Immediate temporary restoration of single-tooth implants : prospective clinical study

Purpose: The goal of this study is to assess the survival, marginal bone loss and complications around sing le-tooth implants on which immediate provisionalization was carried out. Patients and Methods: 78 implant were placed in 57 patients: 56 after extraction and 22 in healed sockets. Immediately after surgery provisional crowns were delivered without contacts in both centric and excursive jaw movements. The final crowns were inserted between 3 to 6 months later. During the study there were 3 x-rays taken per patient. The marginal bone loss was measured and complications were recorded. The statistical analys is of the data was carried out with the STATA 10® software. Results: The mean duration of the study was 92 weeks. Survival rate was 98.7% (1 failure out of 78 implants). The mean mesial bone loss was 0.2±0.4 mm and the mean distal bone loss was 0.2±0.4 mm. No statistically significant diff erences were found between immediate or delayed implants. 67 implants sh owed a bone loss less than 1 mm, and 36 did not sh ow any bone loss at all. The main complications were the uncementing of the crowns (11 crowns), the presence of cement remnants (10 crowns) and the development of apical lesions around implants (6 implants). Conclusion: With the limitations of this study, it can be concluded by saying that immediate restoration with sing le-tooth implants and provisional crowns may be cons idered as a predictable technique. © Medicina Oral S. L

Description of the Modified Vestibular Incision Subperiosteal Tunnel Access (m-VISTA) Technique in the Treatment of Multiple Miller Class III Gingival Recessions: a Case Series

BackgroundGingival recession is a common finding in the adult population. It is considered a challenge for clinicians to obtain a complete root coverage of Miller class III recession. The aim of this case series was to assess the outcomes achieved with the use of modified VISTA technique (m-VISTA) in patients having multiple Miller class III recessions after 6 months.MethodsTen patients (six women and four men; mean age: 53 years), who showed multiple Miller class III recessions (depth >= 2 mm) and who met the established inclusion and exclusion criteria, were treated by postgraduate students with the use of m-VISTA technique.ResultsA total of 38 recessions were performed. The recessions were mainly located in the mandible (80%), which included six molars. The mean baseline recession was 3.12 mm. Post the intervention, a mean root coverage of 58.72% was achieved, with complete root coverage observed in 29% of the recessions.Conclusionsm-VISTA may offer several advantages in the treatment of Miller class III gingival recession. Nevertheless, more clinical trials with a longer follow-up period are needed to arrive at a concrete conclusion about its advantages.Trial registration: NCT03258996.Data registration: 08/18/2017

Comparative study of the modified VISTA technique (m-VISTA) versus the coronally advanced flap (CAF) in the treatment of multiple Miller class III/RT2 recessions: a randomized clinical trial

Objectives To compare the percentage of mean root coverage (MRC%) obtained in the treatment of multiple Miller class III/RT2 gingival recessions using the modified VISTA (m-VISTA) technique versus the coronally advanced flap (CAF) technique, using a connective tissue graft (CTG) in both cases. Materials and methods Twenty-four patients were randomly treated with m-VISTA (test group (TG) = 12) or CAF (control group (CG) = 12). A calibrated, experienced, and blinded examiner collected data related to multiple periodontal clinical variables, especially the recession (REC) in order to calculate the MRC% at 6 and 12 months, which was the primary outcome of the study. Also, the radiological bone level, the characteristics of the CTG, and postsurgical incidences were assessed. Finally, a descriptive and an analytical statistical analysis of the variables and their associations was performed. Results The recessions (n = 84) were located mainly in the mandible (n = 65) and in posterior sectors (premolars: n = 35; molars: n = 8). At 6 months, the MRC% was 61% (2 mm) for both study groups, and at 12 months, it increased to 73.26% (2.11 mm) in the TG and decreased to 56.49% (1.78 mm) in the CG. Conclusion When approaching multiple Miller class III/RT2 recessions, there were no statistically significant differences in the MRC% at 6 and 12 months between the group treated with the m-VISTA technique and the group treated with the CAF.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This research was conducted by the investigators who independently performed all phases of the study, including protocol development, clinical procedures, data analysis, result interpretation, and reporting. We declare that AFJ, JMAU, and XMM have previously received grants from the University of the Basque Country (PPG17/01)

Complete Root Coverage in the Treatment of Miller Class III or RT2 Gingival Recessions: a Systematic Review and Meta-Analysis

BackgroundThe primary objective of this systematic review and meta-analysis was to assess the evidence on complete root coverage (CRC) achieved by periodontal plastic techniques in the treatment of Miller class III/RT2 gingival recessions, comparing techniques developed along the twentieth century (pre-twenty-first) versus surgical approaches of the twenty-first century (21st).MethodsAn electronic bibliographic search was carried out in four databases up to December 2019, focusing on studies that reported CRC results in Miller class III or RT2 recessions treatment with at least a six-month follow-up. In addition, a random-effects models' meta-analysis was performed for the CRC, comparing pre-twenty-first versus twenty-first century techniques at 6 months, 12 months and more than 12 months.ResultsThirty-seven publications were included. A total of 933 gingival recessions were treated, 298 with pre-twenty-first century surgical techniques and 635 with techniques from the twenty-first century. CRC was achieved at 6 months on half of the recessions (pre-twenty-first: 57.60% vs. 21st: 51.11%), but decreased markedly for twenty-first century techniques at 12 months (pre-twenty-first: 63.82% vs. 21st: 32.87%). Thereafter, this difference was the other way around (>12 months: pre-twenty-first: 5.26% vs. 21st: 19.65%). The meta-analysis showed a high heterogeneity, with no significant differences amongst the techniques.ConclusionsAlthough CRC might be achievable by treating Miller class III or RT2 recessions with any of the described techniques, its long-term stability is not predictable. More randomized clinical trials with longer follow-ups and several visits, are needed. In addition, the patient's satisfaction should also be assesse

Endoperiodontal lesions: diagnosis first, then treatment and not always tooth extraction: a cross-sectional survey in Spain and a proposal of a clinical treatment protocol

Background: Endoperiodontal lesion (EPL) is defined as a pathological communication between pulpal and periodontal tissues. Currently, accurate diagnosis and treatment of this pathology are challenging. This study aims to identify the different endoperiodontal therapies to propose a clinical protocol to simplify and unify the criteria for EPL treatment. Material and Methods: Observational cross-sectional study through an electronic survey. This study matches STROBE guidelines. The anonymous questionnaire contained open-ended and close-ended questions and was distributed to dentistry professors of the UPV/EHU and different professionals from Spanish associations and scientific societies. The data collected were analyzed using descriptive and analytical statistics. Results: A total of 128 responses were obtained, of which 120 were active professionals or had not been so for less than 5 years. The majority of professionals were women (65.6%) and from the Basque Country (63.9%). A total of 86.6% reported having complementary studies to a degree or a bachelor’s degree. The treatments performed by these professionals were similar to those reported in the literature, which started with root canal treatment when there was an endodontic origin (91.5%), and with basic periodontal treatment when periodontal (51.3%). Conclusions: Considering the current scientific evidence and the clinical practice of professionals in the treatment of EPL, we designed a clinical protocol. This protocol needs validation in larger populations and with longer follow-ups

Periodontal health in a population with Parkinson's disease in Spain: a cross-sectional study.

Background: The aim of this research is to evaluate the periodontal health of patients with Parkinson Disease (PD) in a Spanish cohort. Material and Methods: A cross-sectional study was performed on 104 patients with PD (mean age: 66.19+9.3 years) and 106 controls (mean age: 59.26+14.11 years). A pre-designed clinical protocol was implemented, which included a standardized epidemiological index for periodontal disease (CPITN), clinical attachment loss (CAL), tooth-loss, full mouth plaque index (FMPI), and oral hygienic habits. Univariate descriptions and comparative analysis were performed. Results: The majority of PD patients presented good oral hygienic habits. There were no significant differences in relation to CPITN, periodontitis, gingival recessions and tooth loss. However, moderate/severe CAL (p=0.027) and FMPI (p=0.003) was higher in the PD group. Conclusions: There were no differences on periodontitis and tooth loss between both groups. The higher number of advanced CAL and presence of biofilm in the PD group could be related to the difficulties to perform an effective tooth brushing due to this neurological disorder.This research was not supported by any specific agency in the public, commercial, or not-for-profit sectors

Miller-en III.motako hortzoiaren atzera-egite anizkoitzen tratamenduan VISTA aldatua (m-VISTA) teknika koroalderantz birjarritako zintzilikarioaren (KBZ) aurreko ikerketa konparatiboa: Ausazko entsegu klinikoa

202 p.El tratamiento de las recesiones gingivales clase III de Miller o RT2 de Cairo sigue siendo todavía un gran reto para el clínico. Todavía no hay ningún estudio que compare diferentes técnicas quirúrgicas mucogingivales en el tratamiento de estas recesiones. Hemos diseñado un ensayo clínico aleatorizado con el objetivo de comparar la técnica VISTA modificada (m-VISTA) (Grupo Test) frente a la técnica colgajo de avance coronal (CAF) (Grupo Control), junto a un injerto de tejido conectivo del paladar, en el tratamiento de las recesiones múltiples (más de 2) clase III de Miller.Se han estudiado 24 pacientes (14 mujeres y 10 hombres, con una edad media de 55,26 años) que presentaban este tipo de recesiones. El estudio se realizó en el Máster en Periodoncia y Osteointegración del Servicio Clínica Odontológica de la UPV/EHU y se asignó aleatoriamente a cada grupo de tratamiento (m-VISTA: 12 / CAF: 12). Los pacientes presentaban 84 recesiones (Grupo Test: 44 / Grupo Control: 40) localizadas principalmente en la mandíbula (Grupo Test: 36 / Grupo Control: 29), con una recesión media inicial de 2,55 mm en el Grupo Test y 3,32 mm en el Grupo Control. A los 6 meses de la intervención, se consiguió un porcentaje de cobertura radicular media (% CR) del 61% para ambos grupos, mientras que, a los 12 meses, fue mayor en el Grupo Test (73,26 %) y menor en el Grupo Control (56,49 %). El porcentaje medio de cobertura radicular completa (% CRC) a los 6 meses fue del 30,61 % y del 36,67 % y, a los 12 meses, del 46,67 % y 29,45 %, para el Grupo Test y el Control, respectivamente.Las diferencias no fueron significativas en relación con el % CR y el % CRC en ambos periodos de seguimiento, aunque clínicamente si resultaron significativas a los 12 meses.El resto de los parámetros clínicos periodontales recogidos fueron mejores en los pacientes del Grupo Test que en los del Grupo Control.Con este estudio podemos concluir que se han obtenido buenos resultados de cobertura radicular con ambas técnicas en recesiones múltiples clase III de Miller, similares a las descritas previamente, siendo la técnica m-VISTA mejor. Para la consolidación de esto resultados es necesario realizar más ensayos clínicos, con muestras más grandes y con seguimiento más largos, comparando las diferentes técnicas mucogingivales en el tratamiento de recesiones múltiples clase III de Miller para poder definir la técnica de elección en cada caso

Human T-lymphotropic virus type 1 infection and disease in Spain

Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20–25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.The work was funded in part by grants from F-IES and ISCIII-Fondos Feder (PI13/01574; ICI14/00372; CD14/0243; FI14/0264; CM13/0309; CES12/003).Peer reviewe

Cystic Echinococcosis in the Province of Álava, North Spain: The Monetary Burden of a Disease No Longer under Surveillance

Cystic echinococcosis (CE) is endemic in Spain but has been considered non-endemic in the province of Álava, Northern Spain, since 1997. However, Álava is surrounded by autonomous regions with some of the highest CE prevalence proportions in the nation, casting doubts about the current classification. The purpose of this study is to estimate the frequency of CE in humans and animals and to use this data to determine the societal cost incurred due to CE in the Álava population in 2005. We have identified epidemiological and clinical data from surveillance and hospital records, prevalence data in intermediate (sheep and cattle) host species from abattoir records, and economical data from national and regional official institutions. Direct costs (diagnosis, treatment, medical care in humans and condemnation of offal in livestock species) and indirect costs (productivity losses in humans and reduction in growth, fecundity and milk production in livestock) were modelled using the Latin hypercube method under five different scenarios reflecting different assumptions regarding the prevalence of asymptomatic cases and associated productivity losses in humans. A total of 13 human CE cases were reported in 2005. The median total cost (95% credible interval) of CE in humans and animals in Álava in 2005 was estimated to range between €61,864 (95%CI%: €47,304-€76,590) and €360,466 (95%CI: €76,424-€752,469), with human-associated losses ranging from 57% to 93% of the total losses, depending on the scenario used. Our data provide evidence that CE is still very well present in Álava and incurs important cost to the province every year. We expect this information to prove valuable for public health agencies and policy-makers, as it seems advisable to reinstate appropriate surveillance and monitoring systems and to implement effective control measures that avoid the spread and recrudescence of the disease

mTORC1-dependent AMD1 regulation sustains polyamine metabolism in prostate cancer

Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#termsActivation of the PTEN-PI3K-mTORC1 pathway consolidates metabolic programs that sustain cancer cell growth and proliferation,. Here we show that mTORC1 regulates polyamine dynamics, a metabolic route that is essential for oncogenicity. Through the use of integrative metabolomics in a mouse model and human biopsies of prostate cancer, we identified alterations in tumours impacting on the production of decarboxylated S-adenosylmethionine (dcSAM) and polyamine synthesis. Mechanistically, this metabolic rewiring stems from mTORC1-dependent regulation of S-adenosylmethionine decarboxylase 1 (AMD1) stability. This novel molecular regulation was validated in murine and human cancer specimens. AMD1 was upregulated in prostate cancer specimens with activated mTORC1. Conversely, samples from a clinical trial with the mTORC1 inhibitor everolimus exhibited a predominant decrease in AMD1 immunoreactivity that was associated to a decrease in proliferation, in line with the requirement of dcSAM production for oncogenicity. These findings provide fundamental information about the complex regulatory landscape controlled by mTORC1 to integrate and translate growth signals into an oncogenic metabolic program