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Objetivo: Esta revisión sistemática tiene como objetivo identificar los factores pronósticos y/o determinantes del éxito del tratamiento de la periimplantitis. Materiales y métodos: Se realizó una búsqueda bibliográfica estructurada y exhaustiva para identificar referencias relevantes en las bases de datos MEDLINE (PubMed), Scielo y Springerlik. La estrategia de búsqueda se realizó combinando los términos periimplantitis con factores pronósticos y / o determinantes del éxito del tratamiento como MeSH y texto libre combinando con los operadores booleanos AND y OR. Se utilizó la clasificación de SIGN (Scottish Intercollegiate Guidelines Network) para analizar el nivel de evidencia. Resultados: De los 239 artículos revisados, 17 cumplieron con los criterios de selección para el análisis cualitativo de la evidencia. Conclusiones: El tipo de implante (macro y microgeometría) y la morfología del defecto, los cuales dificulta el acceso a las superficies contaminadas, son factores que influyen en el resultado del tratamiento de la periimplantitis. No hay evidencia sobre el método de descontaminación más eficaz. Las condiciones generales como la diabetes mellitus y la presencia de enfermedad periodontal activa afectan el resultado del tratamiento, así como la frecuencia de un programa de mantención de higiene profesional postquirúrgica, la cual mejora la sobrevida del implante.
Objective: This systematic review aimed at identifying prognostic factors influencing periimplantitis treatment outcomes. Materials and methods: A structured and comprehensive literature search was performed to identify relevant references from MEDLINE (PubMed), Scielo and Springerlik databases. The search strategy was carried out combining the search terms periimplantitis with prognostic factors and/or determinants of treatment success as MeSH and free text combining with the boolean logical operators AND and OR. The SIGN (Scottish Intercollegiate Guidelines Network) was used to analyze the level of evidence. Results: From 239 articles reviewed, 18 fulfilled the selection criteria for the qualitative analysis of the evidence. Conclusions: The type of implant (macro and microgeometry) and the defect morphology, which make access to contaminated surfaces difficult, are factors that influence the outcome of peri-implantitis treatment. There is no evidence on the most effective decontamination method. General conditions such as diabetes mellitus and the presence of active periodontal disease affect the outcome of the treatment. as Also, the frequency of a post-surgical professional hygiene maintenance program improves the dental implant survival post-treatment.
Assuntos
Humanos , Prognóstico , Implantes Dentários , Peri-Implantite/terapiaRESUMO
Several methods have been described to shorten orthodontic treatments, but the main disadvantage is their invasiveness. Animal studies have shown that piezopuncture can accelerate the rate of tooth movement without causing collateral damage. Objective: To evaluate the clinical outcome, in terms of safety and efficacy, of a flapless piezopuncture on maxillary canine distalization. Methods: A split-mouth randomized clinical trial was carried out on five patients. Piezopuncture was performed on a random side of the maxillary arch to assess the rate of canine movement on the stimulated side, compared to the non-stimulated control side after 15 (T1), 30 (T2), and 60 (T3) days. Also, immediate side effects and changes in buccal bone thickness after one year were assessed. Results: Distalization on the intervention versus control side at T1 was 1.24±0.21mm versus 0.64±0.33mm (p=0.005); at T2 it was 2.00±0.28mm versus 1.36±0.49mm (p=0.046); and at T3 it was 4.28±0.66mm versus 3.65±0.88mm (p=0.102). No adverse effects related to the surgical procedure were observed or reported by patients. The thickness of the buccal bone plate showed no significant changes. Conclusions: Flapless piezopuncture accelerates the rate of tooth movement in orthodontic patients over the first 15 days and its effect declines over the next 45 days.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Ortodontia , Dente Canino , MaxilaRESUMO
INTRODUCTION: Clinical motor skills are essential to train dental students. There is evidence that imagery serves to acquire and improve motor skills, but there is scarce information on its application in dental education. In order to broadly map the available evidence and to detect knowledge gaps in the mental training used to develop motor skills in dentistry, a scoping review was conducted. MATERIALS AND METHODS: A structured search was conducted to identify relevant references from the Web of Science, Scopus and MEDLINE/PubMed databases for studies addressing mental training methods applied to develop motor skills in dentistry. RESULTS: A total of 758 articles were screened and four were selected, all of which were randomized clinical trials. Three studies investigated the effectiveness of visual imagery, and one investigated kinesthetic imagery. The research theme identified was motor skill acquisition. CONCLUSION: The reviewed studies indicate the usefulness of mental training for skill acquisition in dentistry. To improve the generalizability of the results, further research with standardized mental training on motor skills in dentistry is needed.
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ABSTRACT: Clinical motor skills are essential to train dental students. There is evidence that imagery serves to acquire and improve motor skills, since imagining an action, activates the same neural areas as when this is physically performed. The aim of this pilot randomized clinical trial was to examine the feasibility of tridimensional visualization associated with mental imagery on the development of fine motor skills of dental students compared to conventional training. Seventeen dental students without previous preclinical experiences, between 18-25 years old were recruited. After giving a theoretical lecture on the inlay preparation, participants were randomly allocated in two groups. The Experimental Group (N=9) performed daily 30 minutes of "mental practice" after visualizing a video showing the execution of an ideal inlay preparation alternating it with black screen periods to facilitate the imagery. The Control Group (N= 8) performed a 30 minutes "hands on practice" daily of the same preparation. On the fifth day, both groups carried out an inlay preparation physically, which was scanned and overlapped to the virtual preparation to assess accuracy. The execution time and accuracy of the preparation performed with regard to an ideal preparation were compared between groups. The learning style and fine motor skills at baseline were similar in all participants (P>0.001). No statistically significant differences were found between the groups in terms of accuracy. The time of execution in the experimental group was significantly lower than the control group. This pilot study showed that visualization associated to mental imagery could develop fine motor skills in dental students, requiring less execution time than physical practice.
RESUMEN: Las habilidades motoras clínicas son esenciales para entrenar a los estudiantes de odontología. Existe evidencia que la imaginería sirve para adquirir y mejorar las habilidades motoras, ya que al imaginar una acción, se activan las mismas áreas neuronales que cuando la acción se realiza físicamente. El objetivo de este ensayo clínico aleatorizado piloto fue examinar la factibilidad del uso de visualización tridimensional asociada con imaginería para el desarrollo de las habilidades motoras finas en estudiantes de odontología comparado con el entrenamiento convencional. Se reclutaron diecisiete estudiantes de odontología, entre 18-25 años de edad, sin experiencias preclínicas previas. Después de recibir una clase teórica sobre la preparación de una incrustación, los participantes fueron asignados aleatoriamente a dos grupos. El grupo experimental (N = 9) realizó diariamente 30 minutos de "práctica mental" después de visualizar un video que muestra la ejecución de una preparación de incrustación ideal alternando con períodos de pantalla negra para facilitar la imaginación. El grupo de control (N = 8) realizó una práctica diaria de 30 minutos de la misma preparación. El quinto día, ambos grupos llevaron a cabo físicamente una preparación de incrustación, que fue escaneada y esta imagen se superpuso a la preparación virtual ideal para evaluar la precisión. El tiempo de ejecución y la precisión de la preparación realizada con respecto a una preparación ideal se compararon entre ambos grupos. El estilo de aprendizaje y las habilidades motoras finas al inicio del estudio fueron similares en todos los participantes (P > 0,001). No se encontraron diferencias estadísticamente significativas entre los grupos en términos de precisión. El tiempo de ejecución en el grupo experimental fue significativamente menor que en el grupo control. Este estudio piloto mostró que la visualización asociada a imaginería podría desarrollar habilidades motoras finas en estudiantes de odontología, requiriendo menos tiempo de ejecución que la práctica física.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes de Odontologia/psicologia , Educação em Odontologia , Destreza Motora/fisiologia , Testes de Aptidão , Design de Software , Método Simples-Cego , Projetos Piloto , Estatísticas não Paramétricas , Imageamento Tridimensional , Treinamento por Simulação , AprendizagemRESUMO
Questions remain whether postoperative infections and implant failure can be reduced with the use of antibiotics. Especially, when its routine use can cause adverse effects and may contribute to the development of antibiotic-resistant bacteria. Moreover, there is no consensus regarding appropriate dosage regimen of antibiotics to prevent bacterial infection in implant dentistry. To determine effectiveness of different antibiotics regimens to prevent early infection after implant placement. A systematic review of all relevant studies addressing the use of antibiotic for dental implant surgery was carried-out. Implant groups not using antibiotics, were also analyzed. Primary outcomes were incidence of postoperative infection and frequency of implant failure due to infection. From 164 articles reviewed, 11 fulfilled the selection criteria representing 9472 placed implants. Regimens associated with the use of postoperative antibiotics showed a lower incidence of early infection (postoperative regimens 0%, pre and postoperative regimens 0.22% and 0.53%, long- and short-course, respectively (P= 0.275)). Regarding failure due to infection, no differences between groups were found (P= 0.249). A trend favoring the use of postoperative antibiotic to prevent early infections was observed. Further studies should be carried out in order to provide evidence-based clinical guidelines for use of antibiotics in dental implant placement.
Todavía se mantiene el integorrante acerca de si las infecciones postoperatorias y el fracaso de los implantes se pueden reducir con el uso de antibióticos. Especialmente, cuando su uso rutinario puede causar efectos adversos y puede contribuir al desarrollo de bacterias resistentes a los antibióticos. Por otra parte, no hay consenso en cuanto al régimen de dosificación apropiado de antibióticos para prevenir la infección bacteriana en los implantes dentales. Para determinar la efectividad de los diferentes regímenes de antibióticos destinados a prevenir la infección temprana después de la colocación del implante, se llevó a cabo una revisión sistemática de todos los estudios pertinentes sobre el uso de antibióticos para la cirugía del implante dental. También fueron analizados grupos de pacientes en los que se colocaron implantes sin el uso de antibióticos. Los resultados iniciales demostraron la existencia de infección postoperatoria y el fracaso del implante debido a la infección. De 164 artículos revisados, 11 cumplieron con los criterios de selección, representando un total de 9.472 implantes colocados. Estudios asociados con el uso de antibióticos postoperatorios mostraron una menor incidencia de infección temprana (regímenes postoperatorios 0%, regímenes pre y postoperatoria 0,22% y 0,53%, a largo y corto plazo, respectivamente (P= 0,275)). En cuanto al fracaso debido a la infección, no se encontraron diferencias entre los grupos (p= 0,249). Se observó una tendencia a favor del uso de antibióticos para prevenir infecciones postoperatorias tempranas. Nuevos estudios deben llevarse a cabo con el fin de proporcionar directrices clínicas, basadas en la evidencia, para el uso de antibióticos en la colocación del implante dental.
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Humanos , Adolescente , Adulto , Implantes Dentários , Antibioticoprofilaxia , Implantação Dentária/métodos , Infecções/tratamento farmacológicoRESUMO
OBJECTIVES: The aim of this prospective, randomized clinical trial was to evaluate the effect of a minimally invasive implant procedure for denture stabilization on patients' quality of life (QoL). MATERIALS AND METHODS: Thirty totally edentulous patients were selected for this study. All prostheses were adjusted and relined before randomization and allocation to treatment either with two small diameter implants (SDI) - retained overdenture (study group) or non-intervention group (control group). Quality of life was assessed using the Oral Health Impact Profile-EDENT (OHIP-EDENT) questionnaire before intervention and at one-year follow-up. Between-group comparisons were carried out using the non-parametric Mann-Whitney test. RESULTS: Magnitude of change in the OHIP-EDENT total score at one-year follow-up was 25.4 ± 10.7 for the study group, revealing a statistically significant difference with the control group, that showed a change of 9.5 ± 8.3 (P = < 0.001). CONCLUSIONS: After one-year follow-up, patients wearing mandibular overdentures with two minimally invasive splinted SDI, experienced more improvements in perceived oral health-related quality of life, than patients having conventional treatment.
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Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Boca Edêntula/reabilitação , Qualidade de Vida , Idoso , Feminino , Humanos , Masculino , Estudos Prospectivos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
One of the biggest challenges an orthodontic patient faces is the time spent wearing brackets. Over the years, several surgical techniques have been developed to address this issue and reduce the overall treatment time. These combine bone-healing mechanisms with orthodontic loads to accelerate tooth movement. Although effective, these techniques are also quite invasive in nature, requiring the elevation of buccal and lingual full-thickness flaps with extensive decortications of the buccal and lingual alveolar bone. Moreover, these techniques run the risk of teeth devitalization, avascular necrosis of the osseous block, alveolar resorption, and the risks of complications, with low acceptance by the patient. This manuscript reports three cases treated with a novel, flapless approach for minimally invasive rapid orthodontic (MIRO). This procedure includes radiographic-guided micro incisions and localized piezoelectric corticotomies. The clinical implications of this technique are discussed herein. MIRO reduces orthodontic treatment time, avoiding the reported adverse effects of accelerated orthodontics.
Uno de los mayores desafíos que enfrenta un paciente de ortodoncia es el tiempo que lleva usar brackets. A través de los años, varias técnicas quirúrgicas se han desarrollado para hacer frente a este problema y reducir el tiempo total de tratamiento. Estas combinan los mecanismos de cicatrización ósea, con cargas de ortodoncia para acelerar el movimiento de los dientes. Aunque eficaz, estas técnicas son bastante invasivas, que requieren la elevación de colgajos bucales y linguales de espesor total con decorticaciones extensas del hueso alveolar bucal y lingual. Por otra parte, con estas técnicas se corre el riesgo de desvitalización dentaria, necrosis avascular del bloque óseo, reabsorción alveolar, y los riesgos de complicaciones, con baja aceptación por parte del paciente. Este trabajo reporta tres casos tratados con un nuevo enfoque sin colgajo para ortodoncia rápida mínimamente invasiva (MIRO - minimally invasive rapid orthodontic). Este procedimiento incluye microincisiones guiadas por radiografías y corticotomías piezoeléctricas localizadas. Las implicaciones clínicas de esta técnica se analizan en este documento. MIRO reduce el tiempo de tratamiento de ortodoncia, evitando los efectos adversos reportados por la ortodoncia acelerada.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Técnicas de Movimentação Dentária/métodos , Osteotomia/métodos , Piezocirurgia/métodos , Microcirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Fatores de TempoRESUMO
Extraction and immediate implant placement has become routine procedure due to reduced treatment time and the preservation of anatomical structures. However, in many cases, this technique involves teeth with different degrees of tissue compromise due to underlying infections. Until now, the degree of implant compromise has not been described, nor has a clinical management protocol been established for these cases. The aim of this article is to report the clinical results of a protocol used for immediate implant placement and provisionalization in infected extraction sockets. A classification of the implant surface compromise (in contact with previously infected tissue) is also described to facilitate the comparative analysis. It is possible to maintain the benefits of immediate implant placement and provisionalization in infected sites by applying a clinical protocol that considers antibiotic therapy, a thorough curettage of the infected tissue, antisepsis, and sufficient primary implant stability.
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Prótese Dentária Fixada por Implante , Carga Imediata em Implante Dentário/métodos , Abscesso Periodontal/complicações , Alvéolo Dental/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/etiologia , Protocolos Clínicos , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Masculino , Pessoa de Meia-Idade , Peri-Implantite/etiologia , Granuloma Periapical/complicações , Granuloma Periapical/cirurgia , Abscesso Periodontal/cirurgia , Cisto Periodontal/complicações , Cisto Periodontal/cirurgia , Complicações Pós-Operatórias , Reabsorção da Raiz/complicações , Estomatite/etiologia , Infecção da Ferida Cirúrgica/etiologia , Extração Dentária , Fraturas dos Dentes/complicações , Raiz Dentária/lesões , Resultado do Tratamento , Adulto JovemRESUMO
The aim of this article is to describe a chairside method for immediate implant provisionalization, which preserves the original natural emergence profile and anatomy of the teeth.
El objetivo de este artículo es describir un método directo en el sillón de provisionalización inmediata del implante, que conserva el perfil de emergencia natural original y la anatomía de los dientes.
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Humanos , Feminino , Idoso , Prótese Dentária Fixada por Implante , Implantação Dentária Endóssea/métodos , Restauração Dentária Temporária/métodos , Estética Dentária , Satisfação do Paciente , Fatores de Tempo , Coroa do Dente , Extração DentáriaRESUMO
PURPOSE: Dental practitioners are instructed to avoid any type of contact with implant surfaces prior to their insertion. However, the probability of contaminating the surface is high, especially when placement of implants necessitates the use of precise surgical guides. The aim of this study was to evaluate the 2-year survival rate of splinted mini-implants that came into contact with stainless steel prior to their insertion. MATERIALS AND METHODS: During the clinical portion of the study, initiated over a 3-day period, 90 mini-implants were inserted into the anterior mandible of 45 totally edentulous patients; 46 were inserted using a prefabricated stainless steel guide (group 1, bar) and 44 were placed without a guide (group 2, ball). A flapless surgical protocol was used. All implants were immediately loaded with mandibular overdentures, and follow-up was conducted for up to 2 years. The Kaplan-Meier method was used to analyze implant survival in each group, with a confidence level of 95%. In the in vitro phase of the study, five mini-implants were contaminated for 20 seconds with a stainless steel surgical guide. They were then observed using scanning electron microscopy and energy dispersive spectroscopy to identify contaminants and to determine qualitatively the chemical composition of the surface. As a control, five mini-implants recently extracted from their original containers were analyzed. RESULTS: During the 2-year follow-up, one implant failed (97.8% survival rate) in group 1 and four failed in group 2 (90.9% survival rate). The in vitro analysis revealed carbon and oxygen on all implants. On the implants that were in contact with stainless steel, additional elements were identified, including silica, calcium, iron, and chromium. CONCLUSIONS: Contact between mini-implants and stainless steel surgical guides does not seem to generate contamination that compromises the survival of splinted mini-implants.
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Ligas Dentárias/química , Implantes Dentários , Aço Inoxidável/química , Titânio/química , Idoso , Idoso de 80 Anos ou mais , Ligas , Cálcio/análise , Carbono/análise , Cromo/análise , Implantação Dentária Endóssea/instrumentação , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Revestimento de Dentadura , Feminino , Seguimentos , Humanos , Ferro/análise , Arcada Edêntula/cirurgia , Masculino , Mandíbula/cirurgia , Teste de Materiais , Pessoa de Meia-Idade , Oxigênio/análise , Dióxido de Silício/análise , Propriedades de Superfície , Análise de Sobrevida , Resultado do TratamentoRESUMO
PURPOSE: This aim of this study was to evaluate the effect of splinting mini-implants on marginal bone loss when used to retain mandibular overdentures. MATERIALS AND METHODS: With mathematical models, a finite element analysis was performed to compare the bone stress distribution around two mini-implants, either splinted with a bar superstructure or not splinted. In the clinical portion of this study, 90 mini-implants were placed in the anterior mandibles of 45 completely edentulous patients selected from a public health center. Patients were randomly allocated into two groups. Group-ball (22 patients, n = 44) received two single ball-type mini-implants, and group-bar (23 patients, n = 46) received two mini-implants splinted with a prefabricated bar. All implants were placed using a flapless technique and loaded immediately. Marginal bone loss was assessed through standardized retroalveolar radiographs of each mini-implant and compared 5, 10, 15, and 24 months after implant placement. RESULTS: The finite element analysis showed the highest minimum principal stress (-118 MPa) in bone surrounding the unsplinted mini-implant, while around the splinted implants the principal stresses were -56.8 MPa. After 2 years of follow-up in the clinical study, group-ball showed a trend toward greater marginal bone loss than group-bar (1.43 ± 1.26 mm and 0.92 ± 0.75 mm, respectively). Group-ball showed a significantly higher prevalence of vertical bone loss than group-bar (chi-square test, two-tailed). CONCLUSION: Splinted mini-implants with a rigid superstructure decrease the bone stress level in comparison with single mini-implants. The effects of bone stress magnitude may explain the clinical outcome, in which splinted mini-implants supporting a mandibular overdenture showed less marginal bone loss compared with nonsplinted mini-implants. Vertical bone resorption morphology was significantly more prevalent in the latter group.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Implantes Dentários , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Contenções , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/patologia , Fenômenos Biomecânicos , Implantação Dentária Endóssea/instrumentação , Implantação Dentária Endóssea/métodos , Implantes Dentários/efeitos adversos , Prótese Dentária Fixada por Implante/efeitos adversos , Análise do Estresse Dentário , Retenção de Dentadura/instrumentação , Feminino , Análise de Elementos Finitos , Humanos , Arcada Edêntula/patologia , Arcada Edêntula/reabilitação , Estudos Longitudinais , Masculino , Mandíbula/patologia , Mandíbula/cirurgia , Pessoa de Meia-Idade , Modelos Teóricos , Procedimentos Cirúrgicos Pré-Protéticos Bucais/instrumentação , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Resultado do TratamentoRESUMO
El objetivo del presente estudio fue investigar la importancia del desayuno en el estado nutricional y el procesamiento de la información en escolares. A 26 escolares (13 varones, 6.3 a 6.9 años) se les tomaron las medidas antropométricas usadas para evaluar nutrición. Se aplicaron ocho pruebas de la batería K-ABC de Kaufman: repetición de números (RN), orden de palabra, movimiento de manos (MM), cierre gestáltico, triángulos, matrices análogas, memoria espacial y series de fotos. Las medias encontradas del K-ABC son normales, con cierta dispersión y algunos valores bajos (puntaje Z de MM, Triángulos, RN y Procesamiento Secuencial: -2.30; -1.50; -1.41 y -1.71 respectivamente). Los niños que no desayunan tuvieron disminuido su estado nutricional y deficiencias en su procesamiento secuencial, simultáneo y compuesto de la información
The main purpose of this study was to investigate the importance of the breakfast meal in childrens nutritional status and mental processing. Anthropometric measures of 26 children (13 males, 6.3 to 6.9 years old) were used to evaluate nutrition levels. Eight tests of the K-ABC Kaufman battery were applied: numbers recall, word order, hand movements, gestalt closure, triangles, analog matrixes, spatial memory and series of photos. The obtained K-ABC averages wereinside normal ranges, with certain dispersion of values and decreased values for some (Z score of hand movements, triangles, numbers recall and sequential processing: -2.30, -1.50, -1.41 y -1.71 respectively). The children that didnt have breakfast showed diminished nutritional status and deficiencies in their sequential, simultaneous and composite mental processing.