Background: In the third molar surgery, it is important to focus not only on surgical skills, but also on patient satisfaction.Classically studies have been focused on surgery and surgeon's empathy, but there are non-surgical factors that may influence patient satisfaction.Material and Methods: A cross-sectional study was performed on 100 patients undergoing surgical extractions of impacted mandibular third molars treated from October 2013 to July 2014 in the Oral Surgery Unit of the University of Valencia.A questionnaire (20 questions) with a 10-point Likert scale was provided.The questionnaire assessed the ease to find the center, the ease to get oriented within the center, the burocratic procedures, the time from the first visit to the date of surgical intervention, waiting time in the waiting room, the comfort at the waiting room, the administrative staff (kindness and efficiency to solve formalities), medical staff (kindness, efficiency, reliability, dedication), personal data care, clarity in the information received (about the surgery, postoperative care and resolution of the doubts), available means and state of facilities.Outcome variables were overall satisfaction, and recommendation of the center.Statistical analysis was made using the multiple linear regression analysis.Results: Significant correlations were found between all variables and overall satisfaction.The multiple regression model showed that the efficiency of the surgeon and the clarity of the information were statistically significant to overall satisfaction and recommendation of the center.The kindness of the administrative staff, available means, the state of facilities and the comfort at the waiting room were statistically significant to the recommendation of the center.Conclusions: Patient satisfaction directly depends on the efficiency of the surgeon and clarity of the clinical infor-
Aim: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)?Material and Method: An electronic data banks and hand searching were used to find relevant articles on vertical and lateral augmentation procedures performed with intraoral onlay block bone grafts for dental implant therapy published up to October 2013.Publications in English, on human subjects, with a controlled study design -involving at least one group with defects treated with intraoral onlay block bone grafts, more than five patients and a minimum follow-up of 12 months after prosthetic loading were included.Two reviewers extracted the data.Results: A total of 6 studies met the inclusion criteria: 4 studies on horizontal augmentation and 2 studies on vertical augmentation.Intraoperative complications were not reported.Most common postsurgical complications included mainly mucosal dehiscences (4 studies), bone graft or membrane exposures (3 studies), complete failures of block grafts (2 studies) and neurosensory alterations (4 studies).For lateral augmentation procedures, implant survival rates ranged from 96.9% to 100%, while for vertical augmentation they ranged from 89.5% to 100%.None article studied the soft tissues healing.Conclusions: Survival and success rates of implants placed in horizontally and vertically resorbed edentulous ridges reconstructed with block bone grafts are similar to those of implants placed in native bone, in distracted sites or with guided bone regeneration.More surgical challenges and morbidity arise from vertical augmentations, thus short implants may be a feasible option.
The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient. Key words:Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.
A review is made of the publications on the marginal bone loss of implants with a polished neck, rough neck with microthreading, and rough neck without microthreading.A PubMed search was carried out with the following key words: machined neck implant, polished neck implant, marginal bone loss, covering the period between January 1998 and March 2009.Inclusion was limited to those human clinical studies involving a minimum follow-up of 12 months, and registering the level of bone loss from the time of placement of the implant or prosthetic restoration to the end of follow-up.For most of the authors there were no significant differences in marginal bone loss between polished neck and rough neck implants.On the other hand, implants with a rough neck and microthreading showed significantly less bone loss than those with a polished neck or with a rough neck without microthreading.The survival rate of the implants with a polished neck ranged from 87% to 97.7%, versus 94.5% to 100% for those with a rough neck, and 100% for the rough neck implants with microthreading.No peri-implant disease was registered in the different studies.
The aim of this study was to describe the replantation of a maxillary second right molar, which had been removed for surgical reasons in order to remove a dentigerous cyst associated with the adjacent third molar, and the case's 12-month follow-up. A 51-year-old man presented swelling in the right maxillary area. Radiographic examination showed a large radiolucency in close proximity to the third molar, suggesting a follicular cyst. The third molar was extracted and the cyst underwent curettage. The second molar had to be extracted to enable complete removal of the cyst and to achieve primary closure of the wound, which would have been impossible without repositioning the molar. With this objective, extraoral endodontic treatment was performed, the root-end was resected and prepared with ultrasonic retrotips, and root-end filling was accomplished with MTA before the molar was replanted. At the 12-month follow-up, the tooth showed no clinical signs or symptoms, probing depth was no greater than 3 mm and radiographic examination showed no evidence of root resorption or periapical lesion. Key words:Replantation, maxillary molar, follicular cyst, dentigerous cyst.
Extensive literature exists about the use of the BFP in the treatment of oral defects but, to our knowledge, no article refers to the use of the BFP as a substitute of the membrane barriers for treatment of peri-implant bone defects. The aim was to evaluate the use of the buccal fat pad as a coating material for bone grafting in the peri-implant bone defect regeneration of immediate implants placed in the posterior maxilla.A preliminary prospective study of patients involving immediate implants in which the buccal fat pad was used as a coating material to peri-implant bone defects was carried out. The outcome measures assessed were: postoperative pain and swelling, complications related to buccal fat pad surgery, implant survival and success rates and peri-implant marginal bone loss at 12 months of prosthetic loading.Twenty-seven patients (17 women and 10 men) with a mean age of 55.3 ± 8.9 years, and a total of 43 implants were included. Two-thirds of the patients reported either no pain or only mild intensity pain and moderate inflammation, two days after surgery. Post-operative period was well tolerated by the patients and no serious complications occurred. None wound dehiscence occurred. Implant survival and success rates were 97.6% and the average marginal bone loss 1 year after loading was 0.58 ± 0.27 mm.Within the limits of this preliminary study, the use of the buccal fat pad as a coating material for bone grafting in peri-implant bone defects placed in the upper posterior maxilla was a well-tolerated technique by patients; high implant success rate was achieved with a minimal peri-implant marginal bone loss at 12 months of prosthetic loading.