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2.
Compend Contin Educ Dent ; 41(7): e1-e5, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687377

RESUMEN

Achieving predictable outcomes in implant dentistry requires not only an understanding of surgical and prosthetic protocols but also knowledge of bone biology. Regarding implant stability, a distinction exists between non-osseointegrated and osseointegrated implants. Primary or mechanical stability at implant placement is different than secondary or biological stability. Bone quality, implant length, and implant width all influence the achievement of primary stability. This article reviews the contemporary literature on dental implant osseointegration, with the intent of presenting clinicians scientific information concerning the biomechanical parameters and limitations of endosseous implants and their components during the osseointegration phase, as well as their behavior once occlusal forces are present following osseointegration.


Asunto(s)
Implantes Dentales , Implantación Dental Endoósea , Diseño de Prótesis Dental , Oseointegración
3.
Compend Contin Educ Dent ; 41(7): 362-366; quiz 367, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687380

RESUMEN

Digital implant workflows are facilitating new and more accurate methods of implant treatment planning when compared to conventional analog techniques. The placement of implants using guided surgery presents multiple benefits for immediately restoring a patient functionally and esthetically with a provisional restoration. Although digital technology enables efficiency and enhanced accuracy for dental implant treatments, some cases may require the use of a hybrid workflow that employs both conventional and digital procedures, as some limitations to a fully digital approach exist depending on the clinical situation. This article presents several different implant treatment scenarios and discusses whether a fully digital workflow is possible and/or beneficial in each situation. The scenarios describe the full-treatment sequence for immediately loaded implants, allowing a direct comparison of various restorative and surgical implant workflows.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Diseño Asistido por Computadora , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Humanos , Planificación de Atención al Paciente , Flujo de Trabajo
4.
Compend Contin Educ Dent ; 41(7): 368-376; quiz 377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687381

RESUMEN

Dental implant therapies must be planned and executed to meet both the immediate and longer-term expectations of patients. The early developmental success of dental implants was dependent on the quality and quantity of a patient's bone. Implants were commonly placed into the parasymphyseal mandibular and anterior maxillary bone. Building on this success, bone grafting allowed patients lacking sufficient bone to obtain implant-supported prosthetic solutions for treatment of partial or complete edentulism. More recently, several nongrafting solutions for implant therapy, including pterygoid implants, zygomatic implants, tilted implants, and short implants, have reported success. This article will consider the rationale for graftless solutions in implant therapy as well as the data supporting the use of various graftless protocols as alternatives to grafting and conventional dental implant therapy. It will discuss factors concerning graftless versus grafted approaches to treatment of patients with limited bone volume and will describe the use of short dental implants as a graftless solution in the edentulous maxilla.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
5.
Compend Contin Educ Dent ; 41(7): 384-386, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687383

RESUMEN

The design and development of today's dental implants has been an evolving process based on scientific research, clinician input, and manufacturer ingenuity. Newer tapered implants with aggressive thread designs allow for placement at greater torque values than in the past, with high levels of initial stability even in situations with low-density or compromised bone. Modern implants are designed for patient cases involving extraction, immediate placement, and immediate load, as well as cases with less-than-ideal bone volume and quality. Contemporary implant body and platform design strongly considers minimizing bone trauma and crestal bone loss while maintaining gingival architecture. Even the most advanced implant design, however, can only function well when the implant is placed in healthy surrounding bone. Current thought leans toward the notion that implant bed preparation is as important as the implant itself. This article discusses the rationale behind the influence of these modern-day factors in immediate loading and aims to assist clinicians in decision making regarding appropriate selection of implants, instrumentation, and clinical procedures.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Diseño de Prótesis Dental , Encía , Humanos , Osteotomía , Torque
6.
Quintessence Int ; 51(7): 578-584, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32500865

RESUMEN

An edentulous posterior maxilla can present a challenge for placement of dental implants due to the proximity of the maxillary sinus. Sinus augmentation is a surgical bone grafting procedure aimed to increase the bone height for implant support. A number of sinus augmentation techniques have been presented and the outcomes show good implant success rates. In order to achieve the desirable outcomes, it is important to gain knowledge of the maxillary sinus anatomy and complete a thorough preoperative evaluation. Being aware of the location of vasculature, nerves, and the presence of septa will help reduce the risk of intraoperative and postoperative complications. This review provides a narrative clinical overview related to the anatomy, preoperative evaluation, contraindications, techniques, postoperative care, outcome measures, and complications of sinus augmentation procedures.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Maxilar , Seno Maxilar , Resultado del Tratamiento
7.
Swiss Dent J ; 130(6): 486-492, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32512981

RESUMEN

A status report of dental implantology in Switzerland has already been performed in 1994 and 2006. The present study, based on these former surveys, aimed to update these results for the year 2016. To this end, a questionnaire was sent to all dentists in Switzerland who were members of the Swiss Dental Society (SSO) at the time of the survey. The questionnaire asked for personal background data and obtained information about the dentists' knowledge and concepts when using implants, the extent to which they used implants and about specific implant systems, which were selected based on the previous surveys. Out of 3,168 questionnaires, 1,446 were returned (return rate: 45.6%). Approximately 91% of the responding dentists had a practical involvement in implantology (implant placement only, superstructure insertion only, or both). Just over half of them (53%) placed more than twenty implants per year. Good handling was chosen by all dentists (100%) as a selection criterion for the implant system they used preferably. The current data suggested that the range of indications had widened, yet that the edentulous mandible was still the indication of choice. The percentage of dentists engaged in dental implantology doubled from 1994 to 2006 (1994: 42.2%, 2006: 82.2%). An increase of almost 10% in dentists involved in dental implantology was also apparent from 2006 to 2016 (2006: 82.2%, 2016: 91%). Our data show that, whilst the relative number of implant users had greatly increased among Swiss dentists, their rationale to place implants has remained similar.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Estudios Transversales , Pautas de la Práctica en Odontología , Encuestas y Cuestionarios , Suiza
8.
J Oral Implantol ; 46(3): 182-189, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32582919

RESUMEN

The aim of this study was to evaluate the influence of bone quality, drilling technique, implant diameter, and implant length on insertion torque (IT) and resonance frequency analysis (RFA) of a prototype-tapered implant with knife-edge threads. The investigators hypothesized that IT would be affected by variations in bone quality and drilling protocol, whereas RFA would be less influenced by such variables. The investigators implemented an in vitro experiment in which a prototype implant was inserted with different testing conditions into rigid polyurethane foam blocks. The independent variables were: bone quality, drilling protocol, implant diameter, and implant length. Group A implants were inserted with a conventional drilling protocol, whereas Group B implants were inserted with an undersized drilling protocol. Values of IT and RFA were measured at implant installation. IT and RFA values were significantly correlated (Pearson correlation coefficient: 0.54). A multivariable analysis showed a strong model. Higher IT values were associated with drilling protocol B vs A (mean difference: 71.7 Ncm), implant length (3.6 Ncm increase per mm in length), and substrate density (0.199 Ncm increase per mg/cm3 in density). Higher RFA values were associated with drilling protocol B vs A (mean difference: 3.9), implant length (1.0 increase per mm in length), and substrate density (0.032 increase per mg/cm3 in density). Implant diameter was not associated with RFA or IT. Within the limitations of an in vitro study, the results of this study suggest that the studied implant can achieve good level of primary stability in terms of IT and RFA. A strong correlation was found between values of IT and RFA. Both parameters are influenced by the drilling protocol, implant length, and substrate density. Further studies are required to investigate the clinical response in primary stability and marginal bone response.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Densidad Ósea , Retención de Prótesis Dentales , Análisis de Frecuencia de Resonancia , Torque
9.
J Oral Implantol ; 46(3): 235-243, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32582920

RESUMEN

No previously published studies have reported on the placement and restoration of dental implants in a patient diagnosed with sarcoidosis. Patients with sarcoidosis may develop periodontitis as a manifestation of systemic disease and are therefore at increased risk of tooth loss. These patients are likely to want fixed dental prostheses, which may need to be supported by dental implants. The case presented is that of a 31-year-old female patient presenting with a missing maxillary central incisor and a sarcoidal process affecting the anterior maxilla, which had severely compromised the periodontium of the adjacent lateral incisor. The patient was successfully rehabilitated with an implant-retained prosthesis following a staged horizontal and vertical bone augmentation procedure. At the 4-year review, the implant restoration performed well with stable peri-implant bone levels. We conclude that dental implant rehabilitation in patients with sarcoidosis may be a predictable treatment option, depending on disease stability and concurrent systemic therapy, but these patients will require additional maintenance because of the possibility of an increased risk of peri-implantitis. The effects of sarcoidosis and its management on the success of dental implants are discussed to aid treatment planning for such patients.


Asunto(s)
Implantes Dentales , Sarcoidosis , Adulto , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Humanos , Maxilar/cirugía , Resultado del Tratamiento
10.
J Oral Implantol ; 46(3): 249-252, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32582921

RESUMEN

Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.


Asunto(s)
Implantes Dentales , Osteítis , Diente Premolar , Regeneración Ósea , Implantación Dental Endoósea , Humanos , Extracción Dental
11.
Int J Comput Dent ; 23(2): 109-117, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32555764

RESUMEN

AIM: To evaluate width loss of the alveolar ridge three years after implant placement in a fresh extraction socket following two different tissue healing methodologies: conventional healing procedure vs CAD/CAM technology for a customized healing abutment. MATERIALS AND METHODS: Post-extraction sockets underwent immediate dental implant placement without the voids being filled between the implant surface and the socket wall. Samples (one implant per patient) were retrospectively enrolled in each group according to the type of healing procedure: implants in the conventional group underwent standard closed healing with a cover screw, while in the customized group the healing abutment was immediately screwed onto the head of the implant, mimicking the look of the extracted tooth fabricated by CAD/CAM technology. The width of the alveolar ridge was measured on 3D radiographs at baseline (before surgery) and three years postsurgery. Nonparametric statistics were performed with a significance level of 0.01. RESULTS: A total of 54 dental implants were selected. An implant survival rate of 100% was reported for all implants after 36 months. Three years after implant placement, loss in bone width was registered for both the conventional and customized groups, being 2.2 (1.1) and 0.2 (0.7) mm, respectively. Changes in the customized group were significantly lower than in the conventional group. Significant differences were again found between the groups for each of the tooth sites. Loss of bone width appeared negligible (from incisor to premolar), with values ranging between 0.2 and 0.4 mm in the customized group, whereas in the conventional group all tooth sites underwent wide shrinkage (with a bone loss ranging from 1.6 to 3.0 mm). CONCLUSION: The CAD/CAM procedure might provide the following advantages: 1) Stabilization of the gingival setting and bone volume in a fresh socket implant; 2) Maintaining the same emergence profile of teeth for restorative crowns, avoiding laboratory approximation of the emergence profile of the definitive restoration; and 3) Optimal prosthetic-surgical planning and minimally invasive extraction to preserve the integrity of the supporting tissue.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Coronas , Implantación Dental Endoósea , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Extracción Dental , Alveolo Dental/cirugía , Resultado del Tratamiento
12.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 338-342, 2020 Jun 01.
Artículo en Chino | MEDLINE | ID: mdl-32573145

RESUMEN

Adequate bone volume is the primary condition for successful dental implants. However, sufficient bone volume is often encountered in the vertical direction, but the bone volume in the buccolingual direction is insufficient, making it less suitable to be implanted. If the traditional spitting technique is used in the mandible, fracture and necrosis can easily occur in the labial (buccal) bone plate due to the absence of elasticity, thick cortical bone, poor blood supply, and anastomotic branch. The two-stage ridge splitting technique can be used in patients with narrow alveolar ridge in the mandible. This study summarizes the principles and conditions of application, operational points, clinical efficacy, and analysis of the causes of buccal bone plate absorption.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Proceso Alveolar , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Mandíbula/cirugía
13.
J Evid Based Dent Pract ; 20(2): 101420, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32473804

RESUMEN

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Comparison of immediate implant placement in infected and noninfected extraction sockets: systematic review and meta-analysis. Lee J, Park D, Koo K-T, Seol Y-J, Lee Y-M. Acta Odont Scand 2018;76(5):338-45. SOURCE OF FUNDING: This research did not receive any special grants from funding agencies in the public, commercial, or not-for-profit sectors. TYPE OF STUDY/DESIGN: Systematic review and meta-analysis.


Asunto(s)
Implantes Dentales , Alveolo Dental/cirugía , Implantación Dental Endoósea , Humanos , Proyectos de Investigación , Extracción Dental
14.
Head Face Med ; 16(1): 12, 2020 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-32487178

RESUMEN

BACKGROUND: Ameloblastoma is one of the most common benign odontogenic neoplasms. Its surgical excision has the potential to lead to postoperative malocclusion. In this case report, we describe the successful interdisciplinary orthodontic treatment of a patient with ameloblastoma who underwent marginal mandibulectomy. CASE PRESENTATION: A woman of 20-year-old was diagnosed with ameloblastoma, and underwent marginal mandibulectomy when she was 8 years of age. She had an excessive overjet (11.5 mm) and a mild open bite (- 1.5 mm) with a severely resorbed atrophic edentulous ridge in the area around the mandibular left lateral incisor, canine and first premolar. An alveolar bone defect associated with tumor resection was regenerated by vertical distraction osteogenesis (DO). Subsequently, 3 dental implants were placed into the reconstructed mandible. Orthodontic treatment using implant-anchored mechanics provided a proper facial profile with significantly improved occlusal function. The occlusion appeared stable for a 7-year retention period. CONCLUSIONS: These results suggest that surgically assisted and implant anchored-orthodontic approaches might be effective for the correction of such malocclusions.


Asunto(s)
Aumento de la Cresta Alveolar , Ameloblastoma , Implantes Dentales , Neoplasias Mandibulares , Osteogénesis por Distracción , Ameloblastoma/cirugía , Implantación Dental Endoósea , Femenino , Humanos , Mandíbula , Neoplasias Mandibulares/cirugía , Adulto Joven
15.
Bull Tokyo Dent Coll ; 61(2): 135-143, 2020 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-32507778

RESUMEN

Here, we describe the provision of an implant-supported prosthesis in a patient with impacted teeth in the maxilla, which complicated implant placement and necessitated utilization of the extraction sockets of previously impacted teeth and residual submerged roots. The patient was a 63-year-old man who visited our clinic with the chief complaint of difficulty in mastication. Numerous residual roots were observed in the maxilla, and radiographic imaging revealed that the residual roots of teeth #13 and #16 were fully impacted. The patient complained of a strong sensation of a foreign body in the area of a denture support overlying these residual roots. Therefore, the impacted teeth were extracted, 5 implants placed, and a temporary prosthesis provided. Given the necessity of placing the implant through the extraction socket of the impacted canine (#13), favorable initial stability was achieved using a long (>20 mm) implant. Moreover, autogenous bone obtained by osteotomy was grafted onto the extracted impacted tooth socket. The clinical condition was stable at approximately 1 year after implant placement and so the final prosthesis was delivered, with periodic check-ups being performed every 3 months thereafter. After 4 years, the patient has reported no symptoms. Clinically, there are no signs of inflammation, and the postoperative condition is deemed to be very favorable.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Diente Impactado/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Extracción Dental , Alveolo Dental/cirugía , Resultado del Tratamiento
16.
J Contemp Dent Pract ; 21(4): 463-470, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32584287

RESUMEN

AIM: The purpose of this study was to evaluate the degree of vertical peri-implant resorption around implants inserted with an inclination increased more than 10° at a distance of at least 1 year from insertion. MATERIALS AND METHODS: For the realization of the study, a sample consisting of 47 patients for a total of 115 implants was selected. We excluded all those subjects whose conditions could have compromised the outcome of the treatment. An orthopantomography of the dental arches was made using Orthophos XG 3D Sirona at time T0 (at the end of definitive insertion of prosthesis) and at time T1 (at least 1 year after T0) with the aim of an individualized positioner. In this study, all the implants with inclination equal to or greater than 10° were subdivided into three groups, and the implants with inclination between 0 and 10 were used as control sample. RESULTS: In group I, there is a statistically significant difference in at least one of the two sides (distal one) between T0 and T1. In groups II and III, there is a statistically significant difference in the degree of bone resorption on the mesial side with respect to distal side. In group IV, a statistically significant difference on both sides was evidenced. The implant survival at a distance of 1 year was equal to 100% of cases. CONCLUSION: Surgeons must take into account the possibility that an increase in inclination of implants may lead to a more rapid resorption of bone mesially or distally. CLINICAL SIGNIFICANCE: The direction of the prosthetic load transmitted to the fixture is a variable that could influence the degree of reabsorption of both mesial and distal bone structures according to both laboratory and clinical data.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Remodelación Ósea , Prótesis Anclada al Hueso , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos
17.
Med Oral Patol Oral Cir Bucal ; 25(4): e541-e548, 2020 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-32520920

RESUMEN

BACKGROUND: Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae. MATERIAL AND METHODS: Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019. RESULTS: Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality. CONCLUSIONS: Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation.


Asunto(s)
Implantes Dentales , Arcada Edéntula/cirugía , Sinusitis Maxilar , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Maxilar/cirugía , Revisiones Sistemáticas como Asunto
19.
Artículo en Inglés | MEDLINE | ID: mdl-32559036

RESUMEN

This case report describes the minimally invasive full fixed rehabilitation of a totally edentulous severely atrophic mandible. The patient refused to undergo any other treatment, from the reconstructive surgery to the removable prosthesis, and asked for a fixed minimally invasive solution in the shortest possible time. Considering that the posterior mandibular bone was inadequate in height and that the interforaminal bone was only 4.3 to 5 mm in height, the patient received four 4-mm-ultrashort implants in the interforaminal area that were immediately loaded. Within all the limitations of this case report this procedure in this specific case appears successful through 2 years of loading.


Asunto(s)
Implantes Dentales , Arcada Edéntula/cirugía , Atrofia , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Humanos , Mandíbula/cirugía , Resultado del Tratamiento
20.
Artículo en Inglés | MEDLINE | ID: mdl-32559041

RESUMEN

Several approaches for peri-implant soft tissue augmentation have been proposed, including autogenous soft tissue grafts and substitutes. Palatal pedicle flaps have been introduced for increasing facial soft tissue thickness, improving esthetics, and achieving primary closure following alveolar ridge preservation or guided bone regeneration. The main advantage of these approaches is to maintain the vascularization of the flap, which may result in better healing and less shrinkage than graft-based procedures. Nevertheless, different clinical scenarios require different palatal pedicle flaps. The aim of this article was to present several palatal pedicle flap techniques for peri-implant soft tissue augmentation and alveolar ridge preservation, showing flap designs and the main advantages through case presentations.


Asunto(s)
Aumento de la Cresta Alveolar , Proceso Alveolar , Regeneración Ósea , Trasplante Óseo , Implantación Dental Endoósea , Paladar (Hueso)/cirugía , Colgajos Quirúrgicos/cirugía
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