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      Reabsorción del reborde alveolar posterior después de 7 años de uso de una sobredentadura mandibular Translated title: Resorption of the posterior alveolar ridge after 7 years of wearing a mandibular overdenture

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          Abstract

          RESUMEN La sobredentadura retenida por dos implantes es una opción para la rehabilitación del edentulismo, pero no se ha estudiado a profundidad su efecto sobre el mantenimiento de la altura del reborde alveolar posterior. El objetivo de este trabajo fue determinar los cambios en altura del reborde alveolar posterior mandibular después de 7 años del uso de una sobredentadura mandibular. Este estudio descriptivo consideró 17 pacientes. Cada paciente había recibido una sobredentadura mandibular retenida por dos implantes no ferulizados cargados de forma inmediata y unidos mediante ajustes en bola. Se realizaron mediciones en dos radiografías panorámicas (una tomada antes de la inserción de la sobredentadura [T0] y otra siete años después [T7]),para los trazos, el área se expresó como un triángulo posterior formado por el gonion, el borde inferior del agujero mental y un punto que fue el centro del triángulo gonion - foramen mental - muesca sigmoidea. El área medida se comparó con el área triangular en el mismo lado. Los resultados en mm con significancia estadística (p< 0.05) fueron: área de referencia ósea “X”( [T0]:494.3- [T7]:431.6) área de referencia ósea izquierda ([T0]:502.0 -[T7]:405.3) y el índice de área posterior([T0]:1.4-[T7]:1.2).Los resultados en mm sin significancia estadísticas(p>0.05)indicaron: área de referencia ósea “X” derecha([T0]:486.1 - [T7]:458.0), área de referencia en “Y” izquierda ([T0]:354.8-[T7]:360.6), derecha ([T0]:361.9-[T7]:375.6) y promedio de longitud del reborde maxilar ([T0]:35.4-[T7]:36.9). La reabsorción del reborde alveolar posterior a los 7 años estuvo dentro de los parámetros normales, no existiría ningún efecto nocivo de la sobredentadura sobre este reborde.

          Translated abstract

          ABSTRACT The overdenture retained by two implants is an option for the rehabilitation of edentulism, but its effect on the maintenance of the posterior alveolar ridge has not been studied in depth. The objective of this work was to determine the changes in height of the mandibular posterior alveolar ridge after 7 years of the use of a mandibular overdenture. This descriptive study considered 17 patients. Each patient had received a mandibular overdenture retained by two non-splinted implants immediately loaded and joined by ball adjustments. Measurements were made in two panoramic radiographs (one taken before the insertion of the overdenture [T0] and another seven years later [T7]), for the lines the area was expressed as a posterior triangle formed by the gonion, the lower edge of the mental hole and a point that was the center of the gonion triangle - mental foramen - sigmoid notch. The measured area was compared to the triangular area on the same side. The results in mm with statistical significance (p< 0.05) were: bone reference area “X”( [T0]:494.3- [T7]:431.6) left bone reference area ([T0]:502.0 -[T7]: 405.3) and the posterior area index ([T0]:1.4-[T7]:1.2). The results in mm without statistical significance (p>0.05) indicated: right “X” bone reference area ([T0]:486.1 - [T7]:458.0), left “Y” reference area ([T0]:354.8-[T7]:360.6), right ([T0]:361.9-[T7]:375.6) and average ridge length maxilla ([T0]:35.4-[T7]:36.9). The resorption of the alveolar ridge after 7 years was within normal parameters, there would be no harmful effect of the overdenture on this ridge.

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          Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man.

          Early implantation may preserve the alveolar anatomy, and the placement of a fixture in a fresh extraction socket helps to maintain the bony crest. Although a number of clinical studies exist, no histological reports show the outcome of implantation in fresh extraction sockets without the use of membranes in humans compared to implants placed in mature bone. Forty-eight healthy patients, receiving at least 4 fixtures in each of 2 symmetrical quadrants, underwent placement of 1 experimental fixture placed in a fresh extraction socket (TI) and 1 contralateral fixture in mature bone (CI). TI were placed after atraumatical tooth extraction, with a surgical site at the apex of the socket and a tight contact between the fixture and the socket's walls, but without the use of filling materials or membranes. The flap was coronally repositioned to obtain primary wound closure. Immediately after surgical intervention, a standardized periapical radiograph was taken. Second-stage surgery was done after 6 months. Six months after the second surgery, a second standardized periapical radiograph was taken and clinical parameters (bleeding and plaque index) recorded. Marginal bone loss (MBL) from the time of implant placement to the time of fixture removal was calculated by comparing periapical radiographs. TI and CI were then removed by a hollow drill to obtain histological specimens. Non-demineralized sections were stained by acid fuchsin and toluidine blue, and by von Kossa to evaluate the degree of bone mineralization. The percentage of direct implant-bone contact (DBC) was calculated by a computerized microscopic digitizer. No significant differences in the clinical and radiographic parameters were observed between the 2 experimental categories. There was no statistically significant difference between TI and CI for DBC either in the maxilla or in the mandible. No connective or fibrous tissues were present around TI or CI. Bone resorption was not present in any of the histological sections. The present study shows that when a screw-type dental implant is placed without the use of barrier membranes or other regenerative materials into a fresh extraction socket with a bone-to-implant gap of 2 mm or less, the clinical outcome and degree of osteointegration does not differ from implants placed in healed, mature bone.
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            Alveolar ridge resorption after tooth extraction: A consequence of a fundamental principle of bone physiology

            It is well established that tooth extraction is followed by a reduction of the buccolingual as well as the apicocoronal dimension of the alveolar ridge. Different measures have been taken to avoid this bone modelling process, such as immediate implant placement and bone grafting, but in most cases with disappointing results. One fundamental principle of bone physiology is the adaptation of bone mass and bone structure to the levels and frequencies of strain. In the present article, it is shown that the reduction of the alveolar ridge dimensions after tooth extraction is a natural consequence of this physiological principle.
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              Mathematical analysis of trabecular 'trajectories' in apparent trajectorial structures: the unfortunate historical emphasis on the human proximal femur.

              Wolff's "law" of the functional adaptation of bone is rooted in the trajectory hypothesis of cancellous bone architecture. Wolff often used the human proximal femur as an example of a trajectorial structure (i.e. arched trabecular patterns appear to be aligned along tension/compression stress trajectories). We examined two tenets of the trajectory hypothesis; namely, that the trabecular tracts from the tension- and compression-loaded sides of a bending environment will: (1) follow 'lines' (trajectories) of tension/compression stress that resemble an arch with its apex on a neutral axis, and (2) form orthogonal (90 degrees ) intersections. These predictions were analysed in proximal femora of chimpanzees and modern humans, and in calcanei of sheep and deer. Compared to complex loading of the human femoral neck, the chimpanzee femoral neck reputedly receives relatively simpler loading (i.e. temporally/spatially more consistent bending), and the artiodactyl calcaneus is even more simply loaded in bending. In order to directly consider Wolff's observations, measurements were also made on two-dimensional, cantilevered beams and curved beams, each with intersecting compression/tension stress trajectories. Results in the calcanei showed: (1) the same nonlinear equation best described the dorsal ("compression") and plantar ("tension") trabecular tracts, (2) these tracts could be exactly superimposed on the corresponding compression/tension stress trajectories of the cantilevered beams, and (3) trabecular tracts typically formed orthogonal intersections. In contrast, trabecular tracts in human and chimpanzee femoral necks were non-orthogonal (mean approximately 70 degrees ), with shapes differing from trabecular tracts in calcanei and stress trajectories in the beams. Although often being described by the same equations, the trajectories in the curved beams had lower r(2) values than calcaneal tracts. These results suggest that the trabecular patterns in the calcanei and stress trajectories in short beams are consistent with basic tenets of the trajectory hypothesis while those in human and chimpanzee femoral necks are not. Compared to calcanei, the more complexly loaded human and chimpanzee femoral necks probably receive more prevalent/predominant shear, which is best accommodated by non-orthogonal, asymmetric trabecular tracts. The asymmetrical trabecular patterns in the proximal femora may also reflect the different developmental 'fields' (trochanteric vs. neck/head) that formed these regions, of which there is no parallel in the calcanei.
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                Author and article information

                Journal
                odonto
                Avances en Odontoestomatología
                Av Odontoestomatol
                Ediciones Avances, S.L. (Madrid, Madrid, Spain )
                0213-1285
                2340-3152
                December 2022
                : 38
                : 4
                : 143-150
                Affiliations
                [3] Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [1] Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [4] Caldas orgnameUniversidad Autónoma de Manizales Colombia
                [2] Caldas orgnameUniversidad Autónoma de Manizales Colombia
                Article
                S0213-12852022000400003 S0213-1285(22)03800400003
                10.4321/s0213-12852022000400003
                733b2064-b8e3-4174-9633-c32fb6d1b891

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 06 October 2021
                : 08 August 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 8
                Product

                SciELO Spain

                Categories
                Artículos

                implante dental con conexión del pilar,dentadura de soporte implantado,Proceso alveolar,Panoramic Radiography,Dental Implant-Abutment Design,Implant-Supported Dental Prosthesis,Alveolar process,radiografía panorámica

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