Microbial colonization in the partially exposed nonabsorbable membrane during alveolar ridge preservation.

AIM: This study evaluated the impact of the partial exposition of the nonabsorbable membrane (dPTFE) on microbial colonization during bone healing. MATERIALS AND METHODS: Patients indicated for tooth extraction were randomized to dPTFE group (n = 22) - tooth extraction and alveolar ridge preservation (ARP) using an intentionally exposed dPTFE membrane and USH group (n = 22) - tooth extraction and unassisted socket healing. Biofilm samples were collected at the barrier in the dPTFE and on the natural healing site in the USH after 3 and 28 days. Samples from the inner surface of the dPTFE barrier were also collected (n = 13). The microbiome was evaluated using the Illumina MiSeq system. RESULTS: Beta diversity was different from 3 to 28 days in both groups, and at 28 days, different microbial communities were identified between therapies. The dPTFE was characterized by a higher prevalence and abundance of gram-negative and anaerobic species than USH. Furthermore, the inner surface of the dPTFE membrane was colonized by a different community than the one observed on the outer surface. CONCLUSION: Intentionally exposed dPTFE membrane modulates microbial colonization in the ARP site, creating a more homogeneous and anaerobic community on the inner and outer surfaces of the membrane. CLINICAL RELEVANCE: DPTFE promoted faster biofilm colonization and enrichment of gram-negative and anaerobes close to the regenerated site in the membrane's inner and outer surfaces. dPTFE membrane can be used exposed to the oral site, but approaches for biofilm control should still be considered. The study was retrospectively registered at Clinicaltrials.gov (NCT04329351).

Influence of partially exposed nonabsorbable membrane for alveolar ridge preservation: A randomized controlled trial.

AIM: This randomized controlled trial evaluated the impact of a partially exposed non-absorbable membrane (dPTFE) in Alveolar Ridge Preservation (ARP) procedures on clinical, tomographic, immunoenzymatic, implant-related, and patient-centered outcomes. MATERIALS AND METHODS: Patients with a hopeless maxillary single-rooted tooth demanding rehabilitation with implants were included. Patients were randomized into two groups: dPTFE (n = 22)-tooth extraction followed by ARP using a partially exposed dPTFE membrane; USH (n = 22)-unassisted socket healing. Clinical and tomographic analyses were performed at baseline and after 3 months. After 3 months, patients received one dental implant. Implant stability quotient was obtained following implant placement. Bone-related markers were analyzed in bone biopsies using an immunoenzymatic assay. RESULTS: Greater gain in Keratinized Mucosa Width (KMW) was observed in the dPTFE (1.33 ± 0.98 mm) compared to USH (0.59 ± 0.98 mm) (Mann-Whitney test, Z = 2,28, p < 0.05). USH showed a reduction of pain/discomfort, edema, and interference with daily life from the seventh day (Friedman/Wilcoxon test, maxT = 7.48, 8.00, and 5.92, respectively, p < 0.05). dPTFE presents a reduction of edema and interference with daily life from the 7th day and pain/discomfort from the 14th day (Friedman/Wilcoxon test, maxT = 5.40, 5.26, and 4.78, respectively, p < 0.05). The dPTFE group presented higher pain/discomfort in the 35 and 42 days and higher edema from 7 to 42 days postoperatively than USH group (Mann-Whitney test, p < 0.05). No differences between groups were observed in the tomographic measures, immunoenzymatic analysis, and implant stability (p > 0.05). CONCLUSION: dPTFE was superior to USH by increasing KMW gain. However, dPTFE without bone graft presented similar bone loss compared to USH. This clinical trial was not registered prior to participant recruitment and randomization (NCT04329351).

Comparison between flapless-guided and conventional surgery for implant placement: a 12-month randomized clinical trial.

OBJECTIVES: The study was aimed at comparing implants installed with guided and conventional surgery. MATERIAL AND METHODS: Twenty-nine total edentulous patients were selected, and maxillary contralateral quadrants were randomly assigned to static computer-aided implant surgery (S-CAIS): flapless computer-guided surgery, and conventional surgery (CS): flap surgery with conventional planning. Tomography scans were performed at baseline and 10 days after the surgery for deviation measurement, and radiography was done at baseline and after 6 and 12 months, for peri-implant bone level (PIBL) analysis. Peri-implant fluid and subgingival biofilm were collected to evaluate bone markers and periodontal pathogens. RESULTS: S-CAIS showed less linear deviation at the apical point and the midpoint and less angular deviation (p < 0.05), with greater depth discrepancy in the positioning of the platform (p < 0.05). Higher values of vertical PIBL were observed for the S-CAIS group at baseline (p < 0.05), while lower values of horizontal PIBL were observed for CS (p < 0.05). Bone markers and Tf presented higher levels in CS (p < 0.05). Flapless S-CAIS allowed smaller linear and angular deviations than the conventional technique. CONCLUSION: However, PIBL was higher in S-CAIS; the conventional technique led to a greater angiogenic and bone remodeling activity by elevating the angiogenic levels and bone markers. CLINICAL RELEVANCE: Evaluating the different implant insertion techniques can guide clinical and surgical regarding the accuracy, the release pattern of bone markers, and the peri-implant bone level. TRIAL REGISTRATION: ReBEC-RBR-8556fzp.

Avaliação radiográfica do sucesso dos enxertos em seio maxilar quando ocorre perfuração da membrana sinusal / Radiographic evaluation of the success of the grafts in maxillary sinus when occur perforation of the sinus membrane

Com os avanços das técnicas de levantamento da membrana do assoalho do seio maxilar, associadas a enxertos dos mais diversos tipos, tornou-se realidade, a colocação de implantes dentários, em áreas desdentadas da maxila posterior atrófica. Na maioria dos casos, essa cirurgia ocorre, sem intercorrências, e o resultado final, apresenta excelentes perspectivas de reabilitação protética. Existem, porém algumas complicações nesse procedimento, e uma das mais comuns, é a perfuração da membrana sinusal no trans-operatório. Nesse procedimento, mesmo com a ruptura da membrana do assoalho do seio maxilar, os resultados podem ser satisfatórios, pois com uma manobra para fechamento dessa perfuração, há uma regeneração tanto da membrana como óssea obtida através de enxerto ósseo e assim podemos instalar os implantes e reabilitar funcional e esteticamente o paciente. Esse trabalho consistiu em relatar os resultados obtidos, em pacientes que sofreram esse tipo de intercorrência, no transoperatório, e tiveram a cirurgia prosseguida, com o protocolo de correção da fenestração. Foram analisados exames radiográficos panorâmicos iniciais e finais, e relatórios cirúrgicos das seguintes instituições: Universidade Paulista (UNIP) - Faculdade de Odontologia - Curso de Especialização em Implantodontia; Fundação para o Desenvolvimento Científico e Tecnológico da Odontologia (FUNDECTO-USP); Universidade de Uberaba (UNIUBE) e essa análise mostrou que mesmo com a perfuração os resultados na neoformação óssea são satisfatórios

With advances in techniques for lifting the membrane floor maxillary sinus, associated with grafts of all kinds, became reality, the placement of dental implants in edentulous areas of the posterior atrophic maxilla. In most cases, this surgery is without complications, and outcome, presents excellent prospects for prosthetic rehabilitation. There are however some complications in this procedure, and one of the most common is the sinus membrane perforation in surgery. In this procedure, even with the rupture of the membrane of the maxillary sinus floor, the results can be satisfactory, since with a move to close this perforation, there is a regeneration of both the membrane as obtained from bone graft and so we can install the implants and functionally and aesthetically rehabilitate the patient. This work, was to report the results obtained from patients who have suffered this type of occurrence in the trans-operative and had surgery continued, with the correction protocol of fenestration. Panoramic radiographs were analyzed initial and final, and surgical reports of the following institutions: Universidade Paulista (UNIP), Faculty of Dentistry, Specialization Course in Implant; Foundation for Scientific and Technological Development of Dentistry (FUNDECTO-USP), University of Uberaba (UNIUBE) and this analysis showed that even with the drilling, results in new bone formation are satisfactory