Influencia del protocolo de fresado, de la carga prostodóncica y de la geometría de los pilares en la pérdida ósea marginal periimplantaria

La pérdida ósea marginal (MBL) asociada a implantes dentales y a sus correspondientes restauraciones protésicas sigue siendo difícil de controlar y prevenir. Entre los factores más relacionados encontramos el diseño de los implantes, el tipo de carga prostodóntica y los aspectos relacionados con la forma y materiales de los pilares protésicos. Mediante la realización de dos ensayos clínicos analizamos la influencia de la secuencia de fresado para la colocación de los implantes así como el protocolo de carga prostodóntica y la geometría de los pilares y su influencia en la prevención de la pérdida ósea marginal

Applications of OralCDx ® methodology in the diagnosis of oral leukoplakia

Objective: We aim to evaluate the effectiveness of the brush biopsy technique using OralCDx ® (OralScan Laboratories Inc., Suffern, NY) as a new method for early diagnosis and control of a 'potentially malignant disorder' such as oral leukoplakia. Design of the study: We performed a study in which samples were taken using OralCDx ® on 24 patients who visited the Master of Oral Medicine, Oral Surgery and Implantology of the University of Santiago de Compostela between February 2009 and May 2010. These patients presented clinical and histological lesions that were consistent with oral leukoplakia. We evaluated the relationship between the keratinization degree of the lesions and cell representation; the diagnosis obtained through OralCDx ® and biopsies; and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results: 50% of patients were men and 50% women with an average age of 62.38 years. The Kappa coefficient relating keratinization of lesions and cell representation was 0.33, the OralCDx ® - biopsy diagnostic rate reached a Kappa value of 0.66, recording 72.7%, sensitivity and 92.3% specificity, PPV was 88.8%, while NPV reached 80%. Conclusions: cytology sampling with OralCDx ® showed high sensitivity and specificity values, which make it a good tool for monitoring oral leukoplakia, but nowadays the most reliable method that allows us to confirm the exact diagnosis of the lesions and their anatomical and pathological characteristics still is conventional biopsy using a surgical scalpel. © Medicina Oral S. L

Impact of abutment geometry on early implant marginal bone loss. A double-blind, randomized, 6-month clinical trial

Objectives The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL). Material and Methods A balanced, randomized, double-blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were “cylindrical” abutment and “concave” abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months. Results The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of −0.6 ± 0.7 mm in the cylindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was −0.4 ± 0.6 mm (p = .030). The estimated effect size (ES) was negative for the cylindrical abutment (ES = −1.3730, CI −2.5919 to −0.1327; t-value = −2.4893; p = .0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES = 2.8231; CI: 1.4379 to 4.2083; t-value = 4.0957; p = .0002), therefore implying an increase in the average bone level. Conclusions The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did