Simultaneous Implant Placement and Sinus Lift Using Leukocyte-Platelet Rich Fibrin: A Retrospective 40-Month Study.

ABSTRACT: The aim of this study was to report the 40-month clinical radiographical outcomes of maxillary sinus floor augmentation using leukocyte-platelet rich fibrin (L-PRF) as a single graft in combination with immediately placed implants. Twenty partially edentulous individuals with missing teeth in the region associated to maxillary sinus were included in this retrospective study. A lateral sinus floor elevation was performed considering a complete wear of the bone wall of the maxillary sinus and immediately placing the implant and filled the maxillary sinus with L-PRF clots as a single graft. After 5 months, all the implants received single screwed implant-supported prostheses. Subsequent evaluation was every 4 months assessing the success rate and biological complications. Two maxillary sinus membrane were perforated and covered with L-PRF clots. The mean bone height gain was 62.6%, observing a 100% of success and that in all the cases achieved at least the implant height. In conclusion, the use of platelet-rich fibrin clot as a single graft biomaterial during the maxillary sinus lift procedure combined with immediate implant placement may be a reliable clinical alternative, even to repair the sinus membrane.

Clinical evaluation of single 4-mm implants in the posterior mandible: A 3-year follow-up pilot study.

STATEMENT OF PROBLEM: Extra-short implants in the posterior mandible can increase the functional surface area and reduce the risk of implant overload. However, reports of treatment using single extra-short implants in the posterior mandible with a midterm follow-up are lacking. PURPOSE: The purpose of this prospective pilot study was to evaluate the clinical behavior of single extra-short 4-mm implants placed in the posterior mandible during a follow-up of 3 years from implant restoration. MATERIAL AND METHODS: A total of 18 participants with a single extra-short 4-mm-long implant placed in the area of the mandibular first molars participated in this pilot study. The survival and success rates of implants, as well as biologic and prosthetic variables, were evaluated during a follow-up of 3 years from implant restoration. RESULTS: The survival rate of the implants was 100%, with no implant or biologic complications recorded. One prosthetic complication (loosening of 1 screw) was observed. CONCLUSIONS: Single extra-short (4 mm) implants in the posterior mandible showed favorable clinical behavior during the first 3-years of follow-up.

Autologous Fibrin Glue With Collagen Carrier During Maxillary Sinus Lift Procedure.

This study aimed to describe the use of autologous fibrin glue (AFG) with a collagen carrier during maxillary sinus lift procedures with immediate implants during 3 years of follow-up. Twelve patients who had lost their teeth in the region associated to maxillary sinus, with a bone remnant 3 to 5 mm in height, were selected to perform a maxillary sinus augmentation with AFG and collagen membrane, placing the implant immediately. After 5 months, the implants were connected and rehabilitated. The patients were followed-up for a 3-year period, being evaluated every 6 months. At the end of the 3-year follow-up period, 100% implant success was observed, with a mean of bone augmentation of 7.75 mm. Three maxillary sinus membranes were perforated and healed by using AFG and collagen membrane without identify any complication during the follow-up period. Finally, the use of collagen carrier combined with AFG as a filling material during the maxillary sinus lift procedure may be a low-cost and reliable alternative that allows bone formation.

Evaluación de un nuevo método de remoción quirúrgica de implantes oseointegrados considerados en fallo / Evaluation of a new surgical removal method of failed integrated implants

OBJETIVO El objetivo del presente estudio descriptivo es la valoración de un nuevo método de remoción de implantes oseointegrados bajo una técnica mínimamente invasiva. MATERIALES Y MÉTODOS El estudio fue desarrollado sobre un grupo de 66 implantes oseointegrados de conexión interna y externa diagnosticados en falla, a los cuales se les indicó su remoción quirúrgica por presentar un diagnóstico radiográfico de pérdida ósea periimplantaria, mal posicionamiento quirúrgico con imposibilidad de rehabilitación protésica o daño del elemento de retención protésico del implante. El procedimiento quirúrgico, el cual es de carácter ambulatorio, fue llevado a cabo en un pabellón bajo anestesia local. Como primera opción de remoción quirúrgica, el procedimiento consistió en la utilización de instrumental de remoción a contra-torque, sin la apertura de un colgajo de espesor total, y como segunda opción de remoción quirúrgica la utilización de una fresa trefina, para lo cual fue necesario realizar un colgajo de espesor total que expusiera el lecho implantario. RESULTADOS Se removieron un total de 66 implantes oseointegrados, todos bajo la primera modalidad de remoción a contra-torque con el nuevo instrumento, sin colgajo y sin la necesidad de usar fresa trefina. CONCLUSIONES Con las limitaciones de este estudio preliminar planteamos que la utilización del nuevo instrumento de remoción a contra-torque de implantes oseointegrados en fallo se vislumbra como una muy buena alternativa de remoción quirúrgica mínimamente invasiva, disminuyendo los riesgos quirúrgicos del uso de una fresa trefina, el daño a los tejidos aledaños.

OBJECTIVE The aim of this study is the evaluation of a new removal method of osseointegrated implants under a minimally invasive technique. MATERIALS AND METHODS The study was conducted on a group of 66 osseointegrated internal and external connection implants that were considered unsuccesful. The surgical removal was indicated after radiologically confirming peri-implant bone loss, and poor positioning which made the prosthetic rehabilitation impossible, or would damage the prosthetic implant retainer. The surgical procedure was developed in an operating room under local anesthesia. As first surgical removal option, the procedure consisted of the use of a removal instrument that works against torque and which does not need a full thickness flap to reach the surgical site; and as a second surgical removal option a trephine bur was used. For this option, a full thickness flap was performed in order to expose the surgical site. RESULTS A total of 66 osseointegrated implants were removed under the first mode, with no full thickness flaps or Trephine burs required. CONCLUSIONS Within the limitations of this preliminary study, we propose that the use of this new, against torque, removal instrument of osseointegrated implants in failure is seen as a very good alternative to invasive surgical removal techniques, reducing surgical risks.

Synthesis of nanostructured porous silica coatings on titanium and their cell adhesive and osteogenic differentiation properties.

Nanostructured porous silica coatings were synthesized on titanium by the combined sol-gel and evaporation-induced self-assembly process. The silica-coating structures were characterized by X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and nitrogen sorptometry. The effect of the nanoporous surface on apatite formation in simulated body fluid, protein adsorption, osteoblast cell adhesion behavior, and osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) is reported. Silica coatings with highly ordered sub-10 nm porosity accelerate early osteoblast adhesive response, a favorable cell response that is attributed to an indirect effect due to the high protein adsorption observed on the large-specific surface area of the nanoporous coating but is also probably due to direct mechanical stimulus from the nanostructured topography. The nanoporous silica coatings, particularly those doped with calcium and phosphate, also promote the osteogenic differentiation of hBMSCs with spontaneous mineral nodule formation in basal conditions. The bioactive surface properties exhibited by the nanostructured porous silica coatings make these materials a promising alternative to improve the osseointegration properties of titanium dental implants and could have future impact on the nanoscale design of implant surfaces.