RESUMEN
OBJECTIVE: Safe, effective, and biocompatible minimally invasive procedures with the potential to stimulate collagen production have been made to recover dermal thickness and skin quality. The main of this animal model experiment was to observe the effect of poly-L-lactic acid (PLLA) and polydioxanone (PDO) biostimulators in collagen I and III after hypodermal injection. METHODOLOGY: Sixteen adult female rats (Wistar) were randomized into four groups and had dorsal treatment with: G1: hypodermic subcision (HS) only; G2: HS and PLLA hypodermic injection (HI), G3: HS and PDO HI; G4: Control, with no treatment. RESULTS: In histochemical, it was observed hypodermal and dermal tissue in more organized thickness in G3 and in G4 when compared to G1 and G2. There was few difference in G1 compared to G4. The tissue of G2 showed irregularities in the arrangement of collagen fibers, less defined structure and lower distribution of type I collagen compared to the other groups. There is a greater tendency for the proportions of type III collagen among tissues treated with both biostimulators (G2 and G3). PLLA and PDO had relatively similar percentages of collagen when compared to G4. The amount of type I collagen was higher in tissues treated with subcision, while type III collagen was higher in tissues treated with both biostimulators. CONCLUSION: G3 showed better performance in collagen production, although small, when compared with G2.
Asunto(s)
Colágeno Tipo I , Polidioxanona , Poliésteres , Ratas , Femenino , Animales , Polidioxanona/farmacología , Colágeno Tipo III , Ratas Wistar , ColágenoRESUMEN
The aim of this study was to analyze the survival of dental implants installed in maxillae reconstructed with autogenous iliac crest grafts and to assess patient satisfaction with the treatment by means of a questionnaire. The study conducted medical record reviews and clinical/radiographic assessments of 10 patients with severe maxillary atrophy who had undergone reconstruction with autogenous iliac crest grafts and rehabilitation with dental implants between 2008 and 2011. Patients were assessed for the survival of the implants, considering implant diameter and length, smoking status, diagnosis of diabetes, type of loss, and region of implant loss. In addition, a questionnaire with specific questions on the patients' satisfaction with the treatment was administered. Seventy-six implants were installed in the sampled patients, and only 1 loss was observed (late loss in the anterior maxilla region) after an average follow-up of 7.9 years, which corresponds to a 98.60% survival rate. The installed implants were of the most frequently used dimension (3.75 × 10 mm). One sampled patient was diabetic, and a second patient was both diabetic and a smoker. No loss of implants was observed in these 2 patients. All patients reported being completely satisfied with the treatment and would undergo the procedure again or refer it to a friend/relative. Six patients reported regular maintenance of the prosthesis, and only 3 had changed the prosthesis prior to the time of questionnaire administration. The results of this limited study with a restricted sample population suggest that the reconstruction of the maxilla with an autogenous iliac crest graft provides both adequate implant survival and patient satisfaction.
Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Trasplante Óseo , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Ilion , Maxilar , Resultado del TratamientoRESUMEN
OBJECTIVE: Auricular prostheses are artificial substitutes for facial defects. The retention of these has often been a problem. This study aimed to evaluate the mechanical behavior of 3 retained auricular prosthetic connections when submitted to a mechanical cycling test. MATERIALS AND METHODS: Twelve samples with installed implants were obtained and divided into 3 groups according to their retention system with 4 samples in each group. I: bar-clip system; II: magnet system; and III: ball/o-ring system. Each of samples was submitted to the pull-out test during 3240 cycles (fâ=â0.5âHz) to determine its tensile strength. The mechanical cycling test was performed using the servo-hydraulic machine MTS 810-Flex Test 40 (Eden Prairie, MN) that had a 2.5âmm shift at a 10âmm/s velocity. The retaining strength for each of the samples was obtained at 7 intervals. RESULTS: The tensile strength for the group retained by the bar-clip system (29.60âN) was higher with statistically significant difference (Pâ<â0.05) when compared with the group retained by the ball/o-ring system (9.41âN) and magnets system (8.61 N) for all periods assessed. The ball/o-ring system showed loss of retention during the fatigue test (Kruskal-Wallis, chi-squaredâ=â17.28; Pâ<â0.01). CONCLUSIONS: The evaluated systems showed a tensile strength compatible with the clinical use and no fractures of the components were observed.
Asunto(s)
Interfase Hueso-Implante , Oído Externo/cirugía , Prótesis e Implantes , Diseño de Prótesis , Retención de la Prótesis/métodos , Fenómenos Biomecánicos , Humanos , Falla de Prótesis , Resistencia a la TracciónRESUMEN
PURPOSE: To evaluate in vitro resistance of 5 techniques of internal fixation of bilateral fractures involving the mandibular angle and body. MATERIALS AND METHODS: Twenty-five polyurethane mandibles were used as substrates, fixed with a 2-mm fixation system, and divided into 5 groups: I, 1 4-hole plate, without intermediate space, in the neutral zone of the mandibular body and another similar plate in the external oblique ridge of the contralateral mandibular angle; II, 1 6-hole plate, with intermediate space, in the neutral zone of the mandibular body and a similar plate in the external oblique ridge of the left mandibular angle; III, 1 4-hole locking plate, with intermediate space, in the right neutral zone and another similar plate in the left external oblique ridge; IV, 2 4-hole plates, with intermediate space, one in the tension zone and the other in the compression zone of the mandibular body, and 1 4-hole plate, with intermediate space, in the external oblique ridge of the contralateral mandibular angle; V, 2 4-hole plates with intermediate space, one in the tension zone and the other in the compression zone of the mandibular body and similarly in the buccal side of the left mandibular angle. Mandibles were subjected to vertical linear load tests by a mechanical testing machine (Instron 4411, Instron Corp, Norwood, MA) to record peak load and load for displacements of 3, 5, and 7 mm. RESULTS: Group I had the least mechanical resistance of all groups, regardless of displacement, and group IV had the greatest mechanical resistance. Among groups II, III, and V, there was no statistically meaningful difference. CONCLUSION: Fixation of bilateral mandibular fractures involving the mandibular angle and body using 2 plates in the region of the body and 1 plate in the tension zone in the region of the mandibular angle was the technique that presented the best mechanical resistance.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Mandibulares/cirugía , Aleaciones/química , Materiales Biocompatibles/química , Fenómenos Biomecánicos , Placas Óseas , Tornillos Óseos , Diseño de Equipo , Fijación Interna de Fracturas/instrumentación , Humanos , Mandíbula/cirugía , Fracturas Mandibulares/clasificación , Modelos Anatómicos , Poliuretanos/química , Estrés Mecánico , Titanio/químicaRESUMEN
PURPOSE: The maxillary sinus lift is recognized and stable, and there have been different innovations to optimize the technique. The aim of this study was to investigate the maxillary sinus lift technique with the use of a blood clot and without the use of a bone graft. MATERIALS AND METHODS: Ten patients were recruited for a unilateral sinus lift; patients without sinus pathology or other contraindication were selected. The maxillary sinus was accessed conventionally under local anesthesia followed by an osteotomy and a 1-cm(2) bony window access. The sinus membrane was detached and the window was repositioned above and stabilized with a 12- or 14-mm osteosynthesis screw introduced through the alveolar ridge. Dental implants were installed in the second surgical stage. Standardized panoramic radiographic checks were performed at every stage. RESULTS: Seven completely edentulous patients and 3 partially dentate patients were treated surgically. From the first to the second surgery, a bone gain of 2.37 mm was obtained, although loss of bone height was observed in 1 completely edentulous patient. In 7 patients, it was not possible to install the implants owing to insufficient bone height or inadequate bone quality. CONCLUSION: The protocol used in this investigation failed in the bone increase required for implant installation.
Asunto(s)
Coagulación Sanguínea/fisiología , Elevación del Piso del Seno Maxilar/métodos , Implantes Absorbibles , Adulto , Proceso Alveolar/cirugía , Resorción Ósea/etiología , Tornillos Óseos , Trasplante Óseo , Implantación Dental Endoósea/métodos , Implantes Dentales , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Arcada Parcialmente Edéntula/cirugía , Masculino , Maxilar/patología , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Membranas Artificiales , Persona de Mediana Edad , Mucosa Nasal/patología , Osteogénesis/fisiología , Osteotomía/métodos , Radiografía Panorámica , Colgajos QuirúrgicosRESUMEN
PURPOSE: The aim of this study was to analyze histologically and radiographically the influence of particle size of anorganic bovine bone matrix (ABBM) on bone repair. MATERIALS AND METHODS: Four calvarial defects of 8 mm each were prepared in 18 adult New Zealand rabbits. The defects were then filled with either particulate autogenous bone (control group) or ABBM of large, medium, and small size granules. The animals were sacrificed at 15, 30, and 60 days after surgery. The samples were radiographically examined before being submitted to histological processing. RESULTS: Autogenous bone showed a slight radiopacity at the beginning, which was increased at the final period, being very similar to the adjacent bone tissue. The large and medium size ABBM particles maintained the same radiographic behavior, showing a radiolucent area in the central portion of the defect at 60 days. ABBM of small size granules showed a slight radiolucity at the initial period, which was increased at the subsequent periods. More intense bone formation occurred in the control group (autogenous bone). All 3 particle sizes of the biomaterial resulted in inflammatory infiltration at 15 and 30 days. ABBM of small size granules lead to a greater amount of osteoid tissue, and the particles were almost totally reabsorbed within 60 days of implantation. CONCLUSIONS: Autogenous bone graft lead to the best result in terms of bone defect repair; ABBM of large and medium size granules are not totally reabsorbed at the observed period; ABBM of small size granules was more intensively reabsorbed and led to a greater osteoid tissue formation when compared to the medium and large ABBM granules.
Asunto(s)
Enfermedades Óseas/cirugía , Matriz Ósea/trasplante , Trasplante Óseo/métodos , Xenoinjertos/trasplante , Cráneo/cirugía , Implantes Absorbibles , Animales , Autoinjertos/diagnóstico por imagen , Autoinjertos/patología , Autoinjertos/trasplante , Materiales Biocompatibles/uso terapéutico , Matriz Ósea/diagnóstico por imagen , Matriz Ósea/patología , Bovinos , Tejido Conectivo/diagnóstico por imagen , Tejido Conectivo/patología , Xenoinjertos/diagnóstico por imagen , Xenoinjertos/patología , Masculino , Osteogénesis/fisiología , Tamaño de la Partícula , Conejos , Radiografía , Factores de TiempoRESUMEN
The objective of this study was to quantify the cortical bone thickness of the mandibular ramus to determine conditions related to sagittal split ramus osteotomy and placement of screws. The patient sample comprised 44 subjects of ages ranging from 46 to 52 years (mean age, 49 years). The cone-beam computed tomography was performed and realized 3 cuts in the third molar area (section A), 5 mm posterior (section B), and 5 mm posterior to the latter (section C). Measurement in the cortical areas of the superior and inferior levels related to mandibular canal and measurement related to the total width of the mandible was executed. Intraclass correlation coefficient with P < 0.05 was used. The result showed that the buccal and lingual cortical zone did not present statistical differences, and the minor value was 1.5 mm for each one. There were no differences in the superior and inferior cortical bone, and the total width of the mandible was between 15.9 and 8.5 mm in the anterior area, between 17.4 and 12.8 mm in the middle area, and between 18 and 8.8 mm in the posterior area. The distance superiorly to the mandibular canal presented a minimal SD with a mean of 8.5 mm in the anterior region, 10.6 mm for the middle region, and 12.5 mm in the posterior region. In conclusion, the cortical thickness of the mandibular ramus in the adult population is particularly strong and offers a good anchorage for screw insertion in sagittal split ramus osteotomy.
Asunto(s)
Mandíbula/anomalías , Mandíbula/cirugía , Osteotomía Sagital de Rama Mandibular , Análisis de Varianza , Tornillos Óseos , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Reproducibilidad de los Resultados , Resultado del TratamientoRESUMEN
Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.
Asunto(s)
Huesos Faciales/lesiones , Traumatismos Maxilofaciales/epidemiología , Fracturas Craneales/epidemiología , Accidentes por Caídas/estadística & datos numéricos , Adolescente , Factores de Edad , Ciclismo/lesiones , Brasil/epidemiología , Niño , Preescolar , Traumatismos Faciales/epidemiología , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/estadística & datos numéricos , Humanos , Lactante , Laceraciones/epidemiología , Masculino , Fracturas Mandibulares/epidemiología , Traumatismos Maxilofaciales/clasificación , Traumatismos Maxilofaciales/terapia , Hueso Nasal/lesiones , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores Sexuales , Fracturas Craneales/clasificación , Fracturas Craneales/terapia , Traumatismos de los Dientes/epidemiología , Fracturas Cigomáticas/epidemiologíaRESUMEN
The clinical success of dental implants might be associated with such factors as installation technique, implant shape, size, material, and screw threads. Therefore, the aim of this study is to analyze mineralized tissue formation on the screw threads of conical and cylindrical dental implants. This study includes 7 beagle dogs that had the lower premolars extracted. Three months after bone and soft tissue repair, 2 different designs of dental implants (1 conical and 1 cylindrical) were installed in each hemimandible using a nonsubmerged technique. Both implants when installed had different shape and thread, as revealed by scanning electron microscopy. Six weeks after implant installation, animals were killed and submitted to histomorphometric analysis. Cervical, middle, and apical areas were analyzed. Statistical analysis was carried out using Student t test at a significance level of P < .05. Statistically significant differences were not found between the conical and cylindrical implants. The conical implants presented fewer threads, a smaller area, and more bone formation when compared with the cylindrical ones, without significant differences (P â=â .1226). The highest values concerning bone formation were observed for the cervical area (P â=â .4005), and the lowest for the apical area (P â=â .1899); however, no statistically significant difference was observed. In conclusion, no statistically significant difference was observed in thread bone formation between the cylindrical and conical implant designs when placed using the nonsubmerged technique.
Asunto(s)
Implantes Dentales , Diseño de Prótesis Dental , Oseointegración , Animales , Perros , Masculino , Microscopía Electrónica de RastreoRESUMEN
[This retracts the article on p. 217 in vol. 42, PMID: 23346465.].
RESUMEN
AIM: The purpose of this report is to present a case of surgical and prosthetic treatment of a woman with inflammatory fibrous hyperplasia (IFH) and her evaluation during a six month period. BACKGROUND: IFH is a benign pathology, prevalent in female patients, and principally associated with ill-fitting prosthetic devices in need of adjustment. It is common for patients to require surgical removal of the hyperplastic tissue and fabrication of a new prosthesis. CASE REPORT: A 55-year-old female with a history of smoking presented with a chief complaint of missing the scheduled adjustment of her maxillary complete denture and the presence of moveable tissue under the denture. Surgical excision of the hyperplastic tissue followed with fixation of the prosthesis for six months to guide the healing of the soft tissue and to reshape the contours of the maxillary supporting tissues. SUMMARY: Surgical removal of hyperplasic soft tissue is a routine procedure, and the fixation of the prosthesis for the support of tissue during healing improves intraoral conditions for the fabrication of a new prosthesis in the future.
Asunto(s)
Tornillos Óseos , Retención de Dentadura/instrumentación , Dentadura Completa Superior/efectos adversos , Hiperplasia Gingival/etiología , Hiperplasia Gingival/cirugía , Vestibuloplastia , Femenino , Gingivitis/etiología , Gingivitis/cirugía , Humanos , Persona de Mediana Edad , Paladar Duro/cirugíaRESUMEN
PURPOSE: To compare the mechanical characteristics of five techniques for the functionally stable fixation of simulated sagittal split ramus osteotomy with 10 mm of advancement and to evaluate the screw insertion torque. MATERIALS AND METHODS: Fifty polyurethane hemimandibles with sagittal split ramus osteotomy and containing an advancement of 10 mm fixed and distributed as follows: Customized 3D Plate Group: 1 customized 3D miniplate; 4-Hole Plate Group: 2 miniplates with 4 holes; 6-Hole Plate Group: 2 miniplates with 6 holes; Hybrid Group: 1 flat miniplate with 4 holes and 1 bicortical screw; and Bicortical Screw Group: 3 bicortical screws. We conducted a mechanical test using vertical linear loading with a displacement velocity of 1 mm/min on a universal testing machine and assessed the screw insertion torque using a digital torque wrench. RESULTS: The means of strength for the 1-, 3- and 5-mm displacements were determined by a one-way analysis of variance (ANOVA) followed by the post hoc Tukey test. Statistically significant differences were observed only for the 5-mm displacement (F = 3.36; p = 0.01). There was a difference between the 4-H2P and HG groups (p = 0.04). CONCLUSION: The customized miniplate, the fixation methods with three bicortical screws, or with two straight miniplates with either 4 or 6 holes, all offer a similar mechanical resistance suitable for fixation.
Asunto(s)
Tornillos Óseos , Técnicas de Fijación de Maxilares/instrumentación , Osteotomía Sagital de Rama Mandibular , Fenómenos Biomecánicos , Placas Óseas , Análisis del Estrés Dental , Diseño de Equipo , Mandíbula , Modelos Anatómicos , Poliuretanos , TorqueRESUMEN
OBJECTIVES: The aim of this study was to compare the mechanical resistance of four different osteosyntheses modeled in two different sagittal split ramus osteotomy (SSRO) designs and to determine the linear loading in a universal testing machine. MATERIALS AND METHODS: An in vitro experiment was conducted with 40 polyurethane hemimandibles. The samples were divided into two groups based on osteotomy design; Group I, right angles between osteotomies and Group II, no right angles between osteotomies. In each group, the hemimandibles were distributed into four subgroups according to the osteosynthesis method, using one 4-hole 2.0 mm conventional or locking plate, with or without one bicortical screw with a length of 12.0 mm (hybrid technique). Each subgroup contained five samples and was subjected to a linear loading test in a universal testing machine. RESULTS: The peak load and peak displacement were compared for statistical significance using PASW Statistics 18.0 (IBM Co., USA). In general, there was no difference between the peak load and peak displacement related to osteotomy design. However, when the subgroups were compared, the osteotomy without right angles offered higher mechanical resistance when one conventional or locking 2.0 mm plate was used. One locking plate with one bicortical screw showed higher mechanical resistance (162.72±42.55 N), and these results were statistically significantly compared to one conventional plate with monocortical screws (P=0.016) and one locking plate with monocortical screws (P=0.012). The difference in peak displacement was not statistically significant based on osteotomy design or internal fixation system configuration. CONCLUSION: The placement of one bicortical screw in the distal region promoted better stabilization of SSRO. The osteotomy design did not influence the mechanical behavior of SSRO when the hybrid technique was applied.
RESUMEN
OBJECTIVES: This study aimed to evaluate the stability of prosthetic screws from three types of craniofacial prostheses retention systems (bar-clip, ball/O-ring, and magnet) when submitted to mechanical cycling. MATERIALS AND METHODS: Twelve models of acrylic resin were used with implants placed 20 mm from each other and separated into three groups: (1) bar-clip (Sistema INP, São Paulo, Brazil), (2) ball/O-ring (Sistema INP), and (3) magnet (Metalmag, São Paulo, Brazil), with four samples in each group. Each sample underwent a mechanical cycling removal and insertion test (f=0.5 Hz) to determine the torque and the detorque values of the retention screws. A servo-hydraulic MTS machine (810-Flextest 40; MTS Systems, Eden Prairie, MN, USA) was used to perform the cycling with 2.5 mm and a displacement of 10 mm/s. The screws of the retention systems received an initial torque of 30 Ncm and the torque values required for loosening the screw values were obtained in three cycles (1,080, 2,160, and 3,240). The screws were retorqued to 30 Ncm before each new cycle. RESULTS: The sample was composed of 24 screws grouped as follows: bar-clip (n=8), ball/O-ring (n=8), and magnet (n=8). There were significant differences between the groups, with greater detorque values observed in the ball/O-ring group when compared to the bar-clip and magnet groups for the first cycle. However, the detorque value was greater in the bar-clip group for the second cycle. CONCLUSION: The results of this study indicate that all prosthetic screws will loosen slightly after an initial tightening torque, also the bar-clip retention system demonstrated greater loosening of the screws when compared with ball/O-ring and magnet retention systems.
RESUMEN
OBJECTIVES: To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance. MATERIALS AND METHODS: The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P <0.05. RESULTS: A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P <0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models. CONCLUSION: We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system.
RESUMEN
Dental implant and chin osteotomy are executed on the mandible body and the mental nerve is an important anatomical limit. The aim of this research was to know the position of the mental nerve loop comparing result in panoramic radiography and cone beam computed tomography. We analyzed 94 hemimandibles and the patient sample comprised female and male subjects of ages ranging from 18 to 52 years (mean age, 35 years) selected randomly from the database of patients at the Division of Oral Radiology at Piracicaba Dental School State University of Campinas; the anterior loop (AL) of the mental nerve was evaluated regarding the presence or absence, which was classified as rectilinear or curvilinear and measurement of its length was obtained. The observations were made in the digital panoramic radiography (PR) and the cone beam computed tomography (CBCT) according to a routine technique. The frequencies of the AL identified through PR and CBCT were different: in PR the loop was identified in 42.6% of cases, and only 12.8% were bilateral. In contrast, the AL was detected in 29.8% of the samples using CBCT, with 6.4% being bilateral; Statistical comparison between PR and CBCT showed that the PR led to false-positive diagnosis of the AL in this sample. According to the results of this study, the frequency of AL is low. Thus, it can be assumed that it is not a common condition in this population.
RESUMEN
The aim of this research was to ascertain the survival of implants installed in the atrophic maxillae of patients treated with or without autogenous bone graft at 8 to 10 years of follow-up. A retrospective study was conducted using clinical and imaging analysis. 42 adult patients were selected, treated with osseointegrated implants in a fixed maxillary prosthesis model with suprastructure using 6 to 8 implants; of these, 22 underwent reconstruction with a bone graft taken from the anterior iliac crest and 20 were treated without any type of bone graft. The sequence of removal, installation and management of the grafts followed routine patterns, and the implant installation and prosthesis preparation also followed parameters established in previous publications. Variables of implant survival, stage of loss and bone stability of the implants were analyzed with the Wilcoxon signed-rank test, considering a value of P<0.05 to obtain statistical significance. After 8 to 10 years of follow-up the 306 implants installed in the 42 patients were evaluated. 162 implants were in the bone graft group, where 8.0% of implants were lost in the pre-loading stage, 3.7% in the post-loading stage and 88.7% had complete survival. In the group without bone graft, 6.17% were lost in the pre-loading stage, 1.85% in the post-loading stage and 90.97% had complete survival. There was no significant difference in the survival of the implants between the two groups (P=0.082). Cervical bone loss between the groups showed no significant differences either (P=0.241). The implants in grafted maxillae with cases of severe maxillary atrophy are just as efficient as implants installed in maxillae without bone graft.
RESUMEN
The aim of this study was to determine the influence of the design of the sagittal split ramus osteotomy (SSRO) on the mechanical resistance to vertical forces. An in vitro study was designed for 30 test specimens. Two osteotomy models were made on two polyurethane hemimandibles, where group I presented a SSRO with an angle at vestibular level between both molars and group II presented a linear SSRO towards the basilar border. In both groups a standard osteosynthesis was performed with a 2.0 system plate and four monocortical screws, establishing sub-groups according to the degree of mandibular advancement: group A without advancement, group B with an advancement of 3 mm, and group C with advancement of 7 mm. Hemimandibles were subjected to a vertical load in the Instron machine until reaching peak load with failure, recording the value of the load and displacement. The data were analyzed with a t-test to establish statistical significance, considering p<0.05. The results showed that group II presented the best response to the compressive load, tolerating the highest load values. These results were observed in almost all the groups with statistically significant differences (p<0.05). By contrast, group I presented torsional forces prior to reaching system failure. It can be concluded that the osteotomy design influences mechanical resistance and that the linear SSRO offers the best mechanical resistance.
RESUMEN
The aim of this study was to evaluate by photoelastic analysis stress distribution on short and long implants of two dental implant systems with 2-unit implant-supported fixed partial prostheses of 8 mm and 13 mm heights. Sixteen photoelastic models were divided into 4 groups: I: long implant (5 × 11 mm) (Neodent), II: long implant (5 × 11 mm) (Bicon), III: short implant (5 × 6 mm) (Neodent), and IV: short implants (5 × 6 mm) (Bicon). The models were positioned in a circular polariscope associated with a cell load and static axial (0.5 Kgf) and nonaxial load (15°, 0.5 Kgf) were applied to each group for both prosthetic crown heights. Three-way ANOVA was used to compare the factors implant length, crown height, and implant system (α = 0.05). The results showed that implant length was a statistically significant factor for both axial and nonaxial loading. The 13 mm prosthetic crown did not result in statistically significant differences in stress distribution between the implant systems and implant lengths studied, regardless of load type (P > 0.05). It can be concluded that short implants showed higher stress levels than long implants. Implant system and length was not relevant factors when prosthetic crown height were increased.
RESUMEN
The aim of this study was to establish the influence of the design of the sagittal split ramus osteotomy (SSRO) on stress distribution on the osteosynthesis in a photoelastic resin model. Two polyurethane hemimandibles were used to perform the osteotomies, tilted in the lateral sector of the first/second molar (group I) and the other descending downwards and laterally from the first molar (group II), with no higher angle. Six replicas of each were made in photoelastic resin and stabilized with a plate and 5 mm monocortical screws in a standardized way. Stabilization was done in the SSRO without advancement, with 3 mm advancement and with 7 mm advancement. Compressive loads were applied at the level of the lower first molar in an Instron machine (model 4411) with a speed of 1 mm/min until reaching 3 mm of displacement, at which point the data was recorded with a camera to identify the stress distribution bands. The results showed stress distribution in different places: for group I it was observed mainly in the screws of the proximal segment, being more intense closer to the osteotomy; in group II I it was observed mainly in the screws of the proximal segment furthest from the osteotomy, also being distributed towards the upper area of the plate. It may be concluded that under standard osteosynthesis conditions, modifications to the SSRO produce changes in the location and distribution of stress.