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1.
J Prosthet Dent ; 125(4): 683.e1-683.e8, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33583618

RESUMEN

STATEMENT OF PROBLEM: Although luting space is related to the marginal fit of indirect restorations, information on its influence on the marginal fit and tensile strength of zirconia abutments bonded to titanium bases is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the influence of luting space on the marginal discrepancy and tensile strength of zirconia abutments bonded to a titanium base after dynamic loading. MATERIAL AND METHODS: Ninety implant replicas were embedded in resin blocks to attach 4-mm-high titanium luting bases. Zirconia abutments (Ceramill Zolid FX) were fabricated with different internal luting spaces: 25 µm (G25), 50 µm (G50), or 75 µm (G75). The zirconia abutments were cemented on the titanium bases by using a resin cement (Panavia F 2.0) under a constant load of 20 N. The marginal discrepancy and internal fit of 10 random specimens from each group were evaluated with a stereoscopic microscope at ×50 magnification. The remaining specimens were submitted to the tensile strength test in which half were evaluated after dynamic loading (1.2 million cycles of 200 N at 3.8 Hz) in a mechanical fatigue machine. The tensile strength test was performed using a pullout apparatus coupled to a universal testing machine at a crosshead speed of 0.5 mm/min. The mode of failure was determined by observation at ×50 magnification under a stereomicroscope and classified into adhesive or mixed. The groups were compared by using 2-way ANOVA and the Tukey HSD test (α=.05). RESULTS: Increase in the luting space did not influence the marginal discrepancy (P>.05). All zirconia abutments exhibited lower pullout strength after fatigue simulation (P<.05). G75 demonstrated lower tensile strength than G25 and G50 before and after loading (P<.05). Most failures were adhesive at the zirconia-cement interface. CONCLUSIONS: The increase of the luting space to 75 µm did not influence marginal discrepancy; however, it reduced the tensile strength of a zirconia abutment bonded to a titanium base.

2.
Dent Mater ; 2020 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-33276957

RESUMEN

OBJECTIVE: To evaluate the influence of resin-matrix ceramic material and thickness on reliability and stress distribution of occlusal veneers (OV). METHODS: One hundred and twenty-six OV of a mandibular first molar were milled using a CAD/CAM system and allocated according to materials (resin nanoceramic (RNC) or polymer-infiltrated ceramic network (PICN)) and thicknesses (0.5, 1.0 and 1.5 mm), totaling six groups (RNC0.5, RNC1, RNC1.5, PICN0.5, PICN1, and PICN1.5). Step-stress accelerated-life testing was performed (n = 21/group) with the load applied at the distobuccal cusp tip of the occlusal veneer until failure or suspension. The use level probability Weibull curves and reliability were calculated and plotted (90% CI). Finite element analysis evaluated the stress distribution according to maximum principal stress (σmax) on the restoration and maximum shear stress (τmax) on the cement layer. RESULTS: There was no difference in the probability of survival for the estimated missions among the groups, except at 600 N in which the results were significantly lower to PICN1.5 (6%) compared to RNC1 (55%) and RNC1.5 (60%). The σmax values were higher for PICN (31.85-48.63 MPa) than RNC (30.78-33.09 MPa) in the same thicknesses. In addition, 0.5 mm groups concentrated more stress in the restoration (33.09-48.63 MPa) than 1.0 mm (31.11-35.36 MPa) and 1.5 mm (30.78-31.85 MPa) groups in the same material. SIGNIFICANCE: Both resin-matrix ceramic materials seem up-and-coming restorative systems for occlusal veneers irrespective of the thicknesses as a consequence of the high reliability.

3.
Dent Mater ; 2020 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-33234316

RESUMEN

OBJECTIVE: To evaluate the influence of hydrophilicity on the surface integrity of implants after insertion in low-density artificial bone and to determine the distribution of titanium (Ti) particles along the bone bed. METHODS: Forty-eight dental implants with different designs (Titamax Ex, Facility, Alvim, and Drive) and surface treatments (Neoporos® and Aqua™) were inserted into artificial bone blocks with density compatible with bone type III-IV. Hydrophobic Neoporos® surfaces were obtained by sandblasting and acid etching while hydrophilic Aqua™ surfaces were obtained by sandblasting, acid etching, and storage in an isotonic 0.9% NaCl solution. The surface integrity was evaluated by Scanning Electron Microscope (SEM) and the surface roughness parameters (Sa, Sp, Ssk, Sdr, Spk, Sk, and Svk) and surface area were measured with Laser Scanning Confocal Microscopy before and after installation. Bone beds were inspected with Digital Microscopy and micro X-Ray Fluorescence (µ-XRF) to analyze the metallic element distribution along the bone bed. RESULTS: Acqua™ implants had higher initial Sa and a pronounced reduction of Sa and Sp during insertion, compared to NeoPoros® implants. After insertion, Sa and Sp of Acqua™ and NeoPoros® implants equalized, differing only between designs of Acqua™ implants. Surface damage was observed after insertion, mainly in the apical region. Facility implants that are made of TiG5 released fewer debris particles, while the highest Ti intensity was detected in the cervical region of the Titamax Ex Acqua™ and Drive Acqua™ implants. SIGNIFICANCE: Physicochemical modifications to achieve surface hydrophilicity created a rougher surface that was more susceptible to surface alterations, resulting in more Ti particle release into the bone bed during surgical insertion. The higher Ti intensities detected in the cervical region of bone beds may be related to peri-implantitis and marginal bone resorption.

4.
Braz Oral Res ; 34: e113, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965459

RESUMEN

Here, the prevalence of oral candidiasis and denture stomatitis among diabetic patients compared to healthy ones was summarized through a systematic review with meta-analysis. Medline, Scopus, Web of Science, Lilacs, Cochrane Library, Embase, and the grey literature were searched without restriction, until May 2020. Eligibility criteria were established, data were extracted, and quality assessment was conducted by two trained examiners. Qualitative synthesis was based on the recommendations of Fowkes and Fulton. Two meta-analyses were performed on studies investigating patients with: a) oral candidiasis and b) denture stomatitis. Out of 6034 screened studies, seven were eligible for qualitative and quantitative synthesis; of these, three evaluated oral candidiasis and four evaluated denture stomatitis. Qualitative synthesis showed that the main methodological problems of the studies included sample size, source of controls, matching, and randomization. Diabetic patients had a similar chance of developing oral candidiasis to non-diabetic patients (OR1.40 [0.96; 2.04], p = 0.08, I2 = 94%). However, diabetic patients had a higher chance to present denture stomatitis compared to non-diabetic patients (OR 1.92 [1.42, 2.59] p < 0.0001, I2 = 0%). Therefore, diabetic patients have a higher chance of developing denture stomatitis compared to non-diabetic patients. However, for all analyses, the certainty of the evidence was considered to be very low.


Asunto(s)
Candidiasis Bucal , Diabetes Mellitus , Estomatitis Subprotética , Candidiasis Bucal/epidemiología , Diabetes Mellitus/epidemiología , Humanos , Estomatitis Subprotética/epidemiología
5.
Toxicon ; 187: 116-121, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32882256

RESUMEN

Analgesic mechanism of Botulinum toxin type A (BoNT/A) involves retrograde axonal transport to central nervous system, where it may interact with sensory neurons. Though, some authors suggested that BoNT/A antinociceptive action may also be associated with the inhibition intracellular factors and neuromodulators expressed by immune cells, especially by microglia. Antigen-induced arthritis in the temporomandibular joint (TMJ) of rats is signal by P2X7 receptor/Cathepsin S (CatS)/Fractalkine (FKN) microglia-activated pathway. Thus, we aimed to evaluate the possible modulatory effect of an intra-TMJ injection of BoNT/A on the P2X7/CatS/FKN microglia-activated pathway in the trigeminal subnucleus caudalis of rats with antigen-induced arthritis of the TMJ. A model of antigen-induced arthritis was used on Wistar rats (n = 40) by systemic injections of an emulsion containing complete Freund's adjuvant and methylated bovine serum albumin (mBSA) diluted in PBS. The arthritic condition was stablished by an intra-TMJ injection of mBSA (10 µg/TMJ/week) for 3 weeks. Then, animals were treated with an intra-TMJ injection of BoNT/A (onabotulinumtoxinA, Allergan®; 7U/kg) or vehicle saline. Animals were euthanized 24 h, 7 or 14 days after BoNT/A treatment and their trigeminal nucleus caudalis was harvested to evaluate the protein level of microglial purinergic P2X7 receptor and CX3 chemokine receptor 1 (CX3CR1) by Western blot, and to measure the protein level of microglial modulators CatS, FKN, and the pro-inflammatory cytokines tumor necrosis alfa (TNF-α) and interleukin 1ß (IL-1ß) by enzyme-linked immunosorbent assay (ELISA). The antigen-induced arthritis in the TMJ significantly increased the protein levels of P2X7, CatS, FKN, TNF-α and IL-1ß in the trigeminal subnucleus caudalis (P < 0.05). The intra-TMJ injection of BoNT/A reduced the protein levels of P2X7 in all time points tested. Additionally, BoNT/A significantly reduced the protein levels of CatS, FKN, and TNF-α 14 days after treatment. However, IL-1ß was significantly reduced just 24 h after the BoNT/A intra-TMJ treatment. Based on our results, we can suggest that the intra-TMJ injection of BoNT/A may promote a central effect by reducing the P2X7/CatS/FKN microglia-activated pathway in the trigeminal subnucleus caudalis.


Asunto(s)
Toxinas Botulínicas Tipo A/uso terapéutico , Articulación Temporomandibular , Animales , Artritis Experimental/tratamiento farmacológico , Quimiocina CX3CL1/metabolismo , Adyuvante de Freund , Inyecciones Intraarticulares , Masculino , Microglía/metabolismo , Ratas , Ratas Wistar
6.
Braz Oral Res ; 34: e110, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32876123

RESUMEN

Acrylic resin has been used in the manufacture of prostheses, however, in the oral cavity, this material starts to retain microorganisms capable of causing gingival inflammation due its porosities. The aim of this study was to evaluate the influence of the use of silicon dioxide as a coating layer applied onto acrylic resin, on the adhesion of Candida albicans (Ca). After the incubation period in Sabouraud Dextrose Broth, a total of 1 ml of the Ca suspension was added to plate wells, each well containing a specimen of acrylic resin. The adhesion ability of Ca on acrylic resin was determined by counting colonies. Three groups (n = 6) of acrylic resin were assessed: with polishing (RP); without polishing (RW); with polishing and coating layer of silicon dioxide (RPC). Ca deposited on the surface of the acrylic resin was also observed using Scanning Electron Microscopy (SEM). Statistical assessment by Kruskal-Wallis and Student-Newman-Keuls Method were done (α = 2%). There was significant difference among the groups. The RPC group showed the lowest growth, with an average of 5.59 Log CFU/cm 2 ; there was a statistically significant difference in relation to group RW, which presented a growth of 6.07 Log CFU/cm 2 and to group RP with 5.91 Log CFU/cm 2 (p < 000.1). SEM images demonstrated that in the RP and RPC group, the surface of the resin had greater regularity, and smaller number of microorganisms. The application of silicon dioxide coating on acrylic resin appears to be a promising alternative, and its use can help in reducing the adhesion of Ca in prostheses.


Asunto(s)
Candida albicans , Resinas Acrílicas , Bases para Dentadura , Dióxido de Silicio , Propiedades de Superficie
7.
Arch Oral Biol ; 117: 104822, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32592931

RESUMEN

OBJECTIVE: Overcoming substantial shortcomings of soft liners as physico-chemical changes and liner-biofilm-related infections remains a challenge in the rehabilitation treatment. In this study, protective non-thermal plasma (NTP) treatments were developed on the soft liner surface to improve its surface and physico-chemical properties and to reduce fungal colonization after biofilm inhibition challenge. METHODS: Resinous liner specimens (Coe-Soft) were prepared and distributed in 3 groups according to the surface treatments: (1) untreated (control); (2) treated with sulfur hexafluoride-based NTP (SF6); and (3) treated with hexamethyldisiloxane-based NTP (HMDSO). To test the NTP stability and their protective and antimicrobial effect on the liner surface over time, the morphology, chemical composition, roughness, water contact angle, shore A hardness, sorption and solubility were evaluated before and after the specimens were exposed to dual-species biofilm of Candida albicans and Streptococcus oralis for 14 days. Colony forming units and biofilm structure were assessed. Data were submitted to ANOVA and Tukey tests (α = 0.05). RESULTS: Both treatments modified the surface morphology, increased hydrophobicity and roughness of the liner, and were effective to reduce C. albicans adhesion without affecting the commensal health-associated S. oralis. HMDSO presented chemical stability and lower hardness in both periods, whereas SF6 exhibited higher initial hardness than control and the highest sorption; contrarily, similar solubility was noted for all groups. CONCLUSION: HMDSO-based film showed improved physico-chemical properties and inhibited C. albicans biofilm. Thus, it has potential for use to control candida-related stomatitis and improve liner's stability even after being exposed to biofilm inhibition challenge.


Asunto(s)
Antiinfecciosos , Biopelículas , Alineadores Dentales , Gases em Plasma , Antiinfecciosos/farmacología , Candida albicans , Ensayo de Materiales , Gases em Plasma/farmacología , Streptococcus oralis , Propiedades de Superficie
8.
Arch Oral Biol ; 117: 104728, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32585445

RESUMEN

OBJECTIVE: To evaluate, in vitro, the effect of two glucose concentrations (0.1 mM and 1.0 mM, simulating glucose concentration in saliva of healthy and diabetic individuals) on Candida albicans biofilm grown on epithelial monolayer. MATERIAL AND METHODS: C. albicans was inoculated on epithelial monolayers supplemented with 0.1 mM, 1.0 mM or no glucose. Control groups without C. albicans were also evaluated. Tissue response was assessed through the production of Interleukin-1α, Interleukin-8, Interleukin-6, Interleukin-10 and tumor necrosis factor-α. The complex of monolayer and biofilms were evaluated by quantitative reverse transcription polymerase chain reaction for expression of E-cadherin (CDH1), Caspase-3 (CASP3), ß-defensin-1 (DEFB-1) and ß-defensin-3 (DEFB-3). The biofilm architecture was visualized by confocal laser scanning microscopy. RESULTS: The production of Interleukin-1α and Interleukin-8 were increased in the presence of C. albicans (p < 0.05). Glucose did not interfere in the release of any cytokine evaluated. C. albicans downregulated transcripts for CDH1 (p < 0.05). Glucose did not induce a significant change in CDH1, CASP3, DEFB-1 and DEFB-3 messenger RNA expression. The biofilms were more structured in the presence of glucose, but no difference in the diffusion of hyphae through the epithelial cells were observed. CONCLUSIONS: The data suggest that glucose concentration does not affect the behavior of C. albicans during tissue invasion and other mechanisms must be related to the greater susceptibility of diabetic individuals to candidiasis.


Asunto(s)
Biopelículas , Candida albicans , Candidiasis , Células Epiteliales/microbiología , Glucosa/farmacología , Células Cultivadas , Citocinas/metabolismo , Humanos
9.
Clin Oral Investig ; 24(3): 1311-1320, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31312971

RESUMEN

OBJECTIVE: To monitor the cytokine release patterns in the peri-implant crevicular fluid (PICF) and to investigate which factors affect the success rate of narrow diameter implants (NDI) during the first year. MATERIAL AND METHODS: Mandibular implant overdentures (IOD) retained by 2 NDI were installed in 16 clinically atrophic edentulous patients. The following parameters were monitored during the first year: (i) peri-implant health parameters (plaque index (PI), calculus presence (CP), gingival index (GI), probing depth (PD) and bleeding on probing (BoP); (ii) cytokine concentrations in the PICF (TNF-α, IL-1ß, IL-6, IL-10); (iii) implant stability quotient (ISQ); (iv) marginal bone level (MBL) and bone level change (BLC); (v) implant success. The insertion torque, bone type, mandibular atrophy, time since edentulism, and smoking habits were also recorded. All data were analyzed using multivariable multilevel mixed-effects regression models. RESULTS: The variability in the TNF-α release patterns temporarily reduced at weeks (w) 8-12, while the IL-1ß concentrations remained low until they peaked at w48 [p < 0.05; + 177.55 pg/µl (+ 96.13 - + 258.97)]. Conversely, IL-10 release decreased significantly at w48 [p < 0.05; - 456.24 pg/µl (- 644.41 - - 268.07)]. The PD and ISQ decreased significantly (p < 0.05) over the follow-up period, while the MBL was stable after w48 with a BLC of 0.12 ± 0.71 mm. The overall success rate was 81.3%, and was influenced by TNF-α, IL-1ß, IL-10, PI, GI, PD, smoking, and time since edentulism. CONCLUSION: Pro- and anti-inflammatory cytokine release was balanced during the first 24 weeks. The GI, smoking, and time since edentulism are the most important factors determining the implant success. CLINICAL RELEVANCE: The study contributes to the understanding of the osseointegration process in a clinically atrophic population rehabilitated with IOD, and highlights the importance of monitoring clinical peri-implant health-related parameters, smoking habit, and time since edentulism to predict implant success rates.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Líquido del Surco Gingival/química , Oseointegración , Anciano , Biomarcadores/química , Citocinas/análisis , Femenino , Humanos , Estudios Longitudinales , Masculino , Mandíbula , Estudios Prospectivos
10.
Braz. oral res. (Online) ; 34: e113, 2020. tab, graf
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1132680

RESUMEN

Abstract Here, the prevalence of oral candidiasis and denture stomatitis among diabetic patients compared to healthy ones was summarized through a systematic review with meta-analysis. Medline, Scopus, Web of Science, Lilacs, Cochrane Library, Embase, and the grey literature were searched without restriction, until May 2020. Eligibility criteria were established, data were extracted, and quality assessment was conducted by two trained examiners. Qualitative synthesis was based on the recommendations of Fowkes and Fulton. Two meta-analyses were performed on studies investigating patients with: a) oral candidiasis and b) denture stomatitis. Out of 6034 screened studies, seven were eligible for qualitative and quantitative synthesis; of these, three evaluated oral candidiasis and four evaluated denture stomatitis. Qualitative synthesis showed that the main methodological problems of the studies included sample size, source of controls, matching, and randomization. Diabetic patients had a similar chance of developing oral candidiasis to non-diabetic patients (OR1.40 [0.96; 2.04], p = 0.08, I2 = 94%). However, diabetic patients had a higher chance to present denture stomatitis compared to non-diabetic patients (OR 1.92 [1.42, 2.59] p < 0.0001, I2 = 0%). Therefore, diabetic patients have a higher chance of developing denture stomatitis compared to non-diabetic patients. However, for all analyses, the certainty of the evidence was considered to be very low.

11.
Braz. oral res. (Online) ; 34: e110, 2020. graf
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1132720

RESUMEN

Abstract Acrylic resin has been used in the manufacture of prostheses, however, in the oral cavity, this material starts to retain microorganisms capable of causing gingival inflammation due its porosities. The aim of this study was to evaluate the influence of the use of silicon dioxide as a coating layer applied onto acrylic resin, on the adhesion of Candida albicans (Ca). After the incubation period in Sabouraud Dextrose Broth, a total of 1 ml of the Ca suspension was added to plate wells, each well containing a specimen of acrylic resin. The adhesion ability of Ca on acrylic resin was determined by counting colonies. Three groups (n = 6) of acrylic resin were assessed: with polishing (RP); without polishing (RW); with polishing and coating layer of silicon dioxide (RPC). Ca deposited on the surface of the acrylic resin was also observed using Scanning Electron Microscopy (SEM). Statistical assessment by Kruskal-Wallis and Student-Newman-Keuls Method were done (α = 2%). There was significant difference among the groups. The RPC group showed the lowest growth, with an average of 5.59 Log CFU/cm 2 ; there was a statistically significant difference in relation to group RW, which presented a growth of 6.07 Log CFU/cm 2 and to group RP with 5.91 Log CFU/cm 2 (p < 000.1). SEM images demonstrated that in the RP and RPC group, the surface of the resin had greater regularity, and smaller number of microorganisms. The application of silicon dioxide coating on acrylic resin appears to be a promising alternative, and its use can help in reducing the adhesion of Ca in prostheses.

12.
J Oral Rehabil ; 46(11): 1031-1035, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31587344

RESUMEN

BACKGROUND: Excessive daytime sleepiness (EDS) is frequently reported as a symptom for obstructive sleep apnoea (OSA), leading to problems with concentration, mood and memory. Mandibular advance device (MAD) is considered as an effective therapy to control OSA, reducing EDS and improving sleep quality. OBJECTIVES: The present study aimed to investigate the effects MAD therapy on EDS of patients diagnosed with OSA. METHODS: Ten patients from the Sleep Medicine Service of the "Hospital Geral Sanatório" (Maceió, Alagoas, Brazil) were diagnosed with EDS, and a personalised MAD was made for each one of them. Nocturnal polysomnography (NPSG) and maintenance of wakefulness test (MWT) were applied before (baseline) and 3 months after the continuous use of the MAD. The number of arousals and micro-arousals at baseline and after treatment was also evaluated. RESULTS: All 10 patients completed the investigation. A significant decrease in the number of arousals and micro-arousals per night of sleep was observed after the use of MAD for three consecutive months (P = 0.0078; Wilcoxon signed-rank test). Also, there was a significant reduction on the apnoea/hypopnea index between baseline and post-treatment values (P = 0.0001; paired t test), as well as an increase in the mean latency for the onset of sleep (MSL) in the MTW (P = 0.0047; paired t test), indicating a significant difference among baseline and after treatment. CONCLUSION: We conclude that the improvement on EDS is associated with the used of MAD in patients diagnosed with OSA, improving their quality of sleep.


Asunto(s)
Avance Mandibular , Apnea Obstructiva del Sueño , Brasil , Humanos , Polisomnografía , Somnolencia
13.
Braz Oral Res ; 33(suppl 1): e069, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576953

RESUMEN

Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$ AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Fuerza de la Mordida , Bruxismo/complicaciones , Oclusión Dental Traumática/complicaciones , Resorción Ósea/etiología , Humanos , Periimplantitis/etiología , Factores de Tiempo , Insuficiencia del Tratamiento
14.
Biomed Res Int ; 2019: 8132520, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31275984

RESUMEN

Aim: To evaluate the influence of primary insertion torque (IT) values of narrow dental implants on the peri-implant health, implant stability, immunoinflammatory responses, bone loss, and success and survival rates. Methods: Thirty-one edentulous patients received two narrow implants (2.9x10mm, Facility NeoPoros) to retain mandibular overdentures. The implants were categorized in four groups according to their IT: (G1) IT > 10 Ncm; (G2) IT ≥ 10Ncm and ≤ 30 Ncm; (G3) IT >30Ncm and < 45Ncm; (G4) IT ≥ 45Ncm, and all implants were loaded after 3 months of healing. The following clinical outcomes were evaluated 1, 3, 6, and 12 months after implant insertion: (i) peri-implant tissue health (PH), gingival index (GI), plaque index (PI), calculus presence (CP), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ) by resonance frequency analysis; and (iii) IL-1ß and TNF-α concentration in the peri-implant crevicular fluid. The marginal bone level (MBL) and changes (MBC) were evaluated. The Chi2 test, Kruskal-Wallis test, mixed-effects regression analysis, and the Kendall rank correlation coefficient were used for statistical analysis (α = 5%). Results: G1 presented the highest PD at all evaluated periods. G2 presented higher PI at month 6 and 12. G4 showed increased GI at month 3 and 12 and more CP at month 1 (p=.003). G2 and G4 had higher ISQ values over the study period, while those from G1 and G3 presented lower ISQ values. The IL-1ß concentration increased until month 12 and was independent of IT and bone type; G4 had a higher IL-1ß concentration in month 3 than the other groups (p=.015). The TNF-α release was negatively correlated with IT, and TNF-α release was highest in G1 at month 12. The MBL immediately after surgery and the MBC at month 12 were similar between the groups, and G4 presented a positive MBC at month 12. The survival and success rates were 75% for G1, 81.3% for G2, 64.3% for G3, and 95% for G4. Conclusion: The IT did not influence the clinical outcomes and the peri-implant immunoinflammatory responses and was weakly correlated with the narrow dental implants primary stability. The observed success rates suggest that the ideal IT for atrophic fully edentulous patients may deviate from the standardized IT of 32 Ncm.


Asunto(s)
Implantes Dentales , Prótesis de Recubrimiento , Arcada Edéntula/cirugía , Mandíbula/cirugía , Torque , Anciano , Anciano de 80 o más Años , Citocinas/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multinivel , Soporte de Peso
15.
J Oral Rehabil ; 2019 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-30873626

RESUMEN

BACKGROUND: Excessive daytime sleepiness is frequently reported as a symptom for OSA, leading to problems with concentration, mood and memory. MAD are considered as an effective therapy to control OSA, reducing EDS and improving sleep quality. OBJECTIVES: The present study aimed to investigate the effects of mandibular advance device (MAD) therapy on excessive daytime sleepiness (EDS) of patients diagnosed with obstructive sleep apnea (OSA). METHODS: Ten patients from the Sleep Medicine Service of the "Hospital Geral Sanatório" (Maceió, Alagoas, Brazil) were diagnosed with EDS, and a personalized MAD was made for each one of them. Nocturnal polysomnography (NPSG) and Maintenance of wakefulness test (MWT) were applied before (baseline) and three months after the continuous use of the MAD. The number of arousals and microarousals at baseline and after treatment were also evaluated. RESULTS: All 10 patients completed the investigation. A significant decrease in the number of arousals and microarousals per night of sleep was observed after the use of MAD for three consecutive months (P=0.0078; Wilcoxon signed-ranks test). Also, there was a significant reduction on the apnea/hypopnea index between baseline and post-treatment values (P=0.0001; paired-t test), as well as an increase in the mean latency for the onset of sleep (MSL) in the MTW (P=0.0047; paired t- test), indicating a significant difference among baseline and after treatment. CONCLUSION: We conclude that the improvement on EDS is associated with the used of MAD in patients diagnosed with OSA, improving their quality of sleep. This article is protected by copyright. All rights reserved.

16.
Caries Res ; 53(1): 16-23, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-29874649

RESUMEN

Extracellular polysaccharides (EPS) could increase the penetration of fluoride through dental biofilm, reducing its cariogenicity. We measured the concentration of fluoride in EPS-containing (EPS+) or not-containing (EPS-) Streptococcus mutans bacterial pellets resembling test biofilms, before and up to 60 min after a 0.05% NaF rinse in situ. Fluoride penetration and clearance were higher in EPS+ bacterial pellets. The data suggest that EPS enhances fluoride penetration, but also accelerates fluoride clearance from dental biofilms.


Asunto(s)
Biopelículas/efectos de los fármacos , Cariostáticos/química , Fluoruros/química , Polisacáridos Bacterianos/química , Streptococcus mutans/efectos de los fármacos , Adulto , Cariostáticos/farmacología , Estudios Cruzados , Caries Dental/microbiología , Difusión , Método Doble Ciego , Fluoruros/farmacología , Fructosa/química , Glucosa/química , Humanos , Concentración Osmolar , Análisis de Regresión , Saliva/fisiología , Estadísticas no Paramétricas , Streptococcus mutans/fisiología , Sacarosa/química
17.
Clin Oral Investig ; 23(2): 567-575, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29725853

RESUMEN

OBJECTIVES: This randomized split-mouth clinical trial investigated the influence of implant macrogeometry on bone properties and peri-implant health parameters during the healing process. MATERIAL AND METHODS: Ninety-nine implants were placed bilaterally in posterior mandibles of 23 patients that received at least four dental implant macrogeometries: standard geometry, Integra (IN) and three geometries inducing "healing chamber": Duo (D), Compact (C), and Infra (IF). Insertion torque (IT) and implant stability quotient (ISQ) were measured. Peri-implant health were monitored by visible plaque index (VPI), peri-implant inflammation (PI), and presence of calculus (CC). Data were collected during 90 days. Data were assessed for normality using the asymmetry and kurtosis coefficients followed by the Shapiro-Wilk test. A one-way ANOVA was used to investigate differences in IT and linear bone dimensions between the macrogeometry groups. The repeated measurements ANOVA test or ANOVA-R was used for analysis of ISQ, VPI, and PI. Tukey-Kramer test or Student's t test was used for comparisons between the groups or within each macrogeometry. RESULTS: Macrogeometry did not significantly influence IT and ISQ values. The minimum ISQ was recorded after 7 days (71.95 ± 12.04, p = 0.0001). Intermediate ISQ was found after 14 days, when the ISQ reached values that are statistically identical to primary stability. The VPI showed significantly higher scores for the D (0.88 ± 1.03) and IN (0.72 ± 0.94) implants after 7 days. The PI was only influenced by the healing time significantly decreasing from 7 (1.07 ± 0.89) to 21 days (0.18 ± 0.18). CONCLUSION: Implant macrogeometry did not influence IT nor ISQ values. The relationship between IT and SS was more evident for the Duo implant, but only in the final stage of healing process. CLINICAL RELEVANCE: Show to the clinician that the macrogeometry and drilling protocols did not interfere in the clinical behavior of the implants during the healing process. However, the IT, primary and secondary stability, is quite dependent of the surgeon experience.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Diseño de Prótesis Dental , Cicatrización de Heridas/fisiología , Adulto , Retención de Prótesis Dentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oseointegración/fisiología , Estudios Prospectivos , Radiografía Panorámica
18.
J Periodontal Res ; 54(3): 241-250, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30450551

RESUMEN

BACKGROUND: Biological responses to different loading protocols during the bone healing phase in subjects with long time since edentulism, rehabilitated with narrow diameter implants (NDIs) to retain mandibular overdentures (MOs), are still unavailable. OBJECTIVE: This randomized clinical trial compared the peri-implant health, implant stability, and concentrations of pro- and anti-inflammatory cytokines in the peri-implant crevicular fluid (PICF) in mandibular edentulous patients under conventional (CL) and immediate loading (IML) during healing. METHODOLOGY: Twenty totally edentulous patients received two NDIs (2.9 × 10 mm, Facility NeoPoros) placed in mandible anterior region and were randomly assigned to two loading protocols: CL (n = 10) and IML (n = 10). The following clinical outcomes were evaluated 1, 2, 4, 8, and 12 weeks after surgery: (a) peri-implant tissue health (gingival index-GI, plaque index-PI, calculus-presence CP, probing depth-PD, and bleeding on probing-BOP); (b) implant stability quotient (ISQ); and (c) IL-1ß, IL-6, IL-10, and TNF-α levels in the PICF analyzed by ELISA. RESULTS: The CL group showed significantly higher CP scores at weeks 8 and 12. The IML group showed significantly higher GI from the first week onwards. The IML group presented significantly lower PD at all follow-up times, and higher BOP rates than CL at week 12. The ISQ values of the CL group were higher than those of the IML group, except at week 4. The IML group released significantly more TNF-α between weeks 1 and 4 and more IL-1ß during week 4-12, while releasing less IL-6 until week 8, mainly at week 2 (-47.6%). The release of IL-10 was similar for both groups and increased progressively over time. At week 12, the IML group released 45.74% more IL-10 than the CL group. The survival rates were 95% and 90% for CL and IML, respectively. CONCLUSION: The IML group presented more favorable PD at all evaluation times; the differences between the other clinical parameters were less systematic. The implant stability and the inflammatory marker concentrations were more stable in the CL group.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Prótesis de Recubrimiento , Carga Inmediata del Implante Dental , Mandíbula , Cicatrización de Heridas/fisiología , Anciano , Citocinas/metabolismo , Retención de Dentadura , Femenino , Estudios de Seguimiento , Líquido del Surco Gingival/metabolismo , Humanos , Mediadores de Inflamación/metabolismo , Arcada Edéntula/metabolismo , Arcada Edéntula/rehabilitación , Masculino , Persona de Mediana Edad , Factores de Tiempo
19.
Braz. oral res. (Online) ; 33(supl.1): e069, 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1039318

RESUMEN

Abstract Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$ AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force.

20.
Braz Oral Res ; 32: e110, 2018 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-30379212

RESUMEN

This randomized clinical trial evaluated the insertion torque (IT), primary, and secondary stability of dental implants with different surface treatments during the osseointegration period. Nineteen patients with bilateral partial edentulism in the posterior mandibular region were randomly allocated to two implant brand groups and received implants with different surface treatments in the opposite site of the arch: Osseotite and Nanotite or SLA and SLActive. During implant placement, the maximum IT was recorded using a surgical motor equipped with a graphical user interface. The implant stability quotient (ISQ) was assessed immediately after the IT, and was measured weekly via resonance frequency analysis during 3 months. The data were analyzed by a one-way ANOVA, the Bonferroni test, paired t tests and Pearson's correlation coefficient. The IT values were similar (p > 0.05) for all implant types ranging from 43.82 ± 6.50 to 46.84 ± 5.06. All implant types behaved similarly until the 28th day (p > 0.05). Between 35 and 56 days, Osseotite and SLActive showed lower ISQ values (p < 0.001) compared to Nanotite and SLA implants. After 56 days, only Osseotite maintained significantly lower ISQ values than the other implants (p < 0.05). After 91 days the ISQ values were significantly higher than the baseline for all four implant types (p < 0.001). The ISQ and IT values were significantly correlated at the baseline and at the final evaluation for Osseotite, Nanotite, and SLActive implants (p < 0.001). After 91 days, ISQ and IT values were only significantly correlated for the Osseotite implants (p < 0.05). All implants types exhibited acceptable primary and secondary stability.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales/normas , Oseointegración/fisiología , Análisis de Varianza , Diseño de Prótesis Dental , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Valores de Referencia , Propiedades de Superficie , Factores de Tiempo , Torque , Resultado del Tratamiento
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