David Penarrocha-Oltra

• DDS, MSc, PhD
• Professor at University of Valencia

Objective To analyse marginal bone level changes at implants placed using high‐speed drilling (800 rpm) with irrigation versus low‐speed drilling (150 rpm) without irrigation. Peri‐implant soft‐tissue parameters were assessed and the influence of bone density and vertical dimensions of supracrestal soft tissue on marginal bone level changes was eva...

This study involved a randomized clinical trial that included 140 patients. Alveolar ridge preservation was performed with xenografts. Sealing in the control group consisted of a collagen membrane versus cyanoacrylate in the test group. The dental implants were placed immediately after extraction. The variables were evaluated at 3, 12, and 18 month...

Background This study aimed to analyze the influence of concave and cylindrical abutments on peri‐implant soft tissue. Dimensions, collagen fiber orientation, and immunohistochemical data were assessed. Methods A multicenter, split‐mouth, double‐blind randomized clinical trial was conducted. Two groups were analyzed: cylindrical abutments and conc...

This study examined the effect of combining the sandblasting and anodising of titanium alloy used in implants on the cell response and protein adsorption patterns. The titanium samples were divided...

Background A strong seal of soft-tissue around dental implants is essential to block pathogens from entering the peri-implant interface and prevent infections. Therefore, the integration of soft-tissue poses a challenge in implant-prosthetic procedures, prompting a focus on the interface between peri-implant soft-tissues and the transmucosal compon...

Objective To compare the osteoblastic activity and osteogenic potential of autogenous particle harvesting during implant surgery using low‐speed drilling without irrigation and high‐speed drilling with irrigation. Materials and Methods Thirty patients with bilateral missing teeth of 3.6 and 4.6 were randomized into two groups (Group 1: low‐speed d...

Objective To compare collected bone weight and the frequency of autologous bone harvesting from the flutes of surgical drills used for implant bed preparation using two different drilling techniques. A comparative evaluation of radiographic bone density and bone quality was also made. Materials and Methods A randomized clinical trial was made of 6...

Objective: To compare patient satisfaction during surgery, postoperative pain and inflammation and quality of life between high-speed drilling with irrigation and low-speed drilling without irrigation for implant bed preparation. Materials and methods: Sixty-six posterior single edentulous patients were included in a randomized controlled clinic...

Background: Periapical surgery is a complex dental procedure that remains a considerable challenge in clinical practice. The use of APRF+ membranes and piezoelectric osteotomy help to improve outcomes and increase the efficiency and speed of recovery. Material and Methods: This case report describes a 20 years-old man with a periapical lesion which...

Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated wi...

Objective: To analyze the influence of 3-mm high abutments with different shapes (cylindrical abutment vs. wide abutment) on marginal bone-level changes (bone loss and bone remodeling). The influence of abutment shape on implant success, probing pocket depth (PPD), and bleeding on probing (BoP) was studied as secondary objectives. Materials and m...

Unlabelled: Osseointegration is a process that depends on a multitude of factors, including the type of drilling, whether biological or conventional. Objective: Establish box-counting dimension values for radiological images in patients with implants placed with both drilling methods. Material and method: The sample included 129 implants corre...

Background: The main aims of this study were to evaluate mean volume reduction, radiographic healing rate and healing outcome two years after endodontic microsurgery. The effects of certain preoperative clinical factors upon preoperative volume, volumetric changes and healing outcome were also studied. Material and methods: A clinical database w...

Objective: To compare the sequential healing of maxillary sinuses grafted with two different xenogeneic bone substitutes processed at either a low (300°C) or high (1200°C) temperature. Methods: A sinus augmentation procedure was performed bilaterally in 20 rabbits and two different xenogeneic bone grafts were randomly used to fill the elevated s...

Background: To review systematically the bone gain and superficial resorption rate of the onlay block bone grafts versus the cortical tenting technique, as well as secondarily study the postoperative complications, implant survival and success rates, and peri-implant marginal bone loss. Material and methods: Following the recommended methods for...

Introduction To compare the healing of teeth subjected to endodontic microsurgery over long-term (5-9 years) versus middle-term (1-4 years) follow-up, and assess the influence of different healing predictors over time. Methods A retrospective study was made, comparing the endodontic microsurgery healing rates after 1-4 versus 5-9 years of follow-u...

Introduction An analysis was made of the association between the endoscopic findings of the sectioned root end surface and healing of the lesion one year after periapical surgery, though no studies appear to have analyzed them in relation to healing after periapical surgery. Material and methods A retrospective cohort study was made of patients su...

Background: The present study in patients with direct sinus lift and simultaneous or delayed implant placement was carried out to relate the dimensions of the lateral window to sinus augmentation, marginal bone loss, and implant success and survival after a minimum follow-up period of 5 years. Methods: A retrospective cohort study was carried out i...

Background: The aim was to evaluate the influence of axial abutment height, abutment angulation, angulated abutment side and implant site on peri-implant marginal bone loss and marginal bone remodeling after 1 year of follow-up in immediate loading implant-supported full-arch fixed dental prostheses. Methods: A retrospective analysis was conducted...

Background: Two-dimensional (2D) radiographic techniques are commonly used for assessing lesion prognosis after endodontic surgery. The present retrospective cohort study analyzes the sensitivity and ability of different radiographic techniques in obtaining area and volume measurements of periapical lesions. Material and methods: Preoperative an...

Aim To clinically assess the esthetic of the smile and possible influencing factors. Materials and Methods In this explorative study an initial questionnaire on demographic variables and perception of the own quality of the smile (Visual Analogue Scale) was administered by a first examiner. A second blinded assessor examined all patients and recor...

Background: The present in vitro study aimed to investigate the fatigue performance of different dental fixtures in two different emergence profiles. Biological failures are frequently reported because the problem canonly be solved by replacing a failing implant with a new one. Clinicians addressed minor mechanical failures, such as bending, loosen...

Background: Rough and/or plasma-activated abutments seem to be able to increase soft tissue adhesion and stability; however, limited evidence is available about bacterial contamination differences. Purpose: The aim was to investigate the oral microbiota on four dental abutments with different surfaces by quantitative real-time polymerase chain rea...

Purpose This paper aims to review the evidence comparing low-speed drilling without irrigation versus conventional drilling for dental implant osteotomy preparation. Materials and methods A systematic review was carried out based on the PRISMA statement. Four databases and gray literature were searched up to November 2020. In vitro, animal, and cl...

Objective The objective was to answer the question: Do conventional radiographs (periapical/panoramic) afford better diagnostic outcomes than cone beam computed tomography (CBCT) as a complement for clinical diagnosis of apical lesions with persistent apical periodontitis or disease after root canal treatment? Study design Five electronic database...

The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental implants for the rehabilitation of the atrophic edentulous maxilla. Materials and methods: We conducted a systematic literature review and meta-analysis, based on the Preferred Reporting Items...

Objective To evaluate whether abutment surface and surface bio-activation has an effect on soft tissue morphogenesis. Materials and Methods 36 patients (36 implants) were included. Abutments were randomly divided into 4 groups (n=9): Smooth Surface - MAChined (MAC), Ultrathin Threaded Microsurface (UTM), MAC Plasma of Argon activated (Plasma MAC),...

Background Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objec...

Background To introduce a theoretical solution to a posteriori describe the pose of a cylindrical dental fixture as appearing on radiographs; to experimentally validate the method described. Methods The pose of a conventional dental implant was described by a triplet of angles (phi-pitch, theta-roll, and psi-yaw) which was calculated throughout ve...

Background: Systemic antibiotic prophylaxis is frequently prescribed by dentists performing dental implant surgery to avoid premature implant failure and postoperative infections. The scientific literature suggests that a single preoperative dose suffices to reduce the risk of early dental implant failure in healthy patients. Material and Methods:...

Background The socket seal surgery (SSS) technique is a common alternative for the management of the post-extraction sockets that requires a primary closure of the wound to promote proper regeneration and ridge preservation. Objective To learn about the effect of different SSS techniques on alveolar ridge preservation Material and methods Two ind...

Objective This review aimed to evaluate the effects of enamel matrix derivative (EMD) in association with coronally advanced flap (CAF) or CAF + connective tissue graft (CTG) when compared with CAF alone or CAF + CTG for the treatment of gingival recessions (GR) in maxillary teeth.Methods Five databases and gray literature were searched up to April...

Background To introduce a theoretical solution to a posteriori describe the pose of a cylindrical dental fixture as appearing on radiographs; to experimentally validate the method described.Methods The pose of a conventional dental implant was described by a triplet of angles (phi-pitch, theta-roll, and psi-yaw) which was calculated throughout vect...

Introduction: The present clinical case describes periapical microsurgery with an endoscope and microscope in a patient already treated 25 years ago due to persistent periapical disease of the two central upper incisors, restored with poorly adapted crowns. Clinical Case. The first periapical surgery had been performed with silver amalgam as a ret...

Introduction A study was made of the healing rate of teeth subjected to endodontic microsurgery after a minimum follow-up of 5 years, with an analysis of the influence of different pre- and postoperative factors upon the outcome. Methods A retrospective study was made of patients subjected to endodontic microsurgery with the use of mineral trioxid...

Background Inherited epidermolysis bullosa (EB) is a genetic disorder characterized by skin fragility and unique oral features. Aims To provide (a) a complete review of the oral manifestations in those living with each type of inherited EB, (b) the current best practices for managing oral health care of people living with EB, (c) the current best...

An apicomarginal defect can be explained as a total loss of buccal alveolus extending from the original crestal bone to the apex of the tooth. This study presents a case of an apicomarginal defect in a first left molar subjected to periapical surgery with vestibular cortex block replacement and A-PRF + membrane coating approximately one year ago. O...

Background: A systematic review of clinical studies with at least one year of follow-up was done to assess the success rate of endodontic surgery including endoscopy for magnification and illumination. Material and methods: Five electronic databases were searched, including MEDLINE (via PubMed), Embase, Web of Science, Scopus and the Cochrane Li...

Objective The objective of the study was to evaluate the relation between occlusal loading and peri-implant crevicular fluid cytokine expression in patients with implant-supported complete fixed prostheses in both arches. Material and methods A prospective longitudinal clinical study was performed at a university clinic. Fifteen patients were sele...

Background: Non-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abras...

Background : to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods : MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results : The search provided 1028 records and, after r...

Background: Subcrestal implant placement has been suggested as a method that could contribute to maintain the periimplant soft and hard tissues in comparison with crestal placement. The objective of this study was to investigate the relationship between implant placement at different depths in the alveolar bone and (a) the thickness of the buccal...

Cone beam computed tomography (CBCT) had been introduced in oral and maxilla facial surgery since the early 2000s, but many dentists still use orthopantomography (OPT) as a principle diagnostic tool for wisdom tooth extraction or implant planification. The CBCT is usually prescribed as a secondary radiological exam if the wisdom tooth has anatomica...

To assess the difference in smile esthetic impact of Coronally Advanced Flap (CAF) with or without the adjunct of a collagen matrix (CMX) used as root coverage procedures. Subjects with esthetic demands showing multiple upper gingival recessions of at least 2 mm, without interproximal attachment loss and cervical abrasion no more than 1 mm were rec...

Background/purpose The aim of the present in vitro study was to evaluate fatigue resistance of dental fixtures in three different types of fixture/abutment finishing line. Materials and methods Transmucosal dental implants, with or without ferrulized neck, underwent fatigue tests (static and dynamic load) using the following standard protocol: UNI...

Background: Hemostasis is of critical importance in endodontic surgery. Studies on bleeding control in maxillary molars are scarce. The present study compares the efficacy of two hemostatic techniques in controlling bleeding in endodontic surgery. Material and methods: A randomized two-arm pilot study involving 30 patients with peri-radicular le...

Immediate loading of dental implants for either partial or total edentulous jaws is a predictable approach, and it has shown comparable survival rates than those obtained with conventional loading protocols in the long term. It not only provides functionality but aesthetics and improved patient satisfaction. The implementation of new technologies i...

Background: Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This study aimed to systematically review the FAB thickness of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance...

Background: The aim of the authors was to examine the abutment-fixture interface in Morse-type conical implants in order to verify gaps at this level using a new microscopical approach. Material and methods: In this in vitro study, 20 abutment-fixture complexes were prepared by sectioning (longitudinal and cross-sectional to the long axis) with...

A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and i...

Background: The aims of this study were: 1) compare the amount of anesthesia used with the anesthetic technique; 2) relate the quantity of anesthesia needed with the level of anxiety of the patient; 3) study the relationship between the anesthetic technique and the level of hemostasis; 4) correlate the amount of anesthesia with patient and tooth d...

Background Clinical evidence of the autologous platelet concentrates effects on the patient-reported outcome measures (PROMs) after endodontic surgery is still limited. Objectives To investigate the effect of the advanced platelet-rich fibrin (A-PRF+) membrane application upon patient postoperative pain, and quality of life in endodontic surgery....

PURPOSE. To evaluate whether there is a difference in aesthetic outcomes when positioning immediate post-extractive implants in the “central” position (where the natural tooth would be in relation to adjacent teeth/implants) as opposed to roughly 3 mm more pala-tally. MATERIALS AND METHODS. Just after tooth extraction, 20 patients requiring one sin...

Objective: An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation. Material and methods: Three study groups (stainless steel drills with straight blades; diamond-like carbon-coated drills with straight blades; and diamond-like carb...

Purpose: To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed complications such as maxillary sinusitis and soft tissue recession. Materials and methods: Zygomatic implants placed simultaneously with different bone regeneration techniques (b...

Background: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. Material and methods: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized cli...

Purpose: To describe implant survival at least 1 year after the surgical treatment of early apical peri-implantitis (EAP) and explore potential risk factors of failure of such treatment. Materials and methods: An ambispective cohort study was conducted, involving all patients in whom EAP was detected and surgically treated between 1996 and 2016....

Cirugía periapical con regeneración del defecto óseo Caso clínico con seis años de seguimiento INTRODUCCIÓN La cirugía periapical es un procedimiento quirúrgico que se realiza para tratar la periodontitis apical cróni-ca persistente en casos en los que no ha habido cura-ción tras el retratamiento de conductos o, en algunos casos, el tratamiento de...

Background: Epidermolysis bullosa (EB) comprises a group of hereditary disorders characterized by mechanical fragility of the skin and mucous membranes, with the development of blisters and vesicles in response to minimum tissue friction. Recessive dystrophic epidermolysis bullosa (RDEB) with generalized involvement is the most common subtype in t...

Purpose: A systematic review was performed of the dimensional changes in facial cortical bone following implant placement into healed ridges, with the aim of establishing a minimum bone thickness that limits such changes. The influence of such bone remodeling upon the soft tissues and implant survival was also evaluated. Materials and methods: A...

Purpose: To explore risk indicators potentially associated with early apical peri-implantitis (EAP). Materials and methods: A retrospective survey was performed in 2017 with recorded information from patients receiving dental implants between 1996 and 2016. Reporting follows the STROBE (strengthening the reporting of observational studies in epi...

A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and i...

Background: A study is made of the findings of high-magnification rigid endoscopy at the root end surface following apicoectomy of teeth subjected to periapical surgery. Material and methods: A cross-sectional study was made of patients subjected to periapical surgery at the Unit of Oral Surgery and Implantology (University of Valencia, Valencia...

Background: An analysis was made of the correlation between root width, the thickness of the remaining dentinal wall as determined by endoscopy, and the outcome of periapical surgery. Material and methods: A retrospective cohort study was carried out involving patients subjected to periapical surgery between 2017 and 2019 at the University of Va...

Background: This study aimed to evaluate changes in buccal cortical bone and lesion volume in teeth with persistent periapical disease one year after periapical surgery using cone-beam computed tomography (CBCT). Material and methods: A prospective study was conducted involving patients with persistent periapical disease undergoing periapical surg...

Background: Recurrent or occasional aphthous lesions represent a painful oral condition with high prevalence. Since the etiology is still unclear and most likely related to a dysfunction in the local immune system, several treatment strategies have been proposed, including systemic agents, local agents, and laser therapy, to reduce the pain and di...

Background: A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. Material and methods: A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies....

The immediate implant-supported provisional restoration in the partially or totally edentulous patients is a predictable and well-accepted procedure in dentistry. The Glossary of Prosthodontic Terms defines a provisional prosthesis as a prosthesis designed to improve or evaluate esthetics, speech, and occlusal function in a period of time between i...

Severe bone atrophy of the upper maxilla (Cawood and Howell class V and VI) is associated with certain problems such as reduced perioral tissue support, the impossibility of wearing complete dentures, chewing and speech alterations, and difficulties in placing dental implants due to the limited amount of available bone.

Dental implants can be integrated at both hard and soft tissue levels. Osseointegration is a dynamic process during its establishment and maintenance, characterized by resorption and apposition events, and the extent and degree of osseointegration is in part affected by implant surface configuration. It is marked by three distinct healing stages du...

The zygomatic fixture is an extended length (35–55 mm) titanium implant, placed into the zygomatic and maxillary alveolar bone. It was designed for situations where atrophy of the posterior maxilla complicates or prevents the placing of conventional implants. The use of zygomatic implants avoids the need for bone grafting, shortens treatment times,...

In this chapter, biomechanical concepts as tension, types of forces, and static and dynamic loads in oral implantology are explained. Also, biomechanical factors as type of bone, implant design, switching platform, connection type, crown-implant ratio, and passive fit are exposed. So, it is important to know keys for biomechanical control and occlu...

Immediate loading provides functional and esthetic advantages, improving the quality of life of the patient during the osseointegration period. But, clinicians have to know that the three key parameters that should be evaluated for prosthetic planning of the totally edentulous patient are prosthetic space, lip support, and smile line. This is a cru...

Brånemark traditional recommendation was to perform implant rehabilitation in two stages: the first entry was only for implant placement; after 3–6 months of undisturbed submerged healing for mandible and maxilla, respectively, a second surgical entry would have allowed loading of the implants. The rationale behind this approach was that implant mi...

Immediate loading is basically a prosthetic concept. However, the surgical implantological planning is very important to ensure a primary stability in the total edentulous patient. This characteristic is crucial to allow immediate loading in this type of patients. For the first time, the incisional design has allowed the clinician to overview about...

BACKGROUND: To systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. MATERIAL AND METHODS: Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was conducted in the PubMed (MEDLINE), EMBASE and LILACS databases to identify all relev...

Background: To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading. Material and methods: A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibula...

Complications in dental implant surgery are possible. Bleeding complications have been described that may be serious, particularly in the floor of the mouth. We present two cases of sublingual hematomas during dental implant osteotomies that impeded but did not close the airway. The clinical courses of these patient’s complications are reviewed. On...

Background: The aim of the study was compare the sensitivity and measurements obtained from teeth with apical lesions scheduled for periapical surgery using three different diagnostic methods: periapical radiography (Gendex Expert DC), panoramic radiography (Planmeca® Promax 3D Classic) and cone beam computed tomography (CBCT) (Planmeca® Promax 3D...

BACKGROUND: To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. MATERIAL AND METHODS: 27 New Zealand rabbits were implemented. Two implants, one for each macro-design (...

Background: To determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy...

Peri-implantitis is an inflammatory disease affecting tissues surrounding dental implants. Although it represents a common complication of dental implant treatments, the underlying mechanisms have not yet been fully described. The aim of this study is to identify the role of titanium nanoparticles released form the implants on the chronic inflammat...