http://hdl.handle.net/10366/154570 Sat, 02 May 2026 19:30:54 GMT 2026-05-02T19:30:54Z http://hdl.handle.net/10366/168662 [EN]Bone remodelling is a physiological process influenced by mechanical stimuli such as those generated during orthodontic treatment. Biochemical markers allow the phases of remodelling to be identified, its progression to be assessed, alterations to be detected and scaffold-based tissue regeneration to be evaluated. This study reviews the main markers involved in bone formation and resorption, highlighting their clinical relevance. A literature search was conducted in biomedical databases, selecting studies that analysed crevicular gingival fluid samples in areas of tension and compression. The markers were classified according to their function and location, and their baseline values, temporal variations and methods of analysis were compiled. Among the markers of bone formation, Osteoprotegerin (OPG), Transforming Growth factor β1 (TGF-β1) and Interleukin 27 (IL-27) stand out; while resorption markers include Receptor Activator of Nuclear Factor Kappa β Ligand (RANKL), Tumour Necrosis Factor (TNF-α) and Interleukin 1β (IL-1β). The results show different expression patterns depending on the type of force applied and the timing of the follow-up, allowing molecular profiles associated with each phase of remodelling to be established. This characterisation improves our understanding of tooth movement and provides a basis for the development of more precise scaffolds and functional biomaterials in orthodontics. Mon, 22 Dec 2025 00:00:00 GMT http://hdl.handle.net/10366/168662 2025-12-22T00:00:00Z http://hdl.handle.net/10366/168151 [EN]Abstract: Periapical surgery is a procedure indicated for the treatment of persistent apical periodontitis in an endodontically treated tooth and when retreatment has not been successful or not feasible. Various materials have been suggested and tested for this purpose: amalgam, MTA, and zinc-eugenol oxide cements, among others. The objective of the present study was to evaluate the results regarding the success of the periapical surgery and if the retrograde filling material used influences this success rate. A systematic review of the literature on the prognosis of periapical surgery was performed. The following PICO question was asked: “In patients who require periapical surgery (patient), is the retrograde filling (comparison) material used in apicoectomy (intervention) determining for the success of the treatment (outcome)?” Periapical surgery achieves successful results in 84% of cases. All the materials compared obtain satisfactory results. The results of the meta-analysis show that there are no statistically significant differences between MTA compared to SuperEBA (1.37 (95% CI: 0.87, 2.15)) or RRM (0.99 (95% CI: 0.51, 1.94)) but with MRI (1.93 (95% CI: 1.22, 3.05)), where the results favour MTA. In general, the most modern materials obtain better results than amalgam. Surgical techniques with magnification obtain better results (12.3% failure) than conventional techniques (22.93% failure). Periapical surgery is a procedure with a high success rate. The use of all the materials compared obtains satisfactory results. Magnification surgery techniques perform better than conventional techniques. Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10366/168151 2022-01-01T00:00:00Z http://hdl.handle.net/10366/168150 [EN]This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 32.7%) than in the immediate loading group (8.3 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement. Sun, 01 Jan 2023 00:00:00 GMT http://hdl.handle.net/10366/168150 2023-01-01T00:00:00Z http://hdl.handle.net/10366/168121 [EN]To quantify the discolouration of the temporary acetal resins in vivo, based on the weeks of follow-up and the salivary pH in the three thirds of the tooth. To find out if the final CIELAB coordinates can be predicted from the initial colour coordinates, the salivary pH, the situation (in thirds) and the weeks of follow-up. Colour coordinates (L, C, and h) were recorded by spectrophotometry in 13 participants fitted with hybrid provisional complete dentures made of acetal resin. Colour recordings were made on the day of placement and after several weeks of follow-up (6 to 31 weeks). Salivary pH was also measured as a predictor variable for colour change. The ANOVA statistical test and regression models have been used. The highest colour difference according to DEab* was 27.46 units after 15 weeks of follow-up and the lowest was 7.34 units after 17 weeks of follow-up. Neither in the cervical nor in the middle third any regressor variable (initial L*, initial C*, initial h*, salivary pH and weeks of follow-up) was able to significantly predict any of the final colour coordinates (p > 0.05). The colour change of the temporary acetal resins used exceeds the threshold of clinical acceptability, and it is not acceptable to maintain satisfactory aesthetics. The weeks of follow-up and the salivary pH are not capable of satisfactorily predicting the final color coordinates of the acetal resins. Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10366/168121 2022-01-01T00:00:00Z http://hdl.handle.net/10366/168120 [EN]The objective of this work is to review the literature on the use of three-dimensional scaffolds obtained by printing for the regeneration of bone defects in the maxillofacial area. The research question asked was: what clinical experiences exist on the use of bone biomaterials manufactured by CAD/CAM in the maxillofacial area? Prospective and retrospective studies and randomized clinical trials in humans with reconstruction area in the maxillofacial and intraoral area were included. The articles had to obtain scaffolds for bone reconstruction that were designed by computer processing and printed in different materials. Clinical cases, case series, in vitro studies and those that were not performed in humans were excluded. Six clinical studies were selected that met the established inclusion criteria. The selected studies showed heterogeneity in their objectives, materials used and types of regenerated bone defects. A high survival rate was found for dental implants placed on 3D-printed scaffolds, with rates ranging from 94.3% to 98%. The materials used included polycaprolactone, coral-derived hydroxyapatite, biphasic calcium phosphate (BCP) and bioceramics. The use of CAD/CAM technology is seen as key for satisfying variations in the shapes and requirements of different fabrics and size variations between different individuals. Furthermore, the possibility of using the patient’s own stem cells could revolutionize the way bone defects are currently treated in oral surgery. The results indicate a high survival rate of dental implants placed on 3D-printed scaffolds, suggesting the potential of this technology for bone regeneration in the maxillofacial mass. Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/10366/168120 2024-01-01T00:00:00Z http://hdl.handle.net/10366/168071 [EN]Background and Objectives: To study the validity and the degree of representability of the toothguide 3D Master, with 26 physically shade tabs, on the natural tooth colour on a sample of the Spanish population. Materials and Methods: Natural tooth colour was measured in a sample of 1361 Spanish participants of both genders distributed within an age range of 18 and 89 years of age. The colour coordinates were calculated and the frequency of the 26 physically shade tabs of the toothguide as well as the “intermediate shades” (without physical representation in toothguide) through the Easyshade Compact (Vita-Zahnfabrik) spectrophotometer using the 3D Master System nomenclature. The colour differences between the “intermediate shades” were calculated using the Euclidean formula (DEab*). The program used for the present descriptive statistical analysis of the results was SAS 9.1.3. Results: A total of 49 “intermediate shades” were registered in 816 participants (60%). The colour coordinates of the 49 ‘intermediate shades’ cover colour coordinates ranging from 0M1.5 (L* 100.0, C* 7.70, h* 112.2) to 5M2.5 (L* 56.8, C* 35.8, h* 78.5). Not all possible 3D Master System’s “intermediate shades” were registered in the population studied. 82.4% of the colour differences among the “intermediate shades” were clinically unacceptable (DEab* 5.5 units). Conclusions: Only 40% of the population studied presented a natural tooth colour belonging to the 3D Master Toothguide’s physical shade tabs. Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10366/168071 2022-01-01T00:00:00Z http://hdl.handle.net/10366/167972 [EN]Clinicians should be aware of the main methods and materials to face the challenge of bone shortage by manufacturing customized grafts, in order to repair defects. This study aims to carry out a bibliographic review of the existing methods to manufacture customized bone scaffolds through 3D technology and to identify their current situation based on the published papers. A literature search was carried out using “3D scaffold”, “bone regeneration”, “robocasting” and “3D printing” as descriptors. This search strategy was performed on PubMed (MEDLINE), Scopus and Cochrane Library, but also by hand search in relevant journals and throughout the selected papers. All the papers focusing on techniques for manufacturing customized bone scaffolds were reviewed. The 62 articles identified described 14 techniques (4 subtraction + 10 addition techniques). Scaffold fabrication techniques can be also be classified according to the time at which they are developed, into Conventional techniques and Solid Freeform Fabrication techniques. The conventional techniques are unable to control the architecture of the pore and the pore interconnection. However, current Solid Freeform Fabrication techniques allow individualizing and generating complex geometries of porosity. To conclude, currently SLA (Stereolithography), Robocasting and FDM (Fused deposition modeling) are promising options in customized bone regeneration. Fri, 01 Jan 2021 00:00:00 GMT http://hdl.handle.net/10366/167972 2021-01-01T00:00:00Z http://hdl.handle.net/10366/167971 [EN]Background/Objectives: Skull vibration-induced nystagmus (SVIN) is a rapid bedside test that reveals vestibular asymmetry. Its clinical utility in Ménière's disease (MD) remains controversial, particularly regarding its association with radiological endolymphatic hydrops (EH). This study aimed to evaluate the relationship between SVIN, audiovestibular parameters, and EH severity in patients with unilateral definite MD. Methods: This prospective observational study was conducted at a tertiary academic referral center and included patients with unilateral MD who underwent SVIN testing (SVT), audiovestibular evaluation (PTA, cVEMP, oVEMP, vHIT, and caloric testing), and 3T MRI with gadolinium-enhanced 3D-FLAIR sequences to quantify EH. Results: In total, 84 patients were included in the study. SVIN was present in 57.14% of patients (n = 48), with ipsilesional nystagmus being the most frequent subtype (64.58%). Patients with SVIN had significantly higher vestibular EH (p = 0.017) and vestibular endolymphatic ratio (REL) in the affected ear (p = 0.019). Disease duration (p = 0.026) and shorter time since last vertigo spell (p = 0.018) were also associated with SVIN presence. REL correlated moderately with disease duration (r = 0.390, p < 0.001), PTA (r = 0.576, p < 0.001), and number of vertigo spells (r = 0.236, p = 0.031), but not with time since last crisis (r = -0.127, p = 0.252). ROC analysis yielded an AUC of 0.735 for REL in predicting SVIN. Conclusions: SVIN correlates with the severity of vestibular EH. This finding indicates a stimulus-locked response of a vestibular asymmetry rather than a purely structural alteration. Sun, 28 Sep 2025 00:00:00 GMT http://hdl.handle.net/10366/167971 2025-09-28T00:00:00Z http://hdl.handle.net/10366/167961 [EN]Abstract: The importance of augmenting the peri-implant soft- and hard-tissue architecture is now widely accepted. However, while most contemporary research supports this premise, clinicians are encountering peri-implant soft tissue defects with increasing frequency, which they are therefore required to reconstruct. These complications can result from the difficulty of establishing an appropriate diagnosis and treatment plan or from suboptimal clinical situations (implant malposition, insufficient vestibular alveolar bone thickness or inadequate mucosal thickness). In this context, it is the peri-implant soft-tissue phenotype that most influences esthetic and health-related results in the short and long term. This article describes two clinical cases in which a modification of the apical access technique is presented that may be useful in clinical scenarios requiring large gains in mucosal thickness. Use of the modified bilaminar apical access with de-epithelialized free gingival graft technique showed promising results, with a significant increase in mucosal thickness and satisfactory outcomes in esthetics and peri-implant health. Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/10366/167961 2024-01-01T00:00:00Z http://hdl.handle.net/10366/167960 [EN]The aging population in developed countries has increased the number of edentulous patients and, therefore, the need for prosthetic rehabilitation to improve their quality of life. Complete dentures are the main treatment option in these cases. The use of CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) in dentistry has improved clinical protocols and outcomes, achieving a reduction in work time and economic costs for the patients. The main objective of this review was to compare the characteristics of conventional and digital dentures, attempting to determine whether the use of new technologies represents an improvement in the properties of removable complete dentures. A bibliographic review was carried out in the PubMed/MEDLINE, Cochrane Library, Scielo, and Embase databases. With the initial search, 157 articles were obtained. After applying the inclusion and exclusion criteria, 64 publications were selected for this bibliographic review. The different conclusions of the studies consulted were compared regarding fit and retention, fracture resistance, surface roughness, biocompatibility, and aesthetics, taking into account the different methods of prostheses fabrication. In general, digital prostheses have shown better mechanical properties and, consequently, better biocompatibility and aesthetics than conventional prostheses. However, the obtained results were very heterogeneous, preventing a supported conclusion. Mon, 30 Oct 2023 00:00:00 GMT http://hdl.handle.net/10366/167960 2023-10-30T00:00:00Z http://hdl.handle.net/10366/167958 [EN]Statement of Problem: The Vita Toothguide 3D-Master (Vita Zahnfabrik) is consid- ered the dental shade guide in which the three dimensions of color – lightness, hue, and chroma – are most well-ordered in the CIELAB color space. No research has yet explored how well the Vita Toothguide 3D-Master is ordered in the 3D color space by recording color coordinates in vivo. Purpose: To evaluate the spatial color distribution of the Vita Toothguide 3D-Master's lightness, chroma, and hue groups and its 26 physical shade tabs. Materials and Methods: The dental color (L*, C*, h , a*, and b* color coordinates) of a healthy maxillary central incisor was recorded for 1361 participants (aged between 18 and 89 years) using a Vita Easyshade Compact spectrophotometer (Vita Zahnfabrik). The R 2.7.2. statistics program was used to create the visual representations. Results: The five lightness levels are those that are best distributed in the color space, in relation to the L* coordinates, followed by the chroma group and, finally, the hue group. The 5M1, 5M2, and 5M3 physical shade tabs are situated at a greater distance apart from the other tabs in the color space. Conclusions: The Vita Toothguide 3D-Master's 26 physical shade tabs are satisfactorily distributed in three-dimensional space, although strict mathematical criteria are not followed. The natural dental shades that fall lower on the lightness scale are the most poorly represented by the physical shade tabs. Clinical Implications: Darker teeth are poorly represented by the Vita Toothguide 3D-Master's physical shade tabs. The spatial distribution of dental shade guides needs to be improved to ensure they provide homogeneous coverage of the entire chromatic spectrum corresponding to natural teeth. This would help reduce the errors inherent to the subjective visual color selection process. Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/10366/167958 2024-01-01T00:00:00Z http://hdl.handle.net/10366/167955 [EN]Purpose. The purpose of this clinical study was to determine the color coordinates of healthy gingival papillae and compare them according to sex, age, dental hygiene, and smoking habits, to compare the color coordinates of the papillae to other gingival zones, and to present a valid set of pink ceramic specimens for use in subjective color selection with the gingival papillae. Material and methods. Color coordinates of the attached gingiva and interdental papillae adjacent to the maxillary incisor were recorded by using spectrophotometry (Spectroshade; MHT Optic Research) in 62 White participants (124 papillae). To determine which color specimens best represented the interdental papillae, according to the acceptability thresholds (AT), 2 published databases were used: 15 validated ceramic gingival specimens and 133 ceramic gingival specimens. MANOVA was used for comparisons of color coordinates, and the coverage error was calculated to evaluate the guide. Results. The color-coordinate ranges of the interdental papillae were: L*: 42.2 to 57.5; a*: 16.8 to 30.6; and b*: 11.2 to 18.1. Statistically significant differences were found between all gingival zones for all color coordinates (P<.05). The interdental papillae were less yellow than the middle zone of attached gingiva and the free gingival margin, and redder than the mucogingival line. Using the Euclidean formula, the coverage error of the 15-specimen gingival guide was 2.71. Conclusions. The gingival papillae of women were significantly lighter than of men, and the b* coordinate was higher in the papillae of smokers than non-smokers. Age or dental hygiene did not significantly affect interdental papillae color coordinates. Color differences exceeding the AT between the interdental papillae and each of the 3 attached gingival zones were found in a large part of the population. The 15 specimens were useful for subjective shade selection with the interdental papillae. Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10366/167955 2025-01-01T00:00:00Z http://hdl.handle.net/10366/167815 [EN]Some evidence supports the influence of implant macro-design on primary stability. Additionally, tactile perception can be used to assess implant stability when placing the implant. This research aimed to quantify the primary and secondary stability of three implant systems with two different macro geometries (cylindrical and conical) determined based on the insertion torque and the implant stability quotient (ISQ) at the moment of implant placement as a function of implantrelated factors (length, width, dental arch, and implant location in the arch), intraoperative factors (bone density determined subjectively by the clinician’s tactile perception), and patient-related factors (age, gender, and bone density determined objectively based on cone beam computed tomography (CBCT). Methods: 102 implants from three implant systems with two different macro geometries (conical and cylindrical) were placed in 53 patients. The insertion torque, the ISQ at the implant placement (ISQ0), and the bone quality according to the clinician’s tactile sensation were recorded on the day of the surgery. After a three-month healing period, the ISQ was re-evaluated (ISQ3). Results: The cylindrical implants exhibited significantly higher insertion torque and ISQ values at the moment of the surgery and after three months compared to the conical implants. The cylindrical implants also showed significantly lower indices of tactile evaluation of bone quality during the implant placement surgery. However, no differences were demonstrated in the bone density measured objectively using CBCT. (4) Conclusions: The cylindrical implants achieved the highest values for primary stability (Newtons × centimeter (Ncm) and ISQ) and secondary stability (ISQ after three months). The insertion torque was the variable that most influenced the ISQ on the day of the surgery. The implant location (incisors–canines, bicuspids–molars) and the implant macro geometry were the variables that most influenced the secondary stability (ISQ at three months). Mon, 01 Jan 2024 00:00:00 GMT http://hdl.handle.net/10366/167815 2024-01-01T00:00:00Z http://hdl.handle.net/10366/167813 [EN]The presence of isolated or multiple gingival recessions in the mandibular anterior region is a challenge for the clinician, as they may be associated with a shallow vestibule, high frenum insertion and/or little or no attached gingiva. Only limited evidence is available on the use of the double lateral sliding bridge flap technique with connective tissue graft (CTG) technique for treating gingival recessions in the mandibular anterior region. The aim of this study was to describe and evaluate the clinical and esthetic outcomes of the double lateral sliding bridge flap technique with CTG on isolated and multiple gingival recessions at the level of the mandibular incisors. Nine patients required treatment of gingival recessions in the mandibular incisors at the University of Salamanca (Spain) (seven females, two males; mean age: 27.9 ± 6.9) with a total of 14 isolated (42.9%) and multiple (57.1%) Miller class II and III gingival recessions. After a mean follow-up of 36 months, the mean percentage of root coverage was 80.5% for all treated recessions. Statistically significant differences (p < 0.05), were observed for reduction in recession depth, increased width of keratinized tissue and increased gingival thickness, this being dependent on the Miller class. The esthetic outcome was acceptable, with a final mean esthetic score of 7.4 out of 10. The double lateral sliding bridge flap surgical technique with CTG is an effective procedure for the coverage of isolated and multiple gingival recessions in the anterior mandibular region, as it offers satisfactory esthetic results. Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10366/167813 2022-01-01T00:00:00Z http://hdl.handle.net/10366/167811 [EN]This study compard the clinical and esthetic results of the double lateralsliding bridge flap (DLSBF) and the laterally closed tunnel (LCT) techniques, with a subepithelial con-nective tissue graft (SCTG), for the treatment of single Miller class II-III recessions in the mandibularanterior teeth. (2) Methods: This pseudorandomized clinical trial evaluated 14 patients, 7 of whomwere part of the DLSBF + SCTG group, with an average follow-up of 58.7 ± 24.0 months, and 7 ofwhom were in the LCT + SCTG group, with an average follow-up of 16.7 ± 3.3 months. Clinical andesthetic evaluations of the following parameters were performed and the results for the two groupswere compared: gingival recession depth, probing depth, keratinized tissue width, gingival thickness,percentage of root coverage and root coverage esthetic score. (3) Results: After the follow-up period,each technique provided evidence of a reduction in recession depth and clinical attachment level,as well as increased keratinized tissue width and gingival thickness, with statistically significantdifferences (p < 0.05). The analysis showed that gingival recession depth decreased less in the DLSBFgroup (4.3 ± 1.2 mm to 0.6 ± 1.1 mm) than it did in the LCT group (4.9 ± 1.1 mm to 0.1 ± 0.4 mm),but no significant difference was found between the two groups. Similarly, a greater reduction inthe clinical attachment level parameter was observed in the LCT group, while a greater increase ingingival thickness was observed in the DLSBF group. The presence of scars was the only parameterfor which statistically significant differences (p < 0.05) between the two study groups were found.(4) Conclusions: Within the limitations of the study, it indicates that the LCT + SCTG techniquemay be considered an optimal technique in terms of reducing gingival recession depth, completeroot coverage and esthetic results for the treatment of single gingival recessions in the mandibularanterior! teeth. Sat, 01 Jan 2022 00:00:00 GMT http://hdl.handle.net/10366/167811 2022-01-01T00:00:00Z http://hdl.handle.net/10366/167739 [EN]To examine how the accuracy (linear and angular deviation) of implants placed using computer-guided surgery varies in relation to the type of surgical technique (fully guided, half-guided, vs freehand implant placement), bone density (type D1 to D4 bone), and type of support surface (tooth-vs mucosa-supported). Materials and Methods: A total of 32 mandible models were produced (16 partially edentulous and 16 edentulous) using acrylic resin, each calibrated to a different bone density (D1 to D4). Four implants planned using Mguide software were placed in each acrylic resin mandible. A total of 128 implants were placed, distributed according to bone density (D1 to D4, n = 32), the degree of intervention in the surgery (fully guided [FG] = 80, half-guided [HG] = 32, and freehand surgery [F] = 16), and the type of support surface (tooth-supported: n = 64 and mucosa-supported: n = 64). To determine the linear, vertical, and angular deviations between the planned three-dimensional position and the actual position of the implants, the linear and angular difference between them was calculated, with the analysis performed through preoperative and postoperative CBCT scans. The effect was analyzed using parametric tests and linear regression models. Results: All parameters of linear and angular discrepancy in the various regions analyzed (neck, body, and apex) were primarily influenced by the technique and, to a lesser extent, by the bone type, although both variables were predictive and highly significant. These discrepancies tend to increase in completely edentulous models. The regression models show that linear deviations increase by between 630.2 μm at neck level in the buccolingual direction and 836.7 μm at apex level in the mesiodistal direction when comparing the FG and HG techniques. This increase is accumulative when comparing the HG and F techniques. Regarding the effect of bone density, the regression models found that linear discrepancies increase by between 132.6 μm in the axial direction and 199.0 μm at the apex of the implant in the buccolingual direction with each reduction in bone density (D1 to D4). Conclusion: According to this in vitro study, the highest implant placement predictability is found among dentate models with high bone density and a fully guided surgical technique Sun, 01 Jan 2023 00:00:00 GMT http://hdl.handle.net/10366/167739 2023-01-01T00:00:00Z