RESUMO
This study presents the case of a patient who required antrostomy under general anesthesia to treat a sinus lift complication. The patient was a 43-year-old woman with no systemic abnormalities who underwent maxillary sinus lift surgery associated with mineralized bovine bone graft. The Schneiderian membrane was perforated during the procedure, and the rupture was treated with collagen membranes to close the wound and contain the biomaterial, preventing its dispersion. The patient developed a maxillary sinus infection 7 days after surgery. This infection was initially treated with 875 mg amoxicillin combined with 125 mg clavulanic acid. Although the initial infection did not worsen, the patient developed maxillary sinusitis. Thirty days after the onset of the initial infection, the patient underwent an intraoral surgery under local anesthesia to remove the biomaterial and clean the sinus cavity. Despite this procedure, maxillary ostial patency was still compromised, and antrostomy was performed endoscopically in a hospital setting under general anesthesia. This procedure resolved the sinus infection. Then, 12 months after hospitalization, the patient was treated with another sinus graft surgery without postoperative complications. The treatment of sinus infections caused by the graft surgery may require early and active intervention with antibiotics, graft removal, and antrostomy to prevent major complications.
Assuntos
Sinusite Maxilar , Levantamento do Assoalho do Seio Maxilar , Sinusite , Adulto , Animais , Transplante Ósseo , Bovinos , Feminino , Hospitais , Humanos , Seio MaxilarRESUMO
This study aimed to assess the repair of surgically created bone defects filled with blood clot, autogenous bone, and calcium phosphate cement, by histomorphometric and immunohistochemical analyses. Ten adult male rabbits were used. Three bone defects were prepared with an 8-mm diameter trephine bur in the parietal region of each animal and filled with blood clot (Group BC), autogenous bone (Group AB), and calcium phosphate bone cement (Group CPC). The animals were euthanized at 40 and 90 postoperative days. The sections were subjected to histomorphometric analysis of the new bone formed inside the calvarial defects and immunohistochemical staining to determine the expression of osteocalcin (OC), osteopontin (OP), and tartrate-resistant acid phosphatase (TRAP) proteins. Histomorphometric data were analyzed statistically by analysis of variance and Tukey's post hoc test at 5% significance level. In the results at 40 and 90 days, Group AB differed significantly from Group CPC regarding the area of newly formed bone. The immunohistochemical analysis revealed expression of OP, OC, and TRAP proteins in all groups. Group AB showed prevalence of OC and OP, and lower TRAP expression. Therefore, the calcium phosphate bone cement assessed in the present study did not accelerate the protein expression dynamics during bone healing, compared with the autogenous group.
Assuntos
Cimentos Ósseos , Regeneração Óssea/efeitos dos fármacos , Fosfatos de Cálcio/farmacologia , Crânio/patologia , Animais , Materiais Biocompatíveis , Substitutos Ósseos/farmacologia , Transplante Ósseo , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Coelhos , Distribuição Aleatória , Crânio/efeitos dos fármacos , Trombose , Cicatrização/efeitos dos fármacosRESUMO
PURPOSE: This study aimed to describe the clinical case of implant placement in the nasopalatine canal as an aid for atrophic maxilla rehabilitation. CASE REPORT: The surgical procedure was carried out in 2 stages, the first part consisted of a surgery to lift the maxillary sinus membrane associated with the xenogeneic bone placement and the second part consisted of the surgery for the implants placement, both under local anesthesia. A number of seven osseointegrated implants were placed in the maxilla, one was anchored in the nasopalatine canal region after having its neurovascular content emptied by means of the use of drill threads of the implant system. After 5 months, the implant reopening was carried out, followed by the molding, manufacturing and placement of the protocol-type prosthesis. The case has a 4-year follow-up without any painful symptomatology. CONCLUSION: The implant placed in the nasopalatine canal region is a viable option to assist in the rehabilitation with implant-supported prostheses in atrophic maxilla.
Assuntos
Prótese Dentária Fixada por Implante/métodos , Maxila/patologia , Atrofia , Implantação Dentária Endóssea/métodos , Feminino , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Pessoa de Meia-Idade , Osso Nasal/cirurgia , Palato/cirurgia , Radiografia Panorâmica , Levantamento do Assoalho do Seio Maxilar/métodosRESUMO
As life expectancy increases, a larger number of elderly people require dental health care attention for implant-supported rehabilitation, with the aim of restoring the function and aesthetics of the oral cavity. Most of these patients have lost their teeth long time ago, causing a severe bone resorption and maxillary sinus pneumatization. Therefore, the current study aims to demonstrate, through the description of the clinical case, the treatment with zygomatic implants as an option for treating severely atrophic maxillas. In this clinical study, the patient presented, in the clinical and image evaluation, severe alveolar bone atrophy, with height and thickness loss, in addition to a high-level pneumatization of the maxillary sinus, bilaterally. The classical zygomatic fixation technique was suggested, with 2 anterior conventional implants and 2 zygomatic implants in the posterior region with the placement of implant-supported prosthesis with immediate loading. The patient was monitored for 7 years and did not present pain complaints, absence of infection, or implant loss. Based on this clinical case study, it was concluded that the zygomatic implants are satisfactory options to aid the implant-supported rehabilitation of atrophic maxillas.
Assuntos
Perda do Osso Alveolar/cirurgia , Implantação Dentária Endóssea/instrumentação , Prótese Dentária Fixada por Implante , Arcada Edêntula/cirurgia , Zigoma/cirurgia , Adulto , Seguimentos , HumanosRESUMO
OBJECTIVES: The purpose of this study was to evaluate the application of 15 % propolis and 2 % acidulated-phosphate sodium fluoride solutions on the root surface-adhered necrotic cemental periodontal ligament in delayed tooth replantation. MATERIALS AND METHODS: Thirty Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. After this period, the dental papilla, enamel organ, and pulp tissue were removed, and the animals were randomly assigned to three groups: group I = immersion in saline for 10 min; group II = immersion in a 2 % acidulated-phosphate sodium fluoride solution for 10 min; and group III = immersion in a 15 % propolis and propylene glycol solution for 10 min. The root canals were filled with a calcium hydroxide paste and the teeth were replanted. RESULTS: Inflammatory resorption, replacement resorption, and ankylosis were observed in all groups without a statistically significant difference (p > 0.05) among them. CONCLUSIONS: Under the tested conditions, the application of fluoride or propolis on root surface-adhered necrotic periodontal ligament did not favor the healing process in delayed tooth replantation.
Assuntos
Fluoretos/administração & dosagem , Ligamento Periodontal/efeitos dos fármacos , Própole/administração & dosagem , Reimplante Dentário , Animais , Necrose , Ligamento Periodontal/patologia , RatosRESUMO
Endodontic treatment is an important step of tooth replantation protocols, but the ideal moment for definitive obturation of replanted teeth has not yet been established. In this study, a histomorphometric analysis was undertaken to evaluate the repair process on immediate replantation of monkey's teeth after calcium hydroxide (CH) therapy for 1 and 6 months followed by root canal filling with a CH-based sealer (Sealapex(®) ). The maxillary and mandibular lateral incisors of five female Cebus apella monkeys were extracted, kept in sterile saline for 15 min, replanted and splinted with stainless steel orthodontic wire and composite resin for 10 days. In Group I (control), definitive root canal filling was performed before tooth extraction. In Groups II and III, CH therapy started after removal of splint, and definitive root canal filling was performed 1 and 6 months later, respectively. The animals were euthanized 9 months after replantation, and specimens were processed for histomorphometric analysis. In all groups, epithelial attachment occurred at the cementoenamel junction or very close to this region; the areas of resorption on root surface had small extension and depth and were repaired by newly formed cementum; and the periodontal ligament was organized. Statistical analysis of the scores obtained for the histomorphometric parameters did not show any statistically significant difference (P = 0.1221) among the groups. The results suggests that when endodontic treatment is initiated 10 days after immediate replantation and an antibiotic regimen is associated, definitive root canal filling can be performed after a short-term CH therapy.
Assuntos
Hidróxido de Cálcio/uso terapêutico , Cemento Dentário/efeitos dos fármacos , Ligamento Periodontal/efeitos dos fármacos , Obturação do Canal Radicular/métodos , Reabsorção da Raiz/prevenção & controle , Reimplante Dentário/métodos , Animais , Cebus , Feminino , Fatores de TempoRESUMO
The purpose of this study was to evaluate the association of the combination of polylactic/polyglycolic acid around implants installed with and without primary stability through the histometric analysis of bone-implant interface. We used male rabbits, each of which received 2 titanium implants in each tibial metaphysis. The animals were divided into 4 groups: control with primary stability (CPS), control without primary stability (C), polymer with primary stability (PPS), and polymer without primary stability (P). Euthanasia was performed at postoperative days 40 and 90. The pieces were embedded in resin, sectioned, scraped, and stained with alizarin red and Stevenel blue. Histometric analysis evaluated the linear extension of contact between the bone and implant surface on the implant collar (CIC) and contact between the bone and implant surface on the first thread (CFT). Also evaluated was the area of newly formed bone (ANB) in the first thread. The results showed that there was new bone formation in all groups and during all periods. At 40 days, the ANB was higher in the PPS group than in the P group (P < .001); the CFT was statistically higher in the CPS group than the PPS group (P < .001) and was higher in the CPS group than the C group (P < .001). At 40 and 90 days, the CIC was higher in the P group than in the C group (P < .001). In conclusion, the copolymer had biocompatibility, enhanced bone healing, and presented osteoconductive properties, thus raising the contact between bone and implant, even without primary stability.
Assuntos
Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos/uso terapêutico , Implantes Dentários , Ácido Láctico/uso terapêutico , Osseointegração/efeitos dos fármacos , Ácido Poliglicólico/uso terapêutico , Animais , Cimentos Ósseos/química , Cimentos Ósseos/uso terapêutico , Regeneração Óssea/fisiologia , Substitutos Ósseos/química , Retenção em Prótese Dentária , Ácido Láctico/química , Estudos Longitudinais , Masculino , Osseointegração/fisiologia , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Coelhos , Tíbia/citologia , Tíbia/efeitos dos fármacos , Tíbia/cirurgiaRESUMO
This study assessed the occurrence and characteristics of oral and maxillofacial infections in patients treated at a Brazilian oral and maxillofacial emergency service during a 7-year period. The clinical files of all patients treated at the Oral and Maxillofacial Surgery and Traumatology Service of the Araçatuba Dental School, São Paulo State University, Brazil, between 2002 and 2008 were reviewed. From a population of 3645 patients treated in this period, the study sample consisted of 93 subjects who presented odontogenic infections. Data referring to the patients' sex, age, medical history, and the etiology, diagnosis, complications, drug therapy/treatment, and evolution of the pathologic diseases were collected and analyzed using the Epi Info 2000 software. Of these patients, 54 were men (58.1%) and 39 were women (41.9%). Most patients were in the 31- to 40-year-old (20.7%) and 21- to 30-year-old (19.6%) age groups. The most frequent etiology was pulp necrosis due to caries (80.6%). Regarding the treatment, antibiotics were administered to all patients, surgical drainage was done in 75 patients (82.4%), and 44 patients (47.3%) needed hospital admission. First-generation cephalosporin alone or combined with other drugs was the most prescribed antibiotic (n = 26) followed by penicillin G (n = 25). Most patients (n = 85, 91.4%) responded well to the treatment. Five cases had complications: 3 patients needed hospital readmission, 1 case progressed to descending mediastinitis, and 1 patient died. Odontogenic infections can be life-threatening and require hospital admission for adequate patient care. Complications from odontogenic infections, although rare, may be fatal if not properly managed.
Assuntos
Infecção Focal Dentária/epidemiologia , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Brasil/epidemiologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Drenagem , Feminino , Infecção Focal Dentária/diagnóstico , Infecção Focal Dentária/etiologia , Infecção Focal Dentária/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Resultado do TratamentoRESUMO
Success of tooth replantation is limited because part of the replanted tooth is lost because of progressive root resorption. This study used histomorphometry and immunohistochemistry to evaluate the effect of low-level laser therapy (LLLT) on the healing process of rat teeth replanted after different extra-oral periods, simulating immediate and delayed replantation. Sixty Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and randomly assigned to six groups (n = 10): C4, C30 and C45, in which the teeth were replanted 4 min (immediate), 30 min (delayed) and 45 min (delayed) after extraction, respectively, and L4, L30 and L45, in which the teeth were replanted after the same extra-alveolar times, but the root surfaces and the alveolar wounds were irradiated with a gallium-aluminum-arsenate (GaAlAs) diode laser before replantation. The animals were sacrificed after 60 days. The anatomic pieces containing the replanted teeth were obtained and processed for either histomorphometrical analysis under optical microscopy or immunohistochemical expression of receptor activator of nuclear factor Kappa-B (RANK), and its ligand (RANKL), osteoprotegerin (OPG) and tartrate-resistant acid phosphatase (TRAP) proteins. Areas of external replacement and inflammatory root resorption were observed in all groups, without statistically significant differences (P > 0.05). Ankylosis was more frequent in L30 than in C30 (P < 0.05). RANKL immunostaining predominated over RANK and OPG immunostaining in both groups with immediate tooth replantation (P < 0.05). For the 45-min extra-alveolar time, however, there was greater evidence of RANK immunostaining compared to RANKL for both control and laser-treated groups (P < 0.05). Positive TRAP immunostaining predominated in L4 and L30 (P < 0.05). In conclusion, under the tested conditions, the treatment of the root surface and the alveolar wound with LLLT did not improve the healing process after immediate and delayed tooth replantation in rats.
Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Reimplante Dentário/métodos , Raiz Dentária/efeitos da radiação , Alvéolo Dental/efeitos da radiação , Cicatrização/efeitos da radiação , Fosfatase Ácida/metabolismo , Animais , Imuno-Histoquímica , Incisivo , Isoenzimas/metabolismo , Masculino , Maxila , Osteoprotegerina/metabolismo , Periodonto/metabolismo , Periodonto/efeitos da radiação , Ligante RANK/metabolismo , Distribuição Aleatória , Ratos , Ratos Wistar , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Estatísticas não Paramétricas , Fosfatase Ácida Resistente a Tartarato , Fatores de Tempo , Alvéolo Dental/metabolismoRESUMO
This article reports the 20-month clinical outcome of the use of 4 zygomatic implants with immediate occlusal loading and reverse planning for the retreatment of atrophic edentulous maxilla after failed rehabilitation with autogenous bone graft reconstruction and maxillary implants. The intraoral clinical examination revealed mispositioned and loosened implants underneath a maxillary complete denture. The panoramic radiograph showed 6 maxillary implants. One implant was displaced into the right maxillary sinus, and the implant anchored in the region of tooth 21 was fractured. The other implants presented peri-implant bone loss. The implants anchored in the regions of teeth 21 to 23 and 11 to 13 were first removed. After 2 months, the reverse planning started with placement of 4 zygomatic fixtures, removal of the implants migrated into the sinus cavity and anchored in the region of tooth 17, and installation of a fixed denture. After 20 months of follow-up, no painful symptoms, peri-implant inflammation or infection, implant instability, or bone resorption was observed. The outcomes of this case confirm that the zygoma can offer a predictable anchorage and support function for a fixed denture in severely resorbed maxillae.
Assuntos
Implantes Dentários , Arcada Edêntula/cirurgia , Maxila/cirurgia , Zigoma/cirurgia , Adulto , Aumento do Rebordo Alveolar , Atrofia , Reabsorção Óssea , Transplante Ósseo , Dente Suporte , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Retenção de Dentadura , Prótese Total Superior , Revestimento de Dentadura , Humanos , Arcada Edêntula/diagnóstico por imagem , Arcada Edêntula/reabilitação , Masculino , Maxila/diagnóstico por imagem , Radiografia Panorâmica , Retratamento , Zigoma/diagnóstico por imagemRESUMO
Dental trauma is more common in young patients and its sequelae may impair the establishment and accomplishment of an adequate treatment plan. This paper reports a case of complicated crown-root fracture in a young adult that was treated using adhesive tooth fragment reattachment and orthodontic root extrusion. Considering the time elapsed to follow up, the fracture extension, the amount of remaining root portion and the patient's low socioeconomic status, the treatment approach proposed for this case provided good functional and aesthetic outcomes. Clinical and radiographic results after 2 years were successful. This case report demonstrates the importance of establishing a multidisciplinary approach for a successful dental trauma management.
Assuntos
Colagem Dentária , Extrusão Ortodôntica , Fraturas dos Dentes/terapia , Feminino , Humanos , Incisivo/lesões , Equipe de Assistência ao Paciente , Técnica para Retentor Intrarradicular , Tratamento do Canal Radicular , Coroa do Dente/lesões , Raiz Dentária/lesões , Adulto JovemRESUMO
The time elapsed between a trauma and tooth replantation usually ranges from 1 to 4 h. The chances of root surface damage are higher when tooth replantation is not performed immediately or if the avulsed tooth is not stored in an adequate medium. This invariably leads to necrosis of pulp tissue, periodontal ligament cells and cementum, thus increasing the possibility of root resorption, which is the main cause of loss of replanted teeth. This paper presents a comprehensive review of literature on root surface treatments performed in cases of delayed tooth replantation with necrotic cemental periodontal ligament. Journal articles retrieved from PubMed/MedLine, Bireme and Scielo databases were reviewed. It was observed that, when there are no periodontal ligament remnants and contamination is under control, replacement resorption and ankylosis are the best results and that, although these events will end up leading to tooth loss, this will happen slowly with no loss of the alveolar ridge height, which is important for future prosthesis planning.
Assuntos
Avulsão Dentária/cirurgia , Perda de Dente/prevenção & controle , Reimplante Dentário/métodos , Raiz Dentária , Condicionamento Ácido do Dente , Animais , Antibacterianos/farmacologia , Conservadores da Densidade Óssea/farmacologia , Técnica de Descalcificação , Proteínas do Esmalte Dentário/farmacologia , Fluoretos/farmacologia , Humanos , Tratamento do Canal Radicular , Aplainamento Radicular , Reabsorção da Raiz/etiologia , Fatores de Tempo , Anquilose Dental/etiologia , Perda de Dente/etiologia , Reimplante Dentário/efeitos adversos , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/fisiologiaRESUMO
Replantation is an acceptable option for treatment of an avulsed permanent tooth. Nevertheless, an extended extraoral period damages the periodontal ligament and results in external root resorption. The purpose of this study was to assess by histologic and histometric analysis, the influence of propolis 15% (natural resinous substance collected by Apis mellifera bees from various plants) and the fluoride solution used as root surface treatment on the healing process after delayed tooth replantation. Thirty Wistar (Rattus norvegicus albinus) rats were submitted to extraction of their upper right incisor. The teeth were maintained in a dry environment for 60 min. After this, the pulp was extirpated and the papilla, enamel organ and periodontal ligament were removed with scalpel. The teeth were divided into three experimental groups: Group I - teeth immersed in 20 ml of physiologic saline; Group II - teeth immersed in 20 ml of 2% acidulated phosphate sodium fluoride; Group III - teeth immersed in 20 ml of 15% propolis. After 10 min of immersion in the solutions, the root canals were dried and filled with calcium hydroxide paste and the teeth were replanted. The animals were euthanized 60 days after replantation. The results showed that similar external root resorption was seen in the propolis and fluoride groups. Teeth treated with physiologic saline tended to have more inflammatory root resorption compared with those treated with fluoride or propolis. However, the comparative analysis did not reveal statistically significant differences (P > 0.05) between the treatment modalities when used for delayed tooth replantation.
Assuntos
Fluoreto de Fosfato Acidulado/uso terapêutico , Própole/uso terapêutico , Substâncias Protetoras/uso terapêutico , Reimplante Dentário/métodos , Raiz Dentária/efeitos dos fármacos , Processo Alveolar/patologia , Animais , Hidróxido de Cálcio/uso terapêutico , Tecido Conjuntivo/patologia , Cemento Dentário/patologia , Dentina/patologia , Fibroblastos/patologia , Gengiva/patologia , Incisivo/patologia , Masculino , Ligamento Periodontal/patologia , Distribuição Aleatória , Ratos , Ratos Wistar , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/patologia , Anquilose Dental/etiologia , Anquilose Dental/patologia , Raiz Dentária/patologia , Alvéolo Dental/patologia , Cicatrização/efeitos dos fármacos , Óxido de Zinco/uso terapêuticoRESUMO
Dental trauma has been considered as a public health problem that affects mainly children and youngsters and due to its impact on the patient's quality of life. This study presents the results of a 6-year survey of the occurrence and characteristics of dental trauma in patients admitted to the Service of Surgery and Oral and Maxillofacial Traumatology of the School of Dentistry of Araçatuba (UNESP, Brazil) after emergency care in hospital facilities in the region of Araçatuba, SP, Brazil. For such purpose, the clinical files of patients treated at the Service between 1999 and 2005 were reviewed. Information regarding gender, age, number of traumatized teeth, etiology and diagnosis of the trauma was collected from the files of patients with tooth injuries and recorded in case report forms specifically designed for this purpose. The results showed that from a total of 4112 patients admitted to the Service within the surveyed period, 266 (6.5%) had tooth injuries (172 males - 64.7%; 94 females - 35.3%). The total number of traumatized teeth was 496. Most patients belonged to the 16-20 year-old age group (20.3%) and the most frequent causes of tooth injuries were bicycle accidents (28.6%), motorcycle accidents (19.2%) and falls (18.8%). Injuries to the periodontal tissues were the most frequent type of tooth injuries (408 teeth; 82.26%), occurring in 118 primary and 290 permanent teeth. Among the injuries to the periodontal tissues, avulsion was the most common (32.86%) (29.41% for primary and 34.0% for permanent teeth), followed by extrusive luxation (19.15%) (25.21% for primary and 17.24% for permanent teeth). In conclusion, in the surveyed population, cases of tooth injuries were more frequent in males aged 16-20 years old due to cyclist accidents with predominance of injuries to the periodontal tissues, in particular, avulsions.
Assuntos
Traumatismos Dentários/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Ciclismo/lesões , Ciclismo/estatística & dados numéricos , Brasil/epidemiologia , Criança , Pré-Escolar , Unidade Hospitalar de Odontologia/estatística & dados numéricos , Feminino , Humanos , Incisivo/lesões , Lactente , Masculino , Periodonto/lesões , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Fatores Sexuais , Avulsão Dentária/epidemiologia , Fraturas dos Dentes/epidemiologia , Traumatismos Dentários/classificação , Dente Decíduo/lesões , Adulto JovemRESUMO
The major concern in the therapeutics of tooth replantation refers to the occurrence of root resorption and different approaches have been proposed to prevent or treat these complications. The purpose of this study was to evaluate tissue response to delayed replantation of anterior rat teeth treated endodontically using calcium hydroxide, Sealapex, and Endofill without the placement of gutta-percha cones. Thirty rats had their right upper incisor extracted and maintained in dry storage for 60 min. After removal of the dental papilla, enamel organ, pulp tissue, and periodontal ligament remnants, the teeth were immersed in 2% sodium fluoride phosphate acidulated, pH 5.5, for 10 min. The root canals were dried with absorbent paper points and the teeth were assigned to three groups (n = 10) according to the filling material. Group I - calcium hydroxide and propyleneglycol paste, Group II - Sealapex, and Group III - Endofill. The sockets were irrigated with saline and the teeth were replanted. Replacement resorption, inflammatory resorption and ankylosis were observed in all groups. Although the occurrence of inflammatory resorption was less frequent in Group I, there were no statistically significant differences among the groups. It may be concluded that compared to the paste, filling the root canals with Sealapex and Endofill sealers without the placement of gutta-percha cones did not provide better results.
Assuntos
Hidróxido de Cálcio/uso terapêutico , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Salicilatos/uso terapêutico , Reimplante Dentário/métodos , Fluoreto de Fosfato Acidulado/uso terapêutico , Processo Alveolar/patologia , Animais , Tecido Conjuntivo/patologia , Cemento Dentário/patologia , Cavidade Pulpar/patologia , Dentina/patologia , Fibroblastos/patologia , Incisivo/patologia , Linfócitos/patologia , Macrófagos/patologia , Masculino , Ligamento Periodontal/patologia , Ratos , Ratos Wistar , Irrigantes do Canal Radicular/uso terapêutico , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/patologia , Anquilose Dental/etiologia , Anquilose Dental/patologia , Alvéolo Dental/patologia , Cicatrização/fisiologiaRESUMO
PURPOSE: The aim of this study was to evaluate the volumetric stability of deproteinized bovine bone after sinus augmentation, using cone beam computed tomography (CBCT) and three-dimensional (3D) analysis. MATERIALS AND METHODS: Using a specific selection tool and 3D reconstruction from InVesalius 3.0, volumetric analysis of CBCT scans was performed in patients undergoing a sinus elevation technique in critical defects, using deproteinized bovine bone. The first scan was performed immediately after graft surgery (T1), and the second was performed 8 months after graft surgery (T2). RESULTS: A total of 13 patients met the inclusion criteria of this retrospective study; 26 postoperative CBCT scans were analyzed for these patients. All patients exhibited an increase in bone volume (9.10%). The mean bone volume increase from T1 to T2 was 0.137 cm(3) (SD: ± 0.104 cm(3)). There was a statistically significant correlation between bone volume and time (P < .0001). The mean bone volume was 1.506 cm(3) (SD: ± 0.473 cm(3)) for T1 and 1.644 cm(3) (SD: ± 0.506 cm(3)) for T2. CONCLUSION: Within the limited sample, the study demonstrated an increase in graft volume after sinus elevation with deproteinized bovine bone in critical defects.
Assuntos
Transplante Ósseo/métodos , Seio Maxilar/cirurgia , Boca Edêntula/reabilitação , Levantamento do Assoalho do Seio Maxilar/métodos , Adulto , Animais , Bovinos , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante HeterólogoRESUMO
PURPOSE: We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia. METHODS: Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss(®) (BI), and Bio-Oss(®) Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. RESULTS: For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. CONCLUSIONS: Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
RESUMO
ABSTRACT This clinical report describes the implant rehabilitation for the treatment of pathological roots resorption due to inadequate orthodontic movement in prosthetic space reduced by means of load and immediate implants, computer-guided surgery and use of the own tooth crown in a 21-year-old-patient. The atraumatic exodontics of the right and left upper lateral incisors was performed, and then immediate placement of osseointegrated implants using the computer guided surgery technique. The crown teeth itself was used in the immediate aesthetic and functional rehabilitation. Completion of the treatment resulted in a functional and aesthetic successful outcome and a 27 months follow-up presented uneventful. The procedures included in this complex rehabilitation treatment in the esthetic zone were appropriate and essential for the maintenance of the soft and hard tissues contour and thickness ensuring the excellence in rehabilitation.
RESUMO Este relato de caso clínico descreve a reabilitação com implantes para o tratamento da reabsorção radicular patológica devido à movimentação ortodôntica inadequada em espaço protético reduzido, por meio implante imediato e carga imediata, pela técnica da cirurgia guiada por computador e uso da própria coroa dentária, em paciente de 21 anos. A exodontia atraumática dos incisivos laterais superiores direito e esquerdo foi realizada, em seguida realizou-se a instalação imediata dos implantes osseointegráveis, utilizando a técnica de cirurgia guiada por computador. Os próprios dentes da coroa foram usados na reabilitação estética e funcional imediata. A conclusão do tratamento resultou em sucesso funcional e estético com acompanhamento de 27 meses sem intercorrências. Os procedimentos incluídos neste complexo tratamento de reabilitação na zona estética foram adequados e essenciais para a manutenção do contorno e espessura dos tecidos moles e duros garantindo a excelência na reabilitação.
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ABSTRACT Objective: The preoperative evaluation is essential to prevent postoperative surgical complications. The present study aimed to establish quantitative and qualitative profiles of systemic disorders and relate them to postoperative surgical complications in patients subjected to dental extraction Methods: Data were collected from the medical records of 992 patients subjected to dental extractions from 2010 to 2015 through a detailed analysis of anamnesis files. The data collected were tabulated and converted to percentages to facilitate the discussion and comparison with reports in the literature Results: From all the medical records analyzed, 559 presented systemic changes, which corresponds to 56.3%. Among them, there was a higher prevalence of patients with hypertension (24%), smoking habits (20%), and diabetes (11%). The most frequent complications were pain (34%), inflammation (19.8%), and hemorrhage (13.2%). The prevalence of diseases related to age shows patients under the age of 20 (4.7%), 20 to 29 (11.3%), 30 to 39 (16.8%), 40 to 44 (10%), 45 to 49 (10.9%), 50 to 54 (12.3%), 55 to 59 (12.9%), 60 to 64 (10.4%), 65 to 69 (4.8%), and older than 70 years old (5.9%). As for systemic changes with complications, hypertensive patients with complications (n=11) showed higher prevalence of pain (45.4%), the most common complication in smokers (n=15) was exacerbated inflammation (33.3%), and 50% of diabetic patients with complications (n=8) were diagnosed with alveolitis Conclusion: The method studied allowed concluding there was a relationship between postoperative complications and systemic changes, and the main ones were pain-hypertension, inflammation-smoking, and alveolitis-diabetes.
RESUMO Objetivo: A avaliação pré-operatória é de fundamental importância para a prevenção das complicações cirúrgicas pós-operatórias. O objetivo do presente estudo foi estabelecer um perfil quantitativo e qualitativo das enfermidades sistêmicas e relaciona-las com complicações cirúrgicas pós-operatórias em pacientes submetidos exodontia. Métodos: Para isso foram coletados dados de 992 prontuários de paciente submetidos a exodontias no período de 2010 a 2015, por meio da análise minuciosa da ficha de anamnese. Os dados obtidos foram tabulados e transformados em porcentagem, para facilitar a discussão e comparação com os relatos da literatura. Resultados: No total de prontuários analisados, 559 apresentaram alterações sistêmicas, o que corresponde a 56,3%. Dentre elas, houve uma maior prevalência de pacientes com hipertensão (24%), tabagismo (20%) e diabetes (11%). As complicações mais frequentes foram dor (34%), inflamação (19,8%) e hemorragia (13,2%). Considerando-se a prevalência de doenças relacionadas à idade, a faixa etária de menor de 20 anos (4.7%), 20 a 29 (11.3%), 30 a 39 (16.8%), 40 a 44 (10%), 45 a 49 (10.9%), 50 a 54 (12.3%), 55 a 59 (12.9%), 60 a 64 (10.4%), 65 a 69 (4.8%), e maiores de 70 anos (5.9%). Relacionando as alterações sistêmicas com as complicações, dentre os pacientes hipertensos que apresentaram complicações (n=11), a dor foi a mais prevalente (45,4%). Já nos fumantes (n=15) a complicação mais comum foi a inflamação exacerbada (33,3%). Nos diabéticos com presença de complicações (n=8), 50% foram diagnosticados com alveolite. Conclusão: Com base na metodologia estudada foi possível concluir que houve relação das complicações pós-operatórias e alterações sistêmicas, sendo as principais dor-hipertensão, inflamação-tabagismo e alveolite-diabetes.
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Objetivo: ilustrar, por meio de um caso clínico, os benefíciosdo tratamento da síndrome de apneia obstrutivade sono (Saos) por intermédio da cirurgia ortognáticabimaxilar, com o uso de biomateriais de reconstrução.Relato de caso: paciente encaminhado para avaliaçãode discrepância maxilomandibular em relação àbase do crânio e para avaliação de queixa de roncointenso durante a noite e intenso cansaço diurno. Apósavaliação e exames complementares, o paciente foidiagnosticado com apneia obstrutiva do sono; assim,foi realizada a cirurgia de avanço bimaxilar como terapêuticaresolutiva para o caso. Considerações finais:a Academia Americana de Medicina do Sono (AAMS)define Saos como uma doença que se caracteriza porepisódios repetitivos de obstrução total (apneia) ou parcial(hipopneia) das vias aéreas superiores durante osono. A cirurgia de avanço bimaxilar se apresenta comouma das melhores opções terapêuticas para os pacientescom essa síndrome. A cirurgia ortognática, incluindoseus diversos procedimentos, provoca importantesmudanças nas diferentes zonas das vias aéreas faríngeas.A cirurgia ortognática de avanço bimaxilar commentoplastia de avanço foi eficaz, em longo prazo, notratamento da Saos, e o uso simultâneo de biomateriaisde substituição óssea aumenta a estabilidade óssea primária,acelera o processo de reparo ósseo e diminui amorbidade pós-operatória.