Uso de técnicas de distracción, mediante realidad virtual (RV), en el control del dolor y la ansiedad dental en odontoestomatología

Memoria ID-061 Ayudas de la Universidad de Salamanca para la innovación docente, curso 2020-2021

Tactile Sensibility Thresholds in Implant Prosthesis, Complete Dentures and Natural Dentition: Review about Their Value in Literature

[EN]Background and Objectives: The periodontium has important proprioceptive receptors that prevent teeth from using excessive occlusal forces during chewing. There are other receptors from adjacent tissues that replace periodontal ones when teeth are extracted and rehabilitated with prosthesis, although they seem to be less effective. Psychophysical studies investigate tactile sensibility thresholds, which are useful to measure this masticatory efficiency in different prosthetic rehabilitations. There are two types of sensibility depending on the receptors that are activated during these studies: active and passive tactile sensibility. The purpose of this study is to obtain active and passive tactile sensibility threshold figures in natural dentition and prosthetic rehabilitations so we can compare them and understand how this sensibility works in different situations. Materials and Methods: We performed a systematic review of the available literature, following PRISMA guidelines and including articles from 2004 to 2021 in the MEDLINE database. Only 10 articles were included in this investigation as they provided concrete threshold figures. Results: The mean values of active tactile sensibility thresholds in complete dentures, implant prosthesis and natural dentition are 64 µ, 23.3 µ and 16.1 µ, respectively. The mean values of passive tactile sensibility thresholds in implant prosthesis and natural dentition are 6.7 N and 0.8 N, respectively. Conclusions: Implant prosthesis have lower thresholds, that are very close to those present in natural dentition, than complete dentures due to an increased tactile sensibility. Active tactile sensibility thresholds present fewer differences between values than passive tactile ones; as these are only influenced by receptors from periodontal or periimplant tissues

Implant loss and crestal bone loss in early loading versus delayed and immediate loading in edentulous mandibles. A systematic review and meta-analysis

Information about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss i

Active Tactile Sensibility in Implant Prosthesis vs. Complete Dentures: A Psychophysical Study

[EN] Background and Objectives: Proprioceptive information from natural dentition and adjacent oral tissues enables correct masticatory function, avoiding damage to the teeth. Periodontium is the main source of this relevant information, and when a tooth is lost, all this proprioceptive sensibility relies on receptors from muscles, the mucous membrane or the temporomandibular joint, and this sensibility gets worse. Active tactile sensibility measures this proprioceptive capability in microns by psychophysical studies consisting of introducing thin metal foils between patients’ dental arches during chewing to see if they are able to notice them or not. Osseoperception is a complex phenomenon that seems to improve this sensibility in patients wearing dental implants. The objective of this investigation is to measure this sensibility in different prosthetic situations by performing a psychophysical investigation. Material and Methods: We divided 67 patients in three groups depending on their prosthetic situation and performed a psychophysical study by introducing aluminium foils of different thicknesses in order to establish an active tactile sensibility threshold in every group. We also measured variables such as prosthetic wearing time, age or gender to see how they may influence threshold values. We used Student’s t-test and Mann–Whitney U tests to analyse these results. Results: Active tactile sensibility threshold values in implants are lower than those from complete dentures but higher than values in natural dentition. However, values in implants are closer to natural dentition than complete denture values. Age, gender or prosthetic wearing time have no influence in active tactile sensibility thresholds. Conclusion: Active tactile sensibility threshold values depend on prosthetic rehabilitations and the mechanoreceptors involved in every situation. Implant prosthesis presents an increased active tactile sensibility thanks to osseoperception phenomenon

Clinical and epidemiological profile of cleft lip and palate patients in Peru, 2006 ? 2019

The purpose of this study was to determine the clinical-epidemiological profile of patients with cleft lip and / or palate in Peru from 2006 to 2019. This retrospective and cross-sectional study analyzed 3,923 patients with cleft lip and palate attende

Patient‐centered treatment outcomes with full‐arch peek rehabilitation supported on four immediate or conventionally loaded implants. A randomized clinical trial

[ES]Este estudio tiene como objetivo evaluar los resultados del tratamiento (funcionales y subjetivos) de rehabilitaciones híbridas fijas de arco completo hechas de PEEK (poliéter-éter-cetona) con coronas fresadas de compuesto nanorelleno (NFC) soportadas sobre cuatro a seis implantes. En este ensayo clínico aleatorizado, 34 pacientes desdentados en la mandíbula superior y/o inferior fueron tratados con dentaduras postizas híbridas fijas. En 16 pacientes (47,1% de la muestra), los implantes fueron cargados inmediatamente (IL) mediante una rehabilitación fija provisional de PMMA (polimetilmetacrilato) atornillada sobre pilares Multi-Unit (MU) conectados tras la colocación del implante; sin embargo, en las contrapartes (n = 18) estos pilares MU se cubrieron con cofias de cicatrización y se dejaron sin carga durante dos meses (protocolo de carga convencional-CL), cuando todos los pacientes recibieron una rehabilitación híbrida fija de PEEK-NFC en la parte superior y/o la mandíbula inferior. Los resultados del tratamiento se evaluaron 12 meses después de la entrega de las prótesis. Los resultados funcionales se calcularon de acuerdo con el rendimiento masticatorio, estimado mediante pruebas de capacidad de mezcla de dos chicles de colores después de diez golpes de masticación, por la fuerza/área oclusal registrada por láminas sensibles a la presión y por electromiografía de los músculos maseteros y temporales con la fuerza de mordida máxima. Los resultados subjetivos del tratamiento se evaluaron utilizando tanto la escala de satisfacción oral (escala visual analógica) como la versión española del Oral Health Impact Profile (OHIP-20). Los hallazgos del presente estudio mostraron que el tratamiento con prótesis híbridas fijas de PEEK-NFC mejoró significativamente el rendimiento masticatorio, la fuerza de mordida, el patrón oclusal, la calidad de vida y la satisfacción, siendo el grupo IL los que presentaron fuerzas de mordida oclusal significativamente mayores y mayor satisfacción. en comparación con el grupo CL. Se debe concluir que las prótesis híbridas PEEK-NFC pueden mejorar varios resultados centrados en el paciente y que el protocolo de carga afecta significativamente la satisfacción autocalificada del paciente.[EN]This study aims to assess the treatment outcomes (functional and subjective) of full-arch fixed hybrid rehabilitations made of PEEK (poly-ether-ether-ketone) with milled crowns of nano-filled composite (NFC) supported on four to six implants. In this randomized clinical trial, 34 edentate patients in the upper and/or the lower jaws were treated with the fixed hybrid dentures. In 16 patients (47.1% of the sample), the implants were loaded immediately (IL) by means of a provisional fixed rehabilitation made of PMMA (polymethylmethacrylate) screwed on Multi-Unit (MU) abutments connected after emplacement of the implant; however, in the counterparts (n = 18) these MU abutments were covered by healing caps and were left unloaded during two months (conventional loading protocol—CL), when all patients received a fixed hybrid PEEK-NFC rehabilitation on the upper and/or the lower jaw. Treatment outcomes were assessed 12 months after prostheses delivery. Functional outcomes were calculated according to masticatory performance, estimated by mixing ability tests of two colored chewing gums after ten chewing strokes, by the occlusal force/area recorded by pressure-sensitive sheets, and by electromyography of masseters and temporal muscles at maximum biteforce. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analog scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study showed that treatment with fixed PEEK-NFC hybrid prostheses significantly improved the masticatory performance, bite force, occlusal pattern, quality of life, and satisfaction, with the IL group being those with significantly higher occlusal bite forces and greater satisfaction in comparison with CL group. It should be concluded that PEEK-NFC hybrid prostheses can improve several patient-centered outcomes and that loading protocol significantly affects the patient’s self-rated satisfaction

Functional and patient-centered treatment outcomes with mandibular overdentures retained by two immediate or conventionally loaded Implants: A randomized clinical Trial

[ES]Este estudio tiene como objetivo evaluar los resultados del tratamiento (funcionales y subjetivos) de sobredentaduras mandibulares retenidas sobre dos implantes con o sin un protocolo de carga inmediata. En este ensayo clínico aleatorizado, veinte pacientes completamente edéntulos fueron tratados con una sobredentadura mandibular retenida por dos implantes y una dentadura maxilar nueva completa. En la mitad de la muestra, los implantes se cargaron inmediatamente mediante pilares VulkanLoc® tras la colocación del implante, pero en las contralaterales, estos pilares VulkanLoc® se conectaron a los implantes dos meses después de la cirugía (protocolo convencional), y hasta ese momento las dentaduras postizas fueron retenidas por pilares de cicatrización. Los resultados del tratamiento se evaluaron a los dos, seis y doce meses después de la cirugía. Los resultados funcionales se calcularon según el rendimiento masticatorio, estimado por la fracción mixta de un chicle bicolor después de cinco, diez y quince golpes de masticación, por la fuerza oclusal registrada por las láminas sensibles a la presión y por la actividad muscular bioeléctrica. Los resultados subjetivos del tratamiento se evaluaron utilizando tanto la escala de satisfacción oral (escala visual analógica) como la versión española del Oral Health Impact Profile (OHIP-20). Los hallazgos del presente estudio muestran que las nuevas dentaduras postizas completas dieron como resultado mejoras significativas en la capacidad de masticación, la satisfacción del paciente y la calidad de vida relacionada con la salud bucal y que las posteriores sobredentaduras implantosoportadas produjeron mejoras significativas adicionales y más rápidas. El protocolo de carga puede influir en esos resultados positivos auto-informados en lugar de las evaluaciones funcionales objetivas[EN]This study aims to assess the treatment outcomes (functional and subjective) of mandibular overdentures retained on two implants with or without an immediate loading protocol. In this randomized clinical trial, twenty fully edentulous patients were treated with a mandibular twoimplant-retained overdenture and a complete new maxillary denture. In half of the sample, the implants were loaded immediately by means of VulkanLoc® abutments after emplacement of the implant, but in the counterparts, these VulkanLoc® abutments were connected to implants two months after the surgery (conventional protocol), and until that time the dentures were retained by healing abutments. Treatment outcomes were assessed at two, six, and twelve months after surgery. Functional outcomes were calculated according to masticatory performance, estimated by the mixed fraction of a two-coloured chewing gum after five, ten, and fifteen chewing strokes, by the occlusal force recorded by pressure-sensitive sheets, and by the bioelectrical muscular activity. The subjective outcomes of the treatment were assessed using both the oral satisfaction scale (visual analogue scale) and the Spanish version of the Oral Health Impact Profile (OHIP-20). The findings of the present study show that new complete dentures resulted in significant improvements in chewing ability, patient satisfaction, and oral health-related quality of life and that subsequent implant-retained overdentures produced further and faster significant improvements. The loading protocol may influence those positive self-reported outcomes rather than the objective functional evaluations

Gingival hyperplasia as an early manifestation of acute myeloid leukemia. A retrospective review

We study the prevalence of acute myeloid leukemia (AML) among patients with severe gingival enlargement. We retrospective reviewed the clinical records of patients with severe gingival enlargement, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and gingival bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique. A correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean gingival bleeding index was ?3 and the degree of dental mobility ?2.3. 1.7% of patients, with severe gingival hyperplasia were diagnosed with AML. We found a significant association between gingival bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. Severe gingival enlargement, abundant gingival bleeding, and dental mobility could be early manifestations of a blood dyscrasia

Safety and Efficacy of a New Synthetic Material Based on Monetite, Silica Gel, PS-Wallastonite, and a Hydroxyapatite Calcium Deficient: A Randomized Comparative Clinic Trial

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0–5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of −0.9 ± 1.3 mm and −0.6 ± 1.5 mm, and a variation in height of −0.1 ± 0.9 mm and −0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration

Increased urinary markers of kidney damage in the institutionalized frail elderly due to recurrent urinary tract infections.

Objective: To characterize the impact on kidney injury of recurrent urinary tract infections (RUTI) in the frail elderly. Methods: Prospective observational study in 200 frail elderly subjects for 1 year. Groups: GA (n = 100): subjects without RUTI, GB (n = 100): subjects with RUTI. Variables: age, concomitant diseases, glomerular filtration rate (GFR), urine neutrophil gelatinase-associated lipocalin (NGAL) at the beginning (NGAL-1) and end (NGAL-2) of the study, urine N-acetyl glucosaminidase (NAG) at the beginning (NAG-1) and the end (NAG-2) of the study, urine transforming growth factor-beta 1 (TGFbeta-1). Descriptive statistics, Mann-Whitney test, Chi-squared test, Fisher's exact test, and multivariate analysis were used. Results: Mean age was 84.33 (65-99) years old, with no difference between GA and GB. Mean NGAL-1 was 1.29 ng/ml (0.04-8). There was lower in GA than in GB. Mean NGAL-2 was 1.41 ng/ml (0.02-9.22). NGAL-2 was lower in GA than in GB. Mean NAG-1 was 0.38 UU.II/ml (0.01-2.63. NAG-1 in GA was lower than in GB. Mean NAG-2 was 0.44 UU.II/ml (0-3.41). NAG-2 was lower in GA compared with GB. Mean TGFbeta-1 was 23.43 pg/ml (0.02-103.76). TGFbeta-1 was lower in GA than GB. There were no differences in the presence of secondary diagnoses between GA and GB. NAG-2 and NGAL-1 were the most determining factors of renal function; in GA it was NGAL-2, followed by NAG-1; in GB it was NGAL-1, followed by NAG-2. Conclusion: Frail elderly with RUTI have higher urinary levels of renal injury markers, specifically NGAL, NAG, and TGFbeta-1, chronically in periods between urinary tract infection (UTI). Urinary markers of renal injury, specifically NGAL, NAG, and TGFbeta-1, identify early deterioration of renal function, compared with serum creatinine, or albuminuria, in frail elderly with recurrent urinary infections