The clinical management of mobile teeth can be a perplexing problem, especially if the underlying causes for that mobility have not been properly diagnosed. In some cases, mobile teeth are retained because patients decline multidisciplinary treatment that might otherwise include strategic extractions. This article discusses the relationship between occlusion and tooth mobility with an emphasis on identifying differences between increased mobility and d increasing mobility. The indications, contraindications, and basic principles g of tooth splinting are also reviewed. Provisional and definitive splints are defined and described with their respective occlusal considerations. Some mobile teeth can be treated through occlusal equilibration alone (primary occlusal trauma). Whereas mobile teeth with a compromised periodontium can be stabilized with the aid of provisional and/or definitive splinting (secondary occlusal trauma). It is important to consider splint therapy, because it may not only improve the prognosis of teeth, but may actually enhance the stability of the final prosthodontic treatment. The ultimate goal of successful management of mobile teeth is to restore function and comfort by establishing a stable occlusion that promotes tooth retention and the maintenance of periodontal health.
Nanostructured porous silica coatings were synthesized on titanium by the combined sol-gel and evaporation-induced self-assembly process. The silica-coating structures were characterized by X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and nitrogen sorptometry. The effect of the nanoporous surface on apatite formation in simulated body fluid, protein adsorption, osteoblast cell adhesion behavior, and osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) is reported. Silica coatings with highly ordered sub-10 nm porosity accelerate early osteoblast adhesive response, a favorable cell response that is attributed to an indirect effect due to the high protein adsorption observed on the large-specific surface area of the nanoporous coating but is also probably due to direct mechanical stimulus from the nanostructured topography. The nanoporous silica coatings, particularly those doped with calcium and phosphate, also promote the osteogenic differentiation of hBMSCs with spontaneous mineral nodule formation in basal conditions. The bioactive surface properties exhibited by the nanostructured porous silica coatings make these materials a promising alternative to improve the osseointegration properties of titanium dental implants and could have future impact on the nanoscale design of implant surfaces.
Recibido el 12 de septiembre de 2013; aceptado el 25 de junio de 2014 Disponible en Internet el 4 de abril de 2015 PALABRAS CLAVE Implante en fallo; Fresa trefina
ResumenObjetivo: El objetivo del presente estudio descriptivo es la valoración de un nuevo método de remoción de implantes oseointegrados bajo una técnica mínimamente invasiva. Material y métodos: El estudio fue desarrollado sobre un grupo de 66 implantes oseointegrados de conexión interna y externa diagnosticados en falla, a los cuales se les indicó su remoción quirúrgica por presentar un diagnóstico radiográfico de pérdida ósea periimplantaria, mal posicionamiento quirúrgico con imposibilidad de rehabilitación protésica o daño del elemento de retención protésico del implante. El procedimiento quirúrgico, el cual es de carácter ambulatorio, fue llevado a cabo en un pabellón bajo anestesia local. Como primera opción de remoción quirúrgica, el procedimiento consistió en la utilización de instrumental de remoción a contratorque, sin la apertura de un colgajo de espesor total, y como segunda opción de remoción quirúrgica la utilización de una fresa trefina, para lo cual fue necesario realizar un colgajo de espesor total que expusiera el lecho implantario. Resultados: Se removieron un total de 66 implantes oseointegrados, todos bajo la primera modalidad de remoción a contra-torque con el nuevo instrumento, sin colgajo y sin la necesidad de usar fresa trefina. * Autor para correspondencia. Correo electrónico: yerkoleighton@gmail.com (Y. Leighton).
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