RESUMO
Placing implants in fresh postextraction sites is a borderline rehabilitation procedure. The purpose of this report is to describe the pre-, per-, and postoperative procedures for maintaining long-term stability of two full-arch rehabilitations through the All-on-4 protocol, performed in the presence of challenging conditions. Two patients were referred for full-arch rehabilitation with immediate function, with both patients presenting infection in the jaws: patient 1 with an implant (position #45) inserted in a cystic cavity; patient 2 with one implant (position #24) inserted transsinus after the removal of a cyst on the base of the maxillary sinus and another implant (position #15) inserted with a dehiscence. Both patients received a preoperative dental hygiene appointment, a regenerative surgical protocol, and were enrolled in a postoperative maintenance protocol. After surgery a provisional prosthesis was provided ensuring immediate function, and 6 months after surgery, the final prosthesis was delivered. During the follow-up appointments (final follow-up at 5 and 18 years), the implants were stable, and no infection was observed for both patients. The present case report describes two full-arch rehabilitations in immediate function, supported by dental implants inserted in the presence of challenging conditions that do not represent the norm, rather are highly demanding for the clinical team, warranting caution in the interpretation of the results.
RESUMO
Background: Short implants have been used in the restoration of edentulous jaws in the past several years. However, some studies have suggested that short implants are less successful than standard implants. The aim of this study is to investigate the outcome of short implants placed in the posterior maxilla or mandible following one-stage or immediate-function protocols with a follow-up of 7 years (clinically) and 5 years (radiographically). Methods: This study included 127 patients rehabilitated with 217 implants measuring 7 mm and supporting 157 fixed prostheses in the posterior segments of both jaws. Final abutments were delivered at the surgery stage and were loaded after 4 months in 116 patients (199 implants). The primary outcome measure was implant survival measured through life tables. Secondary outcome measures were marginal bone loss and the incidence of biological and mechanical complications at the patient level and implant level (evaluated through descriptive statistics). Results: Twenty-four patients (18.9%) with 45 implants (20.7%) were lost to the follow-up. In total, 32 implants failed (14.8%) in 22 patients (17.3%), resulting in a cumulative survival rate at 7 years of 81.2% for 7 mm implants in the rehabilitation of the posterior regions of the maxilla and mandible. The average (standard deviation) marginal bone loss was 1.47 mm (0.99 mm) at 5 years. The incidence rate of biological complications was 12.6% and 10.6% at the patient and implant levels, respectively. The incidence rate of mechanical complications was 21.3% for patients and 16.1% for implants. A higher failure rate was registered in smokers and in implant arrangements with a sequence of three fixtures in proximity. Conclusions: Within the limitations of this study, it can be concluded that the placement of 7 mm long implants for the partial implant-supported rehabilitation of atrophic posterior jaws is possible in the long term, judging by the survival rate and stable average marginal bone loss. Nevertheless, strict case selection should be performed, especially in smokers and with implant arrangements that provide a minimum of one unit in inter-implant distance.
RESUMO
O objetivo desse estudo é analisar e investigar a qualidade de vida em pessoas com lesão medular, através de uma revisão sistemática. Buscaram-se os principais trabalhos publicados no período de 2006 a 2019, nas bases de dados CAPES e Scielo. Todos os estudos utilizaram medidores quantitativos sobre qualidade de vida, os quais são: o WHOQOL-Bref e o SF-36. Os resultados de forma geral mostraram que o sujeito com lesão medular avalia sua qualidade de vida como boa e sua saúde de forma geral satisfatória. O domínio físico e do meio ambiente foram os domínios mais citados nas pesquisas como um fator negativo, sendo ele relacionado com a questão da acessibilidade. Verificou-se que estudos futuros são de extrema importância, para compreender a qualidade de vida desses indivíduos, assim como para a melhoria de políticas públicas para questão de acessibilidade e autonomia desses sujeitos.(AU)
The aim of this study is to analyze and investigate the quality of life in people with spinal cord injury, through a systematic review. The main studies published in the period 2006 to 2019 were searched in the CAPES, Scielo. All the studies used quantitative measure about quality of life, which were the WHOQOL-Bref and the SF-36. The results generally showed that the subject with spinal cord injury evaluates their quality of life as good and their health in a general satisfactory manner. The physical and environmental domains were the most cited domains in the researches as a negative factor, being related to the issue of accessibility. It was found that future studies are extremely important to understand the quality of life of these individuals, as well as for the improvement of public policies for the question of accessibility and autonomy of these subjects.(AU)