The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bon... more The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods pres...
The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bon... more The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods presented a large percentage of apoptotic cells, although large scale production of necrotic cells was not detected. In summary, although rotary surgical instrument and piezoelectric devices are frequently used instruments for oral osteotomy, fresh autogenous bone chips collected from them did not present a viable bone cell source.
Purpose: The primary goal of this study was to compare implant survival 12 months after immediate... more Purpose: The primary goal of this study was to compare implant survival 12 months after immediate loading of single implants placed in healed ridges versus extraction sockets. Secondary outcomes were to compare marginal bone adaptation and soft tissue changes over time. Materials and methods: A prospective multicenter clinical investigation was initiated to assess clinical performance of immediately loaded implants in the maxilla. Implant survival was ascertained at the time of impression making (8 to 10 weeks) and after 1 year by clinical stability. Radiographic marginal bone levels, soft tissue levels, and plaque and bleeding scores were compared with baseline values (implant placement and provisionalization). Results: One hundred thirty-nine patients received 157 implants in the maxilla. Single implants with provisional crowns were placed in extraction sockets of 55 patients (58 implants) and in healed ridges of 60 patients (65 implants). In addition, 19 patients (23 implants) required bone grafting prior to implant placement, and 11 implants in 10 patients among all groups were not immediately loaded because of insufficient initial stability after surgery. Three implants (5.2%) failed in extraction sites and one implant (1.5%) failed in a healed ridge. The mean change in marginal bone level 1 year after implant placement was 1.30 mm (SD 2.52) (gain) in extraction sockets and -0.40 mm (SD 1.43) (loss) in healed ridges. The mucosal zenith was stable or moved incisally following definitive crown placement in 83.7% of immediate implants and 87.0% of implants placed in healed ridges. Plaque and inflammation scores were low and did not differ between groups. Conclusions: The responses of local bone and soft tissues at immediately loaded implants placed in extraction sockets or healed ridges were similar. Furthermore, these 1-year results suggest that clinical management of esthetically critical soft tissue may be predictably achieved in both indications.
International Journal of Paediatric Dentistry, Aug 24, 2011
Objectives. The objectives were to investigate the prevalence of the condition, by using transill... more Objectives. The objectives were to investigate the prevalence of the condition, by using transillumination, in a group of children. Analysed the prevalence with regard to gender, jaw affected, and the teeth that exhibited dysplasia most commonly. Methods. A sample of 550 children aged 6 to 14 years was selected at the Department of Paediatric Dentistry at the Universitat Internacional de Catalunya, but among those selected only 505 children were eligible for inclusion in the study. The gender and age of the child, number of permanent teeth, number of teeth affected by MIH and their position were registered. Results. Ninety patients (17.85%) had MIH. Of these, 45 were girls (50%) and 45 were boys (50%). A total of 8062 permanent teeth were observed. Of these, 344 (4.2%) were affected by MIH. Of the teeth affected, 198 (57.7%) were located in the maxilla and 146 (42.4%) in the mandible. This result was statistically significant (P = 0.003). Conclusions. The population studied showed a prevalence of MIH of 17.8%. The presence of the defect did not differ according to sex in this population. Defects were more common among teeth in the maxilla.
International Journal of Oral & Maxillofacial Implants, May 1, 2014
This 5-year prospective multicenter study compared implant survival and success, peri-implant hea... more This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Materials and Methods: Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. Results: One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). Conclusion: After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.
International Journal of Periodontics & Restorative Dentistry, Jul 1, 2014
This clinical study assessed at 5 years both implant survival and peri-implant tissue architectur... more This clinical study assessed at 5 years both implant survival and peri-implant tissue architecture of immediately provisionalized implants placed 4 to 6 months following augmentation with demineralized bovine bone allograft and collagen membrane. Of 23 implants in 19 patients, one implant failed prior to loading (95.6% survival). Implant tissue relationships were stable following implant placement; marginal bone level changes from implant placement to 5 years
AimThe purpose of this prospective multicenter clinical study was to compare 3 years implant surv... more AimThe purpose of this prospective multicenter clinical study was to compare 3 years implant survival, bone and soft tissue changes following immediate loading using single Osseospeed™ implants (Astra Tech AB, Mölndal, Sweden) installed in healed ridges or extraction sockets.Material and methodsImplants were provisionally restored the day of surgery using cemented acrylic crowns out of full occlusion. The provisional crowns were replaced after 12 weeks by full‐ceramic crowns. Implant survival, bone levels, soft tissue levels and peri‐implant health were monitored up to 3 years.Results55 patients (22 men, 33 women; mean age 45) had the implant installed in extraction sockets and 58 patients (25 men, 33 women; mean age 42) received conventional implant treatment in healed ridges. Three implants failed in the extraction group and one implant failed in the healed group, all failures occurred before the final crown placement. No further losses occurred during 3 years, giving a statistically comparable survival rate of 94.6% and 98.3%, respectively. The total bone loss after 3 years, compared to implant placement was 0.4 mm (SD 1.5) in healed sites, whilst the immediate sites showed a bone gain of 1.6 mm (SD 2.4) due to bone fill in the alveolus. Papillae retracted with 0.3 and 0.0 mm in the period of provisionalization, but grew back after final crown was placed with 0.3 and 0.5 mm in extraction and healed sites respectively after 3 years. Plaque and inflammation scores were very low throughout the study time, irrespective of treatment modality.ConclusionsImmediate implants restored at the day of surgery show comparable risk for implant failure, bone loss and midfacial soft tissue recession compared to conventionally installed implants. The 3‐years results suggest both hard and soft tissue stability.
Biodentine ® is a bioactive dentin coating widely used for dental restoration; however, its adhes... more Biodentine ® is a bioactive dentin coating widely used for dental restoration; however, its adhesion to the substrate could limit its clinical success. The aim of this study was to evaluate the shear bond strength (SBS) between Biodentine ® and a composite resin, using different types of adhesive. In total, 120 acrylic blocks with a central hole were prepared. They were fully filled with Biodentine ® , and divided into two time groups: 12 min (n = 60) and 24 h (n = 60); each group was subdivided into four groups according to the adhesive: three-step etch and rinse (3-E&R) (n = 15), two-step etch and rinse (n = 15), and a universal adhesive subdivided into two groups, two-step etch and rinse (n = 15) and one-step self-etch adhesive system (n = 15). After adhesive application, the composite was applied and stored at 100% humidity, at 37 • C, for 24 h, before the SBS test. Data were analyzed with one-way ANOVA, Fisher post hoc test, and Kolmogorov-Smirnov test. The 12-min group showed statistically significant differences (p = 0.009), with the highest values of adhesion for 3-E&R. No statistically significant differences were observed for the 24-h group (p = 0.813) and between adhesive systems (p = 0.071) regardless of adhesion time. Higher adhesion values were found at 24 h. It is essential to consider the longest setting time for Biodentine ®. In terms of adhesive, 3-E&R had the highest adhesion values.
PurposeThe aim of this study was to develop a tool to analyze the ethical dimensions during denta... more PurposeThe aim of this study was to develop a tool to analyze the ethical dimensions during dental students' decision making, by using case‐based learning (CBL).MethodsFive clinical scenarios involving ethical aspects addressing different moral dilemmas were selected. The cases were then administered to students during a course on ethics, and the students responded using a narrative technique. To analyze the responses, a criterion inspired by Kohlberg's theory of moral development was used. Subsequently, the data were analyzed statistically, and possible associations between the answers and other variables, such as the student's gender and theoretical knowledge of ethics, were evaluated.ResultsA total of 260 students participated (182 women and 78 men), and 1300 narratives were analyzed. The reliability of the construct, as tested by the Cronbach's alpha and the homogeneity index, was acceptable (0.7). The validity of the construct was also assessed, suggesting a com...
morphology, and proliferation of pluripotent and multipotent cells. Likewise, in the second stage... more morphology, and proliferation of pluripotent and multipotent cells. Likewise, in the second stage of differentiation, surface coating with BMP2 decreases the diameter and the pore size of the scaffold, causing better adhesion and reduced proliferation of BMP-MSCs. Coating oligomerization surfaces with OPN and BSP promotes cell adhesion, but it is clear that the polymeric coating material BSP alone is insufficient to induce priming of MSCs and functional osteoblastic differentiation in vivo. Finally, TN is involved in mineralization and can accelerate new bone formation in a multicellular environment but has no effect on the initial stage of osteogenesis.
Corrosion resistance and ion release behavior have been evaluated for thirty dental restoration s... more Corrosion resistance and ion release behavior have been evaluated for thirty dental restoration samples obtained by three different manufacturing systems: computer-aided design and manufacturing (CAD-CAM), traditional casting and laser sintering. The alloy used was the CoCr alloy (same batch) generally used in clinical dentistry. Corrosion resistance has been evaluated by electrochemical testing in an artificial saliva medium at 37 °C. Corrosion parameters such as critical current density (icr), corrosion potential (Ecorr), and passive current density (ip), have been determined. Cobalt and Chromium ions released from the different samples have also been analyzed in an artificial saliva medium at 37 °C by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at different immersion times. The casted samples showed higher corrosion rates and ion-release levels. The CAD-CAM milled samples presented lower ion-release levels and better corrosion resistance due to the total solubility of t...
The purpose of this study was to evaluate the effects of different surface treatments on the shea... more The purpose of this study was to evaluate the effects of different surface treatments on the shear bond strength (SBS) of a composite resin to the various resin matrix ceramics (RMC). Clinical applications of physical and chemical surface conditioning methods may be required for RMC to optimize the adhesion of additional resin materials. Ninety-nine RMC specimens (6 × 6 × 2 mm) were prepared from a resin nanoceramic (RNC), a polymer-infiltrated hybrid ceramic (PIHC), and a flexible hybrid ceramic (FHC) block with a cutting machine under copious water. All specimens divided randomly into three surface treatment subgroups (n = 11): (1) untreated (Cnt), (2) tribochemical silica coated (Tbc), and (3) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiated with 3 W (150 mJ/pulse, 20 Hz) for 20 sec. A nanohybrid composite resin was layered with a disc-shape mold (2 × 3 mm) onto the ceramics and submitted to thermal cycling (3000 cycles, 5-55°C). The SBS test of specimens was per...
The aim of this study was to perform a narrative review to identify the modifications applied to ... more The aim of this study was to perform a narrative review to identify the modifications applied to the chemical structure of third- and fourth-generation zirconia ceramics and to determine the influence of these changes on the mechanical and optical properties. A bibliographical search using relevant keywords was conducted in the PubMed® and EBSCO databases. The abstracts and full texts of the resulting articles were reviewed for final inclusion. Fifty-four articles were included in this review. The analyzed topics were: (1) the composition of first- and second-generation zirconia materials (Y-TZP), (2) the behavior of the studied generations in relation to mechanical and optical properties, and (3) the modifications that were carried out on third-generation (5Y-TZP) and fourth-generation (4Y-TZP) zirconia materials. However, studies focusing on these specific characteristics in third- and fourth-generation zirconia materials are scarce. The review shows that there is a lack of suffic...
Journal of clinical and experimental dentistry, 2017
Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaba... more Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously. A comprehensive search of the PubMed, Scopus and ISI Web of Science databases was conducted to identify studies that evaluated the relationship between direct oral anticoagulants and dental procedures. The quality of the reported information was assessed following the PRISMA statement. Eleven studies that met the inclusion criteria were included in the review: 2 randomized clinical trials, 3 prospective studies, 3 ...
Background: Large bone defects are a major clinical problem, because in up to 40% of patients aut... more Background: Large bone defects are a major clinical problem, because in up to 40% of patients autologous bone grafts are not available. Bone bioengineering would be a good solution to this common problem. Using sub Mesenchymal Stem Cell (MSC) population from the dental pulp and also standard Mesenchymal Stem Cells also from this tissue we try to form bone like tissue in order to re-establish in the future this large bone defects. Methods: In evaluating the capacity of both populations of cells isolated from the same donor and cultivated in the same osteogenic medium in 3D Cell Carrier. The differentiation was evaluated by SEM analysis, the expression of bone markers like ALPH, osteocalcin, Coll I and osteonectin by q-RT-PCR. And also we have compared the calcium deposition, alizarin staining test and ALP activity. Results: Bone was formed with stem cells from the dental pulp in perfect continuity with the trabecular host bone structure and demonstrated the high interconnectivity of the restored bone network. A significant difference was observed in the expression of bone markers, Calcium deposition and ALP activity during the osteogenic differentiation using DPPSC more than with DPMSC. Conclusion: This study showed the possibility of the specific population of stem cells from the dental pulp a potentially interesting candidate for bone tissue engineering. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
En este trabajo se estudian los pares de torsion maximos para tornillos y casquillos que se puede... more En este trabajo se estudian los pares de torsion maximos para tornillos y casquillos que se pueden aplicar en un sistema de implante dental. Se determina el aflojamiento que sufren estas piezas con las cargas mecanicas en el medio fisiologico a 37oC y se aprecia la mejora de la fijacion producida por recubrimiento de oro de diferentes espesores en tornillos y casquillos. El oro actua como sistema de gripaje aumentando la friccion y la superficie de agarre del tornillo y los casquillos a las roscas del implante dental. Palabras clave: Tornillos. Aflojamiento. Propiedades mecanicas.
The International journal of oral & maxillofacial implants
This study evaluated the effects of abutment height, airborne-particle abrasion, and type of ceme... more This study evaluated the effects of abutment height, airborne-particle abrasion, and type of cement on the tensile resistance to dislodgement of cement-retained implant restorations. Three groups of 12 standardized abutments each were prepared with different heights (4 mm, 5 mm, and 6 mm) using a milling machine. Crowns were cast in cobalt-chrome using the lost-wax technique, airborne particle-abraded using 50-Μm aluminum oxide, and cleaned with acetone. Restorations were cemented using a noneugenol acrylic urethane cement, a resin-modified glass ionomer, or a zinc oxide-noneugenol cement. A 5-kg load was applied for 10 minutes. Samples were kept at 37°C and 100% humidity overnight. A tensile force was applied to the crown using a testing machine at a crosshead speed of 5 mm/minute until failure occurred. Next, the abutments were airborne particle-abraded with 50-Μm aluminum oxide, and the cementation and testing procedures were repeated. The effects of cement, abutment height, and ...
The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bon... more The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods pres...
The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bon... more The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods presented a large percentage of apoptotic cells, although large scale production of necrotic cells was not detected. In summary, although rotary surgical instrument and piezoelectric devices are frequently used instruments for oral osteotomy, fresh autogenous bone chips collected from them did not present a viable bone cell source.
Purpose: The primary goal of this study was to compare implant survival 12 months after immediate... more Purpose: The primary goal of this study was to compare implant survival 12 months after immediate loading of single implants placed in healed ridges versus extraction sockets. Secondary outcomes were to compare marginal bone adaptation and soft tissue changes over time. Materials and methods: A prospective multicenter clinical investigation was initiated to assess clinical performance of immediately loaded implants in the maxilla. Implant survival was ascertained at the time of impression making (8 to 10 weeks) and after 1 year by clinical stability. Radiographic marginal bone levels, soft tissue levels, and plaque and bleeding scores were compared with baseline values (implant placement and provisionalization). Results: One hundred thirty-nine patients received 157 implants in the maxilla. Single implants with provisional crowns were placed in extraction sockets of 55 patients (58 implants) and in healed ridges of 60 patients (65 implants). In addition, 19 patients (23 implants) required bone grafting prior to implant placement, and 11 implants in 10 patients among all groups were not immediately loaded because of insufficient initial stability after surgery. Three implants (5.2%) failed in extraction sites and one implant (1.5%) failed in a healed ridge. The mean change in marginal bone level 1 year after implant placement was 1.30 mm (SD 2.52) (gain) in extraction sockets and -0.40 mm (SD 1.43) (loss) in healed ridges. The mucosal zenith was stable or moved incisally following definitive crown placement in 83.7% of immediate implants and 87.0% of implants placed in healed ridges. Plaque and inflammation scores were low and did not differ between groups. Conclusions: The responses of local bone and soft tissues at immediately loaded implants placed in extraction sockets or healed ridges were similar. Furthermore, these 1-year results suggest that clinical management of esthetically critical soft tissue may be predictably achieved in both indications.
International Journal of Paediatric Dentistry, Aug 24, 2011
Objectives. The objectives were to investigate the prevalence of the condition, by using transill... more Objectives. The objectives were to investigate the prevalence of the condition, by using transillumination, in a group of children. Analysed the prevalence with regard to gender, jaw affected, and the teeth that exhibited dysplasia most commonly. Methods. A sample of 550 children aged 6 to 14 years was selected at the Department of Paediatric Dentistry at the Universitat Internacional de Catalunya, but among those selected only 505 children were eligible for inclusion in the study. The gender and age of the child, number of permanent teeth, number of teeth affected by MIH and their position were registered. Results. Ninety patients (17.85%) had MIH. Of these, 45 were girls (50%) and 45 were boys (50%). A total of 8062 permanent teeth were observed. Of these, 344 (4.2%) were affected by MIH. Of the teeth affected, 198 (57.7%) were located in the maxilla and 146 (42.4%) in the mandible. This result was statistically significant (P = 0.003). Conclusions. The population studied showed a prevalence of MIH of 17.8%. The presence of the defect did not differ according to sex in this population. Defects were more common among teeth in the maxilla.
International Journal of Oral & Maxillofacial Implants, May 1, 2014
This 5-year prospective multicenter study compared implant survival and success, peri-implant hea... more This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Materials and Methods: Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. Results: One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). Conclusion: After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.
International Journal of Periodontics & Restorative Dentistry, Jul 1, 2014
This clinical study assessed at 5 years both implant survival and peri-implant tissue architectur... more This clinical study assessed at 5 years both implant survival and peri-implant tissue architecture of immediately provisionalized implants placed 4 to 6 months following augmentation with demineralized bovine bone allograft and collagen membrane. Of 23 implants in 19 patients, one implant failed prior to loading (95.6% survival). Implant tissue relationships were stable following implant placement; marginal bone level changes from implant placement to 5 years
AimThe purpose of this prospective multicenter clinical study was to compare 3 years implant surv... more AimThe purpose of this prospective multicenter clinical study was to compare 3 years implant survival, bone and soft tissue changes following immediate loading using single Osseospeed™ implants (Astra Tech AB, Mölndal, Sweden) installed in healed ridges or extraction sockets.Material and methodsImplants were provisionally restored the day of surgery using cemented acrylic crowns out of full occlusion. The provisional crowns were replaced after 12 weeks by full‐ceramic crowns. Implant survival, bone levels, soft tissue levels and peri‐implant health were monitored up to 3 years.Results55 patients (22 men, 33 women; mean age 45) had the implant installed in extraction sockets and 58 patients (25 men, 33 women; mean age 42) received conventional implant treatment in healed ridges. Three implants failed in the extraction group and one implant failed in the healed group, all failures occurred before the final crown placement. No further losses occurred during 3 years, giving a statistically comparable survival rate of 94.6% and 98.3%, respectively. The total bone loss after 3 years, compared to implant placement was 0.4 mm (SD 1.5) in healed sites, whilst the immediate sites showed a bone gain of 1.6 mm (SD 2.4) due to bone fill in the alveolus. Papillae retracted with 0.3 and 0.0 mm in the period of provisionalization, but grew back after final crown was placed with 0.3 and 0.5 mm in extraction and healed sites respectively after 3 years. Plaque and inflammation scores were very low throughout the study time, irrespective of treatment modality.ConclusionsImmediate implants restored at the day of surgery show comparable risk for implant failure, bone loss and midfacial soft tissue recession compared to conventionally installed implants. The 3‐years results suggest both hard and soft tissue stability.
Biodentine ® is a bioactive dentin coating widely used for dental restoration; however, its adhes... more Biodentine ® is a bioactive dentin coating widely used for dental restoration; however, its adhesion to the substrate could limit its clinical success. The aim of this study was to evaluate the shear bond strength (SBS) between Biodentine ® and a composite resin, using different types of adhesive. In total, 120 acrylic blocks with a central hole were prepared. They were fully filled with Biodentine ® , and divided into two time groups: 12 min (n = 60) and 24 h (n = 60); each group was subdivided into four groups according to the adhesive: three-step etch and rinse (3-E&R) (n = 15), two-step etch and rinse (n = 15), and a universal adhesive subdivided into two groups, two-step etch and rinse (n = 15) and one-step self-etch adhesive system (n = 15). After adhesive application, the composite was applied and stored at 100% humidity, at 37 • C, for 24 h, before the SBS test. Data were analyzed with one-way ANOVA, Fisher post hoc test, and Kolmogorov-Smirnov test. The 12-min group showed statistically significant differences (p = 0.009), with the highest values of adhesion for 3-E&R. No statistically significant differences were observed for the 24-h group (p = 0.813) and between adhesive systems (p = 0.071) regardless of adhesion time. Higher adhesion values were found at 24 h. It is essential to consider the longest setting time for Biodentine ®. In terms of adhesive, 3-E&R had the highest adhesion values.
PurposeThe aim of this study was to develop a tool to analyze the ethical dimensions during denta... more PurposeThe aim of this study was to develop a tool to analyze the ethical dimensions during dental students' decision making, by using case‐based learning (CBL).MethodsFive clinical scenarios involving ethical aspects addressing different moral dilemmas were selected. The cases were then administered to students during a course on ethics, and the students responded using a narrative technique. To analyze the responses, a criterion inspired by Kohlberg's theory of moral development was used. Subsequently, the data were analyzed statistically, and possible associations between the answers and other variables, such as the student's gender and theoretical knowledge of ethics, were evaluated.ResultsA total of 260 students participated (182 women and 78 men), and 1300 narratives were analyzed. The reliability of the construct, as tested by the Cronbach's alpha and the homogeneity index, was acceptable (0.7). The validity of the construct was also assessed, suggesting a com...
morphology, and proliferation of pluripotent and multipotent cells. Likewise, in the second stage... more morphology, and proliferation of pluripotent and multipotent cells. Likewise, in the second stage of differentiation, surface coating with BMP2 decreases the diameter and the pore size of the scaffold, causing better adhesion and reduced proliferation of BMP-MSCs. Coating oligomerization surfaces with OPN and BSP promotes cell adhesion, but it is clear that the polymeric coating material BSP alone is insufficient to induce priming of MSCs and functional osteoblastic differentiation in vivo. Finally, TN is involved in mineralization and can accelerate new bone formation in a multicellular environment but has no effect on the initial stage of osteogenesis.
Corrosion resistance and ion release behavior have been evaluated for thirty dental restoration s... more Corrosion resistance and ion release behavior have been evaluated for thirty dental restoration samples obtained by three different manufacturing systems: computer-aided design and manufacturing (CAD-CAM), traditional casting and laser sintering. The alloy used was the CoCr alloy (same batch) generally used in clinical dentistry. Corrosion resistance has been evaluated by electrochemical testing in an artificial saliva medium at 37 °C. Corrosion parameters such as critical current density (icr), corrosion potential (Ecorr), and passive current density (ip), have been determined. Cobalt and Chromium ions released from the different samples have also been analyzed in an artificial saliva medium at 37 °C by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at different immersion times. The casted samples showed higher corrosion rates and ion-release levels. The CAD-CAM milled samples presented lower ion-release levels and better corrosion resistance due to the total solubility of t...
The purpose of this study was to evaluate the effects of different surface treatments on the shea... more The purpose of this study was to evaluate the effects of different surface treatments on the shear bond strength (SBS) of a composite resin to the various resin matrix ceramics (RMC). Clinical applications of physical and chemical surface conditioning methods may be required for RMC to optimize the adhesion of additional resin materials. Ninety-nine RMC specimens (6 × 6 × 2 mm) were prepared from a resin nanoceramic (RNC), a polymer-infiltrated hybrid ceramic (PIHC), and a flexible hybrid ceramic (FHC) block with a cutting machine under copious water. All specimens divided randomly into three surface treatment subgroups (n = 11): (1) untreated (Cnt), (2) tribochemical silica coated (Tbc), and (3) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiated with 3 W (150 mJ/pulse, 20 Hz) for 20 sec. A nanohybrid composite resin was layered with a disc-shape mold (2 × 3 mm) onto the ceramics and submitted to thermal cycling (3000 cycles, 5-55°C). The SBS test of specimens was per...
The aim of this study was to perform a narrative review to identify the modifications applied to ... more The aim of this study was to perform a narrative review to identify the modifications applied to the chemical structure of third- and fourth-generation zirconia ceramics and to determine the influence of these changes on the mechanical and optical properties. A bibliographical search using relevant keywords was conducted in the PubMed® and EBSCO databases. The abstracts and full texts of the resulting articles were reviewed for final inclusion. Fifty-four articles were included in this review. The analyzed topics were: (1) the composition of first- and second-generation zirconia materials (Y-TZP), (2) the behavior of the studied generations in relation to mechanical and optical properties, and (3) the modifications that were carried out on third-generation (5Y-TZP) and fourth-generation (4Y-TZP) zirconia materials. However, studies focusing on these specific characteristics in third- and fourth-generation zirconia materials are scarce. The review shows that there is a lack of suffic...
Journal of clinical and experimental dentistry, 2017
Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaba... more Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously. A comprehensive search of the PubMed, Scopus and ISI Web of Science databases was conducted to identify studies that evaluated the relationship between direct oral anticoagulants and dental procedures. The quality of the reported information was assessed following the PRISMA statement. Eleven studies that met the inclusion criteria were included in the review: 2 randomized clinical trials, 3 prospective studies, 3 ...
Background: Large bone defects are a major clinical problem, because in up to 40% of patients aut... more Background: Large bone defects are a major clinical problem, because in up to 40% of patients autologous bone grafts are not available. Bone bioengineering would be a good solution to this common problem. Using sub Mesenchymal Stem Cell (MSC) population from the dental pulp and also standard Mesenchymal Stem Cells also from this tissue we try to form bone like tissue in order to re-establish in the future this large bone defects. Methods: In evaluating the capacity of both populations of cells isolated from the same donor and cultivated in the same osteogenic medium in 3D Cell Carrier. The differentiation was evaluated by SEM analysis, the expression of bone markers like ALPH, osteocalcin, Coll I and osteonectin by q-RT-PCR. And also we have compared the calcium deposition, alizarin staining test and ALP activity. Results: Bone was formed with stem cells from the dental pulp in perfect continuity with the trabecular host bone structure and demonstrated the high interconnectivity of the restored bone network. A significant difference was observed in the expression of bone markers, Calcium deposition and ALP activity during the osteogenic differentiation using DPPSC more than with DPMSC. Conclusion: This study showed the possibility of the specific population of stem cells from the dental pulp a potentially interesting candidate for bone tissue engineering. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: None declared.
En este trabajo se estudian los pares de torsion maximos para tornillos y casquillos que se puede... more En este trabajo se estudian los pares de torsion maximos para tornillos y casquillos que se pueden aplicar en un sistema de implante dental. Se determina el aflojamiento que sufren estas piezas con las cargas mecanicas en el medio fisiologico a 37oC y se aprecia la mejora de la fijacion producida por recubrimiento de oro de diferentes espesores en tornillos y casquillos. El oro actua como sistema de gripaje aumentando la friccion y la superficie de agarre del tornillo y los casquillos a las roscas del implante dental. Palabras clave: Tornillos. Aflojamiento. Propiedades mecanicas.
The International journal of oral & maxillofacial implants
This study evaluated the effects of abutment height, airborne-particle abrasion, and type of ceme... more This study evaluated the effects of abutment height, airborne-particle abrasion, and type of cement on the tensile resistance to dislodgement of cement-retained implant restorations. Three groups of 12 standardized abutments each were prepared with different heights (4 mm, 5 mm, and 6 mm) using a milling machine. Crowns were cast in cobalt-chrome using the lost-wax technique, airborne particle-abraded using 50-Μm aluminum oxide, and cleaned with acetone. Restorations were cemented using a noneugenol acrylic urethane cement, a resin-modified glass ionomer, or a zinc oxide-noneugenol cement. A 5-kg load was applied for 10 minutes. Samples were kept at 37°C and 100% humidity overnight. A tensile force was applied to the crown using a testing machine at a crosshead speed of 5 mm/minute until failure occurred. Next, the abutments were airborne particle-abraded with 50-Μm aluminum oxide, and the cementation and testing procedures were repeated. The effects of cement, abutment height, and ...
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Papers by L. Giner