Surgical experience influences 2-stage implant osseointegration.

PURPOSE: With the increasing number of surgical procedures for osseointegrated implant placement, there has also been an increase in the number of professionals performing this procedure. Surgeons undergo different types of training, and this may influence their surgical experience. The objective of this study was to evaluate the effect of surgical experience on the osseointegration of dental implants. MATERIALS AND METHODS: A retrospective study was conducted using clinical charts from 2002 through 2008, during which time 265 implants were performed in 110 patients by 2 professionals who completed a postgraduate program in implant dentistry in 2002. Cases were selected for degree of difficulty, avoiding those involving areas that required bone grafts for the placement of implants, with a regular platform (3.75) and a height ranging from 10 to 13 mm. The criteria for evaluating implant osseointegration included clinical and radiographic evidence observed for a minimum period of 1 year, in accordance with the success criteria proposed by Albrektsson et al:(1)1) individual, unattached implant is immobile when tested clinically; 2) radiograph does not demonstrate evidence of peri-implant radiolucency; 3) vertical bone loss is less than 0.2 mm annually after the first year postimplantation; and 4) individual implant performance is characterized by an absence of signs and symptoms such as pain, infections, neuropathies, paresthesia, or violation of the mandibular canal. Implantation was performed in 2 stages. To relate the osseointegration rate with professional experience, cases were arranged by increasing order of placement date and were then evaluated per year and region. They were then separated into 2 groups: first 50 implants performed and implants performed after the first 50. RESULTS: The osseointegration rate of implants performed was 92.5%, with rates of 87.6% for those placed in the maxilla and 95.6% for those in the mandible. For the first 50 implants, the osseointegration rate was 84.0%, whereas in the implants performed thereafter, the rate was 94.4%. CONCLUSION: Surgical experience acquired during and after a postgraduate program in implant dentistry appears to influence osseointegration of dental implants, with a higher osseointegration rate found in implants performed by more experienced professionals.

Análise comparativa da adaptação de pilares tipo UCLA em estruturas fundidas em monoblocos provenientes de abutments com cintas de cobalto-cromo e totalmente calcináveis utilizando diferentes ligas de Co-Cr e Ni-Cr-Ti / Comparative analysis of adaptation pillars of UCLA in structures fused en bloc from abutments with braces cobalt chrome and burnout using different alloys of Co-Cr and Ni-Cr-Ti

Apesar do grande desenvolvimento das próteses sobre implantes ainda encontramos diversos problemas na adaptação dos componentes protéticos aos implantes, principalmente em componentes protéticos fundidos em laboratório. É o caso dos pilares tipo UCLA que são utilizados diretamente nos implantes e estão disponíveis pré-fabricados em titânio, totalmente calcináveis ou com a base de assentamento metálica e o corpo calcinável. O presente trabalho teve como objetivo comparar a adaptação de pilares tipo UCLA totalmente calcináveis ou com base de assentamento em Cobalto-Cromo e corpo calcinável fundidos em monobloco com ligas de Co-Cr e Ni-Cr Ti simulando uma prótese fixa de três elementos. Foram utilizados 30 pilares tipo UCLA que foram divididos em três grupos: grupo 1 UCLAS com base de assentamento em Co-Cr fundidos em Co-Cr (Kera 501 ), grupos 2 e 3 UCLAS totalmente calcináveis fundidos com Co-Cr e Ni-Cr-TI (Tilite Star ) respectivamente. Após as fundições, as desadaptações dos componentes protéticos aos implantes foram mensuradas utilizando um esteriomicroscópio óptico comparador (S8APO, Leica, Alemanha) utilizando o teste do parafuso único e com todos os parafusos apertados com torque de 20 N/cm2. Os resultados foram submetidos à análise estatística por meio de Teste “t”de Student, análise de variância (ANOVA) e teste de Tukey com nível de significância de 5%. Não foi encontrada diferença estatisticamente significante (p> 0,05) na adaptação dos pilares totalmente calcináveis comparados aos com base de assentamento em Co-Cr se considerados as faces separadas dos pré-molares e molares, entretanto quando avaliados os dentes pré-molares e molares independentes das faces, foi encontrada melhor adaptação dos pilares com base de assentamento metálico (p=0,0378 e p= 0,0008) em ambos os dentes. Em relação às ligas metálicas utilizadas, não houve diferença significante em nenhuma das situações estudadas, com exceção do molar que obteve melhor adaptação...

Even though the great prostheses development on implants, several problems has found in the prosthetic implants fit, mainly in prosthetic components cast in the dental laboratory. This is the case of UCLA abutments that are directly used in implants and available in machined titanium, plastic burnout or abutments having a metal base and a plastic sleeve cast-on with different alloys. This study aimed to compare the passive fit and vertical fit of the abutments UCLA castable or a metal base on Cobalt-Chromium (Co-Cr) and plastic sleeve casted in one-piece frameworks with Co-Cr alloys and Ni-Cr Ti simulating a fixed prosthesis of three elements. It was utilized 30 UCLA abutments were divided into three groups: group 1 UCLAs premachined on Co-Cr in cast Co-Cr (501 Kera ), group 2 and 3 UCLAs plastic burnout cast-on Co-Cr and Ni- Cr-TI (Tillite Star ) respectively. After casting, the prosthetic implants misfit was measured using an optical comparator stereo microscope (S8APO, Leica, Germany) using the test of single screw where all screws was tightened with 20 N/cm. The results were submitted to statistical analysis by "t" Student, analysis of variance (ANOVA) and Tukey's test with a significance level of 5%. There was no statistically significant difference (p> 0.05) in the pillars fit castable compared to metal base on Co-Cr and plastic sleeve if considered separate sides of the premolars and molars, however when were considered the premolars molars and molars independent of the faces, We found a better pillars fit on the abutments premachined on Co-Cr (p = 0.0378 and p = 0.0008) in both teeth. In relation of metal alloys, no difference was found in any studied conditions, except that the molar obtained a better fit in cases where was used UCLA abutment with settlement based metallic alloy cast on Co-Cr (p = 0.004).