ABSTRACT
PURPOSE: To evaluate in vitro, the efficacy of gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape to act as a seal against the penetration of Escherichia coli through prosthetic implant abutments (PIA) with external hexagon (EH) and morse taper (MT) connections. MATERIALS AND METHODS: 120 sets of implant analogs with their respective PIA were used. 60 sets from each system were divided into four groups (n = 15): I - GP sealing; II - PTFE tape sealing; III - no sealing (NS) and IV - negative control. Microbiological challenge was performed by placing bacterial colonies inside the titanium PIA before screwing them into their respective analogs. Each set was immersed in 5 mL of BHI and incubated for 14 days with daily checks for contamination, according to the nutrient medium turbidity. RESULTS: The type of seal used influenced microbial penetration at all evaluation times (p < 0.05). Compared to GP, PTFE led to an increase in turbidity and its effectiveness against microbial penetration was equivalent to group NS. When the sealing efficacy of each group was compared in terms of time, Cochran's Q test revealed that in the two groups sealed with PTFE, there was a progressive increase in the number of turbid nutrient media (p < 0.0001), while in the group sealed with GP, this was only observed in the MT system (p = 0.0310). CONCLUSIONS: Sealing the PIA channel with GP was a significantly superior approach to sealing it with PTFE tape. PTFE tape or NS led to a progressive increase in microbiological leakage over time in PIA channels, however, this only occurred with GP in the MT system.
Subject(s)
Dental Abutments , Dental Implants/microbiology , Dental Leakage/prevention & control , Gutta-Percha , Polytetrafluoroethylene , Dental Implant-Abutment Design , Dental Leakage/microbiology , Humans , Materials Testing , TitaniumABSTRACT
A atrofia da maxila é um dos maiores desafios da Implantodontia. A expectativa dos pacientes e a falta de colaboração em ficar sem as próteses dificultam os resultados e tornam restritas a indicação do tratamento. Baseados nestes fatos, os autores realizaram a reconstrução de maxilas atróficas através de enxerto de crista ilíaca com instalação dos implantes em carga imediata. Quatro pacientes portadores de atresia severa de maxila foram submetidos a reconstrução com osso de ilíaco. Após cinco meses os implantes foram instalados e quatro foram submetidos à carga imediata. Seis meses depois os demais implantes foram colocados em função e nova prótese foi confeccionada. Foram instalados 52 implantes, sendo 36 de maneira convencional e 16 em carga imediata. O índice de sucesso obtido foi de 89% nos implantes instalados de maneira convencional (perda de quatro implantes) e de 100% nos implantes instalados em carga imediata. Diante dos resultados obtidos, foi possível concluir que a técnica de reconstrução de maxila através da enxertia, cuja área doadora é a crista ilíaca, apresenta alta previsibilidade, além de se enquadrar nas expectativas do paciente. Os implantes colocados em carga imediata como proposto neste estudo facilitam a aceitação do paciente frente ao tratamento.
Jawbone atrophy is one of the largest challenges of the current implantology. The patients' expectation, along with the lack of cooperation in avoiding the use of their prostheses, hinders the results and treatment indication. Based on these facts the authors accomplished the reconstruction of atrophic jaws through iliac bone crest grafts with immediate loading implant placement. Four patients with severe atrophic maxillary or mandibular deficiencies underwent reconstructive procedures. After five months, the implants were installed and four were submitted to immediate loading. Six months later, the other implants were put into function and new prostheses made. Fifty-two implants were installed, being 36 in a conventional way and 16 immediate loaded. The success rate was 89% for conventional loaded implant (four implants were lost) and 100% in the immediate load protocol. It was possible to conclude that jawbone reconstruction with iliac bone crest graft presents high predictability and responds to patient's expectations. The implants immediately loaded in this treatment planning facilitate patient's acceptance.
