Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2019. Vol. 24, no. 5

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    Assessment of the capacity of a pyrophosphate-based mouth rinse to inhibit the formation of supragingival dental calculus. a randomized double-blind placebo-controlled clinical trial
    (2019) Fons Badal, Carla; Agustín Panadero, Rubén; Solá Ruiz, María Fernanda; Alpiste Illueca, Francisco M.; Fons Font, Antonio
    This study aimed to analyze the efficacy of an anti-calculus mouth rinse and its possible adverse effects on the mucosa and teeth. This randomized double-blind placebo-controlled clinical trial included 40 patients with treated and managed periodontal disease, all with a history of rapid calculus formation. Patients used a pyrophosphate-based test mouth rinse (B) or a placebo (A). A range of parameters were measured for: saliva (saliva flow, pH and chemical composition); calculus (Volpe-Manhold [V-M] index, weight, and volume); adverse effects on mucosa and teeth; and the patients? subjective perceptive of mouth rinse efficacy. The test mouth rinse B produced reductions in urea, uric acid, and phosphorous, calcium, saliva flow, and increases in pH. V-M index and calculus weight decreased after using the test mouth rinse. Calculus volume decreased with both mouth rinses. No changes to the mucosa or teeth were observed. Patients perceived that the test mouth rinse was more effective. The test/B and placebo mouth rinses both modified certain parameters in saliva composition, particularly reductions in urea, uric acid, and phosphorous. Calcium tended to increase after using the test-B mouth rinse. The results did not demonstrate the anticalculus efficacy of the pyrophosphate-based mouth rinse or positive effects on saliva flow or composition. This field requires further research, as no product has been developed that prevents calculus formation completely.
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    Oral and dental health status in patients with eating disorders in Madrid, Spain
    (2019) Garrido Martínez, Pablo; Domínguez Gordillo, A.A.; Cerero Lapiedra, Rocío; Burgueño García, Miguel; Martínez Ramírez, María José; Gómez Candela, Carmen; Cebrián Carretero, José Luis; Esparza Gómez, G.
    The aim of the present study was to describe and compare the oral and dental health status of two groups, one diagnosed with eating disorders (EDs), and another group without this pathology, assessing the following oral manifestations: dental alterations, periodontal disorders, soft tissue disorders, non-stimulated salivary flow, and oral pH. This comparative transversal epidemiological study included 179 participants, of whom 59 were diagnosed with EDs (Eating Disorder Group: EDG) and 120 had no antecedents of EDs (No Eating Disorder Group: NEDG). All patients fulfilled the following inclusion criteria: women aged over 18 years, diagnosed with an ED by a specialist, patients who had undergone at least 1 year monitoring by the Clinical Nutrition Unit, and had not received any periodontal treatment during the previous 6 months. Both groups were homogeneous in terms of sex, age, education, and socioeconomic level. Oral exploration was performed, registering clinical variables, as well as sociodemographic and socioeconomic data, oral hygiene habits, and smoking. Statistical significance was established as p<0.05 (confidence level > 95%). The dental erosion (DE) was the most significative feature of dental alterations. The degree of DE was significantly greater in the EDG (p<0.001). A significant association between soft tissue lesions and EDs was found (p<0.001) A notable difference in non-stimulated salivary flow was found between the groups (p<0.001). No significant differences between the groups were found for periodontal status, dental caries, or oral hygiene practices. On the basis of the results obtained, it is necessary to carry out oral/dental examination as soon as an ED is diagnosed with regular check-ups thereafter.
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    Orofacial features and medical profile of eight individuals with Kabuki syndrome
    (2019) Silva-Andrade, Natália; López Ortega, Karem; Gallottini, Marina
    To evaluate oral, craniofacial and systemic characteristics of eight patients with Kabuki syndrome (KS), aged between 3 and 16 years old. In this retrospective study, medical records of all patients were reviewed for information on family history, growth and development, medications in use, general systemic complications and oral and craniofacial characteristics. The medical alterations found included recurrent infections such as pneumonia and otitis media (n = 6), cardiovascular malformations (n = 4), kidney abnormalities (n = 2), epilepsy (n = 2) and visual deficiency (n = 2). The individuals exhibited dental caries (n = 5), agenesis (n = 5), delayed tooth eruption (n = 4), cleft lip/palate (n = 2) enamel hypoplasia (n = 2), fusion (n = 1) and microdontia (n = 1). There was a great diversity of oral, craniofacial and systemic characteristic among the KS patients, suggesting that an inter-disciplinary approach should be taken for their dental treatment.
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    A survey of pathology specimens associated with impacted teeth over a 21-year period
    (2019) Mohammed, Muhanad; Mahomed, Farzana; Ngwenya, Sizakele
    To compare the histologic diagnosis of lesions associated with impacted teeth from a South African population with literature data. A retrospective cross-sectional survey of tissue specimens associated with impacted teeth that were analyzed in the Department of Oral Pathology (University of the Witwatersrand, South Africa) between 1996 and 2016. Patient age, gender, impacted tooth location and the histologic diagnosis were recorded for statistical analysis. Odontogenic pathology was diagnosed in 389 (95.6%) specimens while dental follicle comprised 4.4% of tissue submissions. The mean age was 25.3 ±15.2 years with a male predilection (M:F=1.8:1). The 11-20 year age group was mostly affected and the overall frequency of odontogenic lesions reduced significantly with an increase in age (p=0.01). Dentigerous cyst (56.5%) and ameloblastoma (14%) were most commonly diagnosed. This is the first African epidemiologic survey of histologic specimens associated with impacted teeth and shows striking differences in the ratio of pathologic to non-pathologic diagnoses compared to other populations. Locally aggressive odontogenic lesions appear to develop one to two decades earlier in patients from developing countries.
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    Reconstruction of mandibular defects using vascularized fibular osteomyocutaneous flap combined with nonvascularized fibular flap
    (2019) Wang, Weihong; Zhu, Jin; Xu, Biao; Xia, Bin; Liu, Yu; Shao, Shengjie
    The height of single-layer fibular flap is not long enough to return to the ideal height of the mandible. While the double-layer vascularized fibular osteomyocutaneous flap(VFF) is more complicated in shaping and fixation, along with a longer operation time. The aim of this study was to investigate the clinical effect of VFF combined with nonvascularized fibular flap(NVFF) in the reconstruction of mandibular defect. From September 2016 to June 2018, 15 patients with benign mandibular tumors underwent reconstruction with VFF and NVFF. SimPlant Pro ? software (version 11.04) was used to simulate reconstruction of the mandible preoperatively. All patients were followed up for 8-23 month, with an average of 11.7 months. 15 VFFs survived well. Among the 15 NVFFs, one was almost completely absorbed, two with partial absorption, and the remaining survived regardless of the small amount of absorption. The postoperative absorption of the whole fibula was 7.53±6.362%, a favorable facial contour and speech function were attained. The VFF combined with NVFF to reconstruct the mandibular defect can restore the vertical height of the mandible and achieve satisfactory clinical results.
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    Repeatability of the resonance frequency analysis values in implants with a new technology
    (2019) Díaz Castro, Carmen María; Falcao, Artur; López Jarana, Paula; Falcao, Carlos; Ríos-Santos, JV; Fernández-Palacín, Ana; Herrero Climent, Mariano
    Assess the reliability (by means of reproducibility and repeatability) of the PenguinRFA system, analyse the ISQ values of different implant types and correlate the ISQ with the insertion torque during the placement of the implant. 120 rough surface implants were placed in bovine bone (type II and III). The implants were divided into groups, according to its design. Once the implants were in place, the exact insertion torque was registered. Then, primary stability was measured by means of the resonance frequency analysis with the PenguinRFA and the Osstell ISQ devices. In each implant two transducers of each device were used. Three measurements were obtained with each transducer. The mean ISQ (implant stability quotient) of the whole sample is 67,70 ± 5,51. The Intraclass Correlation Coefficient (ICC) is 0,933 and 0,944 for transducers 1 and 2 respectively. The reproducibility is 0,906. The mean insertion torque is 24,54 ± 8,96N. The correlation between the ISQ and the insertion torque is 0,507 p<0,000 (MultiPeg 1) and 0,468 p<0,000 (MultiPeg 2) for bone type II and 0,533 p<0,801 (MultiPeg 1) and 0,193 p<0,140 (MultiPeg 2) for bone type III. The results of the present trial suggest that the PenguinRFA presents excellent reproducibility and repeatability, so it could be very useful in the monitoring of the stability of implants over time. Additionally, according to the results, the correlation between the IT and the RFA is low and there are no statistically significant differences in between implant types.
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    Oral squamous cell carcinoma of tongue : histological risk assessment. A pilot study
    (2019) Migueláñez-Medrán, Blanca C.; Pozo Kreilinger, Jose Juan; Cebrián Carretero, José Luis; Martínez-García, Miguel-Ángel; López Sánchez, Antonio F.
    More than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and tobacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue. Samples from 26 patients with OSCC were analyzed and histological risk pattern of recurrent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption. We found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization. Based on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas.
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    Temporomandibular arthropathies : a retrospective study with histopathological characteristics
    (2019) Rennó, Tamires-Aparecida S.; Chung, Amy-Chwen-Jing; Gitt, Hans-Albrecht; Corrêa, Luciana; Luz, João-Gualberto C.
    To investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics. Temporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included. The mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes. The pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named.
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    Validation of microRNA expression profile in Oral Lichenoid Disease through cytological samples
    (2019) Setién Olarra, Amaia; Marichalar Mendia, Xabier; Fernández-Pacheco, Juan-Alonso; Fernández-Barriales-López, Marcos; Gainza Cirauqui, María Luisa; Aguirre Urízar, José Manuel
    To validate oral exfoliative cytology in the analysis of the microRNA expression profile in Oral Lichenoid Disease (OLD). The expression of 13 microRNAs identified and presented by our group in a previous study was analyzed in 26 cases, 16 diagnosed as OLD and 10 controls with no oral mucosal pathology. Cytological samples from the oral mucosa obtained using an Orcellex toothbrush were analyzed using RT-qPCR and TaqMan microRNA assays. The aberrant expression was validated for 2 microRNAs (miR-146a-5p and miR-7-1-3p) of those previously recognized in the biopsy study. This is the first time that oral exfoliative cytology is validated in a study of the alterations of the expression of microRNAs in OLD. The alteration of miR-146a and miR-7 compared to controls was validated. These microRNAs are associated with both inflammatory and carcinogenic phenomena that are involved in the etiopathogenesis of this potentially malignant oral disorder.
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    Effects of locally applied Insulin-like Growth Factor-I on osseointegration
    (2019) López Quiles, Juan; Forteza-López, Alba; Montiel, Mónica; Clemente de Arriba, Celia; Fernández-Tresguerres Hernández, Jesús A.; Fernández Tresguerres, Isabel
    The aim of this study was to assess the effect of local application of IGF-I on osseointegration of dental implants placed in osteoporotic bones. 16 rabbits were randomly distributed into two groups: eight animals were ovariectomized and fed a low-calcium diet for six weeks, in order to induce experimental osteoporosis, and the others were sham-operated and fed a standard diet. A titanium implant was inserted into the tibiae in both groups. In half of the rabbits, 4 ?g of IGF-I was applied into the ostectomy, prior to the implant insertion. A total of 32 implants were placed. Animals were sacrificed two weeks after surgery and decalcified samples were processed for Bone-To-Implant Contact (BIC) and Bone Area Density (BAD) measurements. Analysis of variance (ANOVA) was used for statistical evaluation. P<0.05 was considered to be significant. Ovariectomy induced statistically significant lower BAD values (p=0.008) and a tendency towards lower BIC values when compared osteoporotic and healthy groups. The administration of 4 ?g of IGF-I did not produce statistically significant differences neither on BIC nor on BAD values, neither in the osteoporotic animals nor in healthy. Within the limitations of this experimental study, local administration of 4 ?g of IGF-I was not able to induce any changes in the osseointegration process two weeks after surgery, neither in healthy rabbits nor in the osteoporotic group.
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    Stomatological disorders in older people : an epidemiological study in the brazil southern
    (2019) Fattori, Eduarda; Teixeira, Dieni-da Silveira; de Figueiredo, Maria-Antonia-Zancanaro; Cherubini, Karen; Salum, Fernanda-Gonçalves
    The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary.
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    Clinical repercussions and epidemiological considerations of supernumerary canines : a 26 case series
    (2019) Cortés-Bretón Brinkman, Jorge; Martínez Rodríguez, Natalia; Barona Dorado, Cristina; Martín Ares, María; Sanz Alonso, Javier; Suárez García, M. ª Jesús; Prados Frutos, Juan Carlos; Martínez González, José María
    To establish the prevalence of supernumerary canines (SNC) in a sector of the population of Madrid (Spain), as well possible complications associated with this unusual developmental variation. This observational study was performed between 2005 and 2017, among 21,615 patients seeking dental treatment at the Faculty of Dentistry, Complutense University of Madrid (Spain), and at the Virgen de la Paloma Hospital, Madrid (Spain); 22 patients with 26 SNCs were diagnosed. These 22 patients underwent clinical and radiological exploration, registering patient data. SNCs presented a prevalence of 0.10% of the study population. The supernumerary teeth (SNT) were located in the upper maxilla more frequently (61.54%) than the mandible (38.46%). 69.23% were found to be impacted, also causing the impaction of the permanent canine in 53.85% of these cases. In 15.38%, follicular expansion > 3mm was observed. SNCs were associated with other SNT in only four patients. Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological exploration, in the present study over half of them (53.85%) caused impaction of the permanent canine. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.
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    Epigenetics and periodontics : a systematic review
    (2019) Almiñana Pastor, Pedro J.; Boronat Catalá, Montserrat; Micó Martínez, Pablo; Bellot Arcís, Carlos; López Roldán, Andrés; Alpiste Illueca, Francisco M.
    Despite decades of research, our knowledge of several important aspects of periodontal pathogenesis remains incomplete. Epigenetics allows to perform dynamic analysis of different variations in gene expression, providing this great advantage to the static measurement provided by genetic markers. The aim of this systematic review is to analyze the possible relationships between different epigenetic mechanisms and periodontal diseases, and to assess their potential use as biomarkers of periodontitis. A systematic search was conducted in six databases using MeSH and non-MeSH terms. The review fulfilled PRISMA criteria (Preferred Reporting Items for Systematic reviews and Meta-analysis). 36 studies met the inclusion criteria. Due to the heterogeneity of the articles, it was not possible to conduct quantitative analysis. Regarding qualitative synthesis, however, it was found that epigenetic mechanisms may be used as biological markers of periodontal disease, as their dynamism and molecular stability makes them a valuable diagnostic tool. Epigenetic markers alter gene expression, producing either silencing or over-expression of molecular transcription that respond to the demands of the cellular surroundings. Gingival crevicular fluid collection is a non-invasive and simple procedure, which makes it an ideal diagnostic medium for detection of both oral and systemic issues. Although further research is needed, this seems to be a promising field of research in the years to come.
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    Is the re-use of sterilized implant abutments safe enough? (Implant abutment safety)
    (2019) Sánchez-Garcés, María Angeles; Jorba, Marta; Ciurana, Joan; Viñas Ciordia, Miguel; Vinuesa, Teresa
    Background: The reuse of implant healing abutments is common in dental practice. Effective elimination of bacteria and viruses is accomplished by conventional sterilization. The aim of this work was to explore the eventual survival of microorganisms on sterilized healing abutments and to rule out the presence of transmissible organic material after standard procedures. Material and Methods: A total of 55 healing abutments previously used in patients will be washed and sterilized in a steam autoclave at 121ºC for 15 min. Each healing abutment will be cultured in Brain Heart Infusion broth (BHI) under strict aseptic conditions. Besides, two control groups will be included: one of 3 unused healing abutments, and the other of just medium. After 10 days at 37°C under a 5% CO2 100 µl of the broth will be plated on solid media (Brain Infusion Agar, BHIA) and Columbia Blood agar to test for sterility. The remaining volume will be centrifuged, the sediment fixed, and a Gram stain performed to discard the presence of non-cultivable microorganisms. Moreover, to determine the presence of remaining organic material after the cleaning and sterilizing treatments, the bioburden will be determined by measuring total organic carbon (TOC) in another 10 previously used healing abutments, cleaned and sterilized, that will be submerged in Milli-Q water and sonicated. Results: No bacterial growth was detected on any of the 58 cultured abutments, indicating that the sterilization was completely satisfactory in terms of removal of live bacteria or spores. Nevertheless, significant amounts of organic carbon may still be recovered (up to 125,31 µg/abutment) after they have been sterilized. Conclusions: Significant amounts of the bioburden remained adhered to the surfaces in spite of the cleaning and sterilization procedures. Taking into account our results and data from other authors, the presence of infectious particles on the reused healing abutments such as prions cannot be ruled out.
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    Trends of maxillofacial trauma : an update from the prospective register of a multicenter study in emergency services of Chile
    (2019) Werlinger, Fabiola; Villalón, Marcelo; Duarte, Valentina; Acevedo, Raúl; Aguilera, Rodrigo; Alcocer, Diego; Arriola, Mario; Badillo Coloma, Óscar; Briones, René; Condal, Cristian; Del Río, Marcela; Henríquez, Jaime; García, Roberto; Herrera, Mauricio; Jaramillo, Joaquín; Merchan, Felipe; Nasi, Marco; Osbén, Roberto; Rivera Baró, Alejandro; Riviello, Santiago; Rojas, Patricio; Vidal, Constanza; Rodríguez, Gastón; Schild, Sebastián; Arroyo, Esteban; Alvarado Muñoz, María José; Sepúlveda, Pilar; Cortés Araya, Juan
    Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. Descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p<0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). The profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records.
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    Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT)
    (2019) Cabanes Gumbau, Guillermo; Pascual Moscardó, Agustín; Peñarrocha Oltra, David; García Mira, Berta; Aizcorbe Vicente, Javier; Peñarrocha Diago, María
    To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading. A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at two different timepoints: a) on the day of provisionalization, before prosthetic loading; and b) 10 months later without the provisional prosthesis. The STL files were superimposed and the soft tissue changes were recorded using a color scale with measurement of the volumetric changes in mm3. A mean increase in peri-implant mucosal volume of 64.7 mm3 was observed in 29 implants. The zones with the greatest increase in soft tissue volume were the papillae of implants with adjacent teeth and the peri-implant buccal margin. Three implants showed a mean decrease in soft tissue volume of -25.1 mm3. The fitting and design of crowns using the biologically oriented preparation technique (BOPT) over convergent collar implants affords a significant increase in peri-implant soft tissue volume both at the level of the papillae and in the buccal margin.
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    The accuracy of three-dimensional rapid prototyped surgical template guided anterior segmental osteotomy
    (2019) Qu, Moyuan; Zhu, Songsong; Hu, Zhiai; Li, Yunfeng; Abotaleb, Bassam; Bi, Ruiye; Jiang, Nan
    Surgical guiding templates provided a reliable way to transfer the simulation to the actual operation. However, there was no template designed for anterior segmental osteotomy so far. The study aimed to introduce and evaluate a set of 3D rapid prototyping surgical templates used in anterior segmental osteotomy. From August 2015 to August 2017, 17 patients with bimaxillary protrusions were recruited and occlusal-based multi-sectional templates were applied in the surgeries. The cephalometric analysis and 3D superimposition were performed to evaluate the differences between the simulations and actual post-operative outcomes. The patients were followed-up for 12 months to evaluate the incidence rate of complications and relapse. Bimaxillary protrusion was corrected in all patients with no complication. In radiographic evaluations, there was no statistically significant difference between the actual operations and the computer-aided 3D simulations (p >0.05, the mean linear and angular differences were less than 1.32mm and 1.72° consequently, and 3D superimposition difference was less than 1.4mm). The Pearson intraclass correlation coefficient reliabilities were high (0.897), and the correlations were highly significant (P< 0.001). The 3D printed surgical template designed in this study can safely and accurately transfer the computer-aided 3D simulation into real practice.
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    Impact of crestal and subcrestal implant placement upon changes in marginal peri-implant bone level. A systematic review
    (2019) Pellicer Chover, Hilario; Diaz Sanchez, Rosa Maria; Soto Penaloza, David; Peñarrocha Diago, María; Canullo, Luigi; Peñarrocha Oltra, David
    To systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was conducted in the PubMed (MEDLINE), EMBASE and LILACS databases to identify all relevant articles published up until April 2017. The search included human studies comparing marginal bone loss (MBL) between a control group and a study group with a minimum of 10 patients and a minimum follow-up of 6 months after prosthetic loading with rough neck implants. Two independent reviewers assessed the risk of bias in the selected studies based on the Newcastle-Ottawa scale for observational studies and the Cochrane Collaboration for clinical trials. Of 342 potentially eligible items, 7 complied with the inclusion criteria. One article was retrieved through the manual search. Eight articles were finally included: five experimental and three observational studies. The risk of bias assessed by the Cochrane Collaboration and Newcastle-Ottawa showed a high risk of bias. The mean follow-up period was 21 months (range 6-36 months). In four studies, implants placed in a crestal position presented higher MBL than subcrestal implants - the differences being significant in one study, while in three studies, implants placed in a subcrestal position presented greater MBL than crestal implants, with significant differences in only one study. Despite its limitations, the present systematic review did not find better outcomes between crestal and subcrestal implant placement, however, new studies will be needed, involving improved designs and the standardization of protocols to allow statistical comparisons and the drawing of firm conclusions.