Immediate prosthetic rehabilitation of lower molars with hybrid internal tapered implants: report of two cases / Reabilitação protética imediata de molares inferiores com implantes cônicos internos híbridos: relato de dois casos

ABSTRACT The immediate rehabilitation of the posterior region of the mandible with dental implants, expands the set of possible actions for the dental surgeon, in the face of tooth loss. The purpose of this study is to describe two cases of single rehabilitation of mandibular molars with hybrid internal tapered implants indicated for immediate loading in post-extraction socket, associated with the maintenance of the prosthetic and peri-implant space. Implants with macrogeometry and surface treatment (Hydrophilic) were used to optimize primary stability, as well as the type of internal connection and prosthetic abutments that allows better accommodation and healing of adjacent tissues, and protection of the bone graft. Different methodologies of surgical guides did not influence the final result. The predictability of associating techniques and components can be observed in the 2-year follow-up. The initial planning combined with the new technologies enable to achieve stable and functional final restorations.

RESUMO A reabilitação imediata da região posterior da mandíbula com implantes dentários, amplia o conjunto de ações possíveis ao cirurgião dentista, frente as perdas dentárias. O intuito desse estudo é descrever dois casos de reabilitação unitária de molares inferiores com implantes cônicos internos híbridos indicados para carregamento imediato em alvéolos pós-extração, associado a manutenção do espaço protético e peri-implantar. Foram utilizados implantes com macrogeometria e tratamento de superfície que otimizassem a estabilidade primária (Hidrofílicos), bem como o tipo de conexão interna e abutments protéticos que permitisse melhor acomodação e cicatrização dos tecidos adjacentes, e proteção do enxerto ósseo. Diferentes metodologias de guias cirúrgicos não influenciaram o resultado final. A previsibilidade da associação de técnicas e componentes pode ser observada no follow-up de 2 anos. O planejamento inicial aliado às novas tecnologias permite restaurações finais estáveis e funcionais.

Peri-implant bone level assessment of early loaded dental implants submitted to different prosthetic protocols: a case report / Avaliação do nível ósseo peri-implantar de implantes dentários com carregamento antecipado submetidos a protocolos protéticos diferentes: relato de caso

Aim: The present split-mouth case report aims to describe the clinical and radiographic long-term outcomes of the implant rehabilitation of two mandibular premolars in which the digital workflow was used to apply different prosthetic protocols. Case description: A female 42-year-old patient with the absence of both mandibular second premolars was submitted to guided surgery for the placement of platform-switching Grand Morse connection implants. Digital workflow was used for implant and prosthetic planning, applying early loading protocol 21 days after surgery. The implant on the right side received the final abutment at the time of surgery (without loading), whereas the implant on the left side had a healing abutment placed, which was replaced by a temporary abutment and then by a final abutment. Two months after surgery, both implants had final ceramic restorations delivered. The patient was followed clinically and radiographically for 30 months, presenting excellent hard and soft tissue outcomes, with bone level changes lower than 2mm for both implants. Conclusion: The use of digital workflow and early loading, made the present implant-supported rehabilitation predictable, safe and time-efficient, resulting in total patient satisfaction. Peri-implant bone level was observed to be stable after early loading protocol for both platform-switching connection implants inserted, despite the prosthetic protocol applied.(AU)

Objetivo: O presente relato de caso de boca dividida tem como objetivo descrever os resultados clínicos e radiográficos a longo prazo da reabilitação com implante de dois pré-molares inferiores em que o fluxo de trabalho digital foi usado para aplicar os conceitos de "one abutment-one time" em uma das reabilitações e troca de componente no outro. Descrição do caso: Paciente do sexo feminino, 42 anos, com ausência de ambos os segundos pré-molares inferiores, foi submetida à cirurgia guiada para colocação de implantes de conexão Grand Morse plataforma-switching. Foi utilizado fluxo de trabalho digital para planejamento de implante e prótese, aplicando protocolo de carga antecipada 21 dias após a cirurgia. O implante do lado direito recebeu o componente protético definitivo no momento da cirurgia (sem carga), enquanto o implante do lado esquerdo recebeu um cicatrizador, que foi substituído por um pilar provisório e depois por um componente definitivo. Dois meses após a cirurgia, ambos os implantes tiveram restaurações cerâmicas finais entregues. A paciente foi acompanhada clínica e radiograficamente por 30 meses, apresentando excelentes resultados de tecidos duros emoles, com alterações do nível ósseo inferiores a 2mm para ambos os implantes. Conclusão: O fluxo de trabalho digital e carregamento precoce, tornou a presente reabilitação implantossuportada previsível, segura e eficiente em termos de tempo, resultando em total satisfação do paciente. O nível ósseo peri-implantar foi observado como estável após o protocolo de carregamento inicial para ambos os implantes de conexão plataforma-switching inseridos, independente do protocolo protético aplicado. (AU)

Prospective Evaluation of Bone Remodeling in Full-Arch Rehabilitations with Morse Taper Implants: A Case Series Study with One-Year Follow-Up.

This case series study evaluated the survival, success rate and marginal bone remodeling of Morse taper hydrophilic implants placed for full-arch rehabilitations over a 1-year follow-up period. Ten patients in need of maxillary and/or mandibular full-arch rehabilitation were selected. Sixty-six Morse taper implants and sixty-six abutments were inserted. All implants were placed using a surgical flap approach without bone regeneration and were immediately loaded with definitive prostheses according to the passive fitting technique. The patients underwent clinical and radiographic follow-up at different postoperative periods: T0 = immediate (up to 1 month after surgery); T1 = 3-4 months after surgery; T2 = 6-8 months after surgery; and T3 = 1 year after surgery. The survival and success rate of the implants and the marginal bone remodeling were evaluated. Normal distribution of the outcomes was verified by Kolmogorov-Smirnov tests. Therefore, changes in vertical and horizontal marginal bone levels were assessed with paired t-tests. Results were considered significant for P < 0.05. Survival and success rates of 100% and 92.4%, respectively, were observed. Statistically significant vertical bone level changes were shown for all periods. From T0 to T3, there was a mean difference in vertical bone loss of -1.02 mm on the mesial surface and of -0.93 mm on the distal surface, for horizontal bone loss in the same period, it was observed mean changes of -0.14 mm on the mesial surface and -0.09 mm on the distal surface. This 1-year case series follow-up of immediate full-arch rehabilitation, using one-step hybrid passive fitting supported by four to six hydrophilic tapered implants, suggests predictability with high survival and success rates in edentulous patients.

Clinical and radiographic outcomes of maxillary lateral incisors rehabilitation using Morse taper connection extra-narrow implants at 12-month follow-up: A case report.

Narrow-diameter implants (≤3.5 mm) have been proposed to address the challenge of implant placement in cases of insufficient bone quantity, thin alveolar crest, and small cervical diameter teeth replacement The aim of this study is to report one-year outcomes of extra-narrow implant rehabilitation of maxillary lateral incisors, due to agenesis, in a young adult that presented sites with reduced mesiodistal and buccolingual dimensions. A 26-year-old male patient in need of fixed-implant supported prostheses due to the absence of permanent maxillary lateral incisors and with limited space, was submitted to surgery to receive two 2.9 mm hybrid Morse taper connection implants with hydrophilic surfaces. Immediate loading was applied by means of insertion of provisional prostheses, which were replaced for all-ceramic prostheses 12 months after surgery. The 1 year follow-up showed clinical and radiographic success of extra-narrow implant rehabilitation. Also, both regions presented good evolution of peri-implant esthetics, as assesses using the pink esthetic score, with improvements at 4 months follow-up and reaching high scores 12 months after surgery. Although the prosthetic rehabilitation of maxillary lateral incisors is challenging due to limited space for the insertion of implants, the clinical case suggests that the use of extra-narrow Morse Taper implants with hybrid design and hydrophilic surface is a reliable alternative, presenting good outcomes regarding hard and soft tissue and it is a versatile solution or immediate loading procedure. Further studies are needed to confirm extra-narrow implant predictability.

Retrospective Multivariate Clinical Analysis of 2707 Dental Implants with Hydrophilic and Hydrophobic Surfaces: Survival Rates after Up to 5 Years.

The aim of this retrospective study was to evaluate the long-term predictability of treatment using implants with hydrophobic and hydrophilic surfaces, according to clinical parameters and survival rates. Records from all patients who received dental implants between January 2013 and December 2014 at ILAPEO College were fully evaluated by two graduate dentists. Records with incomplete or unclear data were excluded from the study. The variables evaluated were demographic data, design of implants and prosthetic components, type of loading, data related to the patients' general health, and survival of implants and prostheses. The final retrospective sample comprised 776 patients with 2707 implants, with up to 5 years of follow-up. Survival rates of implants and prostheses were 97.93% and 98.77%, respectively. Implants with hydrophobic (97.87%) and hydrophilic (98.34%) surfaces exhibited similar survival rates. Considering the different types of loading, there was no statistically significant difference between loading protocols regarding implant survival rates. Unsuitable healing capacity, uncooperative and not motivated patient, loss of prosthesis, and peri-implant bone loss were confirmed statistically to be factors that may contribute to implant loss, according to hazard ratio and odds ratio. The present study showed similar and high overall survival rates for implant with both types of surfaces, in the long term. The surface treatment, implant model and loading protocol had no significant influence on implant loss. Therefore, the evaluated implant systems were able to offer a high predictability for both hydrophobic and hydrophilic implants.

Implant and prosthesis survival rates of full-arch immediate prostheses supported by implants with and without bicortical anchorage: Up to 2 years of follow-up retrospective study.

OBJECTIVES: To compare implant and prosthesis survival rates between full-arch immediate prostheses supported by 4 hydrophilic implants with bicortical anchorage and by 5 or 6 hydrophilic implants placed without bicortical anchorage. MATERIAL AND METHODS: The sample was retrospectively selected and comprised completely edentulous patients treated with full-arch immediate prostheses supported by Morse Taper hydrophilic implants. The selected patients were divided into four groups, according to the region of implant placement and type of anchorage. Differences in implant and prosthesis survival rates between groups, as well as the influence of bicortical anchorage on implant primary stability, were verified using Fisher's exact tests (significant at p < .05). RESULTS: The sample comprised 392 implants, 72 were placed in the maxilla with bicortical anchorage, and 85 were placed without. In the mandible, 140 implants were placed with and 95 were placed without bicortical anchorage. The follow-up period was up to 24 months. A 98.8% implant survival rate was observed for the group of implants placed without bicortical anchorage in the maxilla, and of 100% for the other groups. The overall implant survival rate was 99.7% (391 of 392 implants). Prosthesis survival rate was 100% for all groups. No differences were observed between groups with respect to implant and prosthesis survival rates. Significantly higher primary stability was observed for implants placed with bicortical anchorage in both jaws. CONCLUSION: Predictable results and high survival rates were achieved within the period evaluated by the present retrospective study, with immediate full-arch prostheses when only four hydrophilic implants are placed bicortically.

Surgical and Prosthetic Outcomes of 967 Implants Under Immediate or Delayed Loading in Full-Arch Rehabilitation: a Retrospective Study With up To 5 Years of Follow-Up / Resultados Cirúrgicos e Protéticos de 967 Implantes Submetidos à Carga Imediata ou Tardia Na Reabilitação de Arcos Completos: um Estudo Retrospectivo com Até 5 Anos de Acompanhamento

Objective: The aim of this study was to evaluate implant and prosthesis survival rates in full-arch rehabilitation supported by implants with platform-switched Morse taper connection submitted to immediate or delayed loading, after up to 5 years of follow-up. Material and Methods: Data was retrospectively collected from clinical records of patients who were treated by means of implant-supported full-arch rehabilitation. Survival rates of implants and prostheses were evaluated according to immediate or delayed loading. Results: The sample comprised 967 implants. Of those, 627 were submitted to immediate loading (IL) while 340 to delayed loading (DL). After a follow-up period of up to 5 years, the implant survival rate for IL was of 99.7% (622/627 implants) and 97.2% (333/340 implants) for DL. The overall implant survival rate was 98.8% (955/967 implants). Prosthesis survival rate was 100% (N = 178) for both groups. Significantly more implants in the DL group presented bone loss (p > 0.01), either greater or lower than 2 mm, during the follow-up period. Conclusion:Within their limits, the present results suggest that full-arch rehabilitation with platform-switched Morse taper connection implants can lead to surgical and prosthetic predictable outcomes. Moreover, immediate loading protocol seems to be a good option for the rehabilitation of fully edentulous patients, as it involves a shorter treatment time, which may lead to greater patient satisfaction. (AU)

Objetivo: O objetivo deste estudo foi avaliar as taxas de sobrevivência de implantes e próteses em reabilitações de arco completo suportadas por implantes de conexão cone Morse e platform switching submetidos à carga imediata ou tardia, após até 5 anos de acompanhamento. Material e Métodos: Os dados foram coletados retrospectivamente em prontuários clínicos de pacientes que foram tratados por meio de reabilitação de arco completo suportada por implantes. As taxas de sobrevivência de implantes e próteses foram avaliadas de acordo com a carga imediata ou tardia. Resultados: A amostra foi composta por 967 implantes. Destes, 627 foram submetidos à carga imediata (IL) e 340 à carga tardia (DL). Após um período de acompanhamento de até 5 anos, a taxa de sobrevivência de implantes para IL foi de 99,7% (622/627 implantes) e de 97,2% (333/340 implantes) para DL. A taxa de sobrevivência geral dos implantes foi de 98,8% (955/967 implantes). Taxa de sobrevivência da prótese de 100% (N = 178) foi encontrada para ambos os grupos. Significantemente mais implantes no grupo DL apresentaram perda óssea (p > 0,01), seja maior ou menor que 2 mm, durante o período de acompanhamento. Conclusão: Os presentes resultados sugerem, dentro de seus limites, que a reabilitação de arco completo com implantes de conexão cone Morse e platform switching pode obter resultados cirúrgicos e protéticos previsíveis. Além disso, o protocolo de carga imediata parece ser uma boa opção para a reabilitação de pacientes totalmente edêntulos, pois envolve um menor tempo de tratamento, o que pode levar a uma maior satisfação do paciente (AU)

Simplificação da técnica para reabilitação de maxila atrófica com implantes zigomáticos com interface cônica interna e carregamento imediato: relato de caso / Simplification of the technique for rehabilitation of atrophic upper jaw with zygomatic implants with internal tapered interface and immediate loading: case report

A reabilitação de maxilas atróficas com implantes dentários é sempre um desafio, visto que o uso de enxertos ósseos é quase sempre necessário para estabilização dos implantes. Os implantes zigomáticos têm sido utilizados como uma opção viável ao uso de procedimentos de enxertia óssea anterior à cirurgia. A interface cônica interna apresenta gap reduzido entre implante e componente protético, mostrando resultados biológicos e estéticos satisfatórios a longo prazo. Este artigo tem como objetivo relatar a reabilitação protética imediata de uma maxila atrófica com implantes convencionais e zigomáticos com interface cônica interna como opção ao uso de enxertos ósseos prévios. Paciente com 47 anos de idade, do sexo masculino, apresentava maxila atrófica e usava uma prótese total superior. O paciente foi reabilitado com quatro implantes convencionais na região anterior e dois implantes zigomáticos cônicos internos instalados nos ossos zigomáticos. Os torques de instalação dos implantes ≥ 60 N.cm proporcionaram estabilidade primária ideal e uma prótese (protocolo) foi instalada imediatamente utilizando a técnica do assentamento passivo. O caso clínico apresentado mostrou que, após 1 ano, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes zigomáticos combinados com implantes convencionais para reabilitação de maxilas atróficas de forma imediata e sem utilização de enxerto ósseos prévios.

The rehabilitation of atrophic upper jaws with dental implants is always a challenge, since the use of bone grafts is almost always necessary to stabilize the implants. Zygomatic implants have been used as a viable option for the use of bone grafting procedures prior to surgery. The internal tapered interface presents a reduced gap between implant and prosthetic component, showing satisfactory long-term biological and aesthetic results. This article aims to report the immediate prosthetic rehabilitation of an atrophic upper jaw with conventional and zygomatic implants with an internal tapered interface as an option for the use of previous bone grafts. A 47-year-old male patient presented with an atrophic upper jaw and used an upper total prosthesis. The patient was rehabilitated with four conventional implants in the anterior region and two internal tapered zygomatic implants placed in the zygomatic bones. The implant placement torques ≥ 60 N.cm provided ideal primary stability and a prosthesis (protocol) was installed immediately using the passive fit technique. The clinical case presented showed that, after 1 year, accurate and aesthetic results are possible to achieve with the placement of zygomatic implants combined with conventional implants for the rehabilitation of atrophic upper jaws immediately and without the use of previous bone grafts.

Retrospective Clinical Study of 453 Novel Tapered Implants Placed in All Bone Types: Survival Rate Analysis Up to 2 Years of Follow-Up.

PURPOSE: The aim of this retrospective study was to report the survival rate of a novel hybrid hydrophilic dental implant design for all bone types. MATERIALS AND METHODS: This study evaluated the data collected from patients who received at least one implant to support a full-arch, partial, or single-crown dental rehabilitation in the maxilla or mandible. Implant survival rate was evaluated according to the clinical area and bone type, loading protocol, implant length and diameter, and placement torque. RESULTS: A total of 453 tapered hybrid implants placed in 101 patients (mean age: 56.39 ± 12.98 years) were evaluated, and the survival rate was 99.6%. The follow-up period was up to 24 months. Regarding bone quality, types I, III, and IV presented a 100% survival rate, whereas type II presented a 99.3% survival rate. The vast majority of implants were immediately loaded (443 implants), which achieved placement torques between 32 and 60 Ncm or higher, and presented an implant survival rate of 99.5%. CONCLUSION: An overall survival rate of 99.6% was found for hydrophilic hybrid dental implants when placed in all bone types, and no statistically significant difference was observed between them. However, further studies should be necessary to confirm these preliminary results.

Guided osteotomy and implants placed with free hands for double full arch rehabilitation with immediate prosthetic loading / Osteotomia guiada e implantes instalados com as mãos livres para reabilitação de arco duplo total com carga protética imediata

ABSTRACT Precise planning for dental implant placement requires appreciation of anatomical limitations and restorative purpose. Diagnosis can be made by complementary exams such as panoramic radiography and cone-beam computed tomography. The purpose of this study was to rehabilitate the upper and lower jaw of a patient with severe periodontal disease using a guided osteotomy and implants placed with free hands and Morse taper implants. The concept of guided surgery was used to prepare the alveolar bone to place eight implants, four implants in the upper jaw and four implants in the lower jaw, all have achieved a minimum torque of 60 Ncm. The modified suture technique was used to better stabilize the soft tissue around the mini conical abutments. The analogues were scanned by CAD/CAM for confection of the metallic structures of the bridges. On the third day, the upper and lower full arch prostheses were installed and simultaneous bilateral contacts were adjusted. After 12 months of patient follow-up, the implants and prostheses were in good condition of aesthetics and function, maintaining the success of the rehabilitation. Within the limitations of this clinical case, it can be concluded that the implants placed with free hands was facilitated by a previous guided osteotomy.

RESUMO O planejamento preciso para a instalação de implantes dentários requer a apreciação das limitações anatômicas e objetivos restaurativos. O diagnóstico pode ser feito por exames complementares, como radiografia panorâmica e tomografia computadorizada de feixe cônico. O objetivo deste estudo foi reabilitar, a mandíbula superior e inferior de um paciente com doença periodontal severa, utilizando uma osteotomia guiada e implantes cone Morse instalados com as mãos livres. O conceito de cirurgia guiada foi utilizado para preparar o osso alveolar para a instalação de oito implantes, quatro implantes no maxilar superior e quatro implantes no maxilar inferior, todos alcançando um torque mínimo de 60 Ncm. A técnica de sutura modificada foi utilizada para melhor estabilizar o tecido mole ao redor dos mini-pilares cônicos. Os abutments foram escaneados por CAD/CAM para confecção das estruturas metálicas das próteses dentárias. No terceiro dia, as próteses de arco superior e inferior foram instaladas e os contatos bilaterais simultâneos foram ajustados. Após 12 meses de acompanhamento do paciente, os implantes e próteses estavam em boas condições de estética e função, mantendo o sucesso da reabilitação. Dentro das limitações deste caso clínico, pode-se concluir que os implantes instalados com as mãos livres foram facilitados pelo uso prévio da osteotomia guiada.

Previsibilidade na Instalação Imediata de Implante Cone Morse pelo Planejamento Digital e Provisionalização Imediata: Relato de Caso / Predictability in Immediate Implant Placement of Morse Taper by Digital Planning and Immediate Provisionalization: Case Report

A instalação imediata de implantes em região estética é uma prática frequente, pois reduzir a remodelação óssea e tecidual. Os implantes com interface cone Morse apresentam resultados biológicos e estéticos satisfatórios a longo prazo, pois apresentam gap reduzido entre implante e componente protético e a interface fica distante do tecido ósseo. Este artigo tem como objetivo relatar a reabilitação estética de um incisivo central superior comprometido através da instalação de um implante cone Morse utilizando a técnica da cirurgia guiada com provisionalização imediata. Paciente com 40 anos de idade, do sexo masculino, apresentava incisivo central superior (#21) com tratamento endodôntico prévio, recessão gengival vestibular, escurecimento coronário e mobilidade. O caso clínico apresentado mostrou que, após 12 meses, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes em alvéolos pós-extração e instalação de um dente provisório imediato em regiões estéticas.

The immediate placement of implant in fresh sockets in the aesthetic area is a frequent practice as it reduces bone and tissue remodeling. Morse taper implants present satisfactory biological and aesthetic results in the long term, since they present a reduced gap between implant and prosthetic component and this interface is distant from bone. This article aims to report the aesthetic restoration of a compromised central upper incisor with the placement of a Morse taper implant using guided surgery with immediate provision. A 40-year-old male patient had a central upper incisor (#21) with previous endodontic treatment, vestibular gingival recession, coronary browning, and mobility. The clinical case presented showed that, after 12 months, precise and aesthetic results are possible to achieve with the placement of implants in post-extracting alveolus and installation of an immediate provisional tooth in esthetic regions.

Implante imediato com a técnica Socket Shield ­ relato de uma complicação / Immediate implants according to Socket Shield technique ­ report of a complication

A técnica socket shield é descrita como a retenção parcial de uma raiz em combinação com a instalação imediata de implantes. Tem como justificativa principal a manutenção do tecido ósseo vestibular em áreas estéticas. O objetivo deste artigo é relatar um caso clínico no qual uma série de implantes foi instalado, entre eles, um de acordo com a técnica socket shield e descrever uma situação clínica observada. Em avaliação clínica e tomográfica, após um ano em função, observou-se o deslocamento do fragmento radicular com reabsorção da parede óssea vestibular, porém sem sintomatologia clínica ou perda de função do implante. A pressão exercida durante a instalação do implante provocou o deslocamento do remanescente dentário. Posteriormente, em acompanhamento de 3 anos, observou-se manutenção e estabilização do fragmento deslocado. Pode ser concluído que a pressão exercida durante a instalação do implante provocou o deslocamento gradativo do remanescente dentário mantido propositalmente durante a instalação de um dos implantes. Porém, a prótese implantossuportada manteve-se em função (AU).

Socket shield technique is described as the partial retention of a root fragment combined to the immediate installation of an implant. It is justified by the maintenance of bone tissue in aesthetic areas. The aim of this paper is to report a clinical case in which a series of implants was inserted, one of them according to the socket shield technique, and to describe a related complication. In a clinical and tomographic evaluation, after one year in function, it was observed the displacement of the root fragment with reabsorption of the vestibular bone wall, but with no clinical symptomatology or loss of implant function. Afterwards, in the 3-year follow-up, it was observed maintenance and stabilization of the displaced fragment. It can be concluded that there was a complication in the technique observed by the buccal displacement of the intentionally left root fragment during the insertion of one implant. Nevertheless, the implant supported prosthesis remained in function (AU).

Retrospective evaluation of the survival rate of single tooth prostheses supported in external hexagonal implants: mean follow-up of 9 years / Avaliação retrospectiva do índice de sobrevivência de próteses unitárias suportadas em implantes de hexágono externo: média de acompanhamento de 9 anos

Introduction: The use of osseointegrated dental implants for the rehabilitation of patients has revolutionized dentistry. Objective: To retrospectively evaluate the survival rate and the frequency of complications with external hexagon platform supporting single crowns. Material and method: Dental forms of 110 patients who received 143 implants at the Ilapeo College (2004-2015) were used. The variables were: age, gender, systemic involvement at the time of surgery, region, implant design, type of surface, fixation system, pillar type and prosthesis material. The outcome variables were the incidence of complications in the implant or prosthesis and time in use. The mean follow-up period was 9 years. Result: 32.8% had some systemic disease. Ninety-six implants (67.1%) were installed in the maxilla and 47 (32.9%) in the mandible, 87 (60.8%) were in the posterior region and 56 (39.2%) in the anterior region, while 40 (28%) were placed in regions that had received bone reconstruction. The majority (97.2%) of the implants presented surface treatment, 42% had a cylindrical design and 58% were tapered. The majority of the prosthetic components (89.6%) used were UCLAs and most of the prostheses were fused-to-metal (79.7%). The rate of prosthetic complications was 19.58% and three implants had been lost (97.9% survival rate). There was no statistical difference between the variables analyzed for both the occurrence of prosthetic complications and for the loss of the implant. Conclusion: Implants with external hexagon connection were an effective and predictable option to support crowns and had high survival rates.

Introdução: O uso de implantes dentários osseointegrados para a reabilitação de pacientes revolucionou a Odontologia. Objetivo: Avaliar retrospectivamente o índice de sobrevivência e a frequência de complicações com plataformas de hexágono externo suportando coroas unitárias. Material e método: Foram utilizados prontuários de 110 pacientes que receberam 143 implantes na Faculdade Ilapeo (2004-2015). As variáveis foram: idade, sexo, envolvimento sistêmico no momento da cirurgia, região, desenho do implante, tipo de superfície, sistema de fixação, tipo de pilar e material da prótese. As variáveis de desfecho foram a incidência de complicações nos implantes e/ou próteses e o tempo em função. O tempo médio de acompanhamento foi de 9 anos. Resultado: 32,8% apresentavam alguma alteração sistêmica. Noventa e seis implantes (67,1%) foram instalados na maxila e 47 (32,9%) na mandíbula, 87 (60,8%) estavam em região posterior e 56 (39,2%) em região anterior, enquanto 40 (28%) necessitaram reconstrução óssea prévia. A maioria dos implantes (97,2%) apresentava tratamento de superfície, 42% eram cilíndricos e 58% cônicos. A maioria dos componentes protéticos (89,6%) eram UCLAs e a maioria das próteses fundidas em metal (79,7%). O índice de complicações protéticas foi de 19,58% e 3 implantes foram perdidos (97,9% de índice de sobrevivência). Não houve diferença estatística em relação às variáveis estudadas e a ocorrência de complicações protéticas e perda de implantes. Conclusão: Implantes com plataforma de hexágono externo são uma opção efetiva e previsível de reabilitação unitária e apresenta elevado índice de sobrevivência.

Estudo observacional retrospectivo sobre o índice de sobrevivência de implantes com superfície com aumento de molhabilidade / A retrospective observational study of the survival rate of implants with larger wettability surface

O propósito desse estudo foi avaliar, retrospectivamente, o índice de sobrevivência de implantes com tratamento de superfície para aumento de molhabilidade instalados em ambos os maxilares e submetidos ou não à carga imediata. Um total de 78 pacientes (17 homens e 61 mulheres), nos quais 182 implantes foram instalados, compuseram a amostra. Todos os implantes foram instalados em pacientes com diferentes situações clínicas, podendo ser reabilitações unitárias, parciais ou totais, nos cursos de pós-graduação do Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO), entre 2011 e 2015. Cento e dezenove implantes (65,38%) foram instalados em maxila e 63 (34,61%) em mandíbula, sendo que em 156 (85,71%) foi aplicada carga imediata. O índice de sobrevivência total foi de 98,90% (180 implantes). Houve perda de apenas 2 implantes instalados em maxila. A perda foi constatada após 5 semanas em ambos os casos. Consideradas as características do estudo, a metodologia aplicada, o tamanho e as características da amostra, o tempo de acompanhamento, bem como a diversidade de variáveis daí decorrentes, parece aceitável concluir, com base nos resultados aqui encontrados e discutidos, que os implantes com tratamento de superfície com aumento de molhabilidade, ora observados, apresentaram altas taxas de sobrevivência dentro dos critérios estabelecidos neste estudo (AU).

The aim of this study was to evaluate, retrospectively, the survival rates of implants with surface treatment that increased wettability, installed in both jaws, and submitted or not to immediate loading. The sample was composed of 78 patients (17 men and 61 women), in which 182 implants were installed. All implants were installed by dentists in post-graduate courses of the Latin American Institute of Research and Dental Education (ILAPEO), between 2011 and 2015. One hundred and nineteen implants (65.38%) were installed in the maxilla and 63 (34.61%) in the mandible, and 156 (85.71%) was applied immediate load. The overall survival rate was of 98.90% (180 implants). Only 2 implants placed in the maxilla were lost, and in both cases the loss was noticed after 5 weeks. Considering the parameters of the study, the methodology, sample size and characteristics, follow-up period and diversity of the variables, it seems acceptable to conclude, based on the present discussed results, that the implants with surface treatment with increased wettability, presented high survival rates according to the criteria considered in this study (AU).