Background: Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri‐implantitis, with variable results.Purpose: To evaluate the 1‐year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri‐implantitis.Material and Methods: Forty‐three patients diagnosed with peri‐implantitis were included. Surgical treatment consisted of implantoplasty of the supra‐crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra‐osseous component of the peri‐implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri‐implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri‐implant marginal bone levels. One implant per patient was included in the analysis.Results: The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p < 0.001) and 14% (p < 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p < 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p < 0.001).Conclusions: The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow‐up and constitutes a viable option for the management of peri‐implantitis.

Objectives: To compare the different variations of sinus elevation techniques with osteotomes, to evaluate the increase in height achieved, and to quantify the osseointegration periods and the success rates for the implants placed. Study Design: A meta-analytic study with descriptive statistics was carried out on sinus elevations using osteotomes, analyzing a total of 11 articles published between the years 2003 and 2008. Results: Summers’ classic technique for performing sinus elevations with osteotomes differs from the current techniques being used with respect to the use of drills, the manner in which the sinus floor is fractured and how the sinus membrane is lifted, and especially on the type of graft used—the most current tendency being not to use a graft. The maximum gain in height is 4.62 mm, and the minimum gain in height is 2.07 mm, starting with a maximum residual bone height of 8.8 mm and a minimum of 4.1 mm. The osseointegration period is 4.9 months and the success rate is 95.5%. Conclusions: Performing sinus elevations with osteotomes is a predictable technique that enables achieving an increase in bone height and successful results, similar to those of other techniques used, in the placement of implants.

Purpose: This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity.Methods: 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes.P < 0.05 was considered statistically significant.Results: PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males.Conclusions: The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.Graphical

The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

The aim of this study was to analyze the prevalence of transmigrated canines in a Spanish population by evaluating their clinical and radiological characteristics. The descriptive observational study obtained 6840 orthopantomographs from all patients seeking dental care in the years 2017–21 via the Patient Reception Service and Dentistry Service at the Faculty of Dentistry at the Complutense University of Madrid and the Central Hospital of the Red Cross of Madrid (Spain). In total, 52 patients presented transmigrated canines, establishing a prevalence of 0.76%. This sample comprised 28 women and 24 men. Whenever a transmigrated canine was identified, a CBCT scan was obtained and used to evaluate the clinical and radiological variables associated with canine transmigration. The predominant side of the transmigration was the left (57.69%) compared to the right side (42.30%). The position of the canine, in order of frequency, according to the Mupparapu classification, corresponded to type IV (42.30%), type II (36.53%), type I (15.38%), and type V (5.76%), with no type III transmigrations found. Clinical manifestations were only recorded in 17.30% of cases, and 11.53% of the radiological findings showed the presence of tooth cysts that were confirmed by histopathological studies. Other impactions, in addition to the transmigrated canine, were found in five patients (9.61%), with the majority being the presence of third molars.

To study the presence of sinus disorders and their diagnosis based on clinical and radiographic findings, correlating their presence with tomography tests and panoramic radiography. We conducted a retrospective study on 152 patients who were seeking implant treatment, thereby allowing us to evaluate 42 patients who had abnormal sinuses. The patients underwent an evaluation of their medical history as well a clinical examination, panoramic radiography and tomographic study. The average age of the patient was 59.8 years old, and 54.76% of the group were males and 45.23% were females. Prior respiratory disorders were present in 52.38% of the patients, and 57.3% of the group presented dental disorders. In assessing the type of wound, we observed that 73.21% were mucosal hyperplasia and 26.78% were mucous cysts. Of the 56 sinuses affected, only 28.57% were diagnosed using panoramic radiography. Panoramic radiography has limitations in the diagnosis of sinus disorders; computerized tomography (CT) remains the most effective diagnostic test.