Dental profile of a community of recovering drug addicts: biomedical aspects. Retrospective cohort study

Objectives: to obtain a biomedical oral profile of a community of adult drug addicts in treatment by analysing their dental health, with a view to determining whether the state of their oral health could be attributed primarily to their lifestyle and the direct consequences of drug abuse on their overall condition, rather than to the effects of the drugs used. Experimental Design: the study was conducted under the terms of an agreement between the Complutense University of Madrid's (UCM) Odontology Faculty and the City of Madrid's Substance Abuse Institute. Seventy drug addicts and 34 control group subjects were examined. The study assessed oral hygiene habits, systemic pathology, type of drugs used and the duration of use, oral pathology, oral health indices, risk of caries based on saliva tests, oral candidiasis and periodontal microbiology. Results: statistically significant differences (p<0.05) were found between the test and control groups for practically all the variables analysed. In the drug users group, dental hygiene was wanting, systemic and oral pathology prevailed and the decayed/missing/filled teeth or surface (DMFT/S) indices denoted very poor buccodental health. The saliva tests showed a substantial risk of caries and candidiasis rates were high. By contrast, with a single exception, the microbiological studies detected no statistically significant difference between drug users and control groups periodontal flora. Conclusions: drug-dependent patients had poor oral health and a significant increase in oral pathology, essentially caries and periodontal disease. Their risk of caries was high and the presence of candidiasis was representative of their poor general and oral health. Drug users' poor buccodental condition was more closely related to lifestyle than to drug abuse itself

Electromyographic study of activity of the masseter and anterior temporalis muscles in patients with temporomandibular joint (TMJ) dysfuction : comparison with the clinical dysfunction index

Objectives: A comparison was made between the electromyographic patterns specific to patient with temporomandibular disorders and that of normal healthy patients. Study design: Electromyographic tests were carried out during rest and function of the masseter muscles and anterior temporalis muscles in a homogeneous group consisting of 95 patients for whom such pathology and its different degree of severity had been previously studied by means of a Helkimo Test. The electromyographic exploration results were compared to those of a control group consisting of 31 healthy subjects. Results: There were significant differences among patients with a different degree of clinical dysfunction, as well as between these and the control group. These differences were more important during maximum effort clenching and mastication. During maximum effort clenching, differences in masseteric activity were observed between control group and group III, between groups I and II and between groups I and III. Meanwhile, differences in temporalis activity were significant among all groups except between groups I and II. The multiple comparison analysis demonstrated the existence of significant statistical differences between healthy subjects and patients with severe TMD. However, the linear combination of these electromyographic (EMG) variables led us to elaborate four linear functions that classify all subjects into four well defined groups. Once extreme cases were eliminated, our EMG classification revealed an 80% match with that of the Helkimo Test. We thus conclude that in many cases, classification using electromyographic criteria matches that established by the Helkimo Test

Complicaciones en prótesis fija sobre implantes

Introducción: En la actualidad las prótesis sobre implantes son una exitosa y esperanzadora alternativa terapeútica avalada por numerosos estudios científicos, sin embargo, no todo son ventajas si no que también surgen complicaciones que afectan en mayor a menor grado a la osteointegración de los implantes, a las restauraciones protésicas y/o a los tejidos orales adyacentes. Discusión: Ante el gran número de clasificaciones de complicaciones implantoprotésicas, se realiza una clasificación que las registra de forma ordenada según su momento de aparición y el componente de la restauración del afectado. Se analizan individualmente los problemas más frecuentes que surgen en cada uno de los tipos de prótesis fija sobre implantes: así el aflojamiento de los tornillos protésicos es la complicación más habitual en las restauraciones unitarias; en cambio, las prótesis de soporte mixto es la intrusión del pilar dentario, que surge en el 2-5 por ciento de los casos. En las restauraciones parciales y complentas implantosoportadas es la fractura del material de revestimiento que surge en un 5-13 pr ciento respectivamente, la alteración más usual. Conclusiones: Es fundamental un buen diagnóstico y planificación individualizada, así como una excelente comunicación implantólogo-prostodoncista. Son imprescindibles las visitas de seguimiento en este tipo de tratamientos para prevenir y tratar las posibles complicaciones

Interim restoration using dynamic abutments to re-treat a single-implant crown with a labial angulation: A clinical report

The cause of some peri-implant problems may be primarily attributable to the design of the prosthesis. A screw-retained interim implant may be advisable for reversibility and to avoid peri-implant cement, although screw retention may be difficult for maxillary anterior implants with a labial angulation. In the treatment described, a interim screw-retained crown was attached to a dynamic abutment with a lingual screw access hole to obtain a correctly fitting restoration.Sin financiación2.787 JCR (2018) Q1, 13/91 Dentistry, Oral Surgery & Medicine1.183 SJR (2018) Q1, 426/2894 Medicine (miscellaneous)No data IDR 2018UE

In vivo study of the wear of a reinforced composite used to cover implant-supported frameworks

The goal of this study was to research the wear shown by a material (Cristobal+) offered as an alternative to ceramics in the covering of an implant-supported fixed prosthesis. Twenty-six active cusps were used in this study; the control group consisted of 12 cusps adjacent to restorations composed of Cristobal+. Five images were obtained from each sample and analyzed using computer software that creates an arch along each cusp, so each image gives the value of the radius described by that arch. If a sample showed any sign of wear, the values for the successive radii would be increasingly larger since a flattened arch would produce a larger radius. An analysis of the paired Student t test was applied. After assessing the results, a statistically significant difference in wear was noted (P < .05). Within the limitations of this study, it can be concluded that the wear of the cusps under function made with Cristobal+ reinforced composite was greater than that of the natural adjacent cusps.Sin financiación1.221 JCR (2009) Q3, 40/64 Dentistry, oral surgery & medicineUE

Electromyographic comparisons between clenching, swallowing and chewing in jaw muscles with varying occlusal parameters

The aim of this study is to determine the influence of Angle molar class, presence of a posterior crossbite, anterior guidance, as well as gender in the muscular activity of the masticatory system in a population of healthy dental students. Study design: Surface electromyography recordings are made for the masseter, anterior and posterior temporalis and digastric muscles; in three different tests: clenching at maximum intercuspation, swallowing and chewing. Results: The results obtained show that: men achieve a higher masseter activity at maximum effort than women. Women achieve higher values than men, for the digastric muscles in deglution. Angle class II show higher activity than other classes for the temporalis muscle in deglution, while class III show higher activity than other classes for all muscles in maximum effort. The anterior guidance does not cause significant differences. The presence of a posterior crossbite affects the behaviour of anterior temporalis and masseter muscles. Conclusion: The results of this study show the influence of the occlusal parameters on the muscular activity of the stomatognatic system

Factors affecting the decision to use cemented or screw-retained fixed implant-supported prostheses: A critical review

Purpose: This review aimed to compile and enumerate all the factors described in the literature that may affect the decision to use either cemented or screw-retained restorations and to determine the relative weights of each factor by type of retention and prosthesis. Materials and Methods: The literature was reviewed, and the factors were classified as either determining (present in a clinical situation in which one of the retention mechanisms was clearly more suitable than the other) or conditioning (present in clinical situations in which one type of restoration was not clearly more advantageous than the other). Results: Three determining factors (esthetic outcome, retention, and biologic risk) and five conditioning factors (passive fit, fracture strength, occlusal area, complications, and retrievability) were identified. Conclusion: Although there is not a clearly better alternative for all clinical situations, determining factors in certain scenarios can render one of the two approaches more recommendable. For esthetic reasons, when the implant angle cannot be corrected to conceal the access hole, cementation is more suitable; however, screw retention is the better option when the occlusal space is under 6 mm or margins cannot be located supra- or equigingivally. In the absence of determining factors, the decision should be based on conditioning factors, which carry different weights depending on the type of prosthesis.Sin financiación1.533 JCR (2018) Q3, 47/91 Dentistry, Oral Surgery & Medicine0.914 SJR (2018) Q1, 657/2894 Medicine (miscellaneous)No data IDR 2018UE

Factors Affecting the Decision to Use Cemented or Screw-Retained Fixed Implant-Supported Prostheses: A Critical Review

Purpose: This review aimed to compile and enumerate all the factors described in the literature that may affect the decision to use either cemented or screw-retained restorations and to determine the relative weights of each factor by type of retention and prosthesis. Materials and Methods: The literature was reviewed, and the factors were classified as either determining (present in a clinical situation in which one of the retention mechanisms was clearly more suitable than the other) or conditioning (present in clinical situations in which one type of restoration was not clearly more advantageous than the other). Results: Three determining factors (esthetic outcome, retention, and biologic risk) and five conditioning factors (passive fit, fracture strength, occlusal area, complications, and retrievability) were identified. Conclusion: Although there is not a clearly better alternative for all clinical situations, determining factors in certain scenarios can render one of the two approaches more recommendable. For esthetic reasons, when the implant angle cannot be corrected to conceal the access hole, cementation is more suitable; however, screw retention is the better option when the occlusal space is under 6 mm or margins cannot be located supra- or equigingivally. In the absence of determining factors, the decision should be based on conditioning factors, which carry different weights depending on the type of prosthesis.Sin financiación1.533 JCR (2018) Q3, 47/91 Dentistry, Oral Surgery & Medicine0.914 SJR (2018) Q1, 657/2894 Medicine (miscellaneous)No data IDR 2018UE

Comparison of the Surface Roughness of CAD/CAM Metal-Free Materials Used for Complete-Arch Implant-Supported Prostheses: An In Vitro Study

The roughness of the intra-oral surfaces significantly influences the initial adhesion and the retention of microorganisms. The aim of this study was to analyze the surface texture of four different CAD-CAM materials (two high-performance polymers and two fifth-generation zirconia) used for complete-arch implant-supported prostheses (CAISPs), and to investigate the effect of artificial aging on their roughness. A total of 40 milled prostheses were divided into 4 groups (n = 10) according to their framework material, bio.HPP (B), bio.HPP Plus (BP), zirconia Luxor Z Frame (ZF), and Luxor Z True Nature (ZM). The areal surface roughness “Sa” and the maximum height “Sz” of each specimen was measured on the same site after laboratory fabrication (lab as-received specimen) and after thermocycling (5–55 °C, 10,000 cycles) by using a noncontact optical profilometer. Data were analyzed using SPSS version 28.0.1. One-way ANOVA with multiple comparison tests (p = 0.05) and repeated measures ANOVA were used. After thermocycling, all materials maintained “Sa” values at the laboratory as-received specimen level (p = 0.24). “Sz” increased only for the zirconia groups (p = 0.01). B-BP exhibited results equal/slightly better than ZM-ZF. This study provides more realistic surface texture values of new metal-free materials used in real anatomical CAISPs after the manufacturing and aging processes and establishes a detailed and reproducible measurement workflow

Influence of the Use of Transepithelial Abutments vs. Titanium Base Abutments on Microgap Formation at the Dental Implant-Abutment Interface: An In Vitro Study

This in vitro study aimed to assess the presence of microgaps at the implant-abutment interface in monolithic zirconia partial implant-supported fixed prostheses on transepithelial abutments versus Ti-base abutments. Methods: Sixty conical connection dental implants were divided into two groups (n = 30). The control group consisted of three-unit bridge monolithic zirconia connected to two implants by a transepithelial abutment. The test group consisted of monolithic zirconia three-unit restoration connected to two implants directly by a titanium base (Ti-base) abutment. The sample was subjected to thermocycling (10,000 cycles at 5 °C to 55 °C, dwelling time 50 s) and chewing simulation (300,000 cycles, under 200 N at frequencies of 2 Hz, at a 30° angle). The microgap was evaluated at six points (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) of each implant-abutment interface by using a scanning electron microscope (SEM). The data were analyzed using the Mann-Whitney U tests (p > 0.05). Results: The SEM analysis showed a smaller microgap at the implant-abutment interface in the control group (0.270 μm) than in the test group (3.902 μm). Statistically significant differences were observed between both groups (p < 0.05). Conclusions: The use or not of transepithelial abutments affects the microgap size. The transepithelial abutments group presented lower microgap values at the interface with the implant than the Ti-base group in monolithic zirconia partial implant-supported fixed prostheses. However, both groups had microgap values within the clinically acceptable range