A case of rehabilitation of the upper front teeth is presented. To prevent bone resorption following extractions, a socket-shield technique on all the extracted teeth was performed. The combination of a staged extraction approach, the sequence of provisionals together with the minimal bone loss of vestibular volume, allowed solving this high aesthetic demanding case in a satisfactory way for the patient both in duration of the treatment and in its final outcome.
The aim of this study was to assess the potential use of a new advanced inertial navigation system for guiding dental implant placement and to compare this approach with standard stereolithographic template guiding. A movement processing unit with a 9-axis absolute orientation sensor was adapted to a surgical handpiece and wired to a computer navigation interface. Sixty implants were placed by 10 operators in 20 jaw models. The 30 implants of the test group were placed in 10 models guided by the new inertial navigation prototype. The 30 implants of the control group were placed in another 10 models using a CAD-CAM template. Both groups were subdivided into experienced and non-experienced operators. Pre- and postoperative computer tomography images were obtained and matched to compare the planned and final implant positions. Four deviation parameters (global, angular, depth, and lateral deviation) were defined and calculated. The primary outcome was the angular deviation between the standard stereolithographic approach and the new inertial navigation system. Results showed no significant differences between both groups, suggesting that surgical navigation based on inertial measurement units (IMUs) could potentially be useful for guiding dental implant placement. However, more studies are still needed to translate this new approach into clinical practice.
Background : The optimal anesthesia for posterior mandibular implant surgery remains controversial. Various comparative studies with Articaine 4% have not found differences between infiltration (INF) and inferior alveolar nerve block (IANB) but current research is still conflicting. Infiltration anesthesia is easier for the operator and more tolerable for the patient. Should it were sufficient for surgical procedures in the posterior mandible it could become the first option in routine surgeries. Aim/Hypothesis : The purpose of this prospective, randomized and multicenter study is to clarify the efficacy of infiltration anesthesia for placing implants in the posterior mandible. Materials and Methods : The study will take place in 8 centers with similar socio-professional characteristics and the same operative protocol. The study has been approved by the Ethical Research Committee of the University Hospital of San Juan (Alicante, Spain). On a significant sample of patients (48n) that meet the in-exclusion criteria, the same intervention (implant placement surgery in posterior area of the mandible) has been carried out randomly with one or another type of anesthesia (group A: IANB or group B: INF). Data of pain perception from patients were collected intraoperatively, by means of a Visual Analog Scale, in three moments (after incision, after drilling, after suturing) and global satisfaction one week post surgery. Five confounding variables were also recorded, gender, use of release incision, number of implants placed, wether or not GBR was applied and the distance from the implant apex to the mandibular canal. A NO-parametric statistical analysis was applied. Results : In both groups, patients referred low levels of pain (nor more than 3/10) and high satisfaction (median 9.0). The type of anesthetic technique did not generate statistically significant differences. The confounding variables measured did not affect significantly pain levels or patient satisfaction in either group. Conclusions and Clinical Implications : The results permit to conclude that an inferior alveolar nerve block could not be needed to undergo standard implant surgery in the posterior mandible and infiltration of Articaine 4% with epinephrine 1:100.000, seems to be sufficient.
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