at 12 weeks after implant insertion (outcome variable). SUDAAN software was used for clustered sampling (multiple implants in patients). RESULTS: Two hundred thirty-five dental implants were placed in 47 men (50.5%) and 46 women (49.5%; total, 93 patients; mean age, 52.13 ± 11.23 years; range, 27 to 76 years). No association was found between the patient variables and the ISQ values at 12 weeks. Among implant variables, worse ISQ values at 12 weeks were observed for a narrow diameter (P < .001) and maxillary implants (P = .006). Among surgical technique variables, the use of plasma rich in growth factors (P = .011) showed the best ISQ values at 12 weeks. CONCLUSIONS: The diameter and localization of implants and the application of plasma rich in growth factors influenced the stability of implants measured at 12 weeks of wound healing. Accordingly, stability was less with a narrower implant diameter and maxillary localization and greater with implants humidified with plasma rich in growth factors.

Effect of platelet-rich plasma on growth and antigenic profile of human osteoblasts and its clinical impact.

PURPOSE: In recent years, there has been widespread clinical use of platelet-rich plasma (PRP) to facilitate the regeneration of different tissues. However, few data are available on the effect of PRP on parameters other than cell growth. The aim of the present study was to evaluate the effect of PRP on the cell cycle, antigenic profile, and proliferation of primary cultured human osteoblasts. MATERIALS AND METHODS: The cells in the present study were derived from human bone sections obtained from healthy volunteers during third molar surgery. PRP was prepared from human venous blood and used to culture the cell line obtained from the same patient. Flow cytometry was used to study the cell cycle, antigenic profile, and proliferation. RESULTS: The treatment of osteoblasts with PRP modified the expression of CD54, CD80, CD86, and HLA-DR antigens. PRP treatment increased cell proliferation in the short term, but the cell proliferation capacity diminished in the long term, perhaps owing to cell exhaustion. No change in the cell cycle profile was observed in the PRP-cultured cells. CONCLUSIONS: These results suggest that PRP treatment accelerates bone neoformation with no cell cycle changes that might carry a risk of malignant transformation.

Influence of cavity preparation technique (rotary vs. ultrasonic) onmicroleakage and marginal fit of six end-root filling materials

Objectives: To evaluate in vitro the effect of cavity preparation with microburs and diamond-coated ultrasonic tipson the microleakage and marginal fit of six end-root filling materials.Study Design. The following materials were assessed: amalgam (Amalcap), zinc oxide eugenol (IRM), glassionomer (Vitrebond), compomer (Cavalite), mineral particle aggregate (MTA) and composite (Clearfil). Cavitypreparation was performed with microburs or diamond ultrasonic tips in single-root teeth. The seal was evaluatedin two experiments: a microleakage assay on the passage of dye to the interface; and a scanning electron microscopystudy and analysis of epoxy resin replicas, measuring the size of gaps in the interface between filling materialand cavity walls. Multifactorial ANOVA, multiple comparison test and Student’s t test were used for statisticalanalyses of the data, considering p<0.05 to be significant.Results: Clearfil and MTA achieved a hermetic seal. Leakage and interface gap size was greater with Cavalitethan with Clearfil and MTA, followed by Vitrebond and IRM. The worst seal was obtained with Amalcap. Theuse of diamond-coated ultrasonic tips improved the seal and reduced the gap when using materials that did nothermetically seal the cavity (Amalcap, IRM, Cavalite, Vitrebond). The preparation technique did not affectmaterials that achieved a hermetic seal (Clearfil, MTA).Conclusions: Clearfil and MTA obtained a hermetic seal due to their excellent marginal fit and are the mostrecommended materials for clinical use, taking account of their sealing capacity. Ultrasonic cavity preparationis preferable because it improves the seal and marginal fit of materials that do not achieve a hermetic seal of thecavity (Amalcap, IRM, Cavalite, Vitrebond) (AU)

Influence of cavity preparation technique (rotary vs. ultrasonic) on microleakage and marginal fit of six end-root filling materials.

OBJECTIVES: To evaluate in vitro the effect of cavity preparation with microburs and diamond-coated ultrasonic tips on the microleakage and marginal fit of six end-root filling materials. STUDY DESIGN. The following materials were assessed: amalgam (Amalcap), zinc oxide eugenol (IRM), glass ionomer (Vitrebond), compomer (Cavalite), mineral particle aggregate (MTA) and composite (Clearfil). Cavity preparation was performed with microburs or diamond ultrasonic tips in single-root teeth. The seal was evaluated in two experiments: a microleakage assay on the passage of dye to the interface; and a scanning electron microscopy study and analysis of epoxy resin replicas, measuring the size of gaps in the interface between filling material and cavity walls. Multifactorial ANOVA, multiple comparison test and Student 's t test were used for statistical analyses of the data, considering p <0.05 to be significant. RESULTS: Clearfil and MTA achieved a hermetic seal. Leakage and interface gap size was greater with Cavalite than with Clearfil and MTA, followed by Vitrebond and IRM. The worst seal was obtained with Amalcap. The use of diamond-coated ultrasonic tips improved the seal and reduced the gap when using materials that did not hermetically seal the cavity (Amalcap, IRM, Cavalite, Vitrebond). The preparation technique did not affect materials that achieved a hermetic seal (Clearfil, MTA). CONCLUSIONS: Clearfil and MTA obtained a hermetic seal due to their excellent marginal fit and are the most recommended materials for clinical use, taking account of their sealing capacity. Ultrasonic cavity preparation is preferable because it improves the seal and marginal fit of materials that do not achieve a hermetic seal of the cavity (Amalcap, IRM, Cavalite, Vitrebond).

Measurement of dental implant stability by resonance frequency analysis: A review of the literature

Dental implant treatment is an excellent option for prosthetic restoration that is associated with high successrates. Implant stability is essential for a good outcome. The clinical assessment of osseointegration is based onmechanical stability rather than histological criteria, considering primary stability (absence of mobility in bonebed after implant insertion) and secondary stability (bone formation and remodelling at implant-bone interface).The aim of this study was to review the literature on Resonance Frequency Analysis (RFA) as a methodfor measuring dental implant stability. An online search of various databases was conducted on experimentaland clinical research published between 1996 and 2008. The studies reviewed demonstrate the usefulness ofRFA as a non-invasive method to assess implant stability. Further research is required to determine whetherthis system is also capable of measuring the degree of dental implant osseointegration (AU)

Factors related to survival from oral cancer in an Andalusian population sample (Spain).

INTRODUCTION: Approximately 3% of malignant tumors originate in the oral cavity. The majority are squamous cell carcinomas, and a small percentage, malignant tumors of the salivary glands, lymphoreticular diseases, bone tumors, melanomas, sarcomas, malignant odontogenic tumors and metastases of tumors from other locations. The prognosis of these pathologies depends on the size, infiltration, and site of the lesion, the presence or absence of metastatic spread, and to a certain degree the differentiation of the tumor. The prognosis of an oral cancer remains generally negative, with 5-year survival figures below 50%, producing high rates of mortality and morbidity. OBJECTIVES: To evaluate the influence of different variables on survival in an oral cancer population. PATIENTS AND METHODS: Two-hundred and sixteen patients with oral squamous cell carcinoma were studied over a period of five years, evaluating 42 variables grouped into five data sections: personal, lesion, site, stage, and risk factors. RESULTS AND CONCLUSIONS: Average survival was 2088 days, with a standard deviation of 98 days. The factors most associated with mortality were: location in the gingiva (p=0.0590), in the trigone (p=0.0104), size (T3-T4) (p=0.0004) and lymph node involvement (N2a-N2b) (p=0.0035). Tobacco and alcohol, nowadays considered to be highly significant in carcinogenesis, had no considerable influence on survival.