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1.
Av. odontoestomatol ; 36(2): 99-106, mayo-ago. 2020. ilus
Artículo en Español | IBECS | ID: ibc-194691

RESUMEN

El uso de pilares de cicatrización transmucosos previos a la colocación del pilar protésico definitivo es una técnica que se ha desarrollado durante muchos años en la implantología clásica. La desconexión y conexión de forma repetida de estos pilares o aditamentos dan lugar a una respuesta ósea negativa que se manifiesta en forma de pérdida de hueso a nivel de la cresta marginal, acompañada por una migración apical de tejidos blandos. Este artículo pretende realizar una revisión de la literatura del estado actual del uso de los pilares transmucosos definitivos con colocación inmediata el día de la inserción de los implantes y el mantenimiento del sellado biológico, minimizando la pérdida ósea periimplantaria y remodelando de forma adecuada los tejidos blandos adyacentes, frente al protocolo tradiciónal del uso de aditamentos que se desconectan en multiples ocasiones produciendo pérdida ósea periimplantaria. La evidencia científica sugiere que los mejores resultados biológicos, estéticos y funciónales se consiguen con el uso del pilar definitivo colocado de forma inmediata a la inserción del implante, especialmente en implantes colocados de forma yuxtacrestal y en implantes postextracción


The use of transmucosal healing abutments before the placement of the definitive prosthetic abutment is a technique that has been developed for many years in classical implantology. Repeated disconnection and connection of theses abutments result in a negative bone response that manifests as bone loss at the marginal ridge level, accompanied by apical soft tissue migration. This article aims to review the current status in the scientific literature of the use of the definitive transepithelial abutments with immediate placement on the day of implant insertion and maintenance of the biological seal, minimizing peri-implant bone loss and adequately remodeling the adjacent soft tissues, compared to the traditional protocol of the use of abutments that are disconnected on multiple occasions producing peri-implant bone loss. Scientific evidence suggests that the best biological, aesthetic, and functional results are achieved with the use of the definitive abutment placed immediately after implant insertion, especially in yuxtacrestal implants and post-extraction implants


Asunto(s)
Humanos , Diseño de Implante Dental-Pilar/métodos , Carga Inmediata del Implante Dental/métodos , Implantes Dentales , Pilares Dentales , Mucosa Bucal , Tejido Periapical/diagnóstico por imagen , Tejido Periapical/cirugía
2.
Cient. dent. (Ed. impr.) ; 16(3): 201-207, sept.-dic. 2019. tab, ilus
Artículo en Español | IBECS | ID: ibc-185995

RESUMEN

Introducción: El empleo de dientes autógenos, como material de injerto, es una opción terapéutica actual en casos de regeneración ósea. Su obtención se ha facilitado con la introducción de dispositivos capaces de procesar los dientes. El objetivo de este trabajo es realizar, a propósito de un caso clínico, una revisión de la literatura sobre el uso de dientes autólogos como material de injerto óseo y los dispositivos para su procesamiento. Caso clínico: Paciente varón de 18 años que acude a consulta presentando un cordal inferior retenido. El diagnóstico determinó la necesidad de extraer el diente y se informó al paciente de la posibilidad de utilizarlo como material de regeneración ósea. Tras la exodoncia, el diente procesado con el dispositivo Tooth Transformer(R) (Imbiodent), fue utilizado como material de injerto autólogo. El postoperatorio no presentó ninguna complicación y la evaluación radiográfica, tras 8 días y tras 10 semanas, mostró una evolución favorable del tratamiento. Discusión: La dentina desmineralizada es un material orgánico cuyo potencial reside en los factores de crecimiento que contiene para estimular la formación y reparación ósea. No obstante, no existe consenso sobre el grado de desmineralización o tamaño de partícula ideal. La reciente introducción de dispositivos, capaces de procesar dientes, facilita la obtención de un material de injerto dental para su uso en terapias de regeneración ósea. Conclusión: El uso de dientes autólogos constituye una alternativa prometedora en el campo de los injertos óseos. La técnica de transformación del diente es sencilla con el empleo de los dispositivos actuales


Introduction: The use of autogenous teeth, as graft material, is a current therapeutic option in cases of bone regeneration. Its obtention has been facilitated by the introduction of devices capable of processing teeth. The aim of this article is to perform, based on a clinical case, a review of the literature about the use of autologous teeth as bone graft material and the devices for its processing. Clinical case: Male patient, 18 years of age, who comes to the dental office presenting a lower wisdom retained. Extraction of the tooth was determined by diagnosis and the patient was informed about the possibility of using it as bone regeneration material. After the extraction, the tooth was processed by the Tooth Transformer(R) (Imbiodent) device and was used as autologous graft material. No postoperative complications were presented and the radiographic evaluation, at 8 days and 10 weeks, showed a favorable evolution of the treatment. Discusion: Demineralized dentin is a organic material whose potential relies in the growth factors it contains to stimulate bone formation and repair. However, there is no consensus on the degree of demineralization or the ideal particle size. The recent introduction of devices, capable of processing teeth, enables the obtention of a dental graft material for bone regeneration therapies. Conclusion: The use of autologous teeth is a promising alternative in the bonev grafts field. The technique of tooth transformation is simple with the use of the current devices


Asunto(s)
Humanos , Masculino , Adolescente , Regeneración Ósea , Pulpa Dental/citología , Dentina , Carga Inmediata del Implante Dental/métodos , Trasplante Óseo/métodos , Procedimientos Quirúrgicos Reconstructivos , Desmineralización Dental , Esmalte Dental/química , Procedimientos Quirúrgicos Orales/métodos
3.
J Appl Oral Sci ; 27: e20180600, 2019 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-31411262

RESUMEN

OBJECTIVE: The immediate loading of implant-assisted fixed prostheses in edentulous maxillae may achieve favorable success rates with reduced treatment time. An evidence summary of clinical trials is key to recommend loading protocols in these cases. OBJECTIVES: To compare immediately loaded, fully implant-supported complete dentures to early and conventional/delayed loading in the edentulous maxillae of adult patients by a systematic review of controlled clinical trials (CCT). METHODOLOGY: CCTs reports were identified up to January 17, 2019 from Cochrane Oral Health Group's Trial register, Cochrane Central Register of controlled trials (CENTRAL), MEDLINE (Ovid), BIOSIS, EMBASE, CINAHL, Web of Science, and DARE. Two independent reviewers screened titles/abstracts and confirmed inclusion using full texts. Data were extracted and quality assessed (Cochrane Risk of Bias tool) independently and in duplicate. Study heterogeneity prevented pooling by meta-analysis. RESULTS: Out of 1,052 candidate studies, four CCTs were included. Two trials had patient satisfaction as an outcome: (1) A randomized trial compared immediately and early loaded fixed dentures and found more satisfaction with the first after 12 months; (2) A non-randomized study found better satisfaction with immediate fixed dentures compared to conventional loading after 3 months (no more at 12 months). Regarding implant success and prosthetic complications, three trials did not report significant differences comparing immediate loading to other protocols. CONCLUSIONS: This review found weak evidence of differences between immediate load and other loading regimens, regarding patient satisfaction and maintenance events/adversities. The potential of immediate loading for favorable results in edentulous maxillae reinforces the need for well-designed RCTs, for solid clinical guidelines. Registration number CRD42018071316 (PROSPERO database).


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Dentadura Completa , Carga Inmediata del Implante Dental/métodos , Ensayos Clínicos Controlados como Asunto , Humanos , Sesgo de Publicación , Factores de Riesgo , Resultado del Tratamiento
4.
Cient. dent. (Ed. impr.) ; 16(2): 123-128, mayo-ago. 2019. ilus
Artículo en Español | IBECS | ID: ibc-183723

RESUMEN

El objetivo de este trabajo es demostrar la estabilidad de los tejidos que rodean a un implante inmediato tras la realización de una extracción parcial de un diente. La técnica de Socket Shield fue descrita por primera vez por Hürzeler y cols., con la finalidad de preservar el volumen y la posición de los tejidos, así como el nivel original de la cortical vestibular tras la exodoncia, manteniendo un fragmento de la raíz dental a la par que se inserta un implante dental en el mismo alveolo y respetando una distancia entre ambos de uno o dos milímetros y que deberá ser ocupado por el coágulo sanguíneo. A continuación, se expone un caso clínico de una mujer de 42 años de edad que acudió de urgencia por una fractura dental en zona estética. El plan de tratamiento implica la extracción del incisivo central superior derecho y su posterior rehabilitación fija. Se colocó un implante Biohorizons(R) a 40N, 72 ISQ, postextracción y empleando la técnica de Socket-shield con una restauración inmediata temporal no funcional. Transcurridas 16 semanas, se conectó un pilar transepitelial personalizado de circonio y se cementó la corona Emax2. Transcurridos 12 meses de carga funcional, no ha habido complicaciones quirúrgicas ni protésicas. El volumen y la forma original de la cortical vestibular no se han visto clínicamente alteradas, el fragmento radicular se encuentra estable y los tejidos blandos circundantes están en armonía con el pilar transepitelial de circonio, cuya altura de 4 mm aleja la interfase pilar-corona de la interfase pilar-implante en pro de la estabilidad tisular en ese plano. Se ha conseguido estabilizar los tejidos periimplantarios con la técnica Socket Shield y salvaguardar el compromiso estético que implica la pérdida de un incisivo central superior


The objective of this work is to demonstrate the stability of the tissues surrounding an inmediate implant after performing a partial extraction. The Socket Shield technique was described by Hürzeler et all in 2010 with the main goal of preserve the volume and the initial position of the soft-tissues and the buccal plate after the tooth extraction, keeping a piece of the buccal dental root into the alveolar socket at same time of the dental implantation, maintaining a security distance of 1 or 2 millimetres, that should be occupied by the blood cloth. In this Clinical case, a female of 42 years old, with a broken teeth's crown requires dental implant treatment. The planning needs teeth extraction at the upper maxilla and posterior rehabilitation with fixed implant prosthesis. It was inserted a Biohorizons(R) dental implant, using the Socket Shield technique after the partial extraction of the teeth. An immediate provisional prosthesis was connected. 16 weeks later; it was substituted by a customized zirconia abutment to make prosthesis over it. After 12 months of functional load, nonsurgical or prosthesis complications were described. The volume and the original shape of the buccal bone plate do not showed clinical changes, the root piece is stable and the zirconia customized abutment maintains an implant rehabilitation connection far away of the biological width. The Socket Shield technique stabilizes the periimplant tissues and preserves the biological width of the immediate dental implant using a customized zirconia abutment


Asunto(s)
Humanos , Femenino , Adulto , Carga Inmediata del Implante Dental/métodos , Circonio/uso terapéutico , Implantes Dentales de Diente Único , Alveolo Dental , Carga Inmediata del Implante Dental/instrumentación , Estética Dental , Extracción Dental , Coronas , Coronas con Frente Estético
5.
Niger J Clin Pract ; 22(5): 739-741, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31089033

RESUMEN

Residual root fragments in posterior mandibula after extraction are often rarely seen. Implant treatment presumes that implants are placed in bone, without any contact with root. At ankylosed teeth, complete root removal is often invasive; subsequently, the sites require additional augmentation procedures to complete the treatment. Different techniques can be used for removal of these residual root fragments. To our knowledge, there are no study in the literature to provide the extraction of the root fragment using bone lid technique and achieve implant rehabilitation at the same time. The aim of the present study is to reduce bone loss during the residual root extraction for implant therapy. The bone lid approach is an easy and safety technique that could be performed to remove the residual root fragment and achieve implant rehabilitation at the same time. Future studies involving long-term follow-up are needed to evaluate the permanence of these results.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental/métodos , Raíz del Diente/cirugía , Femenino , Humanos , Mandíbula , Persona de Mediana Edad , Rehabilitación Bucal
6.
Int J Oral Maxillofac Implants ; 34(2): 521-528, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883625

RESUMEN

PURPOSE: The aim of this cone beam computed tomography (CBCT) study was to assess bone volume changes in molar sites after modified immediate implant placement with xenografts. MATERIALS AND METHODS: This prospective study was performed between June 2015 and September 2016. Surgical procedures included modified implant site preparation, atraumatic tooth extraction, implant placement, and bone grafting with deproteinized bovine bone mineral. CBCT scans were taken at the day of surgery and 6 months after surgery. Horizontal and vertical bone dimensional changes were evaluated through these two CBCTs, including variations of horizontal bone thickness (HBT), vertical bone height (VBH), and the distance from the implant platform to the tip of the intradental bone peak (DIP). RESULTS: Fifteen patients with 17 hopeless molars were included, and no implant was lost during the observation period. With measurements at five different parallel levels (0, 1, 2, 4, and 6 mm apical to the implant platform), the mean HBT in millimeters and percentage between these two time points ranged from -0.88 (33%) to -0.03 (0.7%) buccally and -0.45 (12%) to -0.02 (0.4%) lingually. The change of VBH was greater buccally (0.74 ± 0.32 mm, P < .01) than lingually (0.40 ± 0.17 mm). DIP was reduced 0.46 ± 0.27 mm mesially and 0.39 ± 0.21 mm distally. CONCLUSION: In molar sites, flapless modified immediate implant placement with deproteinized bovine bone is a predictable treatment. However, the dimensional change of the ridge should still be expected, and buccal bone resorption is more evident than lingual.


Asunto(s)
Pérdida de Hueso Alveolar/patología , Resorción Ósea/patología , Trasplante Óseo/métodos , Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental/métodos , Diente Molar , Adulto , Anciano , Animales , Bovinos , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Xenoinjertos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
7.
Int J Oral Maxillofac Implants ; 34(2): e13-e16, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883627

RESUMEN

When surveyed, edentulous patients commonly state that they would prefer an implant-supported restoration to conventional removable dentures. However, acceptance of implant-supported restorations remains low, primarily due to the high cost of available solutions. To reduce cost and treatment time for patients with an edentulous mandible or failing mandibular dentition, an innovative treatment concept consisting of a standardized framework and time-efficient surgical and restorative protocols was developed. The prefabricated titanium framework is supported on three implants using an adaptive fixation mechanism that compensates for surgical misalignment of the implants to achieve passive fit. The definitive fixed, full-arch mandibular prosthesis can be delivered within 24 hours of implant placement. This patient presentation demonstrates the treatment of a man 82 years of age with complete edentulism. The entire treatment time from surgery to definitive placement was 3 hours over a single business day. After 2 years of function with immediate loading, the patient displayed favorable hard and soft tissue outcomes. Initial results indicate that treatment with this premanufactured device could potentially provide patients with a fixed full-arch implant-supported mandibular restoration with reduced clinical treatment time compared with other implant-supported treatments.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Carga Inmediata del Implante Dental/métodos , Arcada Edéntula/cirugía , Mandíbula/cirugía , Anciano de 80 o más Años , Humanos , Masculino , Titanio , Resultado del Tratamiento
8.
Rev. cuba. estomatol ; 56(1)ene.-mar. 2019. graf
Artículo en Español | CUMED | ID: cum-74128

RESUMEN

Introducción: Dentro del marco de su actividad profesional el estomatólogo se enfrenta a diversas afecciones como la reabsorción radicular interna, cuyos casos avanzados pueden complicar el pronóstico del tratamiento endodóntico, debido al debilitamiento de la estructura dental remanente y las posibles afectaciones periodontales. Debido a que la boca está localizada en uno de los puntos focales de la cara, cualquier alteración en la apariencia estética puede provocar implicaciones psicológicas que pueden ir desde una simple forma de esconder el defecto hasta la más grande introversión. Objetivo: Presentar un caso clínico de reabsorción dentaria interna resuelto con implante postextractivo de carga inmediata. Presentación de caso: Paciente femenina de 31 años con reabsorción dental interna de incisivo central superior. Se llevó a cabo un adecuado diagnóstico y plan de tratamiento del caso, colocándose un implante transalveolar cargado de forma inmediata y la rehabilitación definitiva metalcerámica una vez concluida la fase de osteointegración. Conclusiones: Se consiguió una rehabilitación estética, funcional y biomecánicamente estable a largo plazo, que coincide con las expectativas del paciente, lo cual demuestra que cuando se cumplan los requisitos adecuados y la planificación sea exhaustiva, la implantología ofrece el tratamiento más avanzado en casos en que es inminente la extracción dental(AU)


Introduction: In their daily professional practice dentists are faced with a variety of conditions. An example is internal root resorption, the advanced stage of which may complicate the prognosis of dental treatment, due to the weakening of the remnant dental structure and the potential appearance of periodontal disease. Because the mouth is located in one of the focal points of the face, any alteration of its esthetic appearance may result in psychological disorders ranging from a simple attempt to mask the defect to the greatest introversion. Objective: Present a clinical case of internal tooth resorption solved with a post-extraction immediate load implant. Case presentation: A female 31-year-old patient presents with internal tooth resorption of the maxillary central incisor. Appropriate diagnosis was performed and a treatment plan devised, consisting in immediate placement of a transalveolar implant and definitive metal-ceramic rehabilitation upon completion of the osseointegration stage. Conclusions: Stable long-term esthetic, functional and biomechanical rehabilitation was achieved which met the patient's expectations. This result shows that when the established requirements are complied with and exhaustive planning is performed, implantology offers the most advanced treatment when dental extraction is imminent(AU)


Asunto(s)
Humanos , Femenino , Adulto , Resorción Dentaria/diagnóstico , Carga Inmediata del Implante Dental/métodos , Estética Dental
9.
Rev. cuba. estomatol ; 56(1): e1935, ene.-mar. 2019. graf
Artículo en Español | LILACS | ID: biblio-1003871

RESUMEN

Introducción: Dentro del marco de su actividad profesional el estomatólogo se enfrenta a diversas afecciones como la reabsorción radicular interna, cuyos casos avanzados pueden complicar el pronóstico del tratamiento endodóntico, debido al debilitamiento de la estructura dental remanente y las posibles afectaciones periodontales. Debido a que la boca está localizada en uno de los puntos focales de la cara, cualquier alteración en la apariencia estética puede provocar implicaciones psicológicas que pueden ir desde una simple forma de esconder el defecto hasta la más grande introversión. Objetivo: Presentar un caso clínico de reabsorción dentaria interna resuelto con implante postextractivo de carga inmediata. Presentación de caso: Paciente femenina de 31 años con reabsorción dental interna de incisivo central superior. Se llevó a cabo un adecuado diagnóstico y plan de tratamiento del caso, colocándose un implante transalveolar cargado de forma inmediata y la rehabilitación definitiva metalcerámica una vez concluida la fase de osteointegración. Conclusiones: Se consiguió una rehabilitación estética, funcional y biomecánicamente estable a largo plazo, que coincide con las expectativas del paciente, lo cual demuestra que cuando se cumplan los requisitos adecuados y la planificación sea exhaustiva, la implantología ofrece el tratamiento más avanzado en casos en que es inminente la extracción dental(AU)


Introduction: In their daily professional practice dentists are faced with a variety of conditions. An example is internal root resorption, the advanced stage of which may complicate the prognosis of dental treatment, due to the weakening of the remnant dental structure and the potential appearance of periodontal disease. Because the mouth is located in one of the focal points of the face, any alteration of its esthetic appearance may result in psychological disorders ranging from a simple attempt to mask the defect to the greatest introversion. Objective: Present a clinical case of internal tooth resorption solved with a post-extraction immediate load implant. Case presentation: A female 31-year-old patient presents with internal tooth resorption of the maxillary central incisor. Appropriate diagnosis was performed and a treatment plan devised, consisting in immediate placement of a transalveolar implant and definitive metal-ceramic rehabilitation upon completion of the osseointegration stage. Conclusions: Stable long-term esthetic, functional and biomechanical rehabilitation was achieved which met the patient's expectations. This result shows that when the established requirements are complied with and exhaustive planning is performed, implantology offers the most advanced treatment when dental extraction is imminent(AU)


Asunto(s)
Humanos , Femenino , Adulto , Resorción Dentaria/diagnóstico , Carga Inmediata del Implante Dental/métodos , Estética Dental
10.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(1): 100-105, 2019 Jan 30.
Artículo en Chino | MEDLINE | ID: mdl-30692074

RESUMEN

OBJECTIVE: To explore the feasibility of immediate implantation after tooth extraction in the maxillary molar socket with poor bone quality beneath the sinus. METHODS: We collected the data from the patients undergoing extraction of maxillary molars with poor bone quality between the sockets and sinuses. Sinus lifting and immediate implant following the extraction were performed simultaneously in these cases, and the primary stability of the implants, wound healing, and changes of the sinus were observed. At 6 months after the operations, the crowns were installed on the implants. The masticatory function was observed, and the growth of the alveolar bones and their changes after the operations were examined using microcomputed tomography (MCT). RESULTS: We analyzed 32 extraction cases with immediate implantation in the maxillary molar sockets with poor bone quality beneath the sinus. The average age of the patients was 59.8 years, and the length and diameter of the implant ranged from 8.5 to 10 mm and from 4.5 to 5.5 mm, respectively. The torque force of the implants varied from the minimum (in which cases the implants remained fixed after insertion with fingers) to the maximum of 30 N·cm. The postoperative recovery was uneventful in all the cases and no failed or movable implants were found. At 6 months after the operation, none of the patients showed abnormalities in the sinus, and in all the cases the crowns were successfully installed on the implants with good recovery of the masticatory functions. Follow-up of the patients for 12 to 96 months after the operation showed successful immediate implantation in all the cases. After the operation, the changes of the mean alveolar ridge heights on the buccal, palatal, mesial, and distal sides of the patients were 0.8069±0.6253 mm (t=1.2904, P>0.1), 0.5272± 0.3331 mm (t=1.5836, P>0.05), 0.5416±0.4048 mm (t=1.3379, P>0.05), and 0.5172±0.3874 mm (t=1.3351, P>0.05), respectively; the change of the alveolar ridge width was 0.5522±0.4381 mm (t=1.2604, P>0.1) mm. The dimension of the alveolar bone underwent no significant changes after the operation in these patients. CONCLUSIONS: Immediate implantation in the maxillary extraction socket with a poor bone quality can avoid damages to the sinus and achieve good outcomes with such advantages of less trauma, full use of the innate gingiva and alveolar ridge, and well preserved morphology of the alveolar ridge as compared with delayed implantation.


Asunto(s)
Implantación Dental/métodos , Implantes Dentales de Diente Único , Diente Molar/cirugía , Extracción Dental , Microtomografía por Rayos X , Estudios de Factibilidad , Humanos , Carga Inmediata del Implante Dental/métodos , Maxilar , Persona de Mediana Edad , Alveolo Dental , Resultado del Tratamiento
11.
Implant Dent ; 28(1): 91-98, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30640310

RESUMEN

PURPOSE: To introduce a user-friendly protocol for implant-retained prosthetic rehabilitation of fully edentulous patients based on facial profile and the cephalometric intermaxillary relationship. MATERIALS AND METHODS: The prosthetic rehabilitation of edentulous patients with implants based on facial profile assessment protocol commences with a clinical and cephalometric analysis, followed by a preliminary projection to obtain a harmonious interarch relationship, eventually stabilized by the preplanned prosthesis. The protocol is divided into the following 5 phases: esthetic evaluation; cephalometric-occlusal assessment; surgery; provisionalization; and definitive prosthesis. Evaluation of patient's satisfaction from the treatment provided was performed through a preoperative and postoperative visual analogue scale scores. RESULTS: The patient was granted immediate function and superior esthetics at day 1 of the treatment. These results were re-evaluated on an interval of 18 months and continued to be stable. The overall treatment time was significantly reduced. CONCLUSION: Our recommended protocol gives the clinician a chance to grasp results beyond the offered by traditional protocols by using a wider perspective of rehabilitation, involving the patient's facial profile, thus fulfilling the integration of both occlusal and cephalometric parameters in a unified surgical-prosthetic approach.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Estética Dental , Cara/anatomía & histología , Carga Inmediata del Implante Dental/métodos , Arcada Edéntula/rehabilitación , Cefalometría , Diseño de Prótesis Dental , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente
12.
J Prosthodont ; 28(2): e688-e693, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29377338

RESUMEN

PURPOSE: The purpose of this retrospective clinical study was to assess the influence of immediate loading and lengths of splinted implants on the clinical effectiveness of 6.5-mm-long implants supporting two-implant fixed prostheses in the premolar-molar regions. MATERIALS AND METHODS: A clinical database was reviewed in a private dental center to select those patients who had 6.5-mm-long implants placed to support two-implant fixed partial prostheses in the premolar-molar regions of the maxilla and the mandible. All implants were immediately loaded. The study groups were defined according to the lengths of the implants. Two groups were identified: the short-short splinted group, when both implants had 6.5 mm lengths, and the short-long splinted group, when one implant was longer than 6.5 mm. A total of 48 dental implants were placed in 16 patients to support 24 two-implant fixed prostheses. The mean follow-up time was 14 ± 5 months. The short-short splinted group included 8 patients with 16 implants; the short-long splinted group included 16 patients with 32 implants. The main variable was implant survival, and secondary outcomes were marginal bone stability and prosthesis survival. RESULTS: The statistical analyses indicated an absence of significant differences between the two groups in terms of implant and prosthesis survival (100% for both groups and both variables); however, distal bone loss around the splinted implants was significantly higher in the short-long splinted group. Bone loss was 0.37 ± 0.55 mm in the short-short splinted group and 0.94 ± 0.66 mm in the short-long splinted group. CONCLUSIONS: Immediate loading of short (6.5-mm-long) implants in the premolar-molar regions did not jeopardize their survival. Two-implant supported prostheses had the same clinical effectiveness, whether extra-short implants were splinted to another extra-short implant or to a longer one.


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Carga Inmediata del Implante Dental/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Diente Premolar , Implantes Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado/instrumentación , Femenino , Humanos , Carga Inmediata del Implante Dental/instrumentación , Masculino , Persona de Mediana Edad , Diente Molar , Ferulas Periodontales , Radiografía Dental
13.
J Prosthodont ; 28(2): e637-e642, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29143462

RESUMEN

PURPOSE: To evaluate the clinical and radiographic outcomes following the application of autogenous bone (ABG)/melatonin composite graft around immediate implants in the esthetic zone compared to ABG alone. MATERIALS AND METHODS: Twenty-six patients with two nonrestorable anterior/premolar teeth were randomly classified into two equal groups. Dental implants were immediately inserted either with ABG (control group) or ABG/melatonin (test group). Outcome measures were peri-implant sulcus depth (PD), gingival index (GI), and wound healing scores. Cone beam computed tomography (CBCT) was recorded at baseline, 6, and 9 months. RESULTS: At the end of the study, a significant difference was shown in the mean of marginal bone loss between the control group (1.91 mm ± 0.42) and the test group (0.84 mm ± 0.34) at p = 0.0001. The test group showed a significant gain in bone density, 500.73 ± 40.92, versus 420.14 ± 38.33 in the control group (p = 0.0001). There was a statistically significant difference between the control group (0.68 ± 0.42) versus the test group (0.45 ± 0.49; p = 0.044) in GI. PD was significantly reduced at the end of the study in the test group (0.42 mm ± 0.50; p = 0.002), with a similar significant improvement in the healing scores (p = 0.026). CONCLUSION: Within the limitations of this study, immediate implants augmented with ABG/melatonin composite graft would be a valuable option in the esthetic zone.


Asunto(s)
Trasplante Óseo/métodos , Carga Inmediata del Implante Dental/métodos , Melatonina/uso terapéutico , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Estética Dental , Femenino , Humanos , Masculino , Radiografía Dental
14.
J Craniomaxillofac Surg ; 47(1): 23-28, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30514603

RESUMEN

PURPOSE: The aim of this study was to describe the surgical technique of immediate dental implant placement in calvarial grafts for augmentation of the severely resorbed maxilla and to assess the treatment results. METHODS: In 13 patients the maxilla was augmented with calvarial bone followed by simultaneous dental implant placement (total: 68 implants). In the frontal "knife edge" region, implants were inserted in the buccal plated area. In the maxillary sinus area, implants were inserted into alveolar bone that was plated buccally or palatally through the sinus window. After 4 months, the implants were retrieved and subsequently loaded. Per-operative and post-operative variables were scored. One bone biopsy sample was taken for histological analysis. RESULTS: The surgical procedure and wound healing was uneventful. During abutment connection after 4 months, all implants were fully osseointegrated with no signs of graft resorption. Radiographically, the mean (±SD) peri-implant bone loss after 1 year of functional loading was 0.23 ± 0.44 mm. No implants were lost. Histological examination revealed vital calvarial and maxillary bone with active remodeling. CONCLUSION: Immediate dental implant placement in calvarial bone grafts to rehabilitate severely resorbed maxilla is technically feasible and seems to have a high success rate.


Asunto(s)
Trasplante Óseo/métodos , Trasplante Óseo/rehabilitación , Implantación Dental Endoósea/métodos , Implantes Dentales , Carga Inmediata del Implante Dental/métodos , Arcada Edéntula/cirugía , Maxilar/cirugía , Oseointegración , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Aumento de la Cresta Alveolar/métodos , Biopsia , Pilares Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Humanos , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/patología , Masculino , Maxilar/diagnóstico por imagen , Maxilar/patología , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Cicatrización de Heridas
15.
Int J Oral Maxillofac Implants ; 34(1): 141­149, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30521662

RESUMEN

PURPOSE: Immediate dental implant loading has been investigated with favorable results. However, short implants have not been investigated in this treatment option. This study compared the clinical outcomes and survival rates of immediately loaded short and conventional length dental implants in replacing mandibular molar teeth. MATERIALS AND METHODS: Forty-six implants (23 short dental implants and 23 conventional dental implants) in 46 patients were included in the study. Provisional computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crowns were cemented to the abutments and immediately loaded. Several clinical parameters were recorded and statistically analyzed at 4-month- and 1-year-follow-up. RESULTS: Two short implants lost integration, and one conventional implant failed. No statistically significant difference between the two implant types was found (P = 1.00). Minor complications were recorded; three provisional crown fractures were found in the short implant group and two provisional crown fractures in the conventional implant group. There was no significant difference in implant stability quotient values for short or conventional implants between baseline (short: 73.86 ± 2.38, conventional: 75.05 ± 3.26, P = .088), 4 months after loading (short: 72.37 ± 1.35, conventional: 72.89 ± 1.87, P = .165), and 1 year after loading (short: 74.60 ± 2.03, conventional: 75.35 ± 2.66, P = .296). The mean marginal bone level loss 4 months after loading was 0.28 ± 0.29 mm for short implants and 0.25 ± 0.25 mm for conventional implants (P = .73), and at 1 year after loading was 0.33 ± 0.47 mm for short implants and 0.26 ± 0.27 mm for conventional implants (P = .554); there was no statistical difference between the two implant types. CONCLUSION: The immediate loading of short implants is comparable to conventional length implants in terms of implant survival, marginal bone level change, and implant stability quotient value.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Diseño de Prótesis Dental , Carga Inmediata del Implante Dental/métodos , Mandíbula/cirugía , Adulto , Diseño Asistido por Computadora , Fracaso de la Restauración Dental/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Diente Molar , Adulto Joven
16.
Clin Implant Dent Relat Res ; 21(1): 122-129, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30548792

RESUMEN

PURPOSE: To assess the difference in the evolution of implant stability values, determined by resonance frequency analysis (RFA), between two groups of implants subjected to two different loading protocols: immediate and delayed. MATERIALS AND METHODS: A retrospective clinical study was conducted, including a total of 93 implants placed in 38 patients. All implants corresponded to one of two models of the Klockner Implant System (Essential Cone and Vega) and were divided into two groups according to the loading protocol adopted: delayed loading in group A (>10 weeks) and immediate loading in group B (<48 hours). Implant stability was measured four times throughout the study period with a Penguin RFA device: implant placement (T0), definitive loading (T1), 6 months after loading (T2), and 12 months after loading (T3). RESULTS: Implant stability quotient (ISQ) values showed a statistically significant increase in both groups after loading. In group A, the greatest increase in stability occurred between T1 and T2, whereas in group B, the greatest increase occurred between T0 and T1, coinciding in both cases with the period in which the implants were subjected to prosthetic loading. CONCLUSIONS: The functional loading of implants increases their stability, as measured in ISQ values by RFA. Increases in ISQ values are greater during the months immediately following loading, which shows that immediate or early loading protocols are not only possible but can also be beneficial.


Asunto(s)
Implantación Dental Endoósea , Retención de Prótesis Dentales , Implantación Dental Endoósea/métodos , Retención de Prótesis Dentales/métodos , Femenino , Humanos , Carga Inmediata del Implante Dental/métodos , Masculino , Persona de Mediana Edad , Análisis de Frecuencia de Resonancia , Estudios Retrospectivos
17.
J Prosthet Dent ; 121(1): 17-21, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30093118

RESUMEN

This article describes a workflow based on a top-down approach to provide a fixed-type immediate interim restoration after placing a single implant using a digitally driven surgical guide and a matrix-positioning device. A characteristic of the technique is that both the surgical guide and the matrix-positioning device are fabricated from a single diagnostic virtual trial restoration designed on computer-aided design (CAD) software. This workflow may shorten the time required for chairside placement of an interim restoration and enhance esthetics when rehabilitating anterior teeth.


Asunto(s)
Diseño Asistido por Computadora , Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental/métodos , Cirugía Asistida por Computador/métodos , Flujo de Trabajo , Coronas , Implantes Dentales , Modelos Dentales , Diseño de Prótesis Dental/métodos , Prótesis Dental de Soporte Implantado/métodos , Restauración Dental Provisional , Estética Dental , Humanos
18.
J Prosthet Dent ; 121(2): 258-264, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30093119

RESUMEN

STATEMENT OF PROBLEM: Implant-based prosthetic solutions can be time consuming. If implants can be loaded immediately, treatment time can be reduced. PURPOSE: The purpose of this prospective randomized controlled trial was to monitor the survival rate of Ankylos implants, comparing conventional with immediate loading by using abutments with the SynCone concept for screw-retained removable prostheses in the edentulous maxilla. MATERIAL AND METHODS: A total of 90 implants were placed in 15 study participants. The participants were randomly assigned to the immediate or conventional loading treatment group. Radiographic and clinical parameters were recorded at the time of permanent prosthesis installment and at 1- and 2-year follow-up examinations, and participants' satisfaction was measured by using questionnaires before and after prosthesis installation. A linear mixed model was used to measure differences. RESULTS: One implant in the conventional group was lost during abutment placement; hence, 89 implants could be followed for 2 years. Approximately 90% of these implants showed no bone loss or even bone gain at 1 and 2 years follow-up. Mean values for the immediate group were, respectively, 0.09 ±0.35 mm and 0.13 ±0.38 mm and 0.01 ±0.41 mm and -0.06 ±0.32 mm for the conventional method. No significant differences (P=.053) were found in bone level alterations between the groups. For all participants, the mean number of surfaces (4 per implant) with bleeding on probing (BoP) and plaque were 0.76 ±0.81 and 0.16 ±0.42 at 1 year follow-up and 0.44 ±0.66 and 0.02 ±0.15, respectively, at the second-year follow-up. The mean pocket probing depths were 2.05 ±0.54 mm at 1 year and 2.18 ±0.64 mm at 2 years. For both groups, a significant rise in satisfaction and quality of life was observed (P≤.001) at 1 and 2 years compared with pretreatment. CONCLUSIONS: Ankylos implants placed in the edentulous maxilla, immediately or conventionally loaded by a detachable prosthesis, showed favorable bone-level preservation after 2 years of follow-up. No significant differences could be found between the immediate and conventional groups. A significant increase in quality of life was observed for both loading modes.


Asunto(s)
Implantación Dental Endoósea/métodos , Prótesis Dental de Soporte Implantado , Dentadura Parcial Removible , Carga Inmediata del Implante Dental/métodos , Anciano , Tornillos Óseos , Pilares Dentales , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar , Persona de Mediana Edad , Satisfacción del Paciente , Estudios Prospectivos , Encuestas y Cuestionarios , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
19.
Clin Implant Dent Relat Res ; 21(1): 73-79, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30548160

RESUMEN

BACKGROUND: There is lack of studies regarding preservation and possible changes in BBT at dental implants. PURPOSE: To assess, on cone beam computer tomograms, the presence of bone at the time of tooth extraction in the maxillary esthetic region and the mean buccal bone thickness 1 month and 1 year after final restoration placement in patients with large bony defects. MATERIAL AND METHODS: In a cohort study, patients were selected presenting a failing tooth with a large bony defect (test group [n = 20]: large bony defect, immediate placed implant and delayed provisionalization). Results were compared with a group in which patients presented a failing tooth without or with a small bony defect: (control group [n = 20]: without or small bony defect, immediate placed implant and delayed provisionalization). Cone beam computer tomograms were made preoperatively, and 1 month and 1 year after placement of the restoration, and buccal bone thickness was analyzed. RESULTS: In both groups approximately 1 mm of buccal bone thickness was present after 1 month and 1 year, without a significant difference between the groups. CONCLUSION: In patients with large bony defects at a failing tooth it was possible to create a bone layer buccally of the implant and this bone layer remained stable during a 1-year follow-up; there were no significant differences between thickness of buccal bone at 1 month and 1 year in patients with large buccal bony defects and patients without or with small bony defects.


Asunto(s)
Proceso Alveolar/patología , Carga Inmediata del Implante Dental , Adolescente , Adulto , Proceso Alveolar/diagnóstico por imagen , Mejilla , Tomografía Computarizada de Haz Cónico , Implantes Dentales/efectos adversos , Femenino , Humanos , Carga Inmediata del Implante Dental/efectos adversos , Carga Inmediata del Implante Dental/métodos , Masculino , Maxilar , Persona de Mediana Edad , Adulto Joven
20.
Av. odontoestomatol ; 34(6): 285-292, nov.-dic. 2018. ilus
Artículo en Español | IBECS | ID: ibc-182272

RESUMEN

Introducción: El objetivo del presente estudio era presentar los resultados clínicos de la carga inmediata de implantes insertados mediante la técnica de cirugía guiada en pacientes edéntulos mandibulares. Pacientes y Métodos: Pacientes edéntulos totales mandibulares fueron diagnosticados mediante una tomografía computarizada de haz cónico y tratados con 8-10 implantes Galimplant(R) para su rehabilitación mediante la técnica de cirugía guiada y carga inmediata. Inmediatamente después de la cirugía sin colgajo se colocó una rehabilitación total inmediata provisional de resina. A los 3 meses se realizó la rehabilitación fija definitiva. El periodo de seguimiento clínico ha sido al menos de 48 meses después de la carga funcional. Resultados y Discusión: 24 pacientes fueron tratados con 206 implantes. Desde un punto de vista implantológico, los resultados indican un éxito de los implantes del 97,6% después de un seguimiento clínico medio de 62,4 meses desde la rehabilitación definitiva. 5 implantes se perdieron durante el periodo de cicatrización con la prótesis provisional. La pérdida media de hueso marginal ha sido de 1,34 mm. Los hallazgos clínicos demuestran la eficacia clínica de este protocolo de carga inmediata, donde la estabilidad primaria de los implantes y el ajuste oclusal de la prótesis inmediata son factores determinantes del éxito. Conclusiones: Este estudio indica que el tratamiento de pacientes edéntulos mandibulares con implantes dentales mediante cirugía guiada y carga inmediata constituye una alternativa terapéutica implantológica con una tasa elevada de éxito


Introduction: The aim of this study was to present the clinical outcomes of immediate loading of implants inserted by guided surgery in edentulous mandibular patients. Patients and methods: Mandibular edentulous patients were diagnosed by a cone beam tomography and treated with 8-10 Galimplant(R) implants for rehabilitation with guided surgery and immediate loading. After flapless surgery, implants were loaded with an immediate acrylic temporary prosthesis. After a period of three months, a ceramic definitive full arch prosthesis were placed. The follow-up were at least of 48 months of functional loading. Results and discussion: 24 patients were treated with 206 implants. Clinical outcomes showed a global success of 97.6% of implants after a mean follow-up of 62.4 months. Five implants were lost during the healing phase with provisional prosthesis. Mean marginal bone loss was 1.34 mm. Findings of the study showed clinical efficacy of immediate loading, primary stability and occlusal adjustment of immediate prosthesis are key determinants of success. Conclusions: This study indicate that treatment of mandibular edentulous patients by guided surgery and immediate loading constitute an implant option with a high rate of success


Asunto(s)
Humanos , Persona de Mediana Edad , Anciano , Carga Inmediata del Implante Dental/instrumentación , Implantación Dental/instrumentación , Carga Inmediata del Implante Dental/métodos , Tomografía Computarizada por Rayos X/métodos , Profilaxis Antibiótica , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Implantes Dentales/efectos adversos
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