Evaluation of the anaesthetic properties and tolerance of 1:100,000 articaine versus 1:100,000 lidocaine. : a comparative study in surgery of the lower third molar

Objectives: To evaluate the anaesthetic properties and tolerance of articaine versus lidocaine at equal vasoconstrictor concentration. Study Design: A total of 96 male and female patients who underwent surgical treatment of the lower third molar participated. Patients were randomly assigned to articaine hydrochloride with epinephrine 1:100,000 and lidocaine hydrochloride with epinephrine 1:100,000. The variables analysed were latency period, duration of anaesthetic effect, tolerance and adverse reactions. Results: Both the latency period and the duration of anaesthetic effect were greater for articaine, although the differences were not statistically significant. Latency: mean difference of 2.70 ± 2.12 minutes (95%CI of -1.51 minutes - 6.92 minutes). Duration: mean difference of -33 minutes 5 seconds ± 31 minutes (95% CI -1 hour 35 minutes - 29 minutes). There were 4 adverse events that did not require the patients to be withdrawn from the study. Conclusions: The anaesthetics in this study have very similar properties for use in surgery and have demonstrated a good safety and tolerability profile. © Medicina Oral

Precision and practical usefulness of intraoral scanners in implant dentistry : a systematic literature review

This systematic review aimed to evaluate the efficiency and accuracy of digital impression techniques for implant-supported restorations, and to assess their economic feasibility. Two independent electronic database searches were conducted in the Pubmed/MedLine, Cochrane Library, and Lilacs databases complimented by a manual search, selecting relevant clinical and in vitro studies published between 1st January 2009 and 28st February 2019. All type of studies (in vivo and in vitro) were included in this systematic review. Twenty-seven studies (8 in vivo and 19 in vitro studies) fulfilled the inclusion criteria. No meta-analysis was performed due to a large heterogeneity of the study protocols. The passive fit of superstructures on dental implants presented similar results between digital and conventional impression techniques. The studies considered that several factors influence the accuracy of implant impression taking: distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody, and operator experience. Regarding the economic viability of intraoral scanning systems, only one study reported any benefit in comparison with conventional techniques. Digital impressions of dental implants can be considered a viable alternative in cases of one or two contiguous dental implants. However, more studies are needed to evaluate the accuracy of digital techniques in full-arch implant-supported restorations

Assessment of clinical outcomes and histomorphometric findings in alveolar ridge augmentation procedures with allogeneic bone block grafts : a systematic review and meta-analysis

This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings

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

Long term follow-up of a full- arch rehabilitation with an implant-supported overdenture on four zirconia implants and a zirconia bar. A case report

This clinical report describes a mandibular full-arch rehabilitation by means of an implant-supported overdenture on four zirconia implants. A female patient with an edentulous mandibular arch attended our dental clinic seeking a metal-free mandibular re

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

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. 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. 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. Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological exploration, 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