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- Prevalência de retenções dentárias nos utentes adultos da Clínica Universitária da Universidade Católica PortuguesaPublication . Couto, Patrícia; Couto, João; Pereira, Miguel; Borges, Tiago; Almeida, BrunoObjetivos: Verificar a prevalência das anomalias de erupção dentária na população da clínica dentária universitária, bem como a sua caracterização. Métodos: Realizou‐se um estudo retrospetivo e observacional através da análise de 2.977 radiografias panorâmicas, correspondentes aos pacientes adultos que vieram à Clínica Dentária Universitária da Universidade Católica Portuguesa de Viseu, no período de 2011‐2013. Selecionaram‐se todos os processos que preenchiam os critérios de inclusão e analisaram‐se segundo variáveis como: género, idade, classificação de Winter, classificação de Pell & Gregory, características anatómicas das raízes e sua relação com o canal mandibular, localização e orientação, quer tridimensional quer no plano sagital, e comorbilidades associadas à retenção. Resultados: De entre os vários resultados evidenciados podemos salientar: que 16,6% da população em estudo apresenta dentes retidos; que os terceiros molares inferiores foram o grupo de dentes que se encontrou mais frequentemente retido; que a posição mais comum de retenção dos terceiros molares foi a vertical e a IIA de Pell e Gregory; que o nervo alveolar inferior se apresentava numa relação de proximidade com as raízes dos terceiros molares em cerca de 45% dos casos; que a retenção do canino por palatino é muito mais comum que a retenção por vestibular; e que são raros os casos que se encontram de transmigração. Conclusões: Apesar das limitações da ortopantomografia, esta constitui um exame de grande importância para o diagnóstico inicial e avaliação de dentes retidos, que permite obter resultados de prevalências bastante fiáveis.
- Dental implant outcomes in grafted sockets: a systematic review and meta-analysisPublication . Ramanauskaite, Ausra; Borges, Tiago; Almeida, Bruno Leitão; Correia, AndréObjectives: To assess the treatment outcomes of the dental implants placed in the grafted sockets.Material and Methods: A search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles.Results: The present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseases.Conclusions: Implants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.
- Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro studyPublication . Leitão-Almeida, Bruno; Camps-Font, Octavi; Correia, André; Mir-Mari, Javier; Figueiredo, Rui; Valmaseda-Castellon, EduardBackground: Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP. Material and Methods: An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome variable was the maximum compression force (F-max) of implants when subjected to static resistance to fracture tests. Implant fractures were subsequently analyzed by scanning electron microscopy. A descriptive and bivariate analysis of the data was performed. Results: Significant changes in implant width were observed after IP (p<0.05). No significant differences between IP and control implants were recorded in terms of the F-max values in the two bone loss subgroups (3 mm: control 854.37N +/- 195.08 vs. IP 752.12N +/- 186.13;p =0.302, and 7.5 mm: control 548.82N +/- 80.02 vs. IP 593.69N +/- 111.07; p-0.370). Greater bone loss was associated to a decrease in F-max which proved significant for the control implants (p=0.001). Fractures were more frequently located in the platform (n=13). Conclusions: Implants with more apical bone levels appear to be more susceptible to fracture. On the other hand, IP does not seem to significantly decrease the fracture resistance of narrow (3.5 mm) platform dental implants with external hexagonal connections. The fact that most fractures occur in the platform area indicates that the latter is exposed to more mechanical stress.
- Case report of a dilated odontome in the posterior mandiblePublication . Almeida, Bruno; Silva, António; Pereira, Miguel; Silva, Mariana; Nunes, StephanieIntroduction Dens invaginatus (dens in dente) is a developmental malformation resulting from an invagination of enamel organ into the dental papilla, beginning at the crown and sometimes extending into the root before calcification occurs. Dilated odontome is the most extreme form of dens invaginatus and it is extremely rare in the posterior mandible. Presentation of case A 47 years old female patient with occasional episodes of diffuse pain and discomfort in the left posterior mandibular region. The extra-oral examination showed slight facial asymmetry. Panoramic and intra-oral X-rays show an intraosseous circular formation with radiopaque external limits and radiolucent interior. Discussion Computerized tomography scan reveals the bone integrity around the formation, as well as the independence of the neuro-vascular structures of the region. The most likely diagnostic option was dilated odontome. The enucleation procedure was carried out, and the fragments were sent to histopathological examination that revealed a diagnosis consistent with a dilated odontome. Conclusion In this case, the conservative surgical approach after planning was effective and predictable in the treatment of the pathology and patient symptoms without major complications.
- Pterygoid implants for the immediate rehabilitation of the atrophic maxilla: a case report of a full arch on 4 implantsPublication . Sousa, Bernardo Luz Nunes de; Almeida, Bruno Leitão dePterygoid implants are a valid and valuable resource for the rehabilitation of the posterior atrophic maxilla and have been detailed before in the literature. Nonetheless, the full arch rehabilitation with immediate loading of the upper jaw with 4 implants, where the 2 anterior ones are conventional implants and the 2 posterior ones are pterygoid implants has not been addressed in any paper according to the author's best knowledge. In this case report, the authors present this technique performed on a 68-year old woman with atrophic maxilla looking for a fast, non-invasive full-arch fixed solution. A screw-retained acrylic FP3 provisional was installed 6 hours after surgery and a titanium milled/acrylic prosthesis was installed 4 months later. The patient has been recalled for 1,5-years with successful follow-up both on implants and prothesis. The presented technique seems to be a valid solution for the full arch rehabilitation with immediate loading of the atrophic maxilla, avoiding more invasive and time-consuming procedures like the sinus lift, bone regeneration or zygomatic implants.
- The 2nd Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2019. Summary and consensus statements: Group II - Extraction socket preservation methods and dental implant placement outcomes within grafted socketsPublication . Galindo-Moreno, Pablo; Amo, Fernando Suárez López Del; Faria-Almeida, Ricardo; Almeida, Bruno Leitão; Astramskaite-Januseviciene, Inesa; Barootchi, Shayan; Borges, Tiago; Correia, André; Correia, Francisco; Majzoub, Jad; Padial-Molina, Miguel; Pranskunas, Mindaugas; Puisys, Algirdas; Ramanauskaite, Ausra; Ravida, Andrea; Starch-Jensen, Thomas; Tattan, MustafaIntroduction: The task of Group II was to review and update the existing data concerning extraction socket preservation with or without membranes and soft tissue influence on post-extraction alveolar ridge preservation; extraction socket preservation using different biomaterials as bone grafts, growth factors, and stem cells. Special interest was paid to the dental implant placement outcomes within grafted sockets.Material and Methods: The main areas evaluated by this group were as follows: quantitative and qualitative assessment of the effect of different alveolar preservation techniques performed immediately after tooth extraction, with or without membranes and/or soft tissue grafting, and the use of different bone substitutes, stem cells or growth factors in the postextraction socket. Evaluation of the treatment outcomes of dental implants placed in the grafted sockets in terms of primary and secondary outcomes were assessed. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. TThe literature in the corresponding areas of interest was screened and reported following the PRISMA guidelines (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in the Preface chapter.Results: The results and conclusions of the review process are presented in the respective papers. Three systematic reviews and one systematic review and meta-analysis were performed. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.