RESUMEN
This work systematically reviews dental implant placement through impacted teeth or residual roots, as an alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical, and prosthetic complications. The authors conducted an electronic search of four databases up to September 2020; also a complementary handsearch was carried out. The quality of the included studies was assessed using a protocol for assessment of risk of bias in exposure studies. Ten studies fulfilled the inclusion criteria and were analysed. A total of 44 patients received 62 dental implants and were monitored for a minimum of 12-months follow-up. An overall mean implant survival rate was 90.32%, reporting 97.56 % for dental implants through impacted teeth and 76.19% through residual roots. No surgical or prosthetic complications were reported. Placing dental implants through impacted teeth may offer a valid therapeutic option for implant-supported restorations in patients for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery. Moreover, additional caution is recommended when placing implants through retained root fragments, as this may involve long-term risk. Further research generating long-term data are needed to confirm these findings.
Asunto(s)
Implantes Dentales , Diente Impactado , Implantación Dental Endoósea , HumanosRESUMEN
La regeneración localizada de grandes defectos horizontales en los procesos alveolares, previa a la inserción de implantes dentales, sigue siendo un procedimiento quirúrgico desafiante en cirugía bucal. Entre los procedimientos quirúrgicos más utilizados para tal propósito se encuentran la corticotomía con expansión, injerto en bloque "onlay" y la regeneración ósea guiada (ROG), todos ellos con sus diferentes grados de predictibilidad. El uso de micromalla de titanio en combinación con injertos y sustitutos óseos es un método eficiente para la contención, estabilización y protección de estos injertos, permitiendo así una mejor regeneración de los tejidos. Esta técnica no queda exenta de posibles complicaciones asociadas como pueden ser la infección, necrosis del injerto o exposición de la malla de titanio. En el presente artículo se pretende mostrar la evidencia clínica de la efectividad del uso del colgajo pediculado de rotación palatina como método válido para evitar la exposición de la malla de titanio durante la regeneración ósea guiada
Localized regeneration of large horizontal defects in alveolar processes prior to the insertion of dental implants remains a challenging surgical procedure in oral surgery. Among the most widely used surgical procedures for this purpose are expansion corticotomy, onlay block graft and guided bone regeneration all of them with their different degrees of predictability. The use of titanium micromesh in combination with bone grafts and bone substitutes is an efficient method for the containtment, stabilization and protection of these grafts, thus allowing better tissue regeneration. This technique is not exempt from associated complications such as infection, graft necrosis or exposure of the titanium micromesh.This article aims to show the clinical evidence of the effectiveness of using the palatal rotated pedicle graft as an effective method to avoid exposing the micromesh during guide bone regeneration procedure
Asunto(s)
Humanos , Masculino , Anciano , Regeneración Ósea , Implantación Dental Endoósea/métodos , Odontología Basada en la Evidencia/métodos , Resultado del Tratamiento , Colgajos Quirúrgicos , Pérdida de Hueso Alveolar/cirugía , Plasma Rico en Plaquetas , Cirugía BucalRESUMEN
Los implantes dentales constituyen una alternativa predecible para la rehabilitación de los maxilares edéntulos, sin embargo, el éxito del tratamiento puede ver-se comprometido cuando existen graves atrofias maxilares. Para el tratamiento de estos casos complejos, se han desarrolla-do técnicas de regeneración ósea, entre las que destacan la regeneración ósea guiada y los injertos en bloque. Dentro de estos últimos, cabe destacar la técnica de Khoury. Se trata de un procedimiento indicado para regenerar defectos horizontales y verticales, mediante la obtención de finas láminas de hueso autógeno procedentes de la línea oblicua externa mandibular. Se presenta un caso clínico de un gran defecto mandibular reconstruido con la técnica de Khoury, secundario a un fracaso implantológico que además ocasionó patología nerviosa
Dental implants constitute a predictable alternative for the rehabilitation of edentulous jaws. However, the success of the treatment can be limited when severe atrophic alveolar ridges are present. For the treatment of these complex cases, several regeneration techniques have been developed, such as guided bone regeneration and block grafts. Within the last, it should be noted the Khoury technique. It is a procedure indicated for the regeneration of horizontal and vertical defects, through the obtention of autologous graft in form of thin plates, derived from mandibular external oblique line.A clinical case is presented, that consists in a great mandibular defect which was reconstructed by the Khoury technique. The defect was secondary to an implant failure, which was also related with nervous pathology
Asunto(s)
Humanos , Masculino , Anciano , Regeneración Ósea , Atrofia/cirugía , Hipoestesia/cirugía , Fracaso de la Restauración Dental , Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Procedimientos de Cirugía Plástica/métodos , Implantes Dentales , Resorción Ósea/patología , Boca Edéntula/cirugíaRESUMEN
Novel Sr-substituted calcium phosphate cement (CPC) loaded with doxycycline hyclate (DOXY-h) was employed to elucidate the effect of strontium substitution on antibiotic delivery. The cement was prepared using as reactants Sr-substituted beta-tricalcium phosphate (Sr-beta-TCP) and acidic monocalcium phosphate monohydrate. Two different methods were used to load DOXY-h: (i) the adsorption on CPC by incubating the set cement in drug-containing solutions; and (ii) the use of antibiotic solution as the cement liquid phase. The results revealed that the Sr-substituted cement efficiently adsorbs the antibiotic, which is attributed to an enhanced accessibility to the drug-binding sites within this CPC. DOXY-h desorption is influenced by the initial adsorbed amount and the cement matrix type. Furthermore, the fraction of drug released from CPCs set with DOXY-h solution was higher, and the release rate was faster for the CPC prepared with 26.7% Sr-beta-TCP. The analysis of releasing profiles points to Fickian diffusion as the mechanism responsible for antibiotic delivery. We can conclude that Sr substitution in secondary calcium phosphate cements improves their efficiency for DOXY-h adsorption and release. The antibiotic loading method provides a way to switch from rapid and complete to slower and prolonged drug release.