Immediate implant placement and provisionalization has been considered as a preservative procedur... more Immediate implant placement and provisionalization has been considered as a preservative procedure when replacing failing teeth, especially in the esthetic zone. Nevertheless, an average facial gingival tissue recession of 1 mm is still common after one year of function. Furthermore, facial gingival recession of thin periodontal biotype seems to be more pronounced than that of thick biotype. Biotype conversion around both natural teeth and implants with subepithelial connective tissue graft has been advocated, and the resulting tissues appear to be more resistant to recession. A technique combining subepithelial connective tissue graft and immediate implant placement and provisionalization is devised to achieve a more stable peri-implant tissue in thin biotype situations. This article describes the surgical and prosthodontic approach of this procedure as well as its clinical rationale.
The International Journal of Periodontics & Restorative Dentistry
This peer-reviewed, accepted manuscript will undergo final editing and production prior to public... more This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in PRD.
Accuracy of completely edentulous arch scanning with implant scan bodies has not been completely ... more Accuracy of completely edentulous arch scanning with implant scan bodies has not been completely validated for intraoral scanners. For desktop laboratory scanners validations were found in the literature. The aim of this in vitro study was to compare the dimensional accuracy of scanning with splinted and unsplinted scan bodies on a completely edentulous maxillary arch with 6 implants. A maxillary edentulous master cast with 6 implants was used as control for all implant level impressions. 6 implants were digitally planned and placed at different angulation of 0, 0 17° and 30°. A contact coordinate measuring machine (CMM) was used to generate baseline linear measurements of the master cast. Four test groups included: 2 intraoral scanners Trios (3shape, Copenhagen, Denmark) and True Definition (3M ESPE, St Paul, MN), one industrial scanner Atos (Core optical 3D scanner) and one conventional impression group scanned with laboratory scanner Dental Wings 7 Series. Each scan recording wa...
Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medici... more Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medición de una organización afecta muchísimo el comportamiento de la gente, tanto del interior como del exterior de la organización. Si las empresas han de sobrevivir y prosperan en la competencia de la era de la información, han de utilizar sistemas de medición y gestión, derivados de sus estrategias y capacidades. Desgraciadamente muchas organizaciones adoptan estrategias con respecto a las relaciones con los clientes, las competencias centrales y capacidades organizativas, mientras que motivan y miden la actuación solo con indicadores financieros. El Balanced Scorecard conserva la medición financiera como un resumen crítico de la actuación gerencial. Pero realza un conjunto de mediciones mas generales e integradas, que vinculan al cliente actual, los procesos internos, los empleados y la actuación de los sistemas con el éxito financiero a largo plazo
The purpose of this study is to compare the exposure rate of 3 different barrier types after a gu... more The purpose of this study is to compare the exposure rate of 3 different barrier types after a guided-bone regeneration procedure as well as to compare the percentage grafted bone dimensional loss with and without exposed barriers. Patient records from September 2007 to May 2015 were reviewed to identify subjects who had received a bone graft followed by implant placement procedure after the graft had completely healed. The subjects were divided into 3 groups: (1) resorbable barrier, (2) nonresorbable barrier, and (3) titanium-mesh barrier. Incidences of barrier exposure were recorded. Cone-beam computerized tomography images before treatment (T0), right after grafting (T1), and after healing (T2) were used to determine the percentage of grafted bone dimensional loss and am quantitative amount of grafted bone remaining (mm2). Three cross-sectioned areas, at 1-mm apart, of preplanned implant positions at the grafted site were measured using cone-beam computerized tomography to calcul...
The International Journal of Periodontics & Restorative Dentistry, 2019
The computer-assisted design/computer-assisted manufactured compound prosthesis involves designin... more The computer-assisted design/computer-assisted manufactured compound prosthesis involves designing and milling a cement-retained prosthesis over milled titanium bars. In the presented clinical case report, a diagnostic wax pattern was made to assess esthetics, contours, and occlusion. A total of eight maxillary root-form implants were restored by following the combined prosthesis design concept. The mandibular arch was restored with a screwretained implant-supported zirconia fixed prosthesis. A milled polymethyl methacrylate (PMMA) maxillary interim prosthesis was fabricated to intraorally confirm the diagnostic wax pattern. The interim PMMA prosthesis was then scanned, and three screw-retained titanium milled bars were designed that provided the substructure of the definitive restoration. A cement-retained milled zirconia prosthesis was then designed and fabricated. The zirconia prosthesis provided the superstructure of the definitive complete-arch restoration. After confirming esthetics, phonetics, occlusion, and accessibility for oral hygiene, the superstructure was cemented with temporary cement to enable retrievability.
This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Lateral approach sinus grafting has become a routine and predictable surgical method of augmentin... more Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.
The International journal of periodontics & restorative dentistry
Mandibular ridge augmentation via guided bone regeneration in the atrophic mandible is considered... more Mandibular ridge augmentation via guided bone regeneration in the atrophic mandible is considered one of the most challenging scenarios for implant-supported oral rehabilitation. Uneventful wound healing has clearly demonstrated its impact on the final regenerative outcome. Soft tissue management must be precise and adequate to attain flap-free wound closure. Accordingly, it demands exhaustive insight and expertise to avoid damaging the neighboring structures. The cadaver study described herein discusses the mandibular morphologic landmarks (ie, musculature, vascularization, innervation, and salivary glands) necessary to safely perform regenerative procedures in the atrophic mandibular ridge, such as vertical ridge augmentation and dental implant surgery. The potential intraoperative complications are presented, as well as clinical implications of which the clinician must be aware to prevent adverse surgical events during regenerative surgery and implant placement in this anatomical...
Clinical implant dentistry and related research, Jan 30, 2016
To the best of the authors' knowledge, there is very limited clinical data on the outcomes of... more To the best of the authors' knowledge, there is very limited clinical data on the outcomes of simultaneous guided bone regeneration (GBR) for horizontal and/or vertical bone gain for the reconstruction of severely atrophic edentulous maxilla. Therefore, the purpose of the clinical series presented herein was to clinically evaluate long-term horizontal and vertical bone gain, as well as implant survival rate after reconstruction of severely atrophic edentulous maxillary ridges. Sixteen patients (mean age: 64.6 ± 14.6 years of age) were consecutively treated for vertical and/or horizontal bone augmentation via GBR in combination with bilateral sinus augmentation utilizing a mixture of autologous and anorganic bovine bone. Implant survival, bone gain, intraoperative/postoperative complications and peri-implant bone loss were calculated up to the last follow-up exam. Overall, 122 dental implants were placed into augmented sites and have been followed from 12 to 180 months (mean: 76....
Revista Internacional De Odontologia Restauradora Periodoncia, 2005
Este estudio presenta un analisis clinico, radiografico, de laboratorio e histologico/histomorfom... more Este estudio presenta un analisis clinico, radiografico, de laboratorio e histologico/histomorfometrico del uso de los autoinjertos en bloque de la mandibula para el aumento vertical del reborde alveolar. Se incluyeron 12 pacientes en el estudio. Se fijaron los autoinjertos en bloque autogenos en los lechos receptores con tornillos, y se utilizo una mezcla de medula osea autogena y de sustancia mineral inorganica de origen bovino (Bio-Oss) en la periferia. En la cirugia de reapertura, todos los injertos parecian bien incorporados en los lechos receptores. Las mediciones radiograficas revelaron un aumento vertical medio del reborde de 5, 75 ± 1, 29 mm al cabo de 1 mes de la cirugia, y de 4, 75 ± 1, 29 mm despues de 4 a 6 meses de la misma. Esto indico una reabsorcion del 17, 4%. Las mediciones volumetricas en el laboratorio pusieron de manifiesto un promedio de aumento del reborde olveolar de 0, 84 ± 0, 34 ml despues de 1 mes de la cirugia, y de 0, 71 ± 0, 28 ml al cabo de los 6 meses de la intervencion. La tasa de reabsorcion, segun las mediciones volumetricas en el laboratorio, fue del 15, 5%. Las mediciones lineales en el laboratorio revelaron un aumento vertical del reborde de 5, 92 ± 1, 38 mm despues de 1 mes de la intervencion, y de 4, 08 ± 1, 07 mm al cabo de 4 a 6 meses de la cirugia. La evaluacion histologica de los autoinjertos en bloque senalo la existencia de signos de actividad de remodelacion activa en 10 de las 12 muestras. En un caso, el injerto en bloque quedo expuesto y se infecto, y en otro caso, el autoinjerto en bloque se desprendio durante la cirugia de colocacion del implante. El analisis histomorfometrico de las particulas de hueso de la periferia indicaba la presencia de hueso en el 33, 99 ± 8, 82% de la superficie del injerto, mientras que el 42, 43 ± 11, 06% de la zona estaba ocupada por tejido fibroso, y el 23, 89 ± 9, 12% estaba constituida de particulas residuales de Bio-Oss. Dichas particulas estaban en intimo contacto con el hueso recien formado a lo largo del 58, 57 ± 75, 22% de su perimetro.
Periodoncia Sociedad Espanola De Periodoncia, 2009
Recientemente, la tecnologia por ordenador ha hecho posible simular la colocacion de implantes, f... more Recientemente, la tecnologia por ordenador ha hecho posible simular la colocacion de implantes, fabricar una guia quirurgica precisa, basada en la colocacion simulada de los implantes y fabricar la protesis antes de la colocacion quirurgica de los implantes. Tal como se ha publicado, muchos pacientes se han tratado satisfactoriamente siguiendo esta tecnica, aunque se ha publicado muy poco en lo que se refiere a sus complicaciones. Este articulo muestra la colocacion erronea de una protesis completa definitiva que fue construida antes de la cirugia de implantes y cargada inmediatamente despues. La protesis se diseno y se fabrico utilizando datos de los implantes que fueron generados por ordenador. Utilizando el concepto "All-on-Four", se fabrico una guia quirurgica (Nobel Guide) a partir de los datos suministrados por el ordenador, con el objeto de guiar la colocacion de los implantes. En este articulo se discute el manejo de esta protesis mal ajustada, asi como las subsiguientes complicaciones clinicas.
Periodoncia Sociedad Espanola De Periodoncia, 2010
Resumen:Los objetivos del presente estudio son: (1) evaluar los resultados de la Regeneracion Ose... more Resumen:Los objetivos del presente estudio son: (1) evaluar los resultados de la Regeneracion Osea Guiada vertical (ROG) empleando injertos de hueso autogeno particulado, (2) determinar clinica y radiograficamente las tasas de exito y de supervivencia de 82 implantes colocados en dichos lechos quirurgicos entre los 12 y los 72 meses posteriores a la carga protesica, y (3) comparar los defectos que se trataron simultaneamente mediante el aumento del seno y la ROG vertical con otras areas del maxilar tratadas unicamente con ROG vertical.Materiales y metodos: se insertaron 82 implantes en 35 pacientes que presentaban un total de 36 defectos oseos verticales. Los pacientes fueron divididos en tres grupos: pacientes con un solo diente ausente (grupo A), pacientes con multiples dientes ausentes (grupo B), y pacientes con defectos verticales en la zona posterior del maxilar (grupo C). Todos los sujetos del grupo C fueron tratados simultaneamente con procedimientos de aumento de seno y vertical. Todos los pacientes fueron tratados con aumento vertical de cresta empleando membranas de politetrafluoroetileno (e-PTFE) y autoinjertos particulados. Tras la remocion de la membrana de e-PTFE, todos los lechos quirurgicos recibieron una membrana de colageno.Resultados al retirar las membranas, el aumento vertical medio fue de 5, 5 mm (± 2, 29 mm). El remodelado crestal medio fue de 1, 01 mm (± 0, 57 mm) a los 12 meses y permanecio estable durante el periodo de seguimiento de 6 anos. No se produjeron diferencias estadisticamente significativas entre los tres grupos en terminos de remodelado oseo marginal medio. Uno de los defectos presento una complicacion relacionada con el injerto (2, 78%, 95% CI 0, 00%, 8, 15%). La tasa de supervivencia general de los implantes fue del 100%, con una tasa acumulada de exito del 94, 7%. Conclusiones:(1) el aumento vertical mediante membranas de e-PTFE y autoinjertos particulados constituye un tratamiento seguro y predecible; (2) las tasas de exito y supervivencia de los implantes colocados en el hueso sometido al aumento vertical, mediante la tecnica ROG, parecen similares a las de los implantes colocados en hueso propio del paciente en condiciones de carga; (3) las tasas de exito y de fracaso de los implantes colocados en hueso regenerado mediante la aplicacion simultanea de las tecnicas de aumento del seno y aumento vertical son mas favorables que las tasas equivalentes de los casos que solo requirieron el aumento vertical.
The International journal of periodontics & restorative dentistry
The fabrication of a full-arch maxillary prosthesis has been associated with several prosthetic c... more The fabrication of a full-arch maxillary prosthesis has been associated with several prosthetic complications and difficulties. Even though it has been reported that phonetics, esthetics, and proper lip support are difficult to achieve, there is a scarcity in the literature regarding the clinical and laboratory procedures necessary to minimize these complications. This article provides clinical and laboratory steps that may enable the clinician to achieve more predictable restorative results when using computer-aided design/computer-assisted manufacture (CAD/CAM) to fabricate a full-arch maxillary implant-supported prosthesis. The technique presented here describes the use of an implant-retained diagnostic wax-up that is subsequently duplicated to an interim polymethylmethacrylate prosthesis using CAD/CAM before fabricating the definitive restoration.
Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medici... more Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medición de una organización afecta muchísimo el comportamiento de la gente, tanto del interior como del exterior de la organización. Si las empresas han de sobrevivir y prosperan en la competencia de la era de la información, han de utilizar sistemas de medición y gestión, derivados de sus estrategias y capacidades. Desgraciadamente muchas organizaciones adoptan estrategias con respecto a las relaciones con los clientes, las competencias centrales y capacidades organizativas, mientras que motivan y miden la actuación solo con indicadores financieros. El Balanced Scorecard conserva la medición financiera como un resumen crítico de la actuación gerencial. Pero realza un conjunto de mediciones mas generales e integradas, que vinculan al cliente actual, los procesos internos, los empleados y la actuación de los sistemas con el éxito financiero a largo plazo.
Part 1 of this patient report described a prosthetically driven protocol that used computer-aided... more Part 1 of this patient report described a prosthetically driven protocol that used computer-aided engineering for the fabrication of a mandibular conversion denture and maxillary provisional complete denture using the AvaDent Digital Denture system. The report demonstrated that this system combined with NobelClinician implant-planning software can be used to efficiently convert a digital denture into an immediately loaded provisional implant-supported fixed complete denture (hybrid prosthesis). Part 2 of the patient report describes the technique and steps involved in the fabrication of a digitally planned and fabricated mandibular fixed complete denture with incorporated titanium milled bar opposed by a definitive computer-aided design/computer-assisted manufacture-milled maxillary complete denture.
The International journal of oral & maxillofacial implants
The histologic examination of dental implants retrieved from humans provides a unique opportunity... more The histologic examination of dental implants retrieved from humans provides a unique opportunity to evaluate the bone-implant interface. This case report presents a clinical, radiographic, and histologic evaluation of a cylindrical hydroxyapatite- (HA) coated implant retrieved from the posterior maxillary area of a patient after 9 years after placement. The implant had been placed in conjunction with a subantral augmentation procedure with HA as the graft material. Clinical examination revealed an immobile implant with no sign of pathosis. Radiographic examination indicated close proximity of the bone to the implant surface without evidence of radiolucency. Histologically, because of tissue destruction during implant retrieval, only the apical portion of the implant was available for examination under light microscopy, and it appeared to be integrated with the surrounding bone; 45.9% of the surface of the implant had close bone apposition at the interface. There was no evidence of ...
Immediate implant placement and provisionalization has been considered as a preservative procedur... more Immediate implant placement and provisionalization has been considered as a preservative procedure when replacing failing teeth, especially in the esthetic zone. Nevertheless, an average facial gingival tissue recession of 1 mm is still common after one year of function. Furthermore, facial gingival recession of thin periodontal biotype seems to be more pronounced than that of thick biotype. Biotype conversion around both natural teeth and implants with subepithelial connective tissue graft has been advocated, and the resulting tissues appear to be more resistant to recession. A technique combining subepithelial connective tissue graft and immediate implant placement and provisionalization is devised to achieve a more stable peri-implant tissue in thin biotype situations. This article describes the surgical and prosthodontic approach of this procedure as well as its clinical rationale.
The International Journal of Periodontics & Restorative Dentistry
This peer-reviewed, accepted manuscript will undergo final editing and production prior to public... more This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in PRD.
Accuracy of completely edentulous arch scanning with implant scan bodies has not been completely ... more Accuracy of completely edentulous arch scanning with implant scan bodies has not been completely validated for intraoral scanners. For desktop laboratory scanners validations were found in the literature. The aim of this in vitro study was to compare the dimensional accuracy of scanning with splinted and unsplinted scan bodies on a completely edentulous maxillary arch with 6 implants. A maxillary edentulous master cast with 6 implants was used as control for all implant level impressions. 6 implants were digitally planned and placed at different angulation of 0, 0 17° and 30°. A contact coordinate measuring machine (CMM) was used to generate baseline linear measurements of the master cast. Four test groups included: 2 intraoral scanners Trios (3shape, Copenhagen, Denmark) and True Definition (3M ESPE, St Paul, MN), one industrial scanner Atos (Core optical 3D scanner) and one conventional impression group scanned with laboratory scanner Dental Wings 7 Series. Each scan recording wa...
Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medici... more Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medición de una organización afecta muchísimo el comportamiento de la gente, tanto del interior como del exterior de la organización. Si las empresas han de sobrevivir y prosperan en la competencia de la era de la información, han de utilizar sistemas de medición y gestión, derivados de sus estrategias y capacidades. Desgraciadamente muchas organizaciones adoptan estrategias con respecto a las relaciones con los clientes, las competencias centrales y capacidades organizativas, mientras que motivan y miden la actuación solo con indicadores financieros. El Balanced Scorecard conserva la medición financiera como un resumen crítico de la actuación gerencial. Pero realza un conjunto de mediciones mas generales e integradas, que vinculan al cliente actual, los procesos internos, los empleados y la actuación de los sistemas con el éxito financiero a largo plazo
The purpose of this study is to compare the exposure rate of 3 different barrier types after a gu... more The purpose of this study is to compare the exposure rate of 3 different barrier types after a guided-bone regeneration procedure as well as to compare the percentage grafted bone dimensional loss with and without exposed barriers. Patient records from September 2007 to May 2015 were reviewed to identify subjects who had received a bone graft followed by implant placement procedure after the graft had completely healed. The subjects were divided into 3 groups: (1) resorbable barrier, (2) nonresorbable barrier, and (3) titanium-mesh barrier. Incidences of barrier exposure were recorded. Cone-beam computerized tomography images before treatment (T0), right after grafting (T1), and after healing (T2) were used to determine the percentage of grafted bone dimensional loss and am quantitative amount of grafted bone remaining (mm2). Three cross-sectioned areas, at 1-mm apart, of preplanned implant positions at the grafted site were measured using cone-beam computerized tomography to calcul...
The International Journal of Periodontics & Restorative Dentistry, 2019
The computer-assisted design/computer-assisted manufactured compound prosthesis involves designin... more The computer-assisted design/computer-assisted manufactured compound prosthesis involves designing and milling a cement-retained prosthesis over milled titanium bars. In the presented clinical case report, a diagnostic wax pattern was made to assess esthetics, contours, and occlusion. A total of eight maxillary root-form implants were restored by following the combined prosthesis design concept. The mandibular arch was restored with a screwretained implant-supported zirconia fixed prosthesis. A milled polymethyl methacrylate (PMMA) maxillary interim prosthesis was fabricated to intraorally confirm the diagnostic wax pattern. The interim PMMA prosthesis was then scanned, and three screw-retained titanium milled bars were designed that provided the substructure of the definitive restoration. A cement-retained milled zirconia prosthesis was then designed and fabricated. The zirconia prosthesis provided the superstructure of the definitive complete-arch restoration. After confirming esthetics, phonetics, occlusion, and accessibility for oral hygiene, the superstructure was cemented with temporary cement to enable retrievability.
This technique describes a novel approach for planning and augmenting a large bony defect using a... more This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.
Lateral approach sinus grafting has become a routine and predictable surgical method of augmentin... more Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.
The International journal of periodontics & restorative dentistry
Mandibular ridge augmentation via guided bone regeneration in the atrophic mandible is considered... more Mandibular ridge augmentation via guided bone regeneration in the atrophic mandible is considered one of the most challenging scenarios for implant-supported oral rehabilitation. Uneventful wound healing has clearly demonstrated its impact on the final regenerative outcome. Soft tissue management must be precise and adequate to attain flap-free wound closure. Accordingly, it demands exhaustive insight and expertise to avoid damaging the neighboring structures. The cadaver study described herein discusses the mandibular morphologic landmarks (ie, musculature, vascularization, innervation, and salivary glands) necessary to safely perform regenerative procedures in the atrophic mandibular ridge, such as vertical ridge augmentation and dental implant surgery. The potential intraoperative complications are presented, as well as clinical implications of which the clinician must be aware to prevent adverse surgical events during regenerative surgery and implant placement in this anatomical...
Clinical implant dentistry and related research, Jan 30, 2016
To the best of the authors' knowledge, there is very limited clinical data on the outcomes of... more To the best of the authors' knowledge, there is very limited clinical data on the outcomes of simultaneous guided bone regeneration (GBR) for horizontal and/or vertical bone gain for the reconstruction of severely atrophic edentulous maxilla. Therefore, the purpose of the clinical series presented herein was to clinically evaluate long-term horizontal and vertical bone gain, as well as implant survival rate after reconstruction of severely atrophic edentulous maxillary ridges. Sixteen patients (mean age: 64.6 ± 14.6 years of age) were consecutively treated for vertical and/or horizontal bone augmentation via GBR in combination with bilateral sinus augmentation utilizing a mixture of autologous and anorganic bovine bone. Implant survival, bone gain, intraoperative/postoperative complications and peri-implant bone loss were calculated up to the last follow-up exam. Overall, 122 dental implants were placed into augmented sites and have been followed from 12 to 180 months (mean: 76....
Revista Internacional De Odontologia Restauradora Periodoncia, 2005
Este estudio presenta un analisis clinico, radiografico, de laboratorio e histologico/histomorfom... more Este estudio presenta un analisis clinico, radiografico, de laboratorio e histologico/histomorfometrico del uso de los autoinjertos en bloque de la mandibula para el aumento vertical del reborde alveolar. Se incluyeron 12 pacientes en el estudio. Se fijaron los autoinjertos en bloque autogenos en los lechos receptores con tornillos, y se utilizo una mezcla de medula osea autogena y de sustancia mineral inorganica de origen bovino (Bio-Oss) en la periferia. En la cirugia de reapertura, todos los injertos parecian bien incorporados en los lechos receptores. Las mediciones radiograficas revelaron un aumento vertical medio del reborde de 5, 75 ± 1, 29 mm al cabo de 1 mes de la cirugia, y de 4, 75 ± 1, 29 mm despues de 4 a 6 meses de la misma. Esto indico una reabsorcion del 17, 4%. Las mediciones volumetricas en el laboratorio pusieron de manifiesto un promedio de aumento del reborde olveolar de 0, 84 ± 0, 34 ml despues de 1 mes de la cirugia, y de 0, 71 ± 0, 28 ml al cabo de los 6 meses de la intervencion. La tasa de reabsorcion, segun las mediciones volumetricas en el laboratorio, fue del 15, 5%. Las mediciones lineales en el laboratorio revelaron un aumento vertical del reborde de 5, 92 ± 1, 38 mm despues de 1 mes de la intervencion, y de 4, 08 ± 1, 07 mm al cabo de 4 a 6 meses de la cirugia. La evaluacion histologica de los autoinjertos en bloque senalo la existencia de signos de actividad de remodelacion activa en 10 de las 12 muestras. En un caso, el injerto en bloque quedo expuesto y se infecto, y en otro caso, el autoinjerto en bloque se desprendio durante la cirugia de colocacion del implante. El analisis histomorfometrico de las particulas de hueso de la periferia indicaba la presencia de hueso en el 33, 99 ± 8, 82% de la superficie del injerto, mientras que el 42, 43 ± 11, 06% de la zona estaba ocupada por tejido fibroso, y el 23, 89 ± 9, 12% estaba constituida de particulas residuales de Bio-Oss. Dichas particulas estaban en intimo contacto con el hueso recien formado a lo largo del 58, 57 ± 75, 22% de su perimetro.
Periodoncia Sociedad Espanola De Periodoncia, 2009
Recientemente, la tecnologia por ordenador ha hecho posible simular la colocacion de implantes, f... more Recientemente, la tecnologia por ordenador ha hecho posible simular la colocacion de implantes, fabricar una guia quirurgica precisa, basada en la colocacion simulada de los implantes y fabricar la protesis antes de la colocacion quirurgica de los implantes. Tal como se ha publicado, muchos pacientes se han tratado satisfactoriamente siguiendo esta tecnica, aunque se ha publicado muy poco en lo que se refiere a sus complicaciones. Este articulo muestra la colocacion erronea de una protesis completa definitiva que fue construida antes de la cirugia de implantes y cargada inmediatamente despues. La protesis se diseno y se fabrico utilizando datos de los implantes que fueron generados por ordenador. Utilizando el concepto "All-on-Four", se fabrico una guia quirurgica (Nobel Guide) a partir de los datos suministrados por el ordenador, con el objeto de guiar la colocacion de los implantes. En este articulo se discute el manejo de esta protesis mal ajustada, asi como las subsiguientes complicaciones clinicas.
Periodoncia Sociedad Espanola De Periodoncia, 2010
Resumen:Los objetivos del presente estudio son: (1) evaluar los resultados de la Regeneracion Ose... more Resumen:Los objetivos del presente estudio son: (1) evaluar los resultados de la Regeneracion Osea Guiada vertical (ROG) empleando injertos de hueso autogeno particulado, (2) determinar clinica y radiograficamente las tasas de exito y de supervivencia de 82 implantes colocados en dichos lechos quirurgicos entre los 12 y los 72 meses posteriores a la carga protesica, y (3) comparar los defectos que se trataron simultaneamente mediante el aumento del seno y la ROG vertical con otras areas del maxilar tratadas unicamente con ROG vertical.Materiales y metodos: se insertaron 82 implantes en 35 pacientes que presentaban un total de 36 defectos oseos verticales. Los pacientes fueron divididos en tres grupos: pacientes con un solo diente ausente (grupo A), pacientes con multiples dientes ausentes (grupo B), y pacientes con defectos verticales en la zona posterior del maxilar (grupo C). Todos los sujetos del grupo C fueron tratados simultaneamente con procedimientos de aumento de seno y vertical. Todos los pacientes fueron tratados con aumento vertical de cresta empleando membranas de politetrafluoroetileno (e-PTFE) y autoinjertos particulados. Tras la remocion de la membrana de e-PTFE, todos los lechos quirurgicos recibieron una membrana de colageno.Resultados al retirar las membranas, el aumento vertical medio fue de 5, 5 mm (± 2, 29 mm). El remodelado crestal medio fue de 1, 01 mm (± 0, 57 mm) a los 12 meses y permanecio estable durante el periodo de seguimiento de 6 anos. No se produjeron diferencias estadisticamente significativas entre los tres grupos en terminos de remodelado oseo marginal medio. Uno de los defectos presento una complicacion relacionada con el injerto (2, 78%, 95% CI 0, 00%, 8, 15%). La tasa de supervivencia general de los implantes fue del 100%, con una tasa acumulada de exito del 94, 7%. Conclusiones:(1) el aumento vertical mediante membranas de e-PTFE y autoinjertos particulados constituye un tratamiento seguro y predecible; (2) las tasas de exito y supervivencia de los implantes colocados en el hueso sometido al aumento vertical, mediante la tecnica ROG, parecen similares a las de los implantes colocados en hueso propio del paciente en condiciones de carga; (3) las tasas de exito y de fracaso de los implantes colocados en hueso regenerado mediante la aplicacion simultanea de las tecnicas de aumento del seno y aumento vertical son mas favorables que las tasas equivalentes de los casos que solo requirieron el aumento vertical.
The International journal of periodontics & restorative dentistry
The fabrication of a full-arch maxillary prosthesis has been associated with several prosthetic c... more The fabrication of a full-arch maxillary prosthesis has been associated with several prosthetic complications and difficulties. Even though it has been reported that phonetics, esthetics, and proper lip support are difficult to achieve, there is a scarcity in the literature regarding the clinical and laboratory procedures necessary to minimize these complications. This article provides clinical and laboratory steps that may enable the clinician to achieve more predictable restorative results when using computer-aided design/computer-assisted manufacture (CAD/CAM) to fabricate a full-arch maxillary implant-supported prosthesis. The technique presented here describes the use of an implant-retained diagnostic wax-up that is subsequently duplicated to an interim polymethylmethacrylate prosthesis using CAD/CAM before fabricating the definitive restoration.
Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medici... more Las mediciones son importantes “Si no puedes medirlo, no puedes gestionarlo” El sistema de medición de una organización afecta muchísimo el comportamiento de la gente, tanto del interior como del exterior de la organización. Si las empresas han de sobrevivir y prosperan en la competencia de la era de la información, han de utilizar sistemas de medición y gestión, derivados de sus estrategias y capacidades. Desgraciadamente muchas organizaciones adoptan estrategias con respecto a las relaciones con los clientes, las competencias centrales y capacidades organizativas, mientras que motivan y miden la actuación solo con indicadores financieros. El Balanced Scorecard conserva la medición financiera como un resumen crítico de la actuación gerencial. Pero realza un conjunto de mediciones mas generales e integradas, que vinculan al cliente actual, los procesos internos, los empleados y la actuación de los sistemas con el éxito financiero a largo plazo.
Part 1 of this patient report described a prosthetically driven protocol that used computer-aided... more Part 1 of this patient report described a prosthetically driven protocol that used computer-aided engineering for the fabrication of a mandibular conversion denture and maxillary provisional complete denture using the AvaDent Digital Denture system. The report demonstrated that this system combined with NobelClinician implant-planning software can be used to efficiently convert a digital denture into an immediately loaded provisional implant-supported fixed complete denture (hybrid prosthesis). Part 2 of the patient report describes the technique and steps involved in the fabrication of a digitally planned and fabricated mandibular fixed complete denture with incorporated titanium milled bar opposed by a definitive computer-aided design/computer-assisted manufacture-milled maxillary complete denture.
The International journal of oral & maxillofacial implants
The histologic examination of dental implants retrieved from humans provides a unique opportunity... more The histologic examination of dental implants retrieved from humans provides a unique opportunity to evaluate the bone-implant interface. This case report presents a clinical, radiographic, and histologic evaluation of a cylindrical hydroxyapatite- (HA) coated implant retrieved from the posterior maxillary area of a patient after 9 years after placement. The implant had been placed in conjunction with a subantral augmentation procedure with HA as the graft material. Clinical examination revealed an immobile implant with no sign of pathosis. Radiographic examination indicated close proximity of the bone to the implant surface without evidence of radiolucency. Histologically, because of tissue destruction during implant retrieval, only the apical portion of the implant was available for examination under light microscopy, and it appeared to be integrated with the surrounding bone; 45.9% of the surface of the implant had close bone apposition at the interface. There was no evidence of ...
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Papers by Jaime Lozada