El tratamiento con implantes dentales en pacientes con diabetes. Un estudio comparativo a 7 años

La utilización de implantes dentales para la rehabilitación oral de individuos edéntulos está aumentando, ya que es una terapia predecible y con una alta tasa de éxito. Los estudios han demostrado que los implantes dentales pueden oseointegrarse y permanecer estables durante períodos prolongados en pacientes médicamente comprometidos (ej. diabetes mellitus) de manera similar a los individuos sanos sistémicamente. La rehabilitación con prótesis con implantes en los adultos mayores representa una opción de tratamiento muy favorable para conseguir un grado muy favorable de función oral y de estética que mejore la calidad de vida de los pacientes geriátricos. En este sentido, las sobredentaduras mandibulares han demostrado su eficacia clínica mediante la colocación de varios implantes en el sector anterior interforaminal con diversos protocolos de carga convencional, precoz e inmediata. Teniendo en cuenta los avances en la implantología oral y los estudios en pacientes diabéticos relacionados con el tratamiento con implantes a largo plazo, los objetivos del siguiente trabajo de investigación son la valoración de los aspectos quirúrgicos, prostodóncicos y de mantenimiento del tratamiento con implantes en pacientes edéntulos totales diabéticos comparados con pacientes no diabéticos. Pacientes y Métodos. 48 pacientes (24 diabéticos y 24 no diabéticos) con edentulismo total mandibular fueron tratados con 96 implantes Galimplant ® con superficie arenada y grabado para su rehabilitación prostodóncica mediante sobredentaduras. Se realizó un protocolo de carga funcional precoz a los 2 meses. El periodo de seguimiento clínico ha sido de 7 años después de la carga funcional. Resultados. La edad media de los 24 pacientes diabéticos tratados era de 67,5 años (rango: 60 - 82 años). Entre los 24 pacientes, 14 eran hombres (58,3%) y 10 eran mujeres (41,7%). La edad media de los 24 pacientes no daibéticos tratados era de 69,3 años (rango: 60-80 años. Entre los 24 pacientes no diabéticos, 12 eran mujeres (50%) y 12 eran hombres (50%). De los 48 pacientes tratados el 62,5% (30 pacientes) presentaban otras patologías médicas (hipertensión arterial, insuficiencia cardiaca, etc. 10 pacientes diabéticos presentaban otras patologías (41,7%), mientras que 20 pacientes no diabéticos también presentaban otras patologías (83,3%).De los 48 pacientes tratados el 45,8% (22 pacientes) eran fumadores. 10 pacientes diabéticos eran fumadores (41,7%), mientras que 12 pacientes no diabéticos eran fumadores (50%). La pérdida de hueso marginal fué de 0,70 mm con un rango de 0,3-1,4 mm. En los pacientes diabéticos, la pérdida ósea marginal fué de 0,70 mm (rango: 0,3-1,40 mm). En los pacientes no diabéticos, la pérdida ósea marginal fué de 0,70 mm (rango: 0,3-1,45 mm). Entre los 48 pacientes tratados con 96 implantes, se perdieron 4 implantes (4,2%) en 4 pacientes (8,4%), que después de 60 días se sustituyeron por otros 4 implantes. Hubo 3 casos de periimplantitis (3,1%) en 3 pacientes (6,2%). En 14 pacientes (29,2%) hubo complicaciones prostodóncicas relacionadas con los ataches que fueron sustituidos. Discusión. Los resultados globales del presente estudio demuestran que mediante un protocolo clínico integral que englobe los diversos procedimientos quirúrgicos y prostodóncicos, se puede conseguir y mantener una oseointegración favorable de los implantes a largo plazo tanto en los pacientes diabéticos como en los no diabéticos. En este sentido, el tratamiento de los pacientes geriátricos edéntulos con implantes mediante sobredentaduras mandibulares del presente estudio, constituye una técnica predecible obteniendo una supervivencia de los implantes del 95,8% en ambos grupos con y sin diabetes, durante un periodo de 7 años. Los resultados del presente estudio doctoral demuestran que la carga precoz de los implantes dentales con sobredentaduras mandibulares constituye un alternativa implantológica con éxito en la rehabilitación de los pacientes mayores edéntulos totales. En este sentido, el estudio, además de demostrar el éxito en conseguir la integración tisular de los implantes utilizados (95,8%), era valorar el protocolo de carga funcional precoz de los implantes con sus correspondientes sobredentaduras mandibulares que ha representado un éxito del 100%, ya que ninguna prótesis ha tenido que ser sustituida. Conclusiones. Este estudio doctoral indica que el tratamiento con implantes dentales mediante sobredentaduras en pacientes diabéticos y no diabéticos constituye una alternativa terapéutica implantológica similar con una tasa elevada de éxito

Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study

(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 +/- 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 +/- 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure

Immediate Loading of Implants with Fixed Rehabilitations in Geriatric Edentulous Patients; Biological Complications

Background: This study aimed to report the outcomes of the immediate loading of implants with fixed rehabilitations in edentulous geriatric patients. Methods: Edentulous geriatric patients were diagnosed with an oral examination, radiographic evaluation, and intermaxillary relations and treated with fixed rehabilitation over several implants. After immediate surgery, the implants were immediately loaded with a fully fixed prosthesis. Results: Twenty-four patients (20 females and 4 males) were treated using a total 210 implants. All patients (100%) had a previous history of periodontitis. Eleven patients (45.8%) were smokers. Eleven patients (45.8%) suffered from chronic medical diseases (i.e., diabetes, cardiovascular diseases). The study's clinical follow-up period extended for three years, during which thirty-three fixed prostheses were installed over the implants in 24 patients. The average marginal bone loss measured was 1.33 +/- 0.17 mm. The success rate of the implants and prosthodontics being placed in this study yielded 98.5% and 97%, respectively. One patient (4.2%) showed some kind of technical complications. Eleven patients (45.8%) showed mucositis, and 25 implants (11.9%) in 10 patients (41.7%) were associated with peri-implantitis. Conclusions: This study shows that the treatment of edentulous geriatric patients by immediate loading of implants with fixed rehabilitations is a clinically successful protocol but with a high prevalence of peri-implant diseases

Implant Treatment by Guided Surgery Supporting Overdentures in Edentulous Mandible Patients

Introduction: This study aimed to show the clinical outcomes of implants inserted by guided surgery supporting mandibular overdentures in edentulous patients. Patients and methods: Mandibular edentulous patients were diagnosed with an oral examination, cone-beam computerized tomography, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants by guided surgery. After flapless surgery, implants were early loaded with an overdenture at 6 weeks. Results and discussion: Fourteen patients (nine females and five males) were treated with 28 implants. Four patients (28.6%) had a previous history of periodontitis. Five patients (35.7%) were smokers. Nine patients (64.3%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 44.7 ± 31.4 months. Clinical outcomes showed a global success of 100% of implants. Fourteen overdentures were placed in the patients over the implants. Mean marginal bone loss was 1.25 mm ± 0.95 mm. Four patients (28.6%) showed some kind of mechanical prosthodontic complications. Six implants (21.4%) were associated with peri-implantitis. Conclusions: This study indicates that treatment of mandibular edentulous patients with overdentures by guided surgery and early loading of implants placed appears to be a successful implant protocol

Long-Term Clinical Study of Implants Placed in Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate

Introduction. The aim of this study was to show the long-term clinical outcomes of implants placed in maxillary sinus floor augmentation (MFSA) using beta-tricalcium phosphate (β-TCP). Patients and methods. Maxillary patients were diagnosed for MFSA and used beta- β-TCP. After the lateral sinus surgery, implants were loaded at 6 months with restorations. The clinical follow-up was at 10 years. Results. One hundred and one patients (58 females and 43 males) were treated with MFSA. Twenty-nine patients (28.7%) had a history of periodontitis. Thirty-three patients (32.7%) were smokers. One hundred and twenty-one MFSA, 81 unilateral and 20 bilateral sites, with 234 implants were performed. The average vertical bone height available was 4.92 ± 1.83 mm. The average vertical bone gain obtained was 6.95 ± 2.19 mm following MFSA. The implant cumulative survival rate was 97.2%. Three implants (1.3%) were lost during the healing period. Six implants (2.6%) were lost by peri-implantitis. One hundred and fifteen restorations were placed in the patients. Mean marginal bone loss was 1.93 mm ± 1.03 mm. Six patients (27.3%) showed technical complications. Thirty-six implants (15.3%) in 14 patients (13.9%) were associated with peri-implantitis. Conclusions. This study indicates that treatment with implant-supported restoration by MFSA using β-TCP constitutes a successful implant approach

Long-term treatment outcomes of implant prostheses in partially and totally edentulous patients

Implant dental therapy is a clinical procedure used for treating patients with tooth loss with known clinical success. This clinical study aimed to evaluate the long-term clinical outcomes of dental implants in partially and totally edentulous patients. A total of 544 Microdent (Microdent SU, Implant Microdent System®, Santa Eulàlia de Ronçana Barcelona, Spain) screw implants were placed in 111 patients using a two-stage surgical technique and a conventional loading protocol (lasting 3 months). Implant and prosthetic clinical findings were evaluated during a 15-year follow-up. A total of 6 implants were lost during the healing period, and 124 prostheses were placed over the 538 implants that remained: 20 single crowns, 52 partially fixed bridges, 45 full-arch fixed restorations, and 7 overdentures. A total of 20 of these were lost during the follow-up period. The cumulative survival rate for all implants was 96.4%. The data underwent statistical analysis (significance level: p < 0.05). The mean marginal bone loss was 1.82 ± 0.54 mm, ranging from 1.2 to 3.1 mm. The most frequent complications were mechanical prosthodontic complications (16.2%). In all, 11.8% of implants showed periimplantitis as the primary biological complication. Dental implants inserted in both the maxillary and mandibular areas produce long-term favorable outcomes and stable tissue conditions when a delayed loading protocol is followed

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Congreso Internacional de Responsabilidad Social Apuestas para el desarrollo regional.

Congreso Internacional de Responsabilidad Social: apuestas para el desarrollo regional [Edición 1 / Nov. 6 - 7: 2019 Bogotá D.C.]El Congreso Internacional de Responsabilidad Social “Apuestas para el Desarrollo Regional”, se llevó a cabo los días 6 y 7 de noviembre de 2019 en la ciudad de Bogotá D.C. como un evento académico e investigativo liderado por la Corporación Universitaria Minuto de Dios -UNIMINUTO – Rectoría Cundinamarca cuya pretensión fue el fomento de nuevos paradigmas, la divulgación de conocimiento renovado en torno a la Responsabilidad Social; finalidad adoptada institucionalmente como postura ética y política que impacta la docencia, la investigación y la proyección social, y cuyo propósito central es la promoción de una “sensibilización consciente y crítica ante las situaciones problemáticas, tanto de las comunidades como del país, al igual que la adquisición de unas competencias orientadas a la promoción y al compromiso con el desarrollo humano y social integral”. (UNIMINUTO, 2014). Dicha postura, de conciencia crítica y sensibilización social, sumada a la experiencia adquirida mediante el trabajo articulado con otras instituciones de índole académico y de forma directa con las comunidades, permitió establecer como objetivo central del evento la reflexión de los diferentes grupos de interés, la gestión de sus impactos como elementos puntuales que contribuyeron en la audiencia a la toma de conciencia frente al papel que se debe asumir a favor de la responsabilidad social como aporte seguro al desarrollo regional y a su vez al fortalecimiento de los Objetivos de Desarrollo Sostenible

Congreso Internacional de Responsabilidad Social Apuestas para el desarrollo regional.

Congreso Internacional de Responsabilidad Social: apuestas para el desarrollo regional [Edición 1 / Nov. 6 - 7: 2019 Bogotá D.C.]El Congreso Internacional de Responsabilidad Social “Apuestas para el Desarrollo Regional”, se llevó a cabo los días 6 y 7 de noviembre de 2019 en la ciudad de Bogotá D.C. como un evento académico e investigativo liderado por la Corporación Universitaria Minuto de Dios -UNIMINUTO – Rectoría Cundinamarca cuya pretensión fue el fomento de nuevos paradigmas, la divulgación de conocimiento renovado en torno a la Responsabilidad Social; finalidad adoptada institucionalmente como postura ética y política que impacta la docencia, la investigación y la proyección social, y cuyo propósito central es la promoción de una “sensibilización consciente y crítica ante las situaciones problemáticas, tanto de las comunidades como del país, al igual que la adquisición de unas competencias orientadas a la promoción y al compromiso con el desarrollo humano y social integral”. (UNIMINUTO, 2014). Dicha postura, de conciencia crítica y sensibilización social, sumada a la experiencia adquirida mediante el trabajo articulado con otras instituciones de índole académico y de forma directa con las comunidades, permitió establecer como objetivo central del evento la reflexión de los diferentes grupos de interés, la gestión de sus impactos como elementos puntuales que contribuyeron en la audiencia a la toma de conciencia frente al papel que se debe asumir a favor de la responsabilidad social como aporte seguro al desarrollo regional y a su vez al fortalecimiento de los Objetivos de Desarrollo Sostenible

Implant Treatment by Guided Surgery Supporting Overdentures in Edentulous Mandible Patients

Introduction: This study aimed to show the clinical outcomes of implants inserted by guided surgery supporting mandibular overdentures in edentulous patients. Patients and methods: Mandibular edentulous patients were diagnosed with an oral examination, cone-beam computerized tomography, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants by guided surgery. After flapless surgery, implants were early loaded with an overdenture at 6 weeks. Results and discussion: Fourteen patients (nine females and five males) were treated with 28 implants. Four patients (28.6%) had a previous history of periodontitis. Five patients (35.7%) were smokers. Nine patients (64.3%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 44.7 ± 31.4 months. Clinical outcomes showed a global success of 100% of implants. Fourteen overdentures were placed in the patients over the implants. Mean marginal bone loss was 1.25 mm ± 0.95 mm. Four patients (28.6%) showed some kind of mechanical prosthodontic complications. Six implants (21.4%) were associated with peri-implantitis. Conclusions: This study indicates that treatment of mandibular edentulous patients with overdentures by guided surgery and early loading of implants placed appears to be a successful implant protocol