In vitro comparison of primary stability of two implant designs in D3 bone

Primary stability (PS) is a key factor for implant survival rate and depends on implant design or bone quality. The aim of this study was to compare different thread designs implants, evaluating PS with periotest values (PV) and implant stability quotient (ISQ) values through resonance frequency analysis (RFA). A total of 60 implants (Radhex®, Inmet-Garnick S.A., Guadalajara, Spain) were placed in freshly bovine ribs in vitro. Two designs were used: 30 tapered body with single thread design (PHI) and 30 tapered body with double thread design implants (PHIA). Both designs were 4mm wide and 12mm long. Implants were placed according to manufacturer?s guidelines. Osstell? and Periotest® devices were used to evaluate PS by a blinded independent observer. Computed tomographies (CTs) of the ribs were made (BrightSpeed Series CT systems, GE Healthcare, Milwaukee, WI, USA) and bone quality surrounding each implant was evaluated in Hounsfield Units (HU) using Ez3D Plus software (Vatech Co., Korea). Bone quality was classified according to Misch and Kircos in D1, D2, D3 or D4. All implants were mechanically stable. Only implants placed in D3 bone (350-850 HU) were selected for the study: 28 PHI and 26 PHIA. The one way ANOVA showed significant difference (p<0.005) among two implants designs in ISQ values (61,55 ± 6,67 in PHI and 68,94 ± 5,82 in PHIA). No significant difference (p = 0,171) was shown in PV between two designs (-4,47 ± 1,39 in PHI and -4,77 ± 0,87 in PHIA). Higher PS was found using Osstell? device in implants with double thread design (PHIA) in comparison to implants with single thread design (PHI) in D3 bone

Study of available bone for interforaminal implant treatment using cone-beam computed tomography

Objectives: To analyze the availability of bone in the interforaminal region and to demonstrate the variation in diagnosis between panoramic x-ray and cone-beam computed tomography (CBCT). Material and methods: In 50 patients and in 5 areas of each, a series of parameters concerning available bone were measured on both the panoramic and the CT images. Results: Panoramic images underestimate the vertical and horizontal measurements when compared with CBCT. Regarding implant treatment, the interforaminal region presents the same remaining bone height throughout its full extent, the correlation between one side of the midline and the other was highly significant for all the parameters studied, and 20% of the sample showed some buccal and/or lingual concavity. Conclusion: Cone-beam CT is an advantageous system for interforaminal implant treatment planning, especially since the reported radiation dose is minimal and geometric accuracy is very high

Effects of localmelatonin application on post-extraction sockets after third molar surgery: a pilot study

Objectives: The purpose of this study was to assess the anti-inflammatory, analgesic and osteogenic early effects of melatonin on post-extraction sockets ofpatients requiring third molars extraction. Study Design: A randomized, triple-blind clinical trial was made using a split-mouth design. Both lower third molars of 10 patients were extracted and 3 mg of local melatonin or placebo were applied. Concentrations of interleukin-6 and nitrotyrosine were determined on samples of the clot from the socket by independent ELISA tests. Radiographic bone density was evaluated by measuring Hounsfield Units in panoramic and cross sections obtained by digital scanner. Statistycal analysis by Kolmogorov-Smirnov test was performed for ELISA data. Bone density was analyzed by Shapiro-Wilk test. Subsequently t test was applied. P <0.05 was considered to be significant. Results: The concentration of interleukin-6 increased with the application of melatonin without statistically significance (361.32 ± 235.22 pg/ml vs 262.58 ± 233.92 pg/ml). Nitrotyrosine concentrations showed values below to the detectability pattern (<0.001 nM) in Optic Density curve. Bone density in panoramic sections at socket after melatonin application showed no significant difference (561.98 ± 105.92 HU vs 598.82 ± 209.03 HU). In cross sections, bone density in the alveolar region showed no significant difference(377.42 ± 125.67 HU vs 347.56 ± 97.02 HU). Conclusions: Within the limitations of this pilot study, no differences with the application of melatonin were found in terms of the concentration of interleukin-6 and bone density in post-extraction socket of retained mandibular third molars

Pre-operative evaluation of the volume of bone graft in sinus lifts by means of CompuDent

Objective: This study aims to evaluate the usefulness of the CompuDent program in determining the pre-operative volume of bone graft in maxillary sinus floor lifts, and to calculate the volume of graft necessary for rehabilitation using varying lengths of implants. Study design: Based on the CompuDent program, we calculated the volume of graft necessary for 47 sinus lifts. This volume was measured in order to raise the floor of each sinus to 13.4 and 15 mm in height. Results: The average volume of graft in order to achieve a lift of 13?4 mm was 2.42 cm³ for the right maxillary sinus, with a range from 1.4 cm³ to 4.1 cm³, and 2.50 cm³ for the left maxillary sinus, with a range from 1.04 cm³ to 3.79 cm³. The average volume of graft in order to achieve a lift of 15 mm was 3.01 cm³ for the right maxillary sinus, with a range from 1.78 cm³ to 4.59 cm³, and 3.09 cm³ for the left maxillary sinus, with a range from 1.42 cm³ to 4.49 cm³. The statistical results provided by the Pearson Correlation show a significant inversely proportional correlation between the average of the heights and the volume of graft in the sinus. In addition, there is a clear correlation between the average volumes to be grafted for the respective heights 13.4 mm and 15 mm. Conclusions: The CompuDent program is an effective tool in determining the volume of bone graft given its simplicity, rapidness and possibility of standardization in all pre-surgical procedures

Quantification of growth factors by using a new system for obtaining platelet-rich plasma

Objective: To verify the performance of a new method for obtaining platelet-rich plasma, while avoiding contamination of the sample during its processing. Study Design: Twenty healthy patients were selected, from whom 21 ml of blood was extracted. We then pro-Design: extracted. We proceeded to study the platelets and growth factors in basal blood after centrifuging the sample by using a new closed system for obtaining platelet-rich plasma (PRP). Results: After centrifuging the blood sample, double the amount of platelets as that found in basal blood was obtained. Of the four growth factors analyzed, only the factor similar to insulin (IGF) contained the same concentration after the centrifuge process. The platelet-derived growth factor (PDGF) and the vascular growth factor (VGF) were multiplied by six with respect to the basal values and disproportionately increased the levels of the transforming growth factor ? (TGF-?). Conclusions: The new closed method for obtaining PRP, after avoiding contamination of the sample following its use, offers levels of platelet concentrate and growth factors necessary for regeneration. © Medicina Oral S. L

Influence of short implants geometry on primary stability

A correct design is needed in short implants to improve primary stability (PS) in low quality bone. This study aimed to compare PS of double thread and single thread short implants. Thirty implants with single thread design (PHI/SHORT-I) and 30 implants with double thread design (PHIA/SHORT-I) (Radhex®, Inmet-Garnick S.A., Guadalajara, Spain) were placed in 30 randomly selected bovine ribs. PS was assessed in implant stability quotients (ISQ) and periotest values (PV) with Osstell? and Periotest® devices, respectively. Computed tomographies of the ribs were taken and bone quality was evaluated in Hounsfield Units (HU) using Ez3D Plus software (Vatech Co., Korea). Only implants placed in low quality bone according to Misch and Kircos classification were selected (D3 bone: 350-850 HU; and D4 bone: 150-350 HU). Ten implants were not included in the study for being placed in D1 and D2 bone. Finally, 50 implants were selected: 17 and 9 PHI/SHORT-I in D3 and D4 bone respectively, and 15 and 9 PHIA/SHORT-I in D3 and D4 bone respectively. The one-way ANOVA showed statistically significant differences in ISQ (61.35 ± 4.77 in PHI/SHORT-I and 66.43 ± 4.49 in PHIA/SHORT-I, P<0.005) and PV (-2.76 ± 0.8 and -4.11 ± 1.24 respectively, P<0.005) between two implant designs in D3 bone, and statistically significant differences in ISQ (53.44 ± 3.34 in PHI/SHORT-I and 60.56 ± 1.53 in PHIA/SHORT-I, P<0.0001) and PV (1.13 ± 0.95 and -2.5 ± 0.61 respectively, P<0.0001) between two groups in D4 bone. Double thread design short implants resulted to have higher PS in comparison with single thread design short implants in D3 and D4 bone

A cephalometric method to diagnosis the craniovertebral junction abnormalities in osteogenesis imperfecta patients

Osteogenesis imperfecta (OI) is a hereditary bone fragility disorder that in most patients is caused by mutations affecting collagen type I. Their typical oral and craneofacial characteristics (Dentinogenesis imperfecta type I and class III malocclusion), involve the dentist in the multidisciplinary team that treat these patients. It is usual to perform lateral skull radiographs for the orthodontic diagnosis. In addition, this radiograph is useful to analyse the junctional area between skull base and spine, that could be damaged in OI. Pathology in the craneovertebral junction (CVJ) is a serious complication of OI with a prevalence ranging from rare to 37%. To diagnosis early skull base anomalies in these patients, previously the neurological symptoms have been appear, we make a simple cephalometric analysis of the CVJ. This method has four measurements and one angle. Once we calculate the values of the OI patient, we compare the result with the mean and the standard deviations of an age-appropriate average in healthy controls. If the patient has a result more than 2,5 SDs above the age- appropriate average in healthy controls, we should to refer the patient to his/her pediatrician or neurologist. These doctors have to consider acquiring another diagnostic images to be used to determine cranial base measurements with more reliability. Thereby, dentists who treat these patients, must be aware of the normal radiological anatomy of the cervical spine on the lateral cephalogram

Development of a program of mixed radiolucent-radiopaque lesions imaging via radiographic cases for active learning in oral medicine

A través del presente proyecto se ha creado un fichero de imágenes radiográficas mixtas (radiopacas-radiolucidas) que serán utilizadas por los alumnos del tercer curso de Grado de la asignatura Medicina Bucal a fin de mejorar la enseñanza práctica del apartado lesiones radiográficas de los maxilares. Dichos ficheros se incorporarán al Campus Virtual para que el alumno pueda hacer uso de ellos. La elaboración de un fichero de estas características ha exigido en primer lugar la selección de las imágenes radiográficas mixtas de los maxilares más representativas. Se han seleccionado 43 imágenes radiográficas mixtas que se han clasificado en “Mixed Radiolucent-Radiopaque periapical lesions” (15 imágenes), “Mixed Radiolucent-Radiopaque pericoronal lesions” (8 imágenes) y “Mixed Radiolucent-Radiopaque lesions not necessarily contacting teeth“ ( 20 imágenes). Se han realizado 4 flowchart (el tercer grupo se subdividió en dos) para esquematizar las lesiones mixtas más frecuentes con sus características clínicas y radiográficas más habituales. Dichos flowchart ayudarán al alumno a poder llegar al diagnóstico de las lesiones de los casos clínicos seleccionados, cuya historia clínica también se ha reflejado. Todo el trabajo se ha realizado en dos idiomas inglés y español, que ayudará a los alumnos a aprender el vocabulario en inglés relacionado con el tema. Además, facilitará la comprensión de los alumnos de otras nacionalidades que pueden acudir a nuestra facultad y ayudará a los alumnos de la UCM que acuden a otras universidades Europeas o Americanas

In vitro comparison of primary stability of two implant designs in D3 bone

Background: Primary stability (PS) is a key factor for implant survival rate and depends on implant design or bone quality. The aim of this study was to compare different thread designs implants, evaluating PS with periotest values (PV) and implant stability quotient (ISQ) values through resonance frequency analysis (RFA). Material and methods: A total of 60 implants (Radhex®, Inmet-Garnick S.A., Guadalajara, Spain) were placed in freshly bovine ribs in vitro. Two designs were used: 30 tapered body with single thread design (PHI) and 30 tapered body with double thread design implants (PHIA). Both designs were 4mm wide and 12mm long. Implants were placed according to manufacturer's guidelines. Osstell™ and Periotest® devices were used to evaluate PS by a blinded independent observer. Computed tomographies (CTs) of the ribs were made (BrightSpeed Series CT systems, GE Healthcare, Milwaukee, WI, USA) and bone quality surrounding each implant was evaluated in Hounsfield Units (HU) using Ez3D Plus software (Vatech Co., Korea). Bone quality was classified according to Misch and Kircos in D1, D2, D3 or D4. Results: All implants were mechanically stable. Only implants placed in D3 bone (350-850 HU) were selected for the study: 28 PHI and 26 PHIA. The one way ANOVA showed significant difference (p < 0.005) among two implants designs in ISQ values (61,55 ± 6,67 in PHI and 68,94 ± 5,82 in PHIA). No significant difference (p = 0,171) was shown in PV between two designs (-4,47 ± 1,39 in PHI and -4,77 ± 0,87 in PHIA). Conclusions: Higher PS was found using Osstell™ device in implants with double thread design (PHIA) in comparison to implants with single thread design (PHI) in D3 bone.Depto. de Especialidades Clínicas OdontológicasFac. de OdontologíaTRUEpu