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1.
Artículo en Inglés | MEDLINE | ID: mdl-33528449

RESUMEN

This prospective longitudinal clinical trial aimed to evaluate the success of a bone-level implant with an integrated platform-switched connection by assessing peri-implant soft tissue and marginal bone level. Twenty-six patients were treated in two different centers with implants placed in healed partially edentulous ridges. Implant success rate and marginal bone level were evaluated with photographs, radiographs, and clinical measurements, with a 6-month postloading follow-up. The esthetic appearance of the photographed peri-implant soft tissue was evaluated at 6 months via the Pink Esthetic Score applied by two calibrated operators. All of the implants except for one placed in the mandible demonstrated successful osseointegration, resulting in a success rate of 97.8% at the 6-month follow-up. Compared to historical controls, no detectable differences in peri-implant marginal bone loss or esthetic outcome were seen.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Implantación Dental Endoósea , Estudios de Seguimiento , Humanos , Mandíbula/cirugía , Oseointegración , Estudios Prospectivos
2.
Artículo en Inglés | MEDLINE | ID: mdl-33528453

RESUMEN

In everyday practice, surgeons have to deal with bone atrophy. These rehabilitations are even more complex in the posterior mandible, and it is still unclear in the literature which fixed rehabilitation option is best. The purpose of this article was to help oral surgeons to choose the proper and updated treatment for their atrophic patients. Posterior mandible bone atrophies were divided into four main groups depending on the bone height measured above the inferior alveolar nerve: (1) ≤ 4 mm; (2) > 4 mm ≤ 5 mm; (3) > 5 mm ≤ 6 mm; (4) > 6 mm < 7 mm. Different approaches were proposed for each group, considering patient expectations. If ≤ 4 mm of bone height was available, guided bone regeneration was used as the adequate approach. For bone heights > 4 mm and ≤ 6 mm, the "sandwich" technique and/or short implants were used, depending on esthetics. In cases with > 6 mm and < 7 mm above the mandibular canal, short implants might be the proper option. The authors' clinical experience and the literature were considered in order to suggest a possible correct treatment decision based on the residual bone height in the posterior mandible.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Atrofia/patología , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Mandíbula/cirugía , Resultado del Tratamiento
3.
Artículo en Inglés | MEDLINE | ID: mdl-33638216

RESUMEN

OBJECTIVES: To compare the 1-year aesthetic results of flapless single implants, placed in fresh extraction sockets with bone replacement and immediate provisional restoration with or without a connective tissue graft (CTG). MATERIAL AND METHODS: The present study proposes a partially blinded multicentre parallel randomized controlled trial, where computer-generated tables were used for central randomization to allocate treatments. A total of 59 of the 60 patients screened by eight private practices in Northern Italy fulfilled the inclusion criteria. Immediate implants were placed in a fresh extraction socket with a non-functional immediate provisional restoration with (Test group) or without (Control group) a CTG. The primary outcome variable was the implant Crown Aesthetic Index (ICAI) at the 1-year follow-up. RESULTS: ICAI for the 59 randomized patients (Test group = 31, Control group = 28) at the 1-year follow-up was 4.69 (95% CI = 3.16-6.22) for the Test group and 3.45 (95% CI = 1.83-5.08) for the Control group, without statistically significant difference between the two groups (p = .086). One implant failure was recorded in each group, resulting in an implant survival rate of 96.8% [95% CI = 83.3-99.9] for the Test group and 96.4% [95% CI = 81.7-99.9] for the Control group. Other secondary outcome variables and complication rates were comparable across the two groups. CONCLUSIONS: Within the limitations of the present clinical trial, the results suggested that the adjunct use of CTG is not mandatory to achieve successful aesthetic outcomes for a well-planned immediate implant placement with immediate non-functional provisional restoration in a fresh extraction socket.

4.
Artículo en Inglés | MEDLINE | ID: mdl-32925998

RESUMEN

The aim of this retrospective study was to evaluate clinical and radiographic outcomes of guided bone regeneration (GBR) procedures in the rehabilitation of partially edentulous atrophic arches. A total of 58 patients were included with a follow-up of 3 to 7 years after loading. Data seem to indicate that GBR with nonresorbable membranes can be a good clinical choice and suggest that it could be used to vertically reconstruct no more than 6 mm of bone in the posterior mandible. However, this technique remains difficult and requires expert surgeons.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Regeneración Ósea , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Membranas Artificiales , Estudios Retrospectivos
5.
Materials (Basel) ; 12(22)2019 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-31718004

RESUMEN

A short inflammatory phase and fast ingrowth of blood vessels and mesenchymal cells are essential for tissue integration of a biomaterial. Macrophages play a key role in this process. We investigated invasion of macrophages, blood vessels, and proliferating cells into a highly porous and volume-stable collagen matrix (VCMX) used for soft tissue augmentation around teeth and dental implants. The biomaterial was implanted in submucosal pouches in the canine maxilla, and the tissue response was analyzed at six different time points. Immunohistochemistry was done for proliferating cells (PCNA), macrophages (MAC387), multinucleated giant cells (CD86), and blood vessels (TGM2). Blood rapidly filled the VCMX pores. During the first week, MAC387+ cells populated the VCMX pores, blood vessels and PCNA+ cells invaded the VCMX, and CD86+ scattered cells were observed. At 15 days, MAC387+ cells were scanty, blood vessels had completely invaded the VCMX, the number of proliferating cells peaked, and fibroblasts appeared. At 30 days, MAC387+ were absent, the numbers of proliferating and CD86+ cells had declined, while blood vessel and fibroblast numbers were high. At 90 days, residual VCMX was well-integrated in soft connective tissue. In conclusion, the VCMX elicited a short inflammatory phase followed by rapid tissue integration.

6.
Artículo en Inglés | MEDLINE | ID: mdl-31613940

RESUMEN

The aim of this study is to evaluate the long-term performance of anodized surface implants placed in native bone and followed-up for up to 17 years. Success and survival rates, prevalence of peri-implantitis, and the correlation between the presence of peri-implantitis and other clinical and demographic variables were calculated. After a mean follow-up time of 10.4 years (range: 5 to 17 years), 91.7% of 223 analyzed implants were still in function. Peri-implantitis affected 63 implants (28.3%) in 26 patients (44%). Eleven implants with peri-implantitis (4.9%) failed. Within the limits of this retrospective analysis, anodized implants appear to be prone to peri-implantitis, mainly in the posterior mandible and in patients with unsatisfactory plaque control.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Estudios de Seguimiento , Humanos , Estudios Retrospectivos
7.
J Clin Periodontol ; 46 Suppl 21: 277-286, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31038223

RESUMEN

BACKGROUND AND AIMS: Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. MATERIAL AND METHODS: The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures. RESULTS: A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. CONCLUSIONS: The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post-operative complications.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Elevación del Piso del Seno Maxilar , Proceso Alveolar , Regeneración Ósea , Trasplante Óseo , Consenso , Implantación Dental Endoósea
8.
Artículo en Inglés | MEDLINE | ID: mdl-29889912

RESUMEN

The goal of this retrospective investigation was to provide evidence of the longevity of machine-surfaced implants placed in native bone and treated with the original two-stage surgical protocol. The observation times of this study covered periods of 13 to 32 years. Consecutive cases were impossible; the patients' ages when treated reduced the number of available people as a result of death, relocation, being impossible to find, or refusal to cooperate. Mean marginal bone loss after 13 to 32 years was 1.9 ± 0.9 mm, survival rate was 97.7%, and success rate was 92.7%. Peri-implantitis occurred in a limited number of cases, with a prevalence of 1.8%. This study demonstrates long-term reliability of machined implants as a therapeutic choice.


Asunto(s)
Pérdida de Hueso Alveolar/epidemiología , Implantación Dental Endoósea , Implantes Dentales , Periimplantitis/epidemiología , Adolescente , Adulto , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/epidemiología , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/cirugía , Maxilar/cirugía , Persona de Mediana Edad , Periimplantitis/diagnóstico por imagen , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto Joven
9.
Periodontol 2000 ; 77(1): 241-255, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29478252

RESUMEN

The reconstruction of deficient alveolar ridges using vertical and/or horizontal guided bone regeneration techniques allows for ideal implant placement, which is crucial for function and also for esthetically successful outcomes. Unlike in the past, when meeting a patient's functional demands was sufficient, many patients now have greater expectations from their implant restoration. Hence, it is no longer enough simply to restore the edentulous space with a functioning tooth or teeth. It has been suggested that patients now measure their final restoration using the contralateral natural tooth as the gold standard. Both subjective and objective levels of patient information on dental implants have increased significantly in the last decade. As a result of this demand, implant literature has inherited and developed specific esthetic parameters and patient-centered outcomes from studies in the restorative field. Unfortunately, studies reporting on guided bone regeneration in the esthetic zone entirely lack such parameters and outcomes. Currently, there is a strong need for a consensus on objective and well-defined parameters to assess the esthetics in bone regeneration and subsequently on implant dentistry.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Estética Dental , Regeneración Tisular Guiada Periodontal/métodos , Adulto , Sustitutos de Huesos/uso terapéutico , Diente Canino , Femenino , Humanos , Incisivo , Maxilar , Membranas Artificiales , Extracción Dental
10.
Artículo en Inglés | MEDLINE | ID: mdl-28609491

RESUMEN

The aim of this retrospective study was to compare clinical and radiographic outcomes of the interpositional (inlay) augmentation technique in atrophic posterior partially edentulous mandibles using three different types of block bone grafts: autogenous bone block harvested from the iliac crest, deproteinized bovine bone mineral block, and collagenated equine bone block. A total of 115 patients were included with a 4.2-year mean after-loading follow-up. Data seem to suggest that heterologous bone blocks are similar in results to autogenous bone blocks, so they might be considered preferable as they avoid invasive harvesting surgeries.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Implantes Dentales , Ilion/trasplante , Mandíbula/cirugía , Animales , Atrofia , Placas Óseas , Bovinos , Colágeno , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Caballos , Humanos , Italia , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Persona de Mediana Edad , Osteotomía , Estudios Retrospectivos , Colgajos Quirúrgicos , Resultado del Tratamiento
11.
Implant Dent ; 26(5): 790-795, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28445234

RESUMEN

PURPOSE: This article describes the digitoclastic technique, an innovative procedure for coronal displacement of the lingual flap. The new technique has the potential to obtain primary flap closure without surgical risks to the anatomical structures on the lingual side of the mandible. MATERIALS AND METHODS: Reconstruction of an atrophic mandible with guided tissue regeneration (guided bone regeneration) and implant placement is described, using the digitoclastic technique to displace the lingual flap coronally. RESULTS: Coronal flap displacement was sufficient to obtain complete passive coverage of the grafted area. No bleeding or neurosensory complications were recorded, and no membrane exposure occurred. CONCLUSIONS: The digitoclastic technique reduces the risk of damage to the lingual nerve and minimizes the amount of bleeding during surgery, allowing progressive and controlled retraction of the flap until the desired detachment is achieved.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Mandíbula/cirugía , Colgajos Quirúrgicos/cirugía , Lengua/cirugía , Regeneración Tisular Dirigida/métodos , Humanos
12.
Artículo en Inglés | MEDLINE | ID: mdl-27740641

RESUMEN

Reducing the need for a connective tissue graft by using an efficacious biomaterial is an important task for dental professionals and patients. This experimental study aimed to test the soft tissue response to a volume-stable new collagen matrix. The device demonstrated good stability during six different time points ranging from 0 to 90 days of healing with no alteration of the wound-healing processes. The 90-day histologic specimen demonstrates eventual replacement of most of the matrix with new connective tissue fibers.


Asunto(s)
Colágeno , Tejido Conectivo/trasplante , Maxilar/cirugía , Alveolo Dental/cirugía , Cicatrización de Heridas/fisiología , Animales , Materiales Biocompatibles , Perros , Membranas Artificiales , Modelos Animales , Colgajos Quirúrgicos , Técnicas de Sutura , Extracción Dental
13.
Artículo en Inglés | MEDLINE | ID: mdl-27333005

RESUMEN

This case report provided a unique opportunity to investigate the extent of microbiota infiltration on the oxidized implant surface that has been compromised by peri-implantitis. Scanning electron microscopic analysis confirmed the etiologic role of the bacteria on the loss of supporting structure and the difficulty in complete removal of bacterial infiltration on the implant surface. This case report emphasizes the need to perform definitive surface decontamination on failing dental implants prior to a regeneration procedure.


Asunto(s)
Implantes Dentales/efectos adversos , Recesión Gingival/microbiología , Recesión Gingival/terapia , Periimplantitis/microbiología , Periimplantitis/terapia , Adulto , Biopelículas , Fracaso de la Restauración Dental , Recesión Gingival/diagnóstico por imagen , Humanos , Microscopía Electrónica de Rastreo , Oxidación-Reducción , Periimplantitis/diagnóstico por imagen , Propiedades de Superficie
14.
Artículo en Inglés | MEDLINE | ID: mdl-27100800

RESUMEN

The aim of this retrospective clinical trial was to evaluate the performance of 91 turned implants placed in vertically augmented ridges in 33 patients by means of guided bone regeneration techniques after a mean follow-up of 15 years. A total of 88 implants were in function (97% survival rate), whereas 9 showed peri-implantitis (9.9%). A mean radiographic bone loss of 1.02 mm between the baseline evaluation (1 year after loading) and the final visit (13 to 21 years later) was recorded. In conclusion, turned implants placed in vertically augmented bone seem to remain stable after many years of function.


Asunto(s)
Aumento de la Cresta Alveolar , Implantación Dental Endoósea , Pérdida de Hueso Alveolar/cirugía , Implantes Dentales , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Membranas Artificiales , Estudios Retrospectivos
15.
Clin Implant Dent Relat Res ; 18(1): 19-29, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25622713

RESUMEN

BACKGROUND: Vertical ridge augmentation with the use of solid bone blocks or particulate bone autograft, exposed or covered by a nonresorbable expanded polytetrafluoroethylene (ePTFE) membrane, are well known in the literature and have been shown to be effective in treating bone atrophy. PURPOSE: The aim of our study was to assess the two techniques in respect to biological properties of transplanted bone in graft revascularization and bone remodeling in conjunction with dental implants. MATERIALS AND METHODS: Ten patients were treated within the study, with a total of 12 sites with posterior mandibular edentulous ridges with insufficient bone to allow implant placement. Bone regeneration was performed using autogenous intraoral block graft or autogenous particulate graft with an ePTFE barrier membrane. At 6-10 months, reentry surgery was performed; bone biopsies, including microscrews, were harvested; and implants were placed. RESULTS: Eleven sites out of 12 healed uneventfully. A mean height gain of 5.03 mm was achieved. Mean bone-to-implant contact and bone fill were assessed by means of histomorphometric analysis. The block specimens revealed a bone-to-implant contact of 42.34%, and the particulate grafts had a bone-to-implant contact of 26.62% (p < .012). Bone fill values reported were 68.32% and 48.28% (p < .019) for block specimens versus particulate grafts. CONCLUSIONS: The results clearly showed that both techniques were clinically successful for subsequent implant placement and prosthetic rehabilitation. The histological outcomes, including revascularization and bone remodeling, of the two techniques differed significantly. The block grafts outperformed the particulate grafts in terms of bone-to-implant contact and bone fill values; however, the morbidity associated with the donor site of the block must be considered.


Asunto(s)
Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Regeneración Tisular Dirigida/métodos , Adulto , Anciano , Aumento de la Cresta Alveolar/métodos , Regeneración Ósea , Femenino , Humanos , Arcada Parcialmente Edéntula/diagnóstico por imagen , Arcada Parcialmente Edéntula/cirugía , Masculino , Mandíbula/cirugía , Membranas Artificiales , Persona de Mediana Edad , Politetrafluoroetileno , Estudios Prospectivos , Radiografía Panorámica , Trasplante Autólogo , Resultado del Tratamiento
16.
Eur J Oral Implantol ; 8(4): 387-96, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26669548

RESUMEN

PURPOSE: To compare the effectiveness of immediately loaded total prostheses supported by implants with a roughened surface versus implants with a machined/turned surface. MATERIALS AND METHODS: Fifty edentulous or to-be-rendered edentulous patients requiring an implant-supported cross-arch prosthesis, were randomised either to receive four to eight implants with a roughened surface (25 patients) or with a machined/turned surface (25 patients). Provisional metal-reinforced acrylic prostheses were delivered 48 h after implant placement. Provisional prostheses were replaced after 4 months, by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes. Patients were followed 1 year after loading. RESULTS: One year after loading no patient dropped out. No prosthesis failed, but two machined implants were found to be mobile at definitive impression taking in 1 patient (Fisher's exact test: P = 0.312; difference in proportions = 4%; 95% Cl: -10 to 18). No complications occurred. Both groups presented a significant peri-implant marginal bone loss at 1 year after loading (P < 0.0001), -0.64 ± 0.20 mm for rough implants and -0.68 ± 0.23 mm for turned implants, respectively, with no statistically significant differences between the two groups (P = 0.482; mean difference = 0.04 mm; 95% Cl: -0.17 to 0.25). CONCLUSIONS: Up to 1 year after immediate loading, both implant surfaces provided good and similar results, however, the only two implants which failed early in the same patient had a machined surface. These preliminary results must be confirmed by larger trials with longer follow-ups.


Asunto(s)
Implantes Dentales , Diseño de Prótesis Dental , Carga Inmediata del Implante Dental/métodos , Arcada Edéntula/rehabilitación , Resinas Acrílicas/química , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar/etiología , Aleaciones Dentales/química , Grabado Dental/métodos , Implantes Dentales/efectos adversos , Materiales Dentales/química , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Diseño de Dentadura , Dentadura Completa Inmediata , Femenino , Estudios de Seguimiento , Humanos , Carga Inmediata del Implante Dental/efectos adversos , Arcada Edéntula/cirugía , Masculino , Persona de Mediana Edad , Proyectos Piloto , Propiedades de Superficie , Torque , Resultado del Tratamiento
17.
Artículo en Inglés | MEDLINE | ID: mdl-26509979

RESUMEN

This case report presents the correction of severe alveolar ridge atrophy due to congenital and iatrogenic factors. Implants that compromised the natural adjacent teeth and overall esthetics for this young patient were removed and replaced after significant vertical bone and soft tissue regenerative procedures. A treatment combination of bone graft particles, a nonresorbable membrane, and enamel matrix derivatives was used. Significant and stable improvement in esthetics was achieved 12 months after final prosthetic restoration, demonstrating the ability of such a combined treatment to correct the esthetic deformity, improve the health of the adjacent natural teeth, and allow for successful implant treatment.


Asunto(s)
Pérdida de Hueso Alveolar/terapia , Aumento de la Cresta Alveolar/métodos , Regeneración Ósea , Trasplante Óseo/métodos , Proteínas del Esmalte Dental/administración & dosificación , Regeneración Tisular Dirigida , Estética Dental , Femenino , Humanos , Resultado del Tratamiento , Adulto Joven
18.
Clin Oral Implants Res ; 26 Suppl 11: 103-22, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26385626

RESUMEN

BACKGROUND: Peri-implant hard-tissue augmentation is a widely used clinical procedure. AIM: The present review aimed to analyse the current literature regarding medium- and long-term data concerning the stability of peri-implant tissues after hard-tissue augmentation prior or immediately with implant placement. MATERIAL AND METHODS: An electronic literature search was performed using Medline (PubMed) databases detecting clinical studies focusing on hard- and soft-tissue stability around dental implants placed either in augmented alveolar ridges or simultaneously with peri-implant bone grafting. The search was limited to articles published between 1995 and December 2014, focusing on clinical studies with a prospective study design assessing peri-implant bone and soft tissue stability over time with a minimum follow-up of 12 months. Recent publications were also searched manually to find any relevant studies that might have been missed using the search criteria noted above. RESULTS: Thirty-seven articles met the inclusion criteria and were included in this systematic review. Since the outcome measures and methods, as well as types of grafts and implants used were so heterogeneous, the performance of meta-analysis was impossible. The highest level of evidence was achieved by randomized clinical trials. CONCLUSION: Different hard-tissue augmentation procedures seem to show stable peri-implant tissues, although, up to now, long-term stability of the augmented buccal bone is assessed by only few studies. Further research should concentrate on combining three-dimensional radiographic data with non-invasive methods as digital surface measuring techniques or ultrasound evaluation.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea , Implantes Dentales , Sustitutos de Huesos/uso terapéutico , Trasplante Óseo/métodos , Fracaso de la Restauración Dental , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Alveolo Dental/cirugía
19.
Clin Oral Implants Res ; 26 Suppl 11: 148-52, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26385628

RESUMEN

INTRODUCTION: Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. MATERIALS AND METHODS: Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. RESULTS: Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T).


Asunto(s)
Aumento de la Cresta Alveolar , Pilares Dentales , Gingivoplastia , Titanio , Circonio , Consenso , Implantes Dentales , Fracaso de la Restauración Dental , Estética Dental , Encía/efectos de los fármacos , Encía/cirugía , Regeneración Tisular Guiada Periodontal , Humanos
20.
Artículo en Inglés | MEDLINE | ID: mdl-25734702

RESUMEN

Various designs of dental implants representing different geometries and surface technologies are commercially available for patient treatment. However, data with regard to the biologic events that occur immediately after implant placement, regardless of the surface characteristic, are scarce. It has become a common procedure to perform immediate/early prosthetic loading rather than delayed loading. The goal of this study was to observe the early biologic events of peri-implant healing to understand the role of surface modifications in relation to the early phases of bone integration. The secondary goal was to observe the possible differences in the healing pattern at two oral implant surfaces differing in morphology and roughness (Ra, with Ra values ranging from 0.5 µm (machined surface; MS) to 1.5 µm (oxidized surface; OS). A total of 36 implants were placed in six foxhound dogs, equally divided between machined and oxidized surfaces. Three implants were positioned per hemimandible following a randomization scheme. Each animal was euthanized at a specific time point for histologic observation and histomorphometry: immediately after implant insertion and after 24 hours, 7 days, 15 days, 30 days, and 90 days. The study demonstrated an extremely low bone-implant contact (BIC) for both OS and MS implant surfaces during the first 15 days after implant placement (ranging from 12.9% to 26.9% independent of the implant surface). Increased BIC values were observed only in the 30- and 90-day specimens. The presence and the degradation of residual bone particles acted as centers for new bone formation, with osteoblasts lining osteoid tissue and subsequently woven bone independent of the implant surface characteristics. The bone-forming activity appeared strongly reduced after 30 days of healing and seemed to be complete only in the 90-day specimens, where abundant lamellar bone was evident. There is a continuing effort to develop improved titanium surfaces to achieve more rapid osseointegration and improve BIC, with the ultimate goal of applying occlusal load as early as possible. Since immediate or early implant loading is applied during and not after the first 15 days, the findings in the present study of an extremely low BIC and limited mineralized bone formation for both implant surfaces during the first 15 days after implant placement suggest that the surface roughness may not be a key factor for successful osseointegration of immediately or early loaded implants. Within the limits of this study, it can be stated that osseointegration follows a similar healing pattern with machined and oxidized implant surfaces.


Asunto(s)
Desarrollo Óseo , Implantes Dentales , Animales , Perros , Oxidación-Reducción , Propiedades de Superficie
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