Cicatrización de implantes inmediatos con carga inmediata y sin carga. Estudio experimental en perro Beagle

Los implantes inmediatos muestran una alta tasa de éxito en numerosos estudios (Chen y cols. 2004). Así mismo, la carga inmediata de implantes oseointegrados muestra tasas de éxito parecidas a los implantes cargados de forma diferida, siempre y cuando se cumplant una serie de requisitos (Del Fabbro y col. 2006). Existen estudios clínicos que han evaluado la supervivencia y el éxito del uso combinado de ambas técnicas de forma simultánea (Crespi y cols. 2010). Sin embargo, existen pocos estudios histológicos que muestren la cicatrización de los implantes colocados en alveolos post-extracción cargados de forma inmediata (Mangano y cols. 2009, Blanco y cols. 2010). Objetivo El objetivo de este estudio es, por tanto, evaluar la cicatrización de implantes con cambio de plataforma, colocados de forma inmediata, con y sin carga inmediata. Material y métodos Se emplearon 12 perros Beagle, donde se colocaron implantes inmediatos en los alveolos correspondientes a las raíces distales de los premolares 3 y 4 mandibulares, de forma bilateral. En un lado (grupo test), los implantes fueron cargados de forma inmediata, mientras que en el lado contralateral (grupo control), se colocaron tapas de cicatrización, de forma que los implantes cicatrizaron de forma no sumergida y sin carga oclusal. Los animales fueron sacrificados tras 2,4 y 8 semanas, y se procedió a realizar un análisis histológico de las muestras

Mandibular ameloblastoma : reconstruction with iliac crest graft and implants

The ameloblastoma is a bening odontogenic tumor. The treatment planning in young persons is still not clear. We describe a case report of a young boy who was treated in our unit and we review the different aproaches for this type of lesions, which nowadays still not clear in this patients

Immediate implants following tooth extraction. A systematic review

Objectives: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications. Material and Methods: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data. Results: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes. Discussion: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present. Conclusions: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement. © Medicina Oral S. L

Papilla and pontic area regeneration in patient with gingival smile : a clinical case

Connective tissue grafts are widely documented as a predictable technique for treating Miller Class I and II recessions, as well as procedures in which soft tissue augmentation is required for aesthetic reasons. This article aims to explore the resolution of a clinical case with this type of problema. This case describes a technique for reconstructing a pontic area and adjacent papilla by means of two consecutive connective tissue grafts. The first graft served to increase the amount of tissue in the horizontal direction, and the second promoted vertical reconstruction of the defect. In cases with aesthetic requirements, restorative intervention may be able to mask tissue loss, but it can hardly achieve optimal aesthetic results. Periodontal plastic surgery techniques can be used to achieve that ideal result. The clinician must diagnose conditions in order to select correct treatment regimen for each individual case

Volumetric changes in alveolar ridge preservation with a compromised buccal wall : a systematic review and meta-analysis

Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian?s Classification, in socket grafting materials upon volumetric changes in width and height. An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect

Marginal changes at bone-level implants supporting fixed screw-retained partial implant prostheses with or without intermediate standardised abutments: 1-year results of a randomised controlled clinical trial

Objective: To compare marginal changes at bone- level implants restored with screw- retained implant prosthesis with or without intermediate standardised abutments, after 1 year of follow-up.Materials and Methods: Thirty- six partially edentulous patients received 72 implants. Each patient received 2 implants and a 2- to 4- unit screw- retained implant- prosthesis. The test group received implants consisting of a screw- retained prosthesis connected directly to the implant shoulder, while the prostheses in the control group were con-nected through a 3- mm standardised intermediate abutment. Clinical and radiological data were recorded at baseline and at 3, 6 and 12 months in follow-up visits.Results: At 12 months, the marginal bone loss was 0.17 ± 0.24 mm for the test group (19 patients) and 0.09 ± 0.15 mm for the control group (17 patients), with no statistically significant differences (p> .05). The mean probing pocket depth was 2.96 mm ± 0.46 for the test group and 2.86 ± 0.62 mm for the control group. The test and control groups showed bleeding on probing levels of 18.86 ± 14.12% and 13.73 ± 17.66%, re-spectively. All patients scored below 25% on the plaque index levels.Conclusions: Restoration of bone- level implants with fixed screw- retained partial prostheses with or without intermediate abutments presented similar radiographic and clinical outcomes after 1 yearS