Reliability of cone beam computed tomography in locating and measuring the mandibular canal for planning of surgical techniques in the mandibular body

Objetivo: El objetivo de nuestro estudio fue determinar la fiabilidad del estudio tomográfico para localizar el conducto mandibular y tomar mediciones exactas del diámetro de dicho conducto y de la pared ósea vestibular, como mediciones principales en la planificación de la toma de injerto óseo de cuerpo mandibular. Material y método: Se estudiaron 11 mandíbulas (22 hemimandíbulas) de cadáver fresco, la mitad de ellas dentadas, a las cuales se les realizaron una CBTC y un procedimiento quirúrgico de lateralización del nervio dentario inferior con el objetivo de medir el grosor de la tabla vestibular y el grosor del conducto mandibular o dentario inferior (CDI) a los 5, 15 y 25 mm de la parte más posterior del agujero mentoniano. Resultados: Los resultados obtenidos por nuestro estudio indican que el CBTC, siendo el mejor método diagnóstico disponible en la actualidad, aún presenta diferencias respecto a la realidad. Esta discrepancia es de 1,15mm de media con relación al grosor de la tabla ósea vestibular que lo recubre y de 0,3m de media con relación al grosor del CDI. Discusión: Conocer y valorar estas discrepancias es importante dada la multitud de procedimientos quirúrgicos que se pueden realizar en esta zona, y la vecindad con el nervio dentario inferior.Aim: The aim of this study was to determine the reliability of cone beam computed tomography to locate and take measurements of the mandibular canal, as well as the vestibular bone wall, in the planning of the bone graft surgery in the mandibular body. Material and methods: A total of 11 mandibles from fresh cadavers were studied (22 hemimandibles, half of them with teeth). A CBTC and a surgical procedure for the lateralization of the lower dental nerve were performed with the aim of measuring the thickness of the vestibular table and the mandibular canal (MC) or lower dental nerve at 5, 15, and 25 mm from the most posterior position of the mentonian hole. Results: The results obtained in the study indicate that CBTC, being the best diagnostic tool currently available, still appears to be unreliable when compared to actual resultshas. This discrepancy is a mean of 1.15 mm as regards the thickness of the vestibular bone wall that covers the MC, and a mean of 0.3mm in relation to the thickness of the lower dental nerve. Discussion: It is important to know and assess these discrepancies in view of the multitude of surgical procedures that can be performed in this area, and in the vicinity of the lower dental nerve

Superficial characteristics of titanium after treatment of chorreated surface, passive acid, and decontamination with argon plasma

Background. Titanium is characterized by its biocompatibility, resistance to maximum stress, and fatigue and non-toxicity. The composition, surface structure, and roughness of titanium have a key and direct influence on the osseointegration processes when it is used in the form of dental implants. The objective of the present study is to characterize, at chemical, superficial, and biological levels, the result of the application of the sandblasted with large-grit and acid-etched (SLA) treatment consisting of coarse-grained and double-passivated acid blasting with subsequent decontamination with argon plasma on the surface of titanium implants type IV. (2) Methods. Four Oxtein® dental implants (Zaragoza, Spain) were investigated with the following coding: Code L63713T (titanium grade IV, 3.75 mm in diameter, and 13 mm in length). The surface of the implants was SLA type obtained from coarse-grained, double passivated acid, and decontaminated with argon plasma. The samples were in their sealed packages and were opened in our laboratory. The X-ray photoelectron spectroscopy (XPS) technique was used to characterize the chemical composition of the surface, and the scanning electronic microscope (SEM) technique was used to perform topographic surface evaluation. Cell cultures were also performed on both surfaces. (3) Results. The superficial chemical analysis of the studied samples presented the following components, approximately, expressed in atomic percentage: O: 39%; Ti: 18%; C: 39%; N: 2%; and Si: 1%. In the same way, the topographic analysis values were obtained in the evaluated roughness parameters: Ra: 1.5 μm ± 0.02%; Rq: 1.31 μm ± 0.33; Rz: 8.98 μm ± 0.73; Rp: 5.12 μm ± 0.48; Rv: 3.76 μm ± 0.51; and Rc: 4.92 μm ± 0.24. At a biological level, the expression of osteocalcin was higher (p < 0.05) on the micro-rough surface compared to that machined at 48 and 96 h of culture. (4) Conclusions. The data obtained in our study indicate that the total carbon content, the relative concentration of titanium, and the roughness of the treatment performed on the implants are in agreement with those found in the literature. Further, the roughness of the treatment performed on the implants throws a spongy, three-dimensional surface suitable for bone growth on it. The biological results found are compatible with the clinical use of the surface tested

Superficial characteristics of titanium after treatment of chorreated surface, passive acid, and decontamination with argon plasma

Background. Titanium is characterized by its biocompatibility, resistance to maximum stress, and fatigue and non-toxicity. The composition, surface structure, and roughness of titanium have a key and direct influence on the osseointegration processes when it is used in the form of dental implants. The objective of the present study is to characterize, at chemical, superficial, and biological levels, the result of the application of the sandblasted with large-grit and acid-etched (SLA) treatment consisting of coarse-grained and double-passivated acid blasting with subsequent decontamination with argon plasma on the surface of titanium implants type IV. (2) Methods. Four Oxtein® dental implants (Zaragoza, Spain) were investigated with the following coding: Code L63713T (titanium grade IV, 3.75 mm in diameter, and 13 mm in length). The surface of the implants was SLA type obtained from coarse-grained, double passivated acid, and decontaminated with argon plasma. The samples were in their sealed packages and were opened in our laboratory. The X-ray photoelectron spectroscopy (XPS) technique was used to characterize the chemical composition of the surface, and the scanning electronic microscope (SEM) technique was used to perform topographic surface evaluation. Cell cultures were also performed on both surfaces. (3) Results. The superficial chemical analysis of the studied samples presented the following components, approximately, expressed in atomic percentage: O: 39%; Ti: 18%; C: 39%; N: 2%; and Si: 1%. In the same way, the topographic analysis values were obtained in the evaluated roughness parameters: Ra: 1.5 μm ± 0.02%; Rq: 1.31 μm ± 0.33; Rz: 8.98 μm ± 0.73; Rp: 5.12 μm ± 0.48; Rv: 3.76 μm ± 0.51; and Rc: 4.92 μm ± 0.24. At a biological level, the expression of osteocalcin was higher (p < 0.05) on the micro-rough surface compared to that machined at 48 and 96 h of culture. (4) Conclusions. The data obtained in our study indicate that the total carbon content, the relative concentration of titanium, and the roughness of the treatment performed on the implants are in agreement with those found in the literature. Further, the roughness of the treatment performed on the implants throws a spongy, three-dimensional surface suitable for bone growth on it. The biological results found are compatible with the clinical use of the surface tested

Three steps to maintain predictable interdental papilla and gingiva emergence profiles in immediate implant placement. A 3-year follow-up case report

We present a case that describes a three-step clinical technique to provide guidelines to replace fractured teeth with immediate implant placement using the same dental structure as a temporary crown and a regenerative approach. This approach predictably maintains the interdental papilla and gingiva emergence profile to ensure a favorable cosmetic result. A 3-year follow-up has shown good clinical outcomes and stability in crestal bone levels. Consequently, this is an innovative way to do temporary crown and design restorations in everyday clinical practice

Diagnóstico y tratamiento de las periimplantitis. Actualización en el diagnóstico clínico y en el tratamiento de las periimplantitis

En el presente capítulo realizamos una descripción de las investigaciones y hallazgos más importantes aparecidos recientemente en la literatura implantológica, los cuales inciden de una forma más significativa en el diagnóstico clínico y su aplicación en el tratamiento de las periimplantitis por parte del dentista. Aunque todavía no existe claridad ni consenso en los protocolos de actuación terapéutica, hemos realizado un meticuloso análisis de los conocimientos aportados por los diferentes investigadores, y describimos su aplicación más racional al hilo de las últimas investigaciones

El microscopio quirúrgico en cirugía bucal: propuesta de un modelo de enseñanza

El microscopio como herramienta en la práctica de la Medicina, y sobre todo en las especialidades quirúrgicas se ha establecido como un hecho hace ya décadas. Las incorporaciones más tempranas del microscopio a la práctica odontológica debemos buscarlas en los años 70 y 80, si bien la incorporación de una forma más amplia (aún lejos de ser generalizada) ocurre en la década final del siglo pasado. Existen distintos modos de procurar la evolución dentro de las técnicas que se aplican en el gabinete dental. Una primera aproximación podría ser la de aquellos profesionales, con años de experiencia, que aplican directamente el uso del microscopio en sus pacientes, tal como lo hicieron los pioneros del uso del microscopio en Odontología. No obstante, en el trabajo actual presentamos y defendemos un programa de aprendizaje programado que permita introducir esta nueva tecnología de una forma secuencial, siguiendo un método protocolizado de enseñanza, eficiente, ordenado, que reporte al alumno una curva de aprendizaje más rápida y cómoda, dentro de un ambiente de trabajo relajado.The microscope like tool in the practice of the Medicine, and mainly in the surgical specialties, has settled down already decades ago as a fact. The earliest incorporations of the microscope to the odontological practice should look for it in the years 70 and 80, although the incorporation in a wider way (still far from being generalized) it happens in the final decade of last century. Different ways exist of offering the evolution inside the techniques that are applied in the dental cabinet. A first approach could be that of those professionals, with years of experience that apply the use of the microscope directly in its patients, just as they made it the pioneers of the use of the microscope in Dentistry. Nevertheless, in the current work we present and we defend a program of scheduled learning that allows to introduce this new technology in a sequential way, following a protocolized method of teaching, efficient, orderly, that reports the student a quicker and more comfortable learning curve, inside a relaxed working atmospher

Odontoma compuesto asociado a canino permanente inferior incluido

El odontoma representa el tumor odontogénico más frecuente. Normalmente está asociado con un diente permanente impactado, localizándose entre la corona del diente y el proceso alveolar, impidiendo su correcta erupción. El tumor odontogénico asociado con más frecuencia a un canino incluido es el odontoma compuesto, dada la localización preferente de esta entidad en la zona anterior del maxilar. En este artículo se describe el diagnóstico y tratamiento de un paciente de 42 años de edad con presencia de un canino permanente inferior asociado a un odontoma.The most prevalence odontogenic tumor is odontoma. Frequently odontomas are associated with a permanent impacted tooth, interfering with normal tooth eruption. Compound odontoma is a comparatively common odontogenic tumor, which may associate with an included canine. The purpose of this report is to present a case of 42y patient with an included lower canine associated with an odontoma

Strain/counterstrain on internal pterygoid muscles. Short-term effects on mandibular dynamics

Objetivo: evaluar la amplitud articular y la fuerza de mordida tras aplicar los métodos de inhibición de tensión/contratensión (TCT) sobre los puntos gatillo miofasciales latentes (PGMs) del músculo pterigoideo interno. Intervención: cuarenta y nueve sujetos, 25 varones y 24 mujeres, fueron aleatoriamente distribuidos en dos grupos; el grupo experimental (25 sujetos) recibió tratamiento de TCT, y el grupo control (24 sujetos) recibió un tratamiento placebo. Las variables de resultado fueron la máxima apertura oral (MAO) y la máxima fuerza de la mordida (MFM). Resultados: los resultados mostraron una mejora significativa en la MAO [Control: (–0,02) mm ± 0,76; Experimental: 1,48 mm ± 1,3; p 0,05). Conclusión: los procedimientos de inhibición muscular mediante TCT se podrían emplear en el tratamiento de los PGMs del músculo pterigoideo interno para mejorar la MAO y la MFM, con independencia del sexo.Objetive: to assess the short-term effects on mandibular dynamics (in terms of jaw opening and bite force) of the application strain/counterstrain (SCS) on latent myofascial trigger points (MTrPs) of the internal pterygoid muscles. Intervention: forty nine subjects, 25 males and 24 females, were randomly allocated to one of two groups: experimental (25 subjects), who received SCS therapy, and control (24 subjects), who received a placebo treatment. As outcome variables, we considered maximum active jaw opening and maximum bite force. Results: the results showed a significant improvement with respect to active jaw opening [controls: (–0,02) mm ± 0,76; experimental subjects: 1,48 mm ± 1,3; p< 0,01] and maximum bite force [controls: (–0,06) N ± 1,21; experimental subjects: 32,43 N ± 16,81; p< 0,001] after treatment of MTrPs with SCS. Conclusions: our results suggest that muscular inhibition methods through the application of strain/counterstrain (SCS) could be used in the treatment of the MTrPs of the internal pterygoid muscles in order to improve maximum jaw opening and maximum bite force. Key words: strain/counterstrain, myofascial pain syndrome, mouth, bite force, muscle hypertonia, temporomandibula

Satisfaction in complete denture wearers with and without adhesives : a randomized, crossover, double-blind clinical trial

Background: The purpose of this study was to compare the satisfaction of patients regarding retention, stability and accumulation of particles with a randomized, double-blind crossed method in users with complete dentures with and without adhesive. Material and Methods: Seventeen edentulous individuals were randomized and received new upper and lower complete dentures. After a period of adaptation, they participated in some masticatory tests and clinical revisions, after use the protheses with and without the use of two denture adhesives: Adhesive A (Fittydent, Fittydent International GmbH) and adhesive B (Corega, GlaxoSmithKline) at 0, 7 and 14 days. Satisfaction was measured immediately after each test through a survey using a VAS scale (0-10) and data were analyzed with McNemar?s test with Bonferroni correction. Results: The results showed significant differences ( p <.01) between the study groups with adhesive A - B and the group without adhesive, but no significant differences were found between the two stickers for any of the variables studied. Conclusions: Complete denture adhesives significantly improved the satisfaction of patients because a better retention, stability and less accumulation of particles of the food substitute between the denture and the mucosa is obtained compared with non-use of complete denture adhesives

Current state of dental autotransplantation

The aim of this study is to analyse the current situation in dental autotransplantations within the different therapeutic alternatives that the dentist has available to replace a tooth in the dental arcade. For some authors this is an option headed for failure, whereas for others, it is an alternative to keep in mind. In this study we analyse the factors related to the predictability of the technique, based on an analysis of research work published in the scientific literature up to date. We also present two clinical cases performed by our team and their subsequent evaluation. In spite of the satisfactory results seen when reviewing the existing literature, we cannot say that dental autotransplantation is currently the technique of choice when a tooth is lost, given the predictability of osteointegrated implants. © Medicina Oral S. L