Puesta al día sobre implantes de carga inmediata: revisión bibliográfica

El tratamiento del paciente desdentado total o parcial con implantes osteointegrados es cada vez más frecuente en nuestra práctica habitual. Una mayor demanda estética y funcional de estos pacientes, hace que cada día se intenten disminuir más los tiempos de espera para cargar dichos implantes, disminución que en algunos casos podría perjudicar el proceso de osteointegración de las fijaciones. Con este trabajo de revisión bibliográfica pretendemos demostrar al clínico la controversia que aún existe en este tema, pudiendo comparar en los distintos estudios revisados las diferentes tasas de éxito en implantes sometidos a carga inmediata, lo que nos puede dar una visión objetiva a la hora de ofrecer este tipo de tratamiento a nuestros pacientes. Según esta revisión el tipo de hueso y su calidad, así como la superficie del implante serán los parámetros que determinen en qué casos podría realizarse la carga prematura de los implantes.The treatment of totally or partially edentulous patients with osseointegrated implants is an increasing part of daily dental practice. The greater aesthetic and functional demands made by these patients have created a constant pressure to reduce the waiting time before implants are loaded. In some cases, however, a shortening of the waiting period may compromise the osseointegration of the fixtures. The present review aims to inform the clinician about the continuing controversy on this issue. Data from the reviewed studies allow comparisons to be made between the different success rates obtained after immediate implant loading, offering a more objective basis for our advice to patients on this type of treatment. According to our review, the type and quality of the bone and the surface of the implant are the factors that determine the selection of patients who can undergo the premature loading of implants

La repercusión de la invasión francesa en la asistencia al niño expósito en Granada : actitudes reformistas y crisis político-social (1808-1814)

En los últimos años, la historiografía social ha realizado importantes aportaciones sobre el proceso y las consecuencias inmediatas de la ocupación francesa de Granada durante la Guerra de la Independencia (1). Efectivamente, gracias a los estudios realizados desde estos planteamientos metodológicos sabemos que tal ocupación -que despertó grandes esperanzas de cambio entre la minoría de ciudadanos que colaboró con las tropas napoleónicas- terminó con un saldo más bien negativo,.que culminó con la grave crisis de subsistencias de 18 17

Comparison of Implant Stability between Regenerated and Non-Regenerated Bone. A Prospective Cohort Study

Implant stability is one of the main indicators of successful osseointegration. Although it has been measured in numerous studies, there has been little research on implant stability in regenerated bone. The study compares primary and secondary stability between implants placed in regenerated versus native bone and evaluates the influence of bone quality on the results. Sixty implants were placed in 31 patients: 30 implants inserted in native bone (non-regenerated) after a healing period of at least 6 months post-exodontia and 30 inserted in regenerated bone at 6 months after grafting with xenograft. Resonance frequency analysis (RFA) was used to obtain implant stability quotient (ISQ) values at baseline (implant placement), 8 weeks, and 12 weeks. Statistically significant differences were found between implants placed in regenerated bone and those placed in native bone at all measurement time points (p < 0.05). ISQ values were significantly influenced by bone quality at baseline (p < 0.05) but not at 8 or 12 weeks. Greater stability was obtained in implants placed in native bone; however, those placed in regenerated bone showed adequate primary and secondary stability for prosthetic loading. Bone quality influences the primary but not secondary stability of the implants in both native and regenerated bone

Topographic characterisation of dental implants for commercial use

To characterize the surface topography of several dental implants for commercial use. Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls(p<0.05) tests. Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use

Fibroma óseo juvenil: a propósito de un caso clínico

Se presenta el caso clínico de un paciente de 8 años de edad con un fibroma osificante juvenil en el ángulo mandibular derecho y un quiste radicular en el ángulo mandibular izquierdo, los cuales producían un importante abombamiento a nivel de los ángulos mandibulares e impedían la correcta erupción de los primeros molares inferiores. Tras el estudio clínico y radiológico ( Ortopantomografía y Scan dental del maxilar inferior), se llevó a cabo el correspondiente tratamiento quirúrgico (quistectomía y remodelación de los mismos) y el estudio histopatológico. Aunque el fibroma óseo juvenil es una entidad clínica poco frecuente, debido al comportamiento local agresivo y a la recidiva que tiene, es importante realizar un diagnóstico precoz, un tratamiento adecuado y, sobre todo, un seguimiento del paciente a lo largo del tiempo.We present the case of an 8-year-old patient with a juvenile ossifying fibroma in the right mandibular angle and a radicular cyst in the left mandibular angle, which produced a major swelling at the level of the mandibular angles and prevented the correct eruption of the lower first molars. After the clinical and radiological (panoramic X-ray and dental scan of the mandible), the corresponding surgical treatment (cystectomy and remodelling) and histopathological study were carried out. Although juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate mean that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow the patient up over the long term

Influence of cavity preparation technique (rotary vs. ultrasonic) on microleakage and marginal fit of six end-root filling materials

Objectives: To evaluate in vitro the effect of cavity preparation with microburs and diamond-coated ultrasonic tips on the microleakage and marginal fit of six end-root filling materials. Study Design. The following materials were assessed: amalgam (Amalcap), zinc oxide eugenol (IRM), glass ionomer (Vitrebond), compomer (Cavalite), mineral particle aggregate (MTA) and composite (Clearfil). Cavity preparation was performed with microburs or diamond ultrasonic tips in single-root teeth. The seal was evaluated in two experiments: a microleakage assay on the passage of dye to the interface; and a scanning electron microscopy study and analysis of epoxy resin replicas, measuring the size of gaps in the interface between filling material and cavity walls. Multifactorial ANOVA, multiple comparison test and Student?s t test were used for statistical analyses of the data, considering p<0.05 to be significant. Results: Clearfil and MTA achieved a hermetic seal. Leakage and interface gap size was greater with Cavalite than with Clearfil and MTA, followed by Vitrebond and IRM. The worst seal was obtained with Amalcap. The use of diamond-coated ultrasonic tips improved the seal and reduced the gap when using materials that did not hermetically seal the cavity (Amalcap, IRM, Cavalite, Vitrebond). The preparation technique did not affect materials that achieved a hermetic seal (Clearfil, MTA). Conclusions: Clearfil and MTA obtained a hermetic seal due to their excellent marginal fit and are the most recommended materials for clinical use, taking account of their sealing capacity. Ultrasonic cavity preparation is preferable because it improves the seal and marginal fit of materials that do not achieve a hermetic seal of the cavity (Amalcap, IRM, Cavalite, Vitrebond)

Factors related to survival from oral cancer in an Andalusian population sample (Spain)

Introduction: Approximately 3% of malignant tumors originate in the oral cavity. The majority are squamous cell carcinomas, and a small percentage, malignant tumors of the salivary glands, lymphoreticular diseases, bone tumors, melanomas, sarcomas, malignant odontogenic tumors and metastases of tumors from other locations. The prognosis of these pathologies depends on the size, infiltration, and site of the lesion, the presence or absence of metastatic spread, and to a certain degree the differentiation of the tumor. The prognosis of an oral cancer remains generally negative, with 5-year survival figures below 50%, producing high rates of mortality and morbidity. Objectives: To evaluate the influence of different variables on survival in an oral cancer population. Patients and methods: Two-hundred and sixteen patients with oral squamous cell carcinoma were studied over a period of five years, evaluating 42 variables grouped into five data sections: personal, lesion, site, stage, and risk factors. Results and conclusions: Average survival was 2088 days, with a standard deviation of 98 days. The factors most associated with mortality were: location in the gingiva (p=0.0590), in the trigone (p=0.0104), size (T3-T4) (p=0.0004) and lymph node involvement (N2a-N2b) (p=0.0035). Tobacco and alcohol, nowadays considered to be highly significant in carcinogenesis, had no considerable influence on survival

Measurement of dental implant stability by resonance frequency analysis : a review of the literature

Dental implant treatment is an excellent option for prosthetic restoration that is associated with high success rates. Implant stability is essential for a good outcome. The clinical assessment of osseointegration is based on mechanical stability rather than histological criteria, considering primary stability (absence of mobility in bone bed after implant insertion) and secondary stability (bone formation and remodelling at implant-bone interface). The aim of this study was to review the literature on Resonance Frequency Analysis (RFA) as a method for measuring dental implant stability. An online search of various databases was conducted on experimental and clinical research published between 1996 and 2008. The studies reviewed demonstrate the usefulness of RFA as a non-invasive method to assess implant stability. Further research is required to determine whether this system is also capable of measuring the degree of dental implant osseointegration

Las Publicaciones sobre cirugía oral y maxilofacial aparecidas entre 1965-1984 : estudio bibliométrico

Reducción altaTesis Univ. de Granada, Departamento de Anatomía Patológica e Historia de la Ciencia. Leída el 09-10-8