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Osseointegration of dental implants in irradiated bone tissue: experimental study
1048 ICOMS 2011—Abstracts: Oral Papers
78 Postoperative bleeding after dental extraction in the liver pretransplant patient
79 Osseointegration of dental implants in irradiated bone tissue: experimental study
J.P.V. Perdigão 1,∗ , K.C. Mesquita 2 , P.C.d. Almeida 2 , T.D.D.S. Rocha 2 , F.B. Sousa 2 1 State University of Maringá - UEM, Maringá, Brazil 2 Federal University of Ceará, Fortaleza, Brazil
J.F. Santos-Junior 1,∗ , M. Abrahão 2 , L.L. Dib 3 , R.S. Janh 1 , U. Nannmark 4 , G. Granstrom 5 1 Stomatology, Santo Amaro University UNISA, São Paulo, Brazil 2 Otorhinolaryngology and Head and Neck Surgery, Federal São Paulo University UNIFESP, São Paulo, Brazil 3 Stomatology, Paulista University - UNIP, São Paulo, Brazil 4 Anatomy and Cell Biology, Gothenburg, Sweden 5 Otorhinolaryngology and Head and Neck Surgery, University of Gothenburg, Gothenburg, Sweden
Introduction: During dentoalveolar surgery, liver transplant candidates need special care regarding hemostasis impairment, related to reduced hepatic synthesis of procoagulants factors and thrombocytopenia. Purpose: The aim of this prospective study was to evaluate the incidence of postoperative bleeding after dental extraction in candidates for liver transplantation. Patients and methods: A prospective cross-sectional observational study was performed with individuals awaiting liver transplantation and referred for oral health evaluation. All the subjects with dental foci that required extraction were considered to this study. Patients were included in the analysis when the blood exams were according to: platelet count ≥30,000/mm3 and INR ≤ 3.0. Absorbable hemostatic sponges and cross sutures were used as a standard hemostatic measure. All tooth extractions were performed without administration of blood products (platelet concentrate, fresh frozen plasma). Results: In 23 patients included in this study, 84 simple extractions were performed in 35 dental surgical procedures. The main preoperative blood tests found were: mean hematocrit of 34.54% (SD ± 5.84, range 21.7–44.4%), platelets ranged from 31,000/mm3 to 160,000/mm3 , mean international normalized ratio (INR) was 1.50 (SD ± 0.39; range 0.98–2.59). Postoperative bleeding occurred in only one procedure (2.9%) and local pressure with gauze was effective to achieve hemostasis. Conclusion: This paper demonstrates the low bleeding risk of tooth extractions in patients with liver cirrhosis, with INR ≤ 2.50 and platelets ≥30,000/mm3 , without the need of blood transfusion, and in case of bleeding events, the use of local hemostatic measures can be satisfactory. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.079
Background: Previous studies show that the treatment of the implant surface presents more bone formation than the turned implants. Other studies indicate the possibility of having an implant in bone that has undergone radiotherapy. Purpose: The aim of this study was to verify if the use of treated surface implants presents a better bone-to-implant contact rather than machined surface implants in irradiated and no irradiated bone. Materials and methods: Twenty-four Wistar rats (Rattus Norvegicus) and fortyeight mini implants were used in this study. A dose of 30 Gy irradiation was delivered to the right leg of all rats, the left leg was kept as a control group. A turned surface implant was installed to the bilateral tibia thirty days after irradiation. Other twelve rats received a treated surface implant in the tibia bilaterally. The implants were recovered after 28 and 84 days and a boneto-implant contact histometry and a bone density was carried out. Results: The bone-to-implant contact after 84 days in turned implants was 36.2% and in treated implants 51.5% in irradiated bone (p = 0.005). Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.080
80 Efficacy of amoxicillin/clavulanic acid 2000/125 mg in preventing infection after extraction of impacted mandibular third molar totally covered by bone: preliminary results M. Arteagoitia 1,∗ , G. Santamaria 1 , E. Ramos 1 , L. Barbier 1,2 , J. Alvarez 1,2 , J. Martín 1,2 , J. Brunsó 2 , J. Santamaria 1,2 1 Stomatology Department, Faculty of Medicine and Dentistry, University of the Basque Country, Leioa, Spain 2 Oral and Maxillofacial Surgery Department, Hospital Universitario of Cruces, Basque Health Service, Barakaldo, Spain
Objective: To evaluate the effectiveness of systemic antibiotic prophylaxis 2 g amoxicillin/125 clavulanic acid in preventing infection after extracting inferior third molars totally covered by bone in healthy adults. Methods: A double-blind placebocontrolled randomized clinical trial (EUDRACT 2008-005663-34). The sample was derived from the population of subjects attending Cruces Hospital for extraction of an inferior third molar totally covered by bone under loco-regional anaesthesia. Patients were treated with preoperative placebo or amoxicillin/clavulanic acid 2000/125 mg, 1 h before the surgery and post-operatively twice a day for 4 days. 0.2% chlorhexidine gluconate rinses were used. The outcome variable was infectious and inflammatory complications. Sex, age, smoking, molar depth, angulation, C-reactive protein and operation time were recorded. Analysis was by intention to treat. Results: In 33 subjects (16 treated with antibiotic and 17 with placebo), the frequency of infection was 6.25% in the antibiotic group and 11.76% in the placebo group (OR 0.5, 95%CI (0.04–6.12). The number needed to treat was 18 (4, infinity). Absolute risk reduction ARR 5.5% of patients will not be infected under antibiotic therapy that they would have under control, 95% confidence interval (−13.86–24.89%) crosses zero which implies the ARR is not significant. Conclusion: Amoxicillin/clavulanic acid 2 g/125 reduces the incidence of infection following inferior third molar extraction when the molar is totally covered by bone however this reduction is not statistically significative and we consider antibiotic should not be prescribed. Supported by the Health research fund, Carlos III Health Institute.
78 Postoperative bleeding after dental extraction in the liver pretransplant patient
79 Osseointegration of dental implants in irradiated bone tissue: experimental study
J.P.V. Perdigão 1,∗ , K.C. Mesquita 2 , P.C.d. Almeida 2 , T.D.D.S. Rocha 2 , F.B. Sousa 2 1 State University of Maringá - UEM, Maringá, Brazil 2 Federal University of Ceará, Fortaleza, Brazil
J.F. Santos-Junior 1,∗ , M. Abrahão 2 , L.L. Dib 3 , R.S. Janh 1 , U. Nannmark 4 , G. Granstrom 5 1 Stomatology, Santo Amaro University UNISA, São Paulo, Brazil 2 Otorhinolaryngology and Head and Neck Surgery, Federal São Paulo University UNIFESP, São Paulo, Brazil 3 Stomatology, Paulista University - UNIP, São Paulo, Brazil 4 Anatomy and Cell Biology, Gothenburg, Sweden 5 Otorhinolaryngology and Head and Neck Surgery, University of Gothenburg, Gothenburg, Sweden
Introduction: During dentoalveolar surgery, liver transplant candidates need special care regarding hemostasis impairment, related to reduced hepatic synthesis of procoagulants factors and thrombocytopenia. Purpose: The aim of this prospective study was to evaluate the incidence of postoperative bleeding after dental extraction in candidates for liver transplantation. Patients and methods: A prospective cross-sectional observational study was performed with individuals awaiting liver transplantation and referred for oral health evaluation. All the subjects with dental foci that required extraction were considered to this study. Patients were included in the analysis when the blood exams were according to: platelet count ≥30,000/mm3 and INR ≤ 3.0. Absorbable hemostatic sponges and cross sutures were used as a standard hemostatic measure. All tooth extractions were performed without administration of blood products (platelet concentrate, fresh frozen plasma). Results: In 23 patients included in this study, 84 simple extractions were performed in 35 dental surgical procedures. The main preoperative blood tests found were: mean hematocrit of 34.54% (SD ± 5.84, range 21.7–44.4%), platelets ranged from 31,000/mm3 to 160,000/mm3 , mean international normalized ratio (INR) was 1.50 (SD ± 0.39; range 0.98–2.59). Postoperative bleeding occurred in only one procedure (2.9%) and local pressure with gauze was effective to achieve hemostasis. Conclusion: This paper demonstrates the low bleeding risk of tooth extractions in patients with liver cirrhosis, with INR ≤ 2.50 and platelets ≥30,000/mm3 , without the need of blood transfusion, and in case of bleeding events, the use of local hemostatic measures can be satisfactory. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.079
Background: Previous studies show that the treatment of the implant surface presents more bone formation than the turned implants. Other studies indicate the possibility of having an implant in bone that has undergone radiotherapy. Purpose: The aim of this study was to verify if the use of treated surface implants presents a better bone-to-implant contact rather than machined surface implants in irradiated and no irradiated bone. Materials and methods: Twenty-four Wistar rats (Rattus Norvegicus) and fortyeight mini implants were used in this study. A dose of 30 Gy irradiation was delivered to the right leg of all rats, the left leg was kept as a control group. A turned surface implant was installed to the bilateral tibia thirty days after irradiation. Other twelve rats received a treated surface implant in the tibia bilaterally. The implants were recovered after 28 and 84 days and a boneto-implant contact histometry and a bone density was carried out. Results: The bone-to-implant contact after 84 days in turned implants was 36.2% and in treated implants 51.5% in irradiated bone (p = 0.005). Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.080
80 Efficacy of amoxicillin/clavulanic acid 2000/125 mg in preventing infection after extraction of impacted mandibular third molar totally covered by bone: preliminary results M. Arteagoitia 1,∗ , G. Santamaria 1 , E. Ramos 1 , L. Barbier 1,2 , J. Alvarez 1,2 , J. Martín 1,2 , J. Brunsó 2 , J. Santamaria 1,2 1 Stomatology Department, Faculty of Medicine and Dentistry, University of the Basque Country, Leioa, Spain 2 Oral and Maxillofacial Surgery Department, Hospital Universitario of Cruces, Basque Health Service, Barakaldo, Spain
Objective: To evaluate the effectiveness of systemic antibiotic prophylaxis 2 g amoxicillin/125 clavulanic acid in preventing infection after extracting inferior third molars totally covered by bone in healthy adults. Methods: A double-blind placebocontrolled randomized clinical trial (EUDRACT 2008-005663-34). The sample was derived from the population of subjects attending Cruces Hospital for extraction of an inferior third molar totally covered by bone under loco-regional anaesthesia. Patients were treated with preoperative placebo or amoxicillin/clavulanic acid 2000/125 mg, 1 h before the surgery and post-operatively twice a day for 4 days. 0.2% chlorhexidine gluconate rinses were used. The outcome variable was infectious and inflammatory complications. Sex, age, smoking, molar depth, angulation, C-reactive protein and operation time were recorded. Analysis was by intention to treat. Results: In 33 subjects (16 treated with antibiotic and 17 with placebo), the frequency of infection was 6.25% in the antibiotic group and 11.76% in the placebo group (OR 0.5, 95%CI (0.04–6.12). The number needed to treat was 18 (4, infinity). Absolute risk reduction ARR 5.5% of patients will not be infected under antibiotic therapy that they would have under control, 95% confidence interval (−13.86–24.89%) crosses zero which implies the ARR is not significant. Conclusion: Amoxicillin/clavulanic acid 2 g/125 reduces the incidence of infection following inferior third molar extraction when the molar is totally covered by bone however this reduction is not statistically significative and we consider antibiotic should not be prescribed. Supported by the Health research fund, Carlos III Health Institute.