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Purpose: This systematic review aimed to determine the effects of maternal exposure to bisphosphonates (BPs) during pregnancy on neonatal outcomes. It aimed to disclosfe the impact of BPs on neonates and identify aspects that require further investigation., Methods: A comprehensive search of PubMed, Science Direct, LILACS, EMBASE, and Web of Science was conducted until August 2022, with no time restrictions. The selection criteria included studies published in English that evaluated pregnant women who were exposed to BPs., Results: From an initial pool of 2169 studies, 13 met the inclusion criteria for this systematic review. These studies collectively included 106 women (108 pregnancies) who were exposed to BPs either before orduring pregnancy. A summary of the key characteristics of the selected studies and the risk of bias assessment are provided. Exposure to BPs occurs at various stages of pregnancy, with different indications for BP treatment. The most frequently reported neonatal outcomes were spontaneous abortion, congenital malformations, hypocalcemia, preterm birth, and low birth weight., Conclusion: Although previous reports have linked BPs before or during pregnancy with adverse neonatal outcomes, these associations should be interpreted with caution. Given the complexity of these findings, further research is necessary to provide more definitive insights to guide clinical decisions regarding the use of BPs in pregnant women., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: to understand the experiences with diabetes mellitus management of people who use insulin, in order to identify possible factors that may influence adherence to self-care and thus define their learning demands for diabetes self-management., Method: this is a qualitative study carried out using individual semi-structured interviews online. The interviews were recorded, transcribed and evaluated using Atlas.ti® software by means of Thematic Content Analysis, using the Health Beliefs Model as a theoretical framework., Results: 11 people living with diabetes and using insulin took part in the study. Four categories were identified: understanding diabetes, how to deal with diabetes, difficulties related to insulin use and emotional adaptation., Conclusion: the perception of the severity of the disease, its complications and the benefits of adhering to treatment positively influences adherence to self-care behaviors. Although the study participants have lived with diabetes for many years, they are not exempt from difficulties related to insulin use and disease management, reinforcing the importance of continuing health education. In this sense, the findings of this study guide important educational themes to be worked on by health professionals to promote autonomy in diabetes self-management., Background: (1) Perceived severity of diabetes positively influences self-care. (2) Continued health education for people who use insulin is essential. (3) The importance of recognizing the benefits of insulin in adherence to treatment. (4) Emotional aspects in diabetes management should be considered in health education.

Odontogenic cysts are bony lesions in the jaws that can reach large sizes. Decompression, a technique that helps in their surgical treatment, aims to reduce their size. We aimed to conduct a systematic review of the main types of device used for the decompression of odontogenic cysts and to analyse the indications, types, advantages, and disadvantages of the devices used. We searched PubMed, Science Direct, LILACS, EMBASE, and Web of Science until February 2023, with no time restriction. We considered studies with a minimum of 10 patients published only in English, those that reported cases and case series, randomised clinical trials of the decompression of odontogenic cysts, and the types of devices used during the decompression period. All reported odontogenic cysts had to have been confirmed by biopsy in their respective publications. We found 713 articles in the selected databases. After removing duplicates, 499 remained. After reading the titles and abstracts, we excluded 461 articles so 38 remained. Nine studies were selected for the review, totalling 244 patients. A total of 206 lesions were identified and confirmed by anatomopathological examination: 123 keratocysts, 40 dentigerous cysts, 34 radicular cysts, one cyst of epithelial origin but without specification, and eight unicystic ameloblastomas. Although we did not find out which device is best for the decompression of odontogenic cysts, our findings show that those that are most effective should be as comfortable as possible and should remain in place. They should have stability in the oral cavity and be easy for the patient to clean., (Copyright © 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objectives: Competence can be defined as a set of knowledge, skills, and attitudes. In a medical emergency scenario, competent pharmacists are increasingly required, mainly as a result of the expansion of professional functions in this context. Therefore, the objective of this study was to map the scientific evidence that shows the development of knowledge and/or skills, and/or attitudes in the training of pharmacists and pharmacy students to work in emergency care., Findings: The scoping review was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases in January 2021, as recommended by the Joanna Briggs Institute. Our study retrieved 6276 files, and 31 articles met the inclusion criteria. It was observed that the studies were developed mainly in the United States of America and addressed the development and/or assessment of knowledge and skills, and training in cardiac emergencies. The most used teaching strategy was simulation, and the most used assessment strategy was feedback and/or debriefing., Summary: Publications involving the development of at least 1 domain of clinical competence have increased in the last decade. Thus, the mapping of studies has provided subsidies for identifying gaps in the teaching-learning process, as well as the identification of methodologies applied in the development and assessment of clinical competence for the referred population., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Thalita Zago Oliveira reports financial support was provided by Coordination for the Improvement of Higher Education Personnel., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography., Materials and Methods: Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face-to-face diagnoses of three specialists-when only a clinical diagnosis was necessary-or histopathological results-when a biopsy was necessary-were considered the gold standard., Results: The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817-0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases., Conclusion: Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face-to-face diagnosis., (© 2021 Wiley Periodicals LLC.)

This review outlines the historical perspective, status, and future challenges of oral medicine (stomatology) in Brazil based on the records of the Brazilian Society of Stomatology and Oral Pathology (SOBEP) and the Brazilian Federal Dental Council as well as expert evidence input from academic leaders from 3 different generations of Brazilian oral medicine specialists. The beginning of oral medicine in Brazil dates to 1969, followed by the organization of SOBEP in 1974; however, official recognition as an independent specialty was achieved more recently within the Brazilian Federal Dental Council in 1992. After a 50-year maturation period of oral medicine in Brazil in terms of specialty crystallization across dentistry, medicine, and research, it is now time to follow the historical trends of the specialty internationally and establish a standard curriculum at a post-graduate level that will lead to uniformity of training for oral medicine in Brazil., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: The filling of the root canal system (RCS) is an important step in endodontic treatment and aims to obtain a three-dimensional sealing of the root canal spaces to prevent bacterial contamination. For this, the selection of an appropriate sealer must be performed synchronously with the choice of the root canal filling technique. This study aims, through an integrative review, to evaluate the quality of root canal filling by comparing thermoplastic and single-cone (SC) techniques., Material and Methods: The Medline/PubMed, Scopus, Web of Science and Virtual Health Library (VHL) databases were used to find articles published until November 2021. The eligibility criteria comprised articles that evaluating the quality of root canal filling comparing thermoplastic techniques with the SC technique using tricalcium silicate-based sealer. Studies that evaluated primary teeth, endodontic retreatment or perforations, different outcomes, and studies that considered artificial teeth or different sealer and material for obturation of different techniques were excluded. For articles that were not available for access, an additional contact with authors were considered. A total of 1699 articles were found. After duplicate removal, the title and abstract of 828 articles were screened. Sixteen articles were considered for full-text analysis, but only ten articles met the eligibility criteria. Data extracted from the studies were discussed and tabulated to allow the comparison of desired factors., Results: Concerning the formation of gaps/voids, the thermoplastic techniques showed better results than the SC technique in 3 articles. On the other hand, 2 articles reported no statistical difference between the tested techniques. In addition, about the penetration of tricalcium silicate-based sealer in the dentinal tubules, of the 5 articles selected, in 4 there was no significant difference between the tested techniques and only one study showed better penetration of the sealer when using thermoplastic techniques., Conclusions: The thermoplastic technique was better in most selected studies regarding gaps and voids, but regarding the penetration of the sealer into the tubules, both techniques were effective. Key words: Root canal filling, thermoplastic techniques, tricalcium silicate., Competing Interests: Conflicts of interest The authors claim there is no conflict of interest., (Copyright: © 2022 Medicina Oral S.L.)

In Brazil, there are 15,500 incident cases of oral cancer (OC) yearly, and early diagnosis is the main factor for a better prognosis. The objective of this study was to analyze the interval between the first symptoms, diagnosis, and treatment commencement in patients with malignant neoplasms in the oral cavity, lips, and oropharynx diagnosed between 2012-2018. Epidemiological data, duration, history of lesion, biopsy, and diagnosis were obtained from the medical records of these patients, who were then contacted via phone and interviewed about their oncological treatment. The results were analyzed and expressed as mean, median, and SD. Of 184 patients, most were men, white, 50-69 years old, smokers, and alcoholics. The longest interval was between the first symptoms and first evaluation (a mean of 275 days). The interval between the first appointment and the result of the biopsy was shorter (13 days). Among the 85 patients interviewed, the interval between the diagnosis, the first appointment at the oncological clinic and treatment commencement was 55 days (mean) for patients using private-sector health care, and 96 days (mean) for patients using public health care. The interval was twice as long in the public health system compared with the private sector, which highlights the inequality of access to health care in Brazil. Delay in seeking health care after the appearance of the first symptoms remains a major problem.

The objective of this systematic review was to assess whether the use of topical anesthetics reduces the perception of pain during puncture and anesthetic infiltration. Twenty-two randomized controlled clinical trials, published in English on or before August 6, 2020, were found in the PubMed/MEDLINE, Scopus, and Cochrane Library databases. Risk of bias was determined for randomization and other issues. A total of 1029 patients were evaluated using parameters such as type of topical anesthetic, application site, and pain (measured on a scale). Some studies assessed more than one topical anesthetic. Seventeen of them showed a reduction in pain from needle puncture and four from infiltration. Meta-analyses for some results showed considerable statistical heterogeneity. Regarding pain during needle puncture of the maxilla, statistically significant differences were observed in the topical anesthetics group, in both the vestibular (P = 0.0002) and palatal (P = 0.005) region. This was different from the mandible, for which there was no statistically significant difference (P = 0.07). With regard to pain caused by anesthetic infiltration in the maxilla, there was no difference in the use of anesthetic in relation to the control group (P = 0.11). Given these findings, using topical anesthetics only relieves pain during needle puncture and in the maxilla. PROSPERO 2020: CRD42020206362., (Copyright © 2021 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Oral leukoplakia is a potentially malignant disorder, defined as a white plaque that cannot be diagnosed as another known disease or disorder, and has an increased risk of malignancy. The aim of the present study was to evaluate the results of CO2 laser treatment in a well-defined cohort of patients with oral leukoplakia in order to identify the occurrence of clinical outcomes of relapse, resolution, or malignancy after treatment. The study group comprised 37 patients. Before treatment, clinical photographs and incisional biopsies were obtained in all cases. In addition, the post-treatment results were documented using photographs. Evaluation of treatment results was performed by an independent researcher who had not performed the surgery. The minimum, maximum, and mean values of continuous variables were calculated. Statistically significant relationships were tested using the Cox regression analysis. A survival curve was constructed according to the Kaplan-Meier method to analyze the malignant transformation and recurrence of oral leukoplakia. The clinical outcomes analyzed were resolution, recurrence, and malignancy. The mean follow-up period was 36 months (range, 6-239 months). In 13/37 patients, leukoplakia recurred between 6 and 93 months (mean, 38.2 months). In 8/37 patients, a malignant transformation occurred (mean, 50.6 months). In 16/37 patients, lesion resolution occurred. No risk factor was statistically significant for malignancy or recurrence of lesions. The treatment of the lesions by CO2 laser was efficient in the removal of the lesions; however, it did not avoid the clinical outcomes of recurrence or malignancy.

Objective: The objective of this systematic review was to evaluate the efficacy of non-surgical periodontal therapy on rheumatoid arthritis activity., Material and Methods: Articles published until April 2019 were electronically searched and screened using PubMed / MEDLINE, Scopus, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). This study was recorded in the international PROSPERO database (CRD42019132205). The PICO question (population, intervention, comparison, results) was: in adult patients with rheumatoid arthritis and periodontitis (P), does non-surgical periodontal treatment (I), as compared to no treatment (C), provides better outcomes in rheumatoid arthritis activity (O)., Results: After searching the databases, seven articles were selected for qualitative and five for quantitative analysis. The total number of participants included was 292, with an average age of 50.5 years. All patients had rheumatoid arthritis and periodontal disease. Non-surgical periodontal treatment significantly reduced Disease Activity Score 28 (P = 0.004; I 2  = 92%) and erythrocyte sedimentation rate (P = 0.01; I 2  = 78%), but with no significant effect on C-reactive protein (P = 0.34; I 2  = 92%)., Conclusions: It can be concluded that non-surgical periodontal treatment can benefit patients with rheumatoid arthritis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Statement of Problem: A consensus about the effect of crown-to-implant (C/I) ratio in single crowns regarding the implant survival rate and marginal bone loss (MBL) is lacking., Purpose: The purpose of this systematic review and meta-analysis was to evaluate the influence of C/I ratio in implant-supported single crowns on clinical outcomes., Material and Methods: The search was made in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42018095711). The focused question was "Does the crown-to-implant ratio influence clinical outcomes for implant-supported single crowns?", Results: Five direct comparative studies were included (C/I ratio ≤1 or >1, or ≤2 or >2), including a total of 262 participants with a mean age of 54.5 years. The meta-analysis comparing C/I ratio between ≤1 or >1 revealed no significant differences (P=.18; risk difference:-0.05; 95% confidence interval: -0.11 to 0.02) in terms of implant survival rate; the same was true for C/I ratio between <2 or ≥2 (P=.05; risk difference:-0.06; 95% confidence interval: -0.12 to -0.00), both analysis were made with a mean follow-up period was 36 months. The mean MBL was calculated based in the qualitative data for each C/I ratio: ≤1 (0.15 mm [-0.34 to 0.34]); >1 (0.07 mm [-0.29 to 0.22]); <2 (1.32 mm [0.38-0.9]); and ≥2 (1.37 mm [-0.02 to 0.91]). The qualitative data reported that the most common mechanical complication was screw loosening, and the most common biological complication was peri-implantitis., Conclusions: The meta-analysis revealed no relationship between categories of C/I ratio for implant survival rate. The qualitative data also suggested that MBL increased as the C/I ratio increased., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

This study aimed to assess the effects of splinting in 3-unit implant-supported prostheses with varying the splinting factor, length of the implant, and the diameter of the 1°molar (1°M) implant on cortical bone tissue (CBT). Twelve 3D models were simulated, which represented the posterior maxillary with 3 implants, supporting 3-unit FDP varying the splinting factor (single-unit crowns, splinted crowns straight-line and offset implant configuration [OIC]), length of the implant (7mm and 8,5mm), and the diameter of the 1°M (Ø4 mm and Ø5 mm). The CBT was analyzed by maximum principal stress and microstrain maps. The increase in implant diameter improved the biomechanical behavior of rehabilitation. The increase of the implant diameter in the 1°M associated with OIC generated the best biomechanical behavior for CBT. The splinting was effective in decreasing stress and microstrain, mainly when associated with OIC and implant diameter of Ø5 in the 1°M. The effect of increasing the diameter of the implant referring to the 1°M for single-unit crowns was more effective than the effect of the splinting of implants with Ø4 mm in straight-line. The diameter and splinting factors showed to be more important than implant length to reduce the stress and microstrain on CBT., (Copyright© 2021 Dennis Barber Ltd.)

Background: Juvenile spongiotic gingival hyperplasia (JSGH) is a benign proliferation of non-keratinised stratified squamous epithelium with evident spongiosis, exocytosis leukocytes and dilated vessels with varying numbers of inflammatory cells. Although uncertain, it has been suggested that the epithelial proliferation is probably related to trauma and local irritants. It emerges as a painless erythematous patch or papule with an irregular surface., Case Reports: We present a series of eight cases and a literature review of the clinical presentation and treatment approaches for JSGH. This series includes four females and four males with a mean age of 11.6 years, all complaining of injury to the gums. All lesions were painless and not bleeding. One patient associated the lesion with the onset of trauma and another with a previous history of an eruption cyst. Periapical radiographs of the adjacent area did not show any alteration of bone or teeth. Based on these findings, the diagnostic hypotheses were a non-neoplastic proliferative process or a factitious injury. Incisional biopsy was performed and histopathologic diagnosis was conclusive for JSGH. Surgical excision was conducted in three cases, and the other five cases were supported by clinical observation and plaque control in order to prevent gingival recession defects. After a follow-up period of 11 months (mean), no recurrence was observed for surgically treated cases and mild improvement was achieved with periodontal treatment., Conclusion: This case series illustrates the importance of diagnosis and follow-up of patients with JSGH. A conservative approach consisting of basic periodontal support instead of surgical excision may be indicated because of the risk of aesthetic defects at the involved areas.

Background: This systematic review evaluated the most effective therapeutic approach to treat periodontal furcation defects with a minimum follow-up of 12 months. The primary outcome was clinical attachment level (CAL). Secondary outcomes were probing pocket depth, gingival margin level, gingival index and plaque index., Methods: A comprehensive search of studies published up to December 2019 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Two reviewers independently searched eligible studies, made a final article selection, and extracted the data of the selected studies to evaluate qualitatively and quantitatively (meta-analysis)., Results: Overall, 19 studies were selected for the analysis. Six hundred and eighteen patients (mean age, 45.3) were treated. More commonly used treatment was polytetrafluoroethylene barrier (ePTFE), followed by enamel matrix derivative (EMD) and open-flap debridement (OFD). Only one study evaluated maxillary arch and remaining evaluated mandibular arch. All treatments provided CAL gain, but meta-analysis did not show significant difference among more commonly used treatments and controls (P=0.91; P=0.47; P=0.08, respectively)., Conclusion: There is no difference on effectiveness of main therapeutic approaches evaluated for treatment of Class II periodontal furcation defects., Competing Interests: The authors did not declare any conflicts of interest., (Copyright© by the International Academy of Periodontology.)

Aim: The aim of this study was to evaluate the available evidence to identify the influence of pterygomaxillary disjunction on the result of surgically assisted maxillary expansion., Background: LeFort I type osteotomy with disjunction of the pterygomaxillary suture is a procedure widely used in maxillofacial surgery. However, the need for its performance during surgically assisted maxillary expansions has been discussed in literature, since serious complications can be caused during this stage., Review Results: Systematic review of articles was performed using three databases (PubMed, Web of Science, and Cochrane) published until May 2019. After applying the selection criteria, five articles were included in the systematic review, with a total of 141 patients. Meta-analysis showed the absence of significant difference between intervention and control groups in the preoperative period (standardized mean difference = -0.28; confidence interval, CI 95% = -0.81, 0.26; p = 0.31) and postoperative period (standardized mean difference = -0.12; 95% CI = -0.65, 0.42; p = 0.66). In general, the heterogeneity of statistical estimates was low ( I 2 = 0%)., Conclusion: No statistically significant difference was observed between control group (without pterygomaxillary disjunction) and intervention group (with pterygomaxillary disjunction)., Clinical Significance: Based on the data analyzed in this systematic review, it could be concluded that pterygomaxillary disjunction is not a mandatory step to achieve satisfactory maxillary expansion. Thus, not performing pterygomaxillary disjunction can prevent complications and reduce surgical time.

Objective: To present a systematic review that provides updated information about proteins found in salivary fluid extracted strictly from ducts., Methods: The systematic review probing strategy was based on electronic databases word search (PubMed, EMBASE, LILACS, Web of Science, and Scopus). Risk of bias was assessed based on Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data., Results: After 2 rounds of scrutiny, 12 articles were included, totaling 231 individuals (125 were healthy, 41 were elder individuals with radicular caries, 56 had primary Sjögren's syndrome, and 9 were patients who had received radiotherapy for head and neck cancer). The selected studies had no similarities among proteins found, demonstrating the need of standard reference in experimental methodology to obtain a thorough coverage of proteins., Conclusion: Further studies are required to better determine the relative amount of proteins described in this study. It is essential to increase the number of samples, to perform similar collection techniques, to include other analyses methods such as mass spectrometry, and to perform the validation of some proteins using immunoassay techniques such as Elisa and Western blot., Clinical Relevance: Proteomic profile of saliva collected from ducts is essential to better understand the disease process, enabling the identification of biomarkers for specific clinical situations.

Oral problems are common in patients diagnosed with Eating Disorders (ED) and still require better elucidation. We aimed to analyze the prevalence of oral Candida spp in individuals with ED. The sample of the study was comprised of 30 women with purgative habits and 15 without purgative habits. Samples of the oral cavity were collected by sterile cotton swab rubbed on soft tissues and teeth. Yeasts were isolated on Sabouraud dextrose agar. Yeasts were isolated from the oral cavity of 53% of the patients yielding 75 yeast isolates; of these, 43 were identified by conventional mycological methods: C. parapsilosis (n=19), C. glabrata (n=16), Rhodotorula sp (n= 6), C. famata (n=2). The remaining 32 isolates were presumptively identified as C. albicans or C. dubliniensis and required mass spectrometry for the final differentiation: 28 isolates were confirmed as C. albicans and four as C. dubliniensis. Among the control group, only four subjects (26.7%) were found to harbor C. albicans. The four C. dubliniensis isolates were from two patients, one that was only colonized and the other, with severe ED, was diagnosed with an oral candidiasis as demonstrated by the presence of pseudohyphae on the direct mycological exam from different sites. The increased rate of isolation of non-albicans species, such as C. glabrata, C. parapsilosis, and C. dubliniensis in the oral cavity from ED patients with nutritional deficiency may suggest that purgative habits of these patients can lead to changes in normal flora and predispose to oral candidiasis.

Oral alterations in patients diagnosed with eating disorders (ED) are reported in the literature, but few articles demonstrate these changes in a specific population. This study aims to summarize the findings of 26 patients with ED in a Brazilian dental clinic, through analyzing the body mass index and oral conditions (decayed, missing and filled teeth-DMFT, dental wear, salivary flux, xerostomia, oral hygiene-OHI-S, oral lesions, and the prevalence of candidiasis), in order to facilitate recognition and enable accurate diagnosis for the general dentist. Probably, the premature diagnosis of ED resulted in lower DMFT and oral lesions., (© 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.)

The aim of this review was to test the hypothesis of no difference in the efficacy of bone regeneration when using stem cells in maxillary sinus floor augmentation surgery in comparison to other grafts. Nine randomized clinical trials and one follow-up study involving human subjects were identified through a search of the PubMed/MEDLINE, Scopus, Cochrane, and Web of Science databases, supplemented by a hand search. No significant difference between groups was found for the implant survival rate, increase in bone height, marginal bone loss following implant placement, or new bone formation. With regard to the residual bone graft, an effect favouring the graft group at 3-4months (P=0.001) and favouring the stem cell group at 6months (P=0.01) was found. Analyses of the subgroup in which the BMAC system extraction method was used in combination with Bio-Oss, revealed no difference in new bone formation; however, the results for residual bone graft at 3months favoured the control graft (Bio-Oss) (P=0.01), but at 6months favoured the stem cells (Bio-Oss+BMAC system) (P=0.01). Based on all findings, the use of stem cells does not contribute significantly to greater implant survival rates or the efficacy of bone regeneration following sinus lift procedures., (Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The aim of this systematic review was to test the following hypotheses: (1) that there is no difference in implant survival rate between individuals with overweight or obesity and those who are within the ideal weight range; (2) that there are no differences between these groups regarding indicators of peri-implant health. Two independent reviewers performed a literature search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 1, 2018. A meta-analysis was performed to determine the risk difference for implant failure and mean difference for marginal bone loss, probing depth, and bleeding on probing. Six studies were selected for review, involving a total of 746 patients with 986 implants: 609 in overweight or obese individuals and 377 in individuals within the ideal weight range. The findings of this systematic review indicate that the first hypothesis should be accepted, since no statistically significant difference in implant survival rate was found between individuals with overweight/obesity and those within the ideal weight range (P=0.64). The second hypothesis was rejected, as the review indicated a difference in marginal bone loss (P<0.00001), probing depth (P<0.00001), and bleeding around dental implants (P<0.00001)., (Copyright © 2019 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: To evaluate the vertical marginal (VM) and horizontal marginal (HM) misfit of frameworks made using different techniques., Materials and Methods: A total of 30 frameworks were divided into three groups of 10 samples each based on manufacturing technique: nichrome cast (G1), milled in zirconia (G2), and milled in wax and fused to metal (G3). Marginal misfit was measured using a three-dimensional optical microscope., Results: The highest VM misfit was in G3 (83.5 μm), followed by G1 (55 μm) and G2 (42 μm). The highest HM misfit was in G2 (118 μm), followed by G3 (102 μm) and G1 (-85 μm)., Conclusion: Frameworks milled in zirconia resulted in the lowest VM misfit, while frameworks filled in wax and fused to metal resulted in higher VM. The HM misfit was favorable in the lost-wax technique.

Background: Alveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites., Material and Methods: Seven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool., Results: Of the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa=0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p= 0.04; 935 implants; i2= 0%). Peri-implant outcomes showed no statistical difference., Conclusions: Immediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Peri-implant outcomes were not statistically affected in this intervention.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Metastases to the soft tissues of the oral cavity are extremely uncommon. This report describes a rare case of an oral metastatic HCC, located completely within the oral mucosa overlying the alveolar ridge, in a patient who was unware of his primary disease. A 64-year-old man was referred for evaluation of a nodular mass on the edentulous mandibular ridge underneath an implant-supported overdenture. According to the patient, he was successfully treated for hepatitis C infection 7 years previously, and he reported that his α-fetoprotein levels were monitored at semiannual intervals. The results of his current blood tests were within the reference range. A biopsy was performed, and analysis of the specimen revealed a malignant neoplasm suggestive of metastatic HCC. Because the patient was unaware of any underlying disease, he was referred to an oncologist for further evaluation. However, signs of hepatic decompensation appeared immediately after the biopsy results were obtained, and the patient was hospitalized. The overall medical examination disclosed an HCC with metastases to the lungs and oral cavity, and the patient died 8 days after hospitalization. This case reinforces the important potential for dentists to identify neoplastic diseases that are unknown to their patients.

Purpose: The aim of this study was to use three-dimensional finite element analysis to analyze the stress distribution transferred by single implant-supported prostheses placed in the anterior maxilla using different connections (external hexagon, internal hexagon, or Morse taper), inclinations of the load (0, 30, or 60 degrees), and surgical techniques for placement (monocortical/conventional, bicortical, or bicortical with nasal floor elevation)., Materials and Methods: Nine models representing a bone block of this region were simulated by computer-aided design software (InVesalius, Rhinoceros, SolidWorks). Each model received one implant, which supported a cemented metalloceramic crown. Using FEMAP software, finite elements were discretized while simulating a 178-N load at 0, 30, and 60 degrees relative to the long axis of the implant. The problem was solved in NEi Nastran software, and postprocessing was performed in FEMAP. Von Mises stress and maximum principal stress maps were made., Results: The von Mises stress analysis revealed that stress increased with increasing inclination of the load, from 0 to 30 to 60 degrees. Morse taper implants showed less stress concentration around the cervical and apical areas of the implant. The bicortical technique, associated or not with nasal floor elevation, contributed to decreasing the stress concentration in the apical area of the implant. Maximum principal stress analysis showed that the increase in inclination was proportional to the increase in stress on the bone tissue in the cervical area. Lower stress concentrations in the cortical bone were obtained with Morse taper implants and the bicortical technique compared with other connections and surgical techniques, respectively., Conclusion: Increasing the inclination of the applied force relative to the long axis of the implant tended to overload the peri-implant bone tissue and the internal structure of the implants. The Morse taper connection and bicortical techniques seemed to be more favorable than other connections or techniques, respectively, for restoring the anterior maxilla.

The aim of this study was to evaluate the influence of pontic and cantilever designs (mesial and distal) on 3-unit implant-retained prosthesis at maxillary posterior region verifying stress and strain distributions on bone tissue (cortical and trabecular bones) and stress distribution in abutments, implants and fixation screws, under axial and oblique loadings, by 3D finite element analysis. Each model was composed of a bone block presenting right first premolar to the first molar, with three or two external hexagon implants (4.0 × 10 mm), supporting a 3-unit splinted dental fixed dental prosthesis with the variations: M1 - three implants supporting splinted crowns; M2 - two implants supporting prosthesis with central pontic; M3 - two implants supporting prosthesis with mesial cantilever; M4 - two implants supporting prosthesis with distal cantilever. The applied forces were 400 N axial and 200 N oblique. The von Mises criteria was used to evaluate abutments, implants and fixation screws and maximum principal stress and microstrain criteria were used to evaluate the bone tissue. The decrease of the number of implants caused an unfavorable biomechanical behavior for all structures (M2, M3, M4). For two implant-supported prostheses, the use of the central pontic (M2) showed stress and strain distributions more favorable in the analyzed structures. The use of cantilever showed unfavorable biomechanical behavior (M3 and M4), mainly for distal cantilever (M4). The use of three implants presented lower values of stress and strain on the analyzed structures. Among two implant-supported prostheses, prostheses with cantilever showed unfavorable biomechanical behavior in the analyzed structures, especially for distal cantilever.

Purpose: This systematic review evaluates the effectiveness of low-level laser therapy (LLLT) to enhance maxillofacial area bone repair., Methods: A comprehensive search of studies published up to February 2017 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement., Results: The 15 selected studies evaluated a total of 374 patients (mean age, 28.5years) who were treated with LLLT. Gallium-arsenide (GaAs) and gallium aluminium arsenide (GaAlAs) were the most commonly used devices, and LLLT parameters varied greatly. Wavelengths varied from 500 to 1000nm. Tooth extraction, distraction osteogenesis, maxillary expansion, periodontal defects, orthodontic movement and maxillary cystic defects were evaluated. From the 15 selected studies, six evaluated bone repair (primary outcomes). Of these, four studies showed improvement in bone formation after using LLLT, two demonstrated improved results for only one follow up period, and one showed no additional benefits. The other 9 studies evaluated secondary parameters related to healing (secondary outcomes) in the maxillofacial area after applying LLLT, including anti-inflammatory, analgesic, and healing accelerator effects, and quality of life related to oral health. There were no adverse or negative effects of LLLT reported., Conclusion: Within the limitation of this review, a possible improvement in bone density can be found when LLLT is applied postoperatively in maxillofacial bony defects. LLLT also seems to promote anti-inflammatory and analgesic effects and accelerate healing, as well as enhance quality of life related to oral health. However, LLLT use protocols need to be standardized before more specific conclusions can be drawn about this subject., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Aim: The aim of this study was to investigate the association of different degradations on the roughness, gloss, and color changes of microhybrid composites., Materials and Methods: Ten specimens were prepared for Charisma, Amelogen Plus, Point 4, and Opallis resins. Surfaces were polished and baseline measurements of roughness, gloss, and color were recorded. Specimens were then submitted to chemical and mechanical challenges, and the specimens were reevaluated. Roughness and gloss were analyzed by Kruskal -Wallis and Dunn's test (p < 0.05). Color change (ΔE) was analyzed by one-way analysis of variance and Tukey's tests (p < 0.05). The initial and final data were compared using the Wilcoxon test (p < 0.05). Spearman test checked the correlation between the roughness and gloss (p < 0.05)., Results: Regarding surface roughness and gloss, there was no difference between composites before challenges. However, all composites showed a significant increase of roughness after challenges, with highest values for Charisma. The gloss was influenced by challenges, evidencing the best gloss for Point 4. Charisma showed the highest value of color change. There was no correlation between surface roughness and gloss for the initial analysis, and after the challenges., Conclusion: Composites were influenced by association of challenges, and Charisma showed the highest changes for roughness, gloss, and color., Clinical Significance: The type of composite resin influenced the properties of materials, which are surface roughness, gloss, and color change. The dentist should be aware of the performance of different brands, to choose the correct required composite resin for each type of patient or region to be restored.

This systematic review evaluated the efficacy of the morning fasting serum C-terminal telopeptide (CTX) test in predicting the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). A comprehensive search of studies published up to March 2016, and listed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review has been registered in the PROSPERO international prospective register of systematic reviews (CRD42016036717). The search identified 542 publications; eight studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 1442 patients (mean age 66.7 years). The most prescribed drug was alendronate, with osteoporosis being the most frequent indication for the prescription of bisphosphonates. Tooth extraction was the most common trigger for BRONJ. Of all patients evaluated after bisphosphonate treatment, only 24 (1.7%) developed BRONJ. All eight of the selected studies found that CTX levels were not predictive of the development of BRONJ. In conclusion, this systematic review indicates that the CTX test has no predictive value in determining the risk of osteonecrosis in patients taking bisphosphonates., (Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: The purpose of this systematic review was to evaluate the use of mini implants to retain complete overdentures in terms of survival rates of mini implants, marginal bone loss, satisfaction, and quality of life., Data: This report followed the PRISMA Statement and PICO question. This review has been registered at PROSPERO under the number CRD42016036141., Source: Two independent reviewers performed a comprehensive search of studies published until September 2016 and listed in the PubMed/MEDLINE, Embase, and The Cochrane Library databases. The focused question was: is the use of mini implants feasible for prosthodontic rehabilitation with complete overdentures?, Results: The 24 studies selected for review evaluated 1273 patients whose mean age was 65.93 years; these patients had received 2494 mini implants and 386 standard implants for retaining overdenture prosthesis. The mean follow-up time was 2.48 years (range: 1-7 years). There was a higher survival rate of mini implants (92.32%). More frequent failures for maxillary (31.71%) compared with mandibular arches (4.89%). The majority of studies revealed marginal bone loss values similar to those of standard implants (<1.5mm). All studies verified an increase in satisfaction and quality of life after rehabilitation treatment with mini dental implants., Conclusion: The present systematic review indicates that the use of mini implants for retaining overdenture prosthesis is considered an alternative treatment when standard treatment is not possible, since it presents high survival rates, acceptable marginal bone loss, and improvements in variables related to satisfaction and quality of life., Clinical Significance: Based on the results of this study, the use of a minimum 4 and 6 mini implants can be considered a satisfactory treatment option for rehabilitation of the mandibular and maxillary arches respectively with a complete overdenture., (Copyright © 2016. Published by Elsevier Ltd.)

The aim of study was to evaluate the stress distribution in implant-supported prostheses and peri-implant bone using internal hexagon (IH) implants in the premaxillary area, varying surgical techniques (conventional, bicortical and bicortical in association with nasal floor elevation), and loading directions (0°, 30° and 60°) by three-dimensional (3D) finite element analysis. Three models were designed with Invesalius, Rhinoceros 3D and Solidworks software. Each model contained a bone block of the premaxillary area including an implant (IH, Ø4 × 10 mm) supporting a metal-ceramic crown. 178 N was applied in different inclinations (0°, 30°, 60°). The results were analyzed by von Mises, maximum principal stress, microstrain and displacement maps including ANOVA statistical test for some situations. Von Mises maps of implant, screws and abutment showed increase of stress concentration as increased loading inclination. Bicortical techniques showed reduction in implant apical area and in the head of fixation screws. Bicortical techniques showed slight increase stress in cortical bone in the maximum principal stress and microstrain maps under 60° loading. No differences in bone tissue regarding surgical techniques were observed. As conclusion, non-axial loads increased stress concentration in all maps. Bicortical techniques showed lower stress for implant and screw; however, there was slightly higher stress on cortical bone only under loads of higher inclinations (60°).

The aim of this study was to assess stress/strain of different implant modeling simplifications by 3D-FEA. Three variation of external hexagon implant (Ø3.75 × 10 mm) supporting one molar crown were simulated: A (no threads); B (slightly threads simplification); C (original design). 200 N (axial) and 100 N (oblique) were applied. Cortical bone was evaluated by maximum principal stress and microstrain qualitatively and quantitatively (ANOVA and Tukey post hoc (p < 0.05)). Higher stress levels (p < 0.05) were observed in model A. Models B and C presented similar stress transmission. It was possible to conclude that slightly simplification should be used for studies evaluating stress transferring for bone tissue.

This article reports a case of oral rehabilitation with two-implant-retained mandibular overdenture using bar/clip and ball attachment bilaterally on the distal side. A patient aged 69 years, fully edentulous, presented herself to private practice complaining about the instability of mandibular denture. Several possibilities of rehabilitation with advantages and disadvantages were explained to the patient, based in the clinical and radiograph examinations, and patient desire, in which she opted by conventional maxillary complete denture and two-implant-retained mandibular overdenture. Two external hexagon implants of 3.75 × 10 mm were placed in anterior area of mandible. The fabrication of the metal framework with bar/clip and ball attachment bilaterally on the distal side was planned based on prior arrangement of the artificial teeth. Internal adaptation and occlusal adjustments were performed in the day of insertion of finalized denture and instructions about maintenance and sanitation. The patient showed satisfaction with the final result of her treatment, and no complications were observed during this period. The association of bar/clip with ball system may be viable as option of retention for mandibular implant-retained complete overdenture; however, further randomized controlled trials are necessary to obtain detailed knowledge about the topic.

The study was carried out in a Brazilian population and the aim was to describe the prevalence and the clinic-radiographical features of jaw lesions. In addition, a comparison between the main diagnosis hypothesis and final diagnosis was accessed. A prospective study which evaluated all patients with jaw lesions diagnosed in an Oral Diagnosis Center, between August 2013 and October 2014. A total of 450 patients were observed for the first time, and 130 had some type of jaw lesion. The mean age of the patients was 35.2 years ± 17.86. Among these, 71 were women (54.62%) and 87 were Caucasian (66.92%). The mandible was affected more frequently (71.43%) than the maxilla (28.57%). Swelling and pain were the most frequent clinical signs and symptoms and were observed in 60 (42.85%) and 38 (27.14%) cases, respectively. The panoramic x-ray was the main radiographic exam utilized (88.57%). Radiolucent lesions accounted for 89 cases (63.57%) and the unilocular form was present in 114 cases (81.43%). A total of 93 cases had histopathological analyses and the periapical cyst was the most frequent lesion. In the other 47 lesions, the diagnosis was conducted by clinical and radiographic management. Bone lesions were frequent, being noted on first visit in approximately 30% of patients; in 1/3 of the cases, the diagnoses were completed with a combination of clinical and radiographic exams.

The aim of this study is to assess the effect of different dental implant designs, bone type, loading, and surface treatment on the stress distribution around the implant by using the 3D finite-element method. Twelve 3D models were developed with Invesalius 3.0, Rhinoceros 4.0, and Solidworks 2010 software. The analysis was processed using the FEMAP 10.2 and NeiNastran 10.0 software. The applied oblique forces were 200 N and 100 N. The results were analyzed using maps of maximum principal stress and bone microstrain. Statistical analysis was performed using ANOVA and Tukey's test. The results showed that the Morse taper design was most efficient in terms of its distribution of stresses (p<0.05); the external hexagon with platform switching did not show a significant difference from an external hexagon with a standard platform (p>0.05). The different bone types did not show a significant difference in the stress/strain distribution (p>0.05). The surface treatment increased areas of stress concentration under axial loading (p<0.05) and increased areas of microstrain under axial and oblique loading (p<0.05) on the cortical bone. The Morse taper design behaved better biomechanically in relation to the bone tissue. The treated surface increased areas of stress and strain on the cortical bone tissue., (Copyright © 2016 Elsevier B.V. All rights reserved.)

The aim of this study was to evaluate the stress distribution on full-arch prostheses, considering axial implants and tilted implants with or without abutments. Two photoelastic models were made, being that in 1 model the implants were inserted perpendicular, whereas in the other model 2 implants were inserted perpendicular and 2 implants were inserted with tilting 30° to the distal area. The prosthetic situations were evaluated: A-axial implants and nonsegmented full-arch prosthesis; B-axial implants and segmented full-arch prosthesis; C-tilted distal implants and nonsegmented full-arch prosthesis; D-tilted distal implants and segmented full-arch prosthesis, and was applied an axial load of 100 N at 5 points. The results showed greater stress concentration for axial implants than tilted implants in anterior and posterior loading. There was no difference in stress distribution to the use of abutment in the tilted implants. Shorter cantilever with tilted implants improved the stress distribution; the use of abutment did not influence the stress distribution.

The aim of this study was to evaluate the shear bond strength of resin composite repairs with and without aging of the surface to be repaired, using different adhesive systems and resin composites. Ninety specimens were prepared: 10 for the Control Group (GC - without repair); 40 for Group I (GI - repairs after 7 days) and 40 for Group II (GII - repairs after 180 days). Groups I and II were divided into 4 subgroups of 10 specimens each, according to the adhesive system and composite resin used: A) Adper Scotch Bond Multipurpose + Filtek Z350 XT; B) Adper Single Bond Plus + Filtek Z350 XT; C) Adper Scotch Bond Multipurpose + Esthet-X; D) Adper Single Bond Plus + Esthet-X. The specimens were tested for shear strength in a universal testing machine. The results were analyzed by two-factor one-way ANOVA and Fisher's post hoc tests (alpha=0.05). The control group had better performance than the other groups. There was no significant difference when comparing different adhesive systems and composite resins. Repairs performed at 7 days were better than those performed at 180 days. The composite repairs decreased the mechanical strength of the restoration. Aging of the resin substrate may decrease repair bond strength over time, regardless of the type of adhesive systems and resin composites used., (Sociedad Argentina de Investigación Odontológica.)

This systematic review evaluated the effect on bone formation and implant survival of combining platelet-rich plasma (PRP) with bone grafts in maxillary augmentation. A comprehensive review of articles listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases covering the period January 2000 to January 2015 was performed. The meta-analysis was based on bone formation for which the mean difference (MD, in millimetres) was calculated. Implant survival was assessed as a dichotomous outcome and evaluated using the risk ratio (RR) with 95% confidence interval (CI). The search identified 3303 references. After inclusion and exclusion criteria were applied, 17 studies were selected for qualitative analysis and 13 for quantitative analysis. A total of 369 patients (mean age 51.67 years) and 621 maxillary sinus augmentations were evaluated. After the data analysis, additional analyses were performed of the implant stability quotient, marginal bone loss, and alveolar bone height measured by MD. The results showed no significant difference in implant stability (P=0.32, MD 1.00, 95% CI -0.98 to 2.98), marginal bone loss (P=0.31, MD 0.06, 95% CI -0.05 to 0.16), alveolar bone height (P=0.10, MD -0.72, 95% CI -1.59 to 0.14), implant survival (P=0.22, RR 1.95, 95% CI 0.67-5.69), or bone formation (P=0.81, MD -0.63, 95% CI -5.91 to 4.65). In conclusion, the meta-analysis indicates no influence of PRP with bone graft on bone formation and implant survival in maxillary sinus augmentation., (Copyright © 2016. Published by Elsevier Ltd.)

Statement of Problem: No consensus has been reached on which retention system, cement- or screw-retained, is best to avoid bone loss around the implant of a fixed implant-supported restoration., Purpose: The purpose of this systematic review and meta-analysis was to compare cement- and screw-retained retention systems in fixed implant-supported restorations in terms of marginal bone loss, implant survival, and prosthetic complications., Material and Methods: A comprehensive search of studies published from January 1995 to March 2015 and listed in the PubMed/MEDLINE, Embase, Scopus and the Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Marginal bone loss was the continuous outcome measure evaluated by mean difference (MD), and implant survival and prosthetic complications were the dichotomous outcome measures evaluated by risk ratio (RR), both with corresponding 95% confidence intervals (CI)., Results: The 20 studies selected for review evaluated 2139 participants, whose mean age was 47.14 years and who had received 8989 dental implants. The mean follow-up was 65.4 months (range: 12-180 months). Results of the MD for marginal bone loss showed statistically significant differences in favor of the cement-retained prosthesis (P =.04; MD: -0.19; CI: -0.37 to -0.01). The implant survival rate was higher for the cement-retained prosthesis (P =.01; RR: 0.49; CI: 0.28 to 0.85), and the prosthetic complication rate was higher for the screw-retained prosthesis (P =.04; RR: 0.52; CI: 0.28 to 0.98). Additional analysis of the mean plaque index did not show differences between retention systems (P=.58; MD: 0.13; CI: -0.32 to 0.57)., Conclusions: The current meta-analysis indicated that cement-retained, fixed implant-supported restorations showed less marginal bone loss than screw-retained, fixed implant-supported restorations during the follow-up period, which ranged from 12 to 180 months. However, the small difference between the mean values may not show clinical significance. The rates of prosthetic complication and implant survival also compared favorably with cement-retained prostheses., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of the present systematic review and meta-analysis was to compare short implants (equal or less than 8mm) versus standard implants (larger than 8mm) placed in posterior regions of maxilla and mandible, evaluating survival rates of implants, marginal bone loss, complications and prosthesis failures., Data: This review has been registered at PROSPERO under the number CRD42015016588. Main search terms were used in combination: dental implant, short implant, short dental implants, short dental implants posterior, short dental implants maxilla, and short dental implants mandible., Source: An electronic search for data published up until September/2015 was undertaken using the PubMed/Medline, Embase and The Cochrane Library databases., Study Selection: Eligibility criteria included clinical human studies, randomized controlled trials and/or prospective studies, which evaluated short implants in comparison to standard implants in the same study., Conclusion: The search identified 1460 references, after inclusion criteria 13 studies were assessed for eligibility. A total of 1269 patients, who had received a total of 2631 dental implants. The results showed that there was no significant difference of implants survival (P=.24; RR:1.35; CI: 0.82-2.22), marginal bone loss (P=.06; MD: -0.20; CI: -0.41 to 0.00), complications (P=.08; RR:0.54; CI: 0.27-1.09) and prosthesis failures (P=.92; RR:0.96; CI: 0.44-2.09). Short implants are considered a predictable treatment for posterior jaws. However, short implants with length less than 8 mm (4-7 mm) should be used with caution because they present greater risks to failures compared to standard implants., Clinical Significance: Short implants are frequently placed in the posterior area in order to avoid complementary surgical procedures. However, clinicians need to be aware that short implants with length less than 8mm present greater risk of failures., (Copyright © 2016. Published by Elsevier Ltd.)

Purpose: Bisphosphonate (BP) therapy in the treatment of bone diseases and malignancy may induce a major side effect known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). A particular view of this condition is reported in this case series investigating eight patients. The aim of the study was to evaluate the BRONJ lesions concerning their aspects and progression. Also, identify if it is possible to predict the degree of severity in these cases., Methods: Patients were evaluated by their condition and systemic health. The lesions were evaluated in clinical and radiographic aspects. The patients were followed-up for 2 years., Results: The patients presented with specific peculiarities, and the BRONJ lesions varied in several characteristics. The BRONJ lesions ranged from simple to severe conditions, and the complicated cases presented with major pain, swelling, secondary infection and an extensive necrotic area, classified with high grade of severity., Conclusions: The patients presented here confirm the existence of a relation between multiple features and BRONJ and to understand the whole process of aggravation, all systemic and local information have to be taken into account, together with all data related to the BP utilized. Regardless of the low incidence of this side effect in relation to osteoporosis treatment, in some cases, the BRONJ may become a severe condition and compromise the patient's quality of life.