Clinical findings and main considerations of the use of bisphosphonate in dental implants: a concise systematic review

Introduction: In the scenario of dental implant and osseointegration, it is highlighted that the scope of modern dentistry is to restore the patient's normal comfort, function, esthetics, speech, and health. More than one million dental implants are performed each year in the USA. Bisphosphonates (BP) have been the best drug associated with a significant improvement in the quality of life of patients with bone diseases such as Paget's disease, bone metastases, osteogenesis imperfecta, hypercalcemia, and even severe osteoporosis. Objective: Aimed to carry out a concise systematic review of the main considerations regarding the use of bisphosphonate in osseointegration for dental implants. Methods: The present study followed by a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias of the included studies. Results: Bisphosphonate coating of dental implants is a promising tool for surface modification, aiming to improve the osseointegration process and clinical outcome. The biological effects of bisphosphonates are thought to be primarily associated with inhibition of osteoclasts, whereas their effects on osteoblast function are unclear. Thus, surfaces coated with bisphosphonates to stimulate osteoblast differentiation have been investigated by several in vitro studies with contradictory results. Conclusion: Based on results, osteoporosis is a metabolic condition that affects alveolar bone density, but it does not present problems for the installation of osseointegrated implants, as long as there is sufficient bone mass in the region where the tooth will be implanted. Locally administered bisphosphonates induce bone regeneration in periodontal defects and decrease the rate of marginal bone loss after dental implant therapy

Major clinical results of mentoplasty: a systematic review

Introduction: In the context of oral and maxillofacial surgery, orthognathic surgery (OS) is used to improve the patient's facial appearance and to correct maxillary and mandibular deformities resulting from malocclusions, disease, or trauma. Objective: It was carried out a concise systematic review of the main clinical approaches to genioplasty (genioplasty), as well as the results of more current clinical studies, to show the state of the art of this surgery. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from February 2022 to May 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 108 articles were found. In total, 68 articles were fully evaluated and 23 were included and evaluated in this study. And of the total of 23 articles, only 09 articles were developed as the main clinical results. A total of 16 articles were excluded because they did not meet the GRADE classification, and 45 were excluded because they were at risk of bias. Mentoplasty represents one of the most common auxiliary procedures and may be associated with corrective surgery for dentofacial dysmorphisms. However, care must be taken with mental nerve injuries, asymmetries, and intraoperative bleeding are the main immediate complications of mentoplasty, and to minimize these risks, the ultrasonic piezoelectric osteotomy with the selective cutting of the mineralized structure stands out. Furthermore, one-piece mentoplasty based on a three-dimensional impression model proved to be very successful for the natural modeling of the mandible. Also, it has been shown that the use of piezotomes is advantageous in mentoplasty surgery compared to traditional surgical instruments. In the context of hylotherapy, the results of the study indicate slightly less residual edema at 18°C temperature on the 30th postoperative day. Finally, in orthognathic surgery, a fibrinolytic shutdown is significantly amplified by tranexamic acid

Major clinical results of virtual zygomatic implant and assessment of the risk of bias: a systematic review

Introduction: In the context of implantology and severe resorption, zygomatic implants (ZI) are indicated and the procedures can be completed with the placement of a custom-made provisional prosthesis, reducing surgical time and optimizing results. Digital (virtual) optimizations for the ZI were developed in computerized radiology machines that allowed improvements in diagnostic and therapeutic tools. Objective: It was carried out a systematic review of the main considerations and clinical outcomes of using digital tools for the optimization of the virtual zygomatic implant. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from January 2022 to April 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 94 articles were found. In total, 62 articles were fully evaluated and 41 were included and evaluated in this study, and of the total of 41 articles, only 14 articles were developed as the main clinical results of the virtual zygomatic implant. Reducing errors and complications is essential if zygomatic implants are to remain a viable treatment alternative, and further research on a guided approach to their placement is encouraged. The surgical guide system showed accuracy for all variables studied and allowed acceptable and accurate implant placement, regardless of the complexity of the case. Thus, the surgical and prosthetic plan, the position, the emergence, the shape of the implants, the position of the provisional prosthesis, the inter-arch relationships, and the surgical templates were designed in a virtual environment and previously performed by the surgeon in stereolithographic models, allowing the surgical procedure was significantly simplified

Oral cancer and bucco-maxillo-facial surgery: a systematic review of clinical findings

Introduction: In the context of oral cancer management, it is a multidisciplinary effort, as each patient presents physicians with a unique set of challenges whose management impacts both survival and quality of life. Oral and maxillofacial surgery remains the mainstay of treatment. Oral cancer (OC) has a high incidence and mortality and is among the 10 (ten) most common pathologies in the world, Brazil today represents alarming public health. OC awareness is low, especially in terms of knowledge of signs and symptoms. Also, self-examination is relatively fast, inexpensive, and simple to perform. The diagnostic accuracy of the oral self-examination needs to be established first before advocating it as a potential screening tool for early detection. Objective: the present study aimed to carry out a systematic review of the main clinical findings on the surgical treatment of oral cancer by dentists. Methods: The rules of the Systematic Review-PRISMA Platform. The research was carried out in December 2021 to February 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 243 articles were found. In total, 104 articles were fully evaluated and 25 were included and evaluated in this study. there was a positive impact of CAD/CAM mandibular reconstruction on mastication and swallowing function after surgery for locally advanced oral cancer for the first time. Therefore, neoadjuvant chemotherapy plays a potential role in mandibular preservation in oral cancers with acceptable toxicities and without compromise in survival. The low prevalence of oral self-examination was more common among the elderly, being more common to oral cancer. Thus, educational actions can influence people's self-perception of their oral condition. In this way, the studies showed that to achieve the success of the surgical treatment of oral cancer, it is necessary for the individuals themselves to expand the self-examination care, linked to the evaluation and early diagnosis of dental surgeons. Conclusion: The studies showed that to achieve the success of the surgical treatment of oral cancer, it is necessary that self-perception of oral health, one of the components of quality of life, refers to a subjective experience of the individual about their functional, social and psychological well-being

Platelet-rich plasma and bone morphogenetic protein: bucomaxillofacial and bone regeneration

Introduction: Science has evolved at an accelerated pace in the last decades, due to the need to know more and more the human being and the environment that surrounds them. In the search for this knowledge, aiming to improve the quality of life and the treatment of diseases previously considered incurable, research, especially in the field of biotechnology, has transformed the day-to-day health professionals. The application of this biotechnology related to growth factors can be exemplified in the use of platelet-rich plasma (PRP), gel capable of modulating and accelerating some repair processes. Objective: The objective of this work was to review the concepts related to growth factors, as well as in relation to platelet-rich plasma as an adjuvant in bone regeneration therapies. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. This study focuses on the treatment of bone regeneration through platelet-rich plasma and morphogenetic protein (BMP). To this end, a survey was conducted in scientific articles in the databases PubMed, Medline, Scielo, Lilacs, and e-books. The Cochrane Instrument was used to assess the risk of bias of the included studies, and GRADE was used to classify the quality of articles to the type of study and scientific evidence. Results and Conclusion: Therefore, the use of PRP, which would accelerate the rate of bone formation, with bone morphogenetic proteins (BMPs), recombinant or autogenous, should be quite important and elucidative. The development of new research, seeking to use all known technology, will always be the best way for a short future to recognize what should be incorporated into the daily routine of medical and dental clinics, differing from what, for various reasons, whether it was just a marketing procedure or something. The greatest advantage of the use of platelet-rich plasma is its ability to accelerate the process of bone regeneration by increasing the number of growth factors present in human platelets. On the other hand, it is observed that one of its major disadvantages is the low life expectancy of these platelets in the recipient or graft bed. However, it is also known that the PRP technique would only accelerate a process of bone regeneration that normally already occurs and this process follows its path until the formation of the mature bone

Investigation on the bisphosphonate and osseointegrated implants: a concise systematic review

The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population has this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. The aim of this study was to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decreasing its reabsorption, often acting as supporting the process of osseointegration of dental implants

Investigation of the main clinical findings of maxillary sinus surgery with platelet-rich fibrin: a systematic review

Introduction: The maxillary sinus is the largest of the paranasal sinuses and its function is to contribute to phonation resonance, conditioning the air we breathe and aiding in the production of mucus in the nasal cavity. Around 25% of all maxillary sinuses, there is an accessory bone that is located in a lower portion than the main ostium. Aiming to increase the bone formation potential of these grafts, combinations have been proposed to obtain better regenerative conditions through volume preservation and induction of cell migration differentiation. Objective: Conducted a systematic review of the main clinical findings of maxillary sinus surgery using Platelet-rich fibrin. Methods: The present study followed a systematic review model (PRISMA). Experimental and clinical studies were selected, involving retrospective, prospective and randomized studies. The online databases consulted were PubMed, Scopus, Ovid, Periodicos.com, and Google Scholar. Results and Conclusion: A total of 59 articles were found involving the surgery of the maxillary sinuses using plasma rich in fibrin. A total of 34 articles were fully evaluated and 24 were included and discussed in this study. Studies have shown that PRF has the characteristic of polymerizing. The incorporation of circulating cytokines increases in the fibrin network, implying a longer life for these cytokines, as they will be released and used only in the remodeling of the initial scar matrix, which is long-term. PRF is based on protecting growth factors from proteolysis that can maintain their activity for a longer period and stimulate bone regeneration more efficiently. Another study indicated the use of fibrin membranes obtained from PRF to seal the perforations. In the presence of perforations larger than 10.0 mm, the surgery must be aborted and re-entry performed after 60 to 90 days. Furthermore, the combination of biomaterial and PRF significantly improved bone regeneration in the peri-implant area. Therefore, although the results do not seem to confirm that PRF is better than other biomaterials, it is suggested that its use can result in a decrease in the total healing time, around 104 days, and improve the handling of the graft material

Major clinical findings of short implants and virtual surgery: a systematic review

Introduction: After the confirmation and publication of the phenomenon known as osseointegration by Brånemark, dental implants have been used to repair total and partial edentulous jaws. However, the implants were long and had to be longer than 11 mm to be considered functional. Short implants compared to long ones require less remaining bone, reducing the patient's exposure to surgeries for bone grafting, the elevation of the maxillary sinus mucosa, and repositioning of the inferior alveolar nerve. Added to this, several dental treatments have benefited from this digital advance. Objective: To review the literature on short implants installed in both dental arches, evaluating their advantages, disadvantages, indications, and contraindications in the context of virtual surgery. Methods: The present study followed a systematic review model (PRISMA). The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. Results: A total of 110 articles were found, 64 articles were evaluated and 35 were rejected for not meeting the GRADE classification, and only 29 articles were used in this study to compose the textual part. Based on these findings, it was found that in remote years, authors reported that regions with reduced bone height are favored with the use of short implants not only because of their dimensions but also because of their surface treatment, which suggests that it is an important factor for achieving 100% success rates. The advantages of short implants are related to the simplicity of the technique, installation of implants in remaining bone, avoidance of bone grafts that present questionable results in the increases in height of the posterior alveolar ridge of the mandible, reduction of treatment time, and reduction of costs for the patient. A systematic review and meta-analysis studies analyzed the accuracy of implant placement using computer-guided surgery. A randomized study compared the precision of guided planning of new computer-assisted implant placement techniques, based on models that use CAD/CAM. Conclusion: It was concluded that short implants are a reliable, safe, and practical alternative to be used in any necessary location or situation. They do not show bone loss or resorption over the years, nor are they at risk of fracture or any damage to patients. They are safe to use, as long as they have an adequate design, therefore, fundamental tools in the dental clinic

Major indications and current clinical findings of zygomatic implant: a systematic review

Introduction: The lack of bone in the alveolar crest represents a major problem in aesthetic recovery in patients who have suffered dentoalveolar trauma, traumatic extractions, congenital tooth absence pathologies involving maxilla and mandible, and the possibility of deformity. In this sense, the zygomatic implant (ZI) is an alternative when there is bone loss. Objective: It was to carry out a systematic review of the main clinical outcomes of ZI, emphasizing the main indications. Methods: The present study followed the PRISMA rules. The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases, following the rules of the word PICOS (Patient; Intervention; Control; Outcomes; Study Design). The Cochrane Instrument was used to assess the risk of bias of the included studies. Results and Conclusion: A total of 82 articles were found involving zygomatic implantation and the evolution of the technique. Initially, the duplication of articles was excluded. A total of 54 articles were fully evaluated and 33 were included in this study. Based on the clinical results of the last five years, some studies have broadened clinical understanding based on comparative studies to show the success rate of ZI. Even if more complications were reported for ZI that resolved spontaneously or could be handled, ZI proved to be a better modality of rehabilitation for severely atrophic jaws. Furthermore, zygomatic surgery proved to be a viable and safe alternative to conventional treatment modalities for oral rehabilitation of patients with ectodermal dysplasia syndrome. Also, there was greater accuracy and drastically reduced risk of perioperative/postoperative complications using the dynamic navigation system compared to the freehand placement of implants. Finally, guided surgery for the placement of ZI using specially designed metal jigs that must be supported by bone showed the placement of a made-to-measure provisional prosthesis, reducing surgery time, simplifying the procedure, and optimizing the result

Virtual and minimally traumatic surgery in bucomaxillofacial procedures: a concise systematic review

Introduction: In recent years, maxillary atrophy is an increasingly frequent clinical condition and the causes that lead to focal or generalized atrophy are multiple factors. Based on the histological concept in which living tissues are formed by cells joined by thin elastic tissue and with nerve fibrils, capillaries, lymphatic and blood vessels. The disruption of these cells by surgical trauma provides the release of enzymes that delay healing. For this reason, surgical trauma should be minimized. Objective: Aimed to perform a brief review of the main considerations of virtual and minimally traumatic surgery in the context of maxillofacial surgery. Methods: The model used for the review was PRISMA. We used databases such as Scielo, Lilacs, Google Scholar, PubMed. The Cochrane Instrument was used to assess the risk of bias of the included studies. Results and Conclusion: A total of 118 articles were found involving virtual and minimally invasive surgery in maxillofacial procedures. A total of 56 articles were fully evaluated and 28 were included in this study. the main considerations regarding minimally traumatic surgery are the attempt to minimize the professional's effort, reduce surgical time and alleviate bleeding and inflammatory processes, edema, pain, and ecchymosis that can affect patients. Thus, the maximum preservation of the integrity of the soft tissues adjacent to the prosthetic spaces and the preservation of the level of the ridge of the alveolar bone to achieve a minimization of surgical trauma must be sought