RESUMEN
Introduction: Osteomyelitis of the jaws is a common disease of the maxillofacial region. The goal of treatment is to alleviate pain, reduce infection, inhibit the progression of the disease and induce bone and mucosal healing. In addition to surgical management and antibiotic and oxygen hyperbaric therapy, new therapeutic strategies for the treatment of osteomyelitis are developed. One of the novel approaches is photobiomodulation therapy or low-level light therapy (LLLT). Materials and Methods: After surgical treatment, experimental group patients (n = 4) were treated with LLLT for five sessions with an extraoral pulsed 635-nm LED lamp (Repuls7, Repuls Lichtmedizintechnik GmbH, Austria), maximum output power: 140 mW/cm2, frequency: 2.5 Hz, duty cycle: 50%. Clinical achievement and patient pain perception (through Visual Analogue Scale score) were evaluated at 1-, 3- and 6-month follow-up appointments and compared with control group (n = 4) patients, treated with standard therapy. Results: At three and six months, clinical achievement was better in patients treated with LLLT. Pain and discomfort resolution was significantly greater in the experimental group. Discussion: Taking into consideration the results of this study, it can be concluded that LLLT shows potential for improving clinical outcome of surgical and medical treatment of secondary chronic osteomyelitis of the jaws. Furthermore, pain and discomfort were significantly reduced in patients treated with LLLT. Further research with a larger sample size is needed to obtain a more accurate insight into this promising field.
RESUMEN
BACKGROUND: The aim of this systematic review was to evaluate the survival rates of immediately loaded implants after at least five years. Besides implant failure, the amount of marginal bone loss around implants and the complication type were assessed. METHODS: The electronic search was undertaken on Medline, Scopus, and Cochrane Central Register of Controlled Trials using key terms such as: "immediate loading", "immediate function", "immediate restoration", "immediate temporization", "dental implants", "fully edentulous patients", "partially edentulous patients". The search terms were combined using the Boolean operators AND, OR. The last electronic search was performed on 15 February 2018. Two authors independently screened the studies, extracted the data, and assessed the risk-of bias. The main outcomes recorded for each study were: implant and prosthesis success and survival, marginal bone level change, incidence and type of complications. Kaplan-Meier analysis was used to estimate cumulative survival rates. RESULTS: Thirty-four prospective studies with at least five-year follow-up, published between 2007 and 2017 were included. A total of 5349 immediately loaded implants in 1738 patients were analyzed. The mean follow-up was 72.4 months (median 60 months, 95% confidence intervals (CI): 64.53, 80.25 months, range 60 to 147 months). The mean weighted implant survival was 97.4% (median 98.15%, 95% CI: 96.29%, 98.54%, range 83.80% to 100%). Cumulative survival rate of implants placed in the mandible was significantly higher than for the maxilla (p < 0.01). No significant difference in failure rate was found among the types of prosthesis employed (p = 0.27). The mean peri-implant bone level change at the end of the follow-up in each study ranged from 0.3 to 1.7 mm. CONCLUSION: Immediate loading of implants appears to have long-term predictability and success rate under well-defined circumstances.