Estudio comparativo de estructuras unitarias sobre implantes atornilladas en relación con el material y la técnica de confección

Objetivos: El objetivo de este trabajo es evaluar la eficacia clínica de estos injertos alogénicos en bloque. En el primer estudio nos centramos en estudiar la tasa de reabsorción comparando dos aloinjertos con diferente microarquitectura, esponjoso y córticoesponjoso, además de evaluar otros factores que podrían influir en la reabsorción del bloque. El segundo estudio clínico evalúa la influencia de la decorticación del área receptora en la regeneración con bloques alogénicos esponjosos en maxilar. El último estudio se trata de un artículo de revisión que se centra en evaluar el papel de los osteocitos en la reabsorción y remodelado de los injertos

Estudio preliminar sobre la colonización microbiológica de elementos de retención en sobredentaduras sobre implantes

Objetivo Principal: Determinar si existe colonización microbiológica en la superficie de los elementos de retención de las sobredentaduras sobre implantes. Objetivos Secundarios: Estudiar qué especies microbiológicas colonizan con mayor frecuencia la superficie de los elementos de retención de las sobredentaduras sobre implantes. Comparar las especies microbiológicas que colonizan los elementos de retención con las del surco periimplantario

Influence of 2% Chlorhexidine on the Bond Strength of Three Adhesive Systems on Primary Molars: An In Vitro Study

The hydrolysis of the collagen matrix by metalloproteinases (MMPs) is one of the paradigms that currently arouses most interest due to its close relationship with a decrease in bond strength (BS) and consequent restoration failure. Chlorhexidine 2% has demonstrated its ability to inhibit MMPs’ activity in the permanent dentition, improving the duration of resin–dentine, but there are few studies on deciduous dentition and its possible repercussions. Aim: To determine the influence of 2% chlorhexidine digluconate (CHX) as a dentine pretreatment on the BS of three adhesive systems on primary molars. Methods: 128 primary extracted molars were assigned to eight groups at random. BS in vitro was recorded by micropush-out test, and analyzed by two-way ANOVA. Results: BS values oscillated from 15.01 MPa to 20.41 MPa. There was no statistically relevant variation between the BS total mean of those adhesive groups that had received CHX pretreatment versus those that did not. Adper Prompt L-Pop was the self-etching adhesive with the best BS. Adper Scotchbond 1XT was the total-etch adhesive with the best BS values. Conclusions: Application of 2% chlorhexidine for 60 s as dentine pretreatment did not affect the immediate BS of several adhesive systems used in primary dentition

Accuracy of Intraoral Scanner for Recording Completely Edentulous Arches-A Systematic Review.

Scanning edentulous arches during complete denture fabrication is a crucial step; however, the quality of the resulting digital scan is still questionable. The purpose of this study is to systematically review studies (both clinical and in vitro) and determine whether intraoral scanners have clinically acceptable accuracy when recording completely edentulous arches for the fabrication of removable complete dentures. An electronic search in medical databases like PubMed, Scopus, and Web of Science (WOS), using a combination of relevant keywords, retrieved 334 articles. After full-text evaluation, twelve articles fulfilled the inclusion criteria for this review (eight clinical studies and four in vitro studies). A quality analysis of the included studies was carried out using the QUADAS-2 tool. The accuracy values varied between different intraoral scanners. Different regions of the edentulous arches showed differences in trueness and precision values in both in vitro and clinical studies. Peripheral borders, the inner seal, and poorly traceable structures like the soft palate showed maximum discrepancies. The accuracy of intraoral scanners in recording clear anatomic landmarks like hard tissues with attached mucosa was comparable to conventional edentulous arch impressions. However, higher discrepancies were recorded when digitizing mobile and poorly traceable structures. Intraoral scanners can be used to digitize denture-bearing areas, but the interpretation of the peripheral border and the soft palate should be carefully carried out

Clinical performance of tooth implant-supported removable partial dentures: a systematic review and meta-analysis.

OBJECTIVE To assess the clinical performance of tooth implant-supported removable partial dentures in terms of abutment survival in relation to the attachment system used. METHODS An electronic search in MEDLINE/PubMed Web of Science and Cochrane Central Register of Controlled Trials databases was performed. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Survival rates after 3 years and 5 years, loss, and complication rates per 100 years were estimated by Poisson regression. RESULTS A total of twelve studies were included; eleven studies were used for the meta-analysis. Survival analysis for mixed attachments showed an estimated survival rate of 100% after 3 years and 5 years. For uniform attachments, the estimated survival rate was 99.3% after 3 years and 98.8% after 5 years. Tooth abutment survival analysis for mixed attachments estimated a survival rate of 95% after 3 years and 91.7% after 5 years: Uniform attachments reached a survival rate of 97.2% after 3 years and 95.4% after 5 years. The prosthetic survival rate was 100% for mixed and uniform abutments after 3 years and 5 years of function. CONCLUSIONS Tooth implant-supported removable partial dentures can be considered as a reliable option with excellent prosthetic and implant survival rates and favorable rates for the abutments after 3-year and 5-year follow-ups. Complications may be reduced when 5 or more abutments are used. CLINICAL RELEVANCE Tooth implant-supported removable partial dentures are a favorable and potential alternative to restore a partially edentulous arch by optimizing the number and distribution of abutments

Improving PMMA resin using graphene oxide for a definitive prosthodontic rehabilitation - A clinical report

The use of acrylic resins as a definitive material has shown some advantages comparing to other definitive materials. However, their poor mechanical properties remain a major drawback. In this case report, graphene oxide (GO) was incorporated into polymethyl methacrylate (PMMA) resin for a definitive maxillary rehabilitation, combined with an intraoral digital impression and a three-dimensional facial scan. After 8 months of the placement of the definitive prosthesis, no mechanical, aesthetic, or biologic complications were reported, and the soft tissues showed excellent health and stability. The incorporation of GO in PMMA resins seems to be a suitable option for prosthetic rehabilitation. However, further studies are needed to ensure rigorous scientific support of these techniques and materials

The influence of age and gender on perception of orofacial esthetics among laypersons in Switzerland.

OBJECTIVE The purpose of this study was to evaluate the perception and role of orofacial esthetics by laypersons, and how attitudes may be correlated with age and gender in Switzerland. MATERIAL AND METHODS Self-administrated questionnaires (SAQ) were distributed both conventionally and digitally to Swiss residents over 16 years of age (range 16-99 years). The participants were identified in the medical practice, at an open house of the ZMK Bern, in elderly care centers, and via the internet (Facebook and Instagram). To verify that the participants were Swiss residents and laypersons, they were checked by an operator (conventional) or were provided an exact description of eligible participants at the beginning of the SAQ (digital). The SAQ included 30 questions with multiple-choice responses and visual analogue scales (0-100) divided into four sections regarding dental appearance with respect to body esthetics, partner selection, employment and career opportunities, and overall health/quality-of-life. For statistical analysis, respondents were segregated into two age groups (<25 years and ≥25 years) and into two gender groups (male and female). Descriptive analyses, the Fisher exact test, and Welch's t-test were applied (α = 0.05). RESULTS Five hundred and two laypersons completed the SAQ. The study's hypothesis-that various age groups and genders have different perceptions of dental esthetics-was supported. The willingness to correct one's own dentition was lower among older participants (OR: 0.54; p = 0.001); charisma and dental esthetics were considered equally important with a trend toward charisma in both age groups (p = 0.003). The belief that excellent dentition improves employment chances at a job interview (OR: 0.47; p = 0.0003) was significantly lower among older participants, and the belief that dental correction would improve quality-of-life was significantly higher among older participants (OR: 1.81; p = 0.001). The assumption that individuals with attractive teeth appear happier was significantly lower among older respondents (OR: 0.67; p = 0.03). Women were less satisfied with their dental appearance and, proportionally, their willingness to receive correction was significantly higher (OR: 1.79; p = 0.01 and OR: 1.77; p = 0.002 relative to men, respectively). Moreover, male participants had a lower desire to have brighter teeth and undergo bleaching treatments (OR: 0.54; p = 0.002; OR: 0.53; p = 0.002). The proportion of men believing that having beautiful teeth improves attractiveness and employment chances was significantly lower (OR: 0.33; p = 0.02 and OR: 0.66; p = 0.04; respectively). CONCLUSIONS Within the limitations of this observational study, it was concluded that age and gender of laypersons in Switzerland have a significant impact on the perception of dental esthetics. CLINICAL SIGNIFICANCE Evaluating and quantifying perceptions of dental esthetics for daily life across various age groups and genders can improve clinicians' understanding of individual needs in order to offer patient-oriented dental care

Single-visit chairside adjustment of a metal-acrylic resin implant-supported fixed complete dental prosthesis on an unloaded implant using a novel fixed attachment system: a case report

Background: Implant-supported prosthetic treatment options are reliable for elderly edentulous patients with systemic health problems. These patients often need cost- and time-efficient solutions to avoid complications. However, it is a challenge for clinicians to treat these patients without surgical interventions, placement of additional implants, or the need to renew existing prostheses. Case presentation: A 75-year-old medically compromised caucasian male patient using multiple medications was referred for prosthetic rehabilitation of his edentulous maxilla after several implant failures. Because the patient's health was compromised, further surgical interventions were ruled out and the treatment was centered on the use of the remaining implants by placing a fixed attachment system and altering the existing prosthesis. The stepwise management of the patient's situation through the use of a new attachment system and adjustment of existing prosthesis is described in the present case report. Conclusions: Although implant therapy is not always contraindicated for medically compromised patients, it is preferable not to perform extensive surgeries to avoid complications. This clinical report describes an alternative, safe option based on a novel fixed attachment system to salvage an existing maxillary implant-supported fixed complete dental prosthesis of a patient with systemic health problems

Which clinical and laboratory procedures should be used to fabricate digital complete dentures? A systematic review.

STATEMENT OF PROBLEM Digital workflows for digital complete denture fabrication have a variety of clinical and laboratory procedures, but their outcomes and associated complications are currently unknown. PURPOSE The purpose of this systematic review was to evaluate the clinical and laboratory procedures for digital complete dentures, their outcomes, and associated complications. MATERIAL AND METHODS Electronic literature searches were conducted on PubMed/Medline, Embase, and Web of Science for studies published from January 2000 to September 2022 and screened by 2 independent reviewers. Information on digital complete denture procedures, materials, their outcomes, and associated complications was extracted. RESULTS Of 266 screened studies, 39 studies were included. While 26 assessed definitive complete dentures, 7 studies assessed denture bases, 2 assessed trial dentures, and 4 assessed the digital images only. Twenty-four studies used border molded impression technique, 3 studies used a facebow record, and 7 studies used gothic arch tracing. Only 13 studies performed trial denture placement. Twenty-one studies used milling, and 17 studies used 3D printing for denture fabrication. One study reported that the retention of maxillary denture bases fabricated from a border-molded impression (14.5 to 16.1 N) was statistically higher than the retention of those fabricated from intraoral scanning (6.2 to 6.6 N). The maximum occlusal force of digital complete denture wearers was similar across different fabrication procedures. When compared with the conventional workflow, digital complete dentures required statistically shorter clinical time with 205 to 233 minutes saved. Up to 37.5% of participants reported loss of retention and up to 31.3% required a denture remake. In general, ≥1 extra visit and 1 to 4 unscheduled follow-up visits were needed. The outcomes for patient satisfaction and oral health-related quality of life were similar between conventional, milled, and 3D-printed complete dentures. CONCLUSIONS Making a border-molded impression is still preferred for better retention, and trial denture placement is still recommended to optimize the fabrication of definitive digital complete dentures

Effect of the lack of primary stability in the survival of dental implants

The survival of dental implants has been linked to primary stability. The aim of this study is to analyse the factors that influence the survival of dental implants placed without primary stability. A cohort study of implants placed without primary stability was carried out between September 2011 and July 2016. All cases with registered information on the patient and surgical intervention were used. Cases that did not have a 12-month follow-up after implant placement were excluded. Out of 2,400 analysed implants, 92 were placed without primary stability. The absence of primary stability was classified as B in 49 cases, C in 38 cases and D in 5 cases. No statistically significant influence of the patient?s age, primary stability, brand, or implant size in terms of implant survival was established. A tendency towards greater early implant loss was observed in implants whose absence of primary stability was classified as C. Poor primary stability is not statistically significant in the loss of dental implants of the characteristics studied. Any of the factors studied are related with early implant loss as a main factor