Bacterial cellulose matrix and acellular dermal matrix seeded with fibroblasts grown in platelet-rich plasma supplemented medium, compared to free gingival grafts: a randomized animal study.

PURPOSE: Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model. METHODS: Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema. RESULTS: The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (P<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group. CONCLUSIONS: Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.

Evaluation of Removal Torque and Internal Surface Alterations in Frictional Morse Taper Connections After Mechanical Loading Associated or Not with Oral Biofilm.

PURPOSE: To evaluate the abutment removal torque and the morphologic aspects of wear in frictional Morse taper connections after axial loading with or without biofilm immersion. MATERIALS AND METHODS: Thirty sets of Morse taper implants and prosthetic abutments were divided into six groups based on the number of mechanical loading cycles and immersion in biofilm derived from human saliva: without load, without biofilm; without load, with biofilm; 100,000 cycles of load, without biofilm; 100,000 cycles of load, with biofilm; 500,000 cycles of load, without biofilm; and 500,000 cycles of load, with biofilm. Mechanical loading was applied at a force of 80 ± 15 N with a frequency of 2 Hz for 100,000 or 500,000 cycles. After removal torque evaluation, the internal surface of the implants was evaluated by scanning electron microscopy and optical profilometer. The results were statistically analyzed at a significance level of P = .05. RESULTS: Overall, the removal torque increased for samples submitted to loading (100,000 cycles of load, without biofilm = 83.8 ± 15.8 Ncm; 100,000 cycles of load, with biofilm = 160.6 ± 16.2 Ncm; 500,000 cycles of load, without biofilm = 147.0 ± 29.3 Ncm; 500,000 cycles of load, with biofilm = 154.5 ± 14.0 Ncm) compared to samples without loading (without load, without biofilm = 23.0 ± 9.4 Ncm; without load, with biofilm = 27.2 ± 7.5 Ncm). The removal torque was not different between groups that received the same number of loading cycles and varied on biofilm exposure (P > .05). However, samples immersed in biofilm showed higher values of removal torque. Surface analysis revealed that the damage on the internal surface of implants was lower in samples not submitted to cyclic mechanical loading (P < .05) independently of immersion in biofilm medium. CONCLUSION: Cyclic mechanical load on the frictional implant-abutment connection of Morse taper implants increased the removal torque of abutments. The findings of this research suggest that the presence of biofilm can potentially increase the removal torque in frictional Morse taper connections, although more studies are recommended to support this affirmation. Oral biofilm did not interfere with the presence of wear areas along the internal surface of Morse taper implants but increased the roughness values.

Prótese unitária metalocerâmica para implantes colocados em nível ósseo: a estratégia para o pilar Gold / Single-tooth implant-supported metalloceramic crowns for bone level implants: the Gold abutment strategy

O planejamento protético sobre os atuais sistemas de implantes dentais tipo cone-morse junto à prótese parafusada procura obter uma versatilidade protética, facilidade de elaboração, boa resposta biológica, reversibilidade e estética, apresentando-se como um pilar protético com cilindro de plástico que permite fabricação diretamente para a fixação no implante, envolvendo o mecanismo antirrotacional, e sendo uma alternativa no tratamento de reabilitação em casos de requerimento estético em implantes instalados no nível ósseo (Bone level, Straumann). Este relato de caso descreveu o procedimento de exodontia atraumática, seguida da instalação de implante imediato com preenchimento de gap, e subsequente sequência clínica da reabilitação sobre implante cone-morse com componente protético com cilindro de plástico (Gold abutment, Straumann), que promove maior previsibilidade estética na reabilitação em implantes instalados no nível ósseo, apresentando um prognóstico satisfatório e equilíbrio mecânico/funcional que envolve mecanismo antirrotacional.

The prosthetic design on the current cone morse dental implant systems, together with the screwed prosthesis, seeks prosthetic versatility, ease of preparation, good biological response, retrievability and aesthetics, presenting a prosthetic abutment with a plastic burnout cylinder for direct connection to the implant with an antirrotational mechanism for esthetic situations involving a bone level implant (Straumann). This case report describes the atraumatic extraction procedure, followed by the installation of an immediate gap filling implant, and a subsequent clinical sequence using the Gold abutment (Straumann) plastic prosthetic component, which promotes greater aesthetic predictability in the rehabilitation of implants installed at the bone level, presenting a satisfactory prognosis and mechanical/functional balance involving antirotation mechanism.

The Value of Occlusion in Dentistry: A Clinical Report Showing the Correction of an Anterior Reverse Articulation with Selective Occlusal Adjustment.

The subject of occlusion has been deemphasized by academia over the last 30 years. This marginalization in turn has negatively impacted recent graduates who are largely unfamiliar with the use of occlusal adjustment by selective reshaping as a treatment modality. Use of proper occlusal therapy enables clinicians to more effectively help patients recover from parafunctional wear of the anterior and posterior teeth. In addition, familiarity with this field enhances the correction of progressive posterior and anterior reverse articulations. This article aims to highlight the importance of occlusal principles in treatment planning. In addition, we illustrate the benefits of occlusal adjustment by using a conservative technique, selective reshaping, as an option to correct anterior reverse articulation in a 20-year-old patient. The knowledge of occlusal principles enhances diagnosis of malocclusion in the development of a treatment plan. When properly employed, the technique of occlusal adjustment by selective reshaping may be used to correct an adaptive anterior reverse articulation with a high degree of predictability for select patients.

Avaliação da experiência e do grau de satisfação de pacientes tratados com próteses totais fixas sobre implantes / Assessing the degree of experience and satisfaction of patients treated with implant-supported complete dentures

Introdução: com os implantes dentários consegue-se resolver a falta de estabilidade de próteses totais convencionais, mas pouco se conhece quanto à satisfação dos pacientes tratados com próteses totais implantos suportadas. Objetivo: identificar a experiência e o grau de satisfação de pacientes tratados com próteses totais fixas sobre implantes. Métodos: sessenta e seis pacientes foram entrevistados por um único pesquisador. Questionou-se os pacientes sobre a experiência de algo desagradável durante o tratamento e a recomendação do tratamento para outras pessoas. Também foi utilizada uma Escala Visual Analógica, para medir o grau de satisfação dos pacientes em relação à estabilidade, estética, conforto, fonética, mastigação e facilidade de higienizar suas próteses. Os dados obtidos foram analisados por meio da correlação de Spearman (P < 0,05) e submetidos a uma regressão múltipla. Resultados: dos pacientes entrevistados, 22,7% relataram ter experimentado algo desconfortável ou desagradável durante o tratamento e todos afirmaram que recomendariam o tratamento. O grau de satisfação dos pacientes foi alto, alcançando uma média de 97,7%. Os itens que obtiveram significância estatística foram a estabilidade, a fonética e o conforto, juntamente com a recomendação do tratamento. Conclusão: identificou-se que o grau de satisfação dos pacientes tratados com próteses totais fixas sobre implantes é alto, devido, principalmente, à estabilidade, seguida da fonética e do conforto dessas próteses.

Introduction: Dental implants can solve the issue of lack of stability of conventional dentures, but little is known about patients’ satisfaction regarding implant-supported completedenture. Objective: Identify the experience and the degree of satisfaction of patients treated with implant-supported complete denture. Material and Methods: Sixty-six patients were interviewed by one single investigator. Patients were questioned about potential unpleasant experiences during treatment and whether treatment should be recommended to others. A Visual Analogue Scale was also used to assess the degree of patients’ satisfaction in terms of stability, esthetics, comfort, speech, and ease of sanitization. Data were analyzed by Spearman correlation (P < 0.05) and submitted to multiple regression. Results: Of the patients interviewed, 22.7% reported experiencingsomething unpleasant or uncomfortable during treatment, and all of them stated that they would recommend it. The degree of patients’ satisfaction was high, reaching an average of 97.7%. Thefollowing items were statistically relevant: stability, speech and comfort, as well as treatment recommendation.Conclusion: The degree of patients’ satisfaction proves high, mainly due to stability, followed by speech and comfort provided by implant-supported complete denture.

Técnica do conjuntivo rotacionado palatino para fechamento de alvéolos pós-extração / Technique of rotational palatal connective closure of post extraction sockets

O completo selamento marginal do alvéolo, por tecido mole, após a instalação imediata de implantes e/ou regeneração óssea guiada, é fundamental. Entre as técnicas para fechamento de alvéolo, destacam-se os retalhos pediculados. Objetivos: descrever e elucidar a técnica do conjuntivo rotacionado palatino para fechamento de alvéolo. Métodos: relato de um caso de agenesia do elemento 15, em que se realizou extração atraumática do dente 55 e a técnica de conjuntivo rotacionado palatino. Resultados: o paciente apresentou pós-operatório de sete dias muito satisfatório. Conclusão: a técnica apresentada apresenta excelência estética associada à função e homeostasia marginal, possui uma fonte de nutrição extra, proveniente do pedículo, além de possuir menor morbidade e ausência de área doadora isolada...

Complete marginal soft tissue sealing of the socket after immediate implantplacement and / or guided bone regeneration is essential. Among the techniques of socket closure, we highlight the pedicle flaps. Objectives: To describe and explain the technique of rotational palatal connective closure of post extraction sockets. Methodology: Case report of agenesis of tooth #15 treated by means of atraumatic extraction of tooth #55 and the technique of rotational palatal connective closure. Results: The patient had a very satisfactory 7-day postoperative follow-up. Conclusion: The technique presents esthetic excellence associated with marginal function and homeostasis, an extra source of nutrition from the pedicle, lower morbidity and absenceof an isolated donor site...