Long-term treatment with alendronate increases the surgical difficulty during simple exodontias - an in vivo observation in Holtzman rats

Background: Atraumatic teeth extractions protocols are highly encouraged in patients taking bisphosphonates (Bps) to reduce surgical trauma and, consequently, the risk of jaws osteonecrosis development. In this way, this paper aims to report the findings of increased surgical difficulty during simple exodontias in animals treated with bisphosphonates.Methods: Sixty male Holtzman rats were randomly distributed into three groups of 20 animals and received daily subcutaneous administration of 1 mg/kg (AL1) or 3 mg/kg (AL3) of alendronate or saline solution (CTL). After 60 days of drug therapy all animals were submitted to first lower molars extractions under general anesthesia. Operatory surgical time and the frequency of teeth fractures were measured as principal outcomes and indicators of surgical difficulty degree.Results: Animals treated with alendronate (AL1 and AL3) were associated to higher operatory times and increased frequency of teeth fractures compared to match controls.Conclusions: The bisphosphonate therapy may be associated with an increased surgical difficulty and trauma following simple exodontias protocols, which is considered a critical issue when it comes to osteonecrosis development.

Anterior restorations in bleached teeth: Difficulty establishing the color after bleaching

It is becoming more common for patients to look for cosmetic procedures in dental offices. The search for lost or desired esthetics by patients is increasingly frequent and the professional must be able to meet this demand. To do this, dentists not only need to return the tooth back to its normal functioning state but also promote esthetic excellence. In this context, the association of cosmetic procedures, such as teeth whitening and restorative procedures, such as direct adhesive restorations is very common. The composite resins employed nowadays allow the reproduction of various optical properties of natural teeth. With these composite resins, it is possible to reproduce features such as translucency, opacity and specific features of the dental element, to bring back the esthetic harmony of the smile. This article reports a clinical case demonstrating the placement, in a stratified manner, of composite resins in bleached teeth, as well as the reproduction of optical and natural aspects of the teeth. In order to achieve esthetic and functional success of the restored procedure, it is important to be familiar with the new techniques and new materials in the marketand above all, we must know when and where to use them.