Post-traumatic trigeminal neuropathy. A study of 63 cases

Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not affected in three cases, while mild alterations were recorded in 25 subjects and severe alterations in 8. Partial or complete recovery was observed in 25 cases after 6 months, and in 32 after one year. There were few recoveries after this period of time. Recovery proved faster in the youngest patients, who moreover were the individuals with the least pain. Conclusion. Our patients with trigeminal neuropathy recovered particularly in the first 6 months and up to one year after injury. The older patients more often suffered pain associated to the sensory defect. On the other hand, their discomfort was more intense, and the patients with most pain and the poorest clinical scores also showed a comparatively poorer course. © Medicina Oral

Immediate bleeding complications in dental implants: a systematic review

Objective: A review is made of the immediate or immediate postoperative bleeding complications in dental implants, with a view to identifying the areas of greatest bleeding risk, the causes of bleeding, the length of the implants associated with bleeding, the most frequently implicated blood vessels, and the treatments used to resolve these complications. Material and Methods: A Medline (PubMed) and Embase search was made of articles on immediate bleeding complications in dental implants published in English up until May 2014. Inclusion criteria: studies in humans subjects with severe bleeding immediately secondary to implant placement, which reported the time until the hemorrhage, the implant lenght, the possible cause of bleeding and the treatment. Exclusion criteria: patients receiving anticoagulation treatment. Results: Fifteen articles met the inclusion criteria. The area with the largest number of bleeding complications corresponded to the mandibular canine. The cause of bleeding was lingual cortical bone perforation during implant placement, with damage to the sublingual artery. The implants associated with bleeding were those measuring 15 mm in length or more. Management focused on securing the airway (with intubation or tracheostomy if necessary), with bleeding control. Conclusions: It’s important to pay special attention when the implants are placed in the mandibular anterior zone, especially if long implants are used. The most frequently cause of bleeding was the perforation of the lingual plate. Treatment involves securing the airway, with bleeding contro

Influence of perforation of the sinus membrane on the survival rate of implants placed after direct sinus lift : literature update

The aim of this paper was to review the procedures adopted when a perforation of the sinus membrane takes place during a direct sinus lift for filling with bone graft; and the survival of implants in those cases in which perforation of the sinus membrane occurred. A bibliographical search in PUBMED was carried out of articles published from 1997 to 2008, with the key words ?sinus perforation? and ?membrane perforation?. All articles specifying the two following criteria were included: (a) procedure in the case of perforation of the sinus membrane during direct sinus lift; and (b) the number and survival rate of implants placed in direct sinus lift with perforated and non perforated membrane. Six articles fulfilled the inclusion criteria. In all the articles the sinus lift was continued when a perforation of the sinus membrane took place. In maxillary sinus lift procedures with perforation of the membrane a 88.6% implant survival rate was obtained, and in maxillary sinus lifts with intact membrane the survival rate rose to 98%. In case of small perforation of the sinus membrane, it is possible to continue with the procedure; there is no consensus on the procedure when a perforated membrane is to be repaired, but the method of choice according to the majority of authors is to use a resorbable membrane. In the case of large perforation, there is no consensus either, although the majority of authors choose to abandon the procedure. The survival of the implants diminishes when they are placed in sinus lifts with perforated membrane

Immunohistochemical study of Langerhans cells in periapical lesions : correlation with inflammatory cell infiltration and epithelial cell proliferation

Aim: The aim of this study is to determine the presence and distribution of Langerhans cells in periapical lesions, and correlate this with inflammatory cell infiltration and epithelial cell proliferation. Material and Methods: Seventy chronic dental periradicular lesions, obtained during periapical surgery from 70 patients, were included in this study, including: 46 granulomas, 18 scar tissue and 6 periradicular cysts. Immunohistochemical staining was performed using the following markers: CD3 to analyze the inflammatory infiltrate, CD1a to determine the presence of Langerhans cells and Ki67 to analyze the epithelial cell proliferation. The CD1a immunostaining density was established following Cincura (2007) criteria, being classified ranging from intense (3), moderate (2), discrete (1) or no (0) immunostaining. CD3 and Ki67 staining was evaluated following the Liapatas et al. scale, as: 0) no cells stained; 1) weak stain or few cells stained (11-25%); 2) moderate staining or some cells stained (26-75%); 3) intense staining or many cells stained (more than 76%). Results: Langerhans cells were found in 32.8% of the periapical lesions being more intense in the epithelialized lesions. CD3 immunohistochemical staining was found in all lesions, but with different values in relation to histological subtypes. Ki67 was positive in all epithelialized lesions, although with a moderate staining. Conclusions: Langerhans cells appeared to be associated with T-lymphocyte infiltration and the proliferative potential of the epithelial tissue in periapical lesion

Model-based observer proposal for surface roughness monitoring

Comunicación presentada a MESIC 2019 8th Manufacturing Engineering Society International Conference (Madrid, 19-21 de Junio de 2019)In the literature, many different machining monitoring systems for surface roughness and tool condition have been proposed and validated experimentally. However, these approaches commonly require costly equipment and experimentation. In this paper, we propose an alternative monitoring system for surface roughness based on a model-based observer considering simple relationships between tool wear, power consumption and surface roughness. The system estimates the surface roughness according to simple models and updates the estimation fusing the information from quality inspection and power consumption. This monitoring strategy is aligned with the industry 4.0 practices and promotes the fusion of data at different shop-floor levels

Irritative and sensory disturbances in oral implantology. literature review

The aim of this study was to review irritative and sensory disturbances following placement of dental implants. A literature search was made of PubMed for articles published between 2000 and 2010. Studies that reported sensory disturbances directly caused by the placement of dental implants were included. Sensory deficits or trigeminal neuropathy are caused by damage to the third branch of the trigeminal nerve du-ring surgery. This manifests in the immediate postoperative period as a sensory deficit not usually associated with pain and generally transient. The literature reviewed reported irritative and sensory disturbances caused during surgery, after surgery, and as a result of complications. Postoperative pain appears after oral surgery as a result of inflammation associated with damage to tissue during surgery. Pain due to postoperative complications following implant placement was classified as neurogenic pain, peri-implant pain and bone pain. © Medicina Oral S. L

Satisfaction of patients fitted with implant-retained overdentures

Objective: to evaluate patient satisfaction with implant-retained overdentures, and its relationship with age, sex, period of follow-up, the rehabilitated jaw (maxilla, mandible or both), number of implants, splinting, type of attachment and the antagonist.Material and methods: the study comprised patients with overdentures fitted between January 1996 and June 2007, and with a minimum follow-up of one year. Data regarding patients and prostheses were collected. The patients indicated their overall satisfaction on a visual analogue scale (VAS) from 0 to 10, as well as satisfaction for individual items such as aesthetics, speech, mastication, prosthetic stability and selfesteem. These data were collected one month after fitting the prostheses, at 12 months and at a final examination. Statistical analyses were made using the SPSS version 15, statistical significance was considered for p<0.05.Results: the study included 95 patients, 43 men and 52 women, with a mean age of 55.9 years; 76 edentulous mandibles and 31 edentulous maxillae were rehabilitated with 107 overdentures. One hundred and thirty-seven implants were placed in the maxilla, and 224 in the mandible. The mean level of overall satisfaction was 9 at one month of fitting the prosthesis, 8.8 at 12 months and 8.7 at the final control (mean 71 months).Conclusions: the patients fitted with implant-retained overdentures expressed a high level of overall satisfaction, independently of age, sex, length of follow-up, rehabilitated jaw, number of implants per overdenture, whether splinted or non-splinted, and type of attachment. Men were more satisfied with mastication and stability

Comparative study between manual injection intraosseous anesthesia and conventional oral anesthesia

Objective: To compare intraosseous anesthesia (IA) with the conventional oral anesthesia techniques. Materials and methods: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for res-pective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Results: A total of 200 oral anesthetic procedures were carried out in 100 patients. The mean patient age was 28.6±9.92 years. Fifty-five vestibular infiltrations and 45 mandibular blocks were performed. All patients were also subjected to IA. The type of intervention (conservative or endodontic) exerted no significant influence (p=0.58 and p=0.62, respectively). The latency period was 8.52±2.44 minutes for the conventional techniques and 0.89±0.73 minutes for IA - the difference being statistically significant (p<0.05). Regarding patient anesthesia sensation, the infiltrative techniques lasted a maximum of one hour, the inferior alveolar nerve blocks lasted between 1-3 hours, and IA lasted only 2.5 minutes - the differences being statistically significant (p?0.0000, ?=0.29). Anesthetic success was recorded in 89% of the conventional procedures and in 78% of the IA. Most patients preferred IA (61%) (p=0.0032). Conclusions: The two anesthetic procedures have been compared for latency, duration of anesthetic effect, anesthetic success rate and patient preference. Intraosseous anesthesia has been shown to be a technique to be taken into account when planning conservative and endodontic treatments. © Medicina Oral S. L

QCD duality and the mass of the Charm Quark

The mass of the charm quark is analyzed in the context of QCD finite energy sum rules using recent BESII e+e- annihilation data and a large momentum expansion of the QCD correlator which incorporates terms to order (alpha_s)^2 (m_c^2/q^2)^6. Using various versions of duality, we obtain the consistent result m_c(m_c)=(1.37 +- 0.09)GeV. Our result is quite independent of the ones based on the inverse moment analysis

Radiological implications of crestal and subcrestal implant placement in posterior areas. A cone-beam computed tomography study

Subcrestal implant placement has been suggested as a method that could contribute to maintain the periimplant soft and hard tissues in comparison with crestal placement. The objective of this study was to investigate the relationship between implant placement at different depths in the alveolar bone and (a) the thickness of the buccal bone plate (BBP); and (b) crestal cortical bone thickness, based on the use of cone-beam computed tomography (CBCT). A cross-sectional study was performed, analyzing CBCT scans from the database of the Oral Surgery Unit of the University of Valencia. Individuals with single missing teeth in posterior sectors were included. Two trained dentists used a software application to plan implant placement at four different depths from the bone crest (from 0-2 mm subcrestal). The thickness of the BBP was measured at each established depth, tracing a line from the implant platform to the outermost part of the facial alveolar bone, and the ratio between the implant platform and cortical bone thickness was calculated. The study sample consisted of 64 patients. In the case of implants placed in a crestal position, the distance from the platform to the BBP was 1.99±1.10 mm. This distance increased significantly (p<0.001) with the planned implant placement depth, reaching an average of 2.90±1.22 mm when placement was 2 mm subcrestal. Subcrestal implant placement at this depth implied surpassing the cortical bone in 91% of the cases. Radiological planning of implant placement in a subcrestal position results in a greater distance from the implant platform to the BBP. In general terms, planning implant placement at a depth of 2 mm subcrestal surpassed the cortical bone in 91% of the cases