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1.
Trials ; 22(1): 101, 2021 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-33509257

RESUMEN

BACKGROUND: The volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4-6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists. METHODS/DESIGN: The study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone. DISCUSSION: The current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes. TRIAL REGISTRATION: International Clinical Trials Registry Platform ChiCTR1900020648 . Registered on 1 January 2019.


Asunto(s)
Implantación Dental Endoósea/métodos , Seno Maxilar/cirugía , Diente Molar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Extracción Dental/efectos adversos , Adulto , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/efectos adversos , Humanos , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/patología , Osteogénesis , Cuidados Posoperatorios/efectos adversos , Cuidados Posoperatorios/métodos , Cuidados Preoperatorios/efectos adversos , Cuidados Preoperatorios/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los Resultados , Elevación del Piso del Seno Maxilar/efectos adversos , Resultado del Tratamiento
2.
Cient. dent. (Ed. impr.) ; 17(3): 199-208, sept.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-198602

RESUMEN

El objetivo del estudio es comparar los valores del Coeficiente de Estabilidad Implantaria (ISQ) de implantes colocados en zona antral en hueso nativo frente a los colocados en zona antral en hueso regenerado, para saber si tras tres meses de osteointegración los valores aumentan, ver si son diferentes entre sí según el tipo de hueso y evaluar la relación entre: torque de inserción, tipo de hueso, ISQ obtenido y sus cambios después de la osteointegración. Se trata de un ensayo clínico de propósito analítico, cuya dirección temporal es longitudinal, el inicio del estudio en relación con la cronología de los eventos es prospectivo, existiendo dos grupos de estudio. Los resultados proporcionan evidencias de que los implantes colocados en hueso regenerado, al analizar valores ISQ iniciales, son iguales a los del hueso nativo y, tras la oseointegración, son mayores que los de éstos, pudiendo rehabilitarse esperando el mismo tiempo. CONCLUSIONES: El valor inicial de ISQ es similar en ambos grupos y después de tres meses de osteointegración fue mayor en implantes sobre hueso regenerado. El torque de inserción de implantes en hueso regenerado es mayor que en hueso nativo y existe relación positiva, pero no estadísticamente significativa, entre los valores de ISQ y el torque de inserción. La pérdida ósea marginal de los implantes es similar en ambos grupos y dicha pérdida no está relacionada con los valores de ISQ ni con el torque de inserción obtenido, aunque este hecho puede ser debido a la evaluación a corto plazo


The objectives of the present study are to compare the Implant Stability Quotient (ISQ) values of implants placed in the antral area in native bone versus those placed on regenerated bone, to know whether after three months of osseointegration period the values increase and see if they are different from each other depending on the type of bone and assess the relationship between: insertion torque, type of bone and ISQ obtained an its changes after 3 months of osseointegration.The study design is a Clinical Trial of analytical purpose, whose temporal direction is longitudinal, the beginning of the study in relation to the chronology of the events is prospective. The results provide some evidence in the fact that implants placed in antral zone in regenerated bone, when presenting baseline ISQ values equal to and after osseointegration greater than implants in native bone, could be rehabilitated waiting for the implant. CONCLUSIONS: The initial ISQ value is similar in implants placed in native and regenerated bone and after three months were higher in implants placed in regenerated bone. The insertion torque of the implants placed in regenerated bone is greater than those placed in native bone and there is a positive relationship but not statistically significant between ISQ values and insertion torque. The marginal bone loss of the implants is similar in those placed in native versus regenerated bone and this loss is not related to ISQ values niether to insertion torque obtained. This fact is due to being evaluated in a short period of time


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Implantes Dentales , Oseointegración , Implantación Dental Endoósea/métodos , Retención de Prótesis Dentales , Regeneración Ósea , Estudios Prospectivos , Estudios Longitudinales
3.
Cient. dent. (Ed. impr.) ; 17(3): 209-214, sept.-dic. 2020. ilus
Artículo en Español | IBECS | ID: ibc-198603

RESUMEN

La regeneración localizada de grandes defectos horizontales en los procesos alveolares, previa a la inserción de implantes dentales, sigue siendo un procedimiento quirúrgico desafiante en cirugía bucal. Entre los procedimientos quirúrgicos más utilizados para tal propósito se encuentran la corticotomía con expansión, injerto en bloque "onlay" y la regeneración ósea guiada (ROG), todos ellos con sus diferentes grados de predictibilidad. El uso de micromalla de titanio en combinación con injertos y sustitutos óseos es un método eficiente para la contención, estabilización y protección de estos injertos, permitiendo así una mejor regeneración de los tejidos. Esta técnica no queda exenta de posibles complicaciones asociadas como pueden ser la infección, necrosis del injerto o exposición de la malla de titanio. En el presente artículo se pretende mostrar la evidencia clínica de la efectividad del uso del colgajo pediculado de rotación palatina como método válido para evitar la exposición de la malla de titanio durante la regeneración ósea guiada


Localized regeneration of large horizontal defects in alveolar processes prior to the insertion of dental implants remains a challenging surgical procedure in oral surgery. Among the most widely used surgical procedures for this purpose are expansion corticotomy, onlay block graft and guided bone regeneration all of them with their different degrees of predictability. The use of titanium micromesh in combination with bone grafts and bone substitutes is an efficient method for the containtment, stabilization and protection of these grafts, thus allowing better tissue regeneration. This technique is not exempt from associated complications such as infection, graft necrosis or exposure of the titanium micromesh.This article aims to show the clinical evidence of the effectiveness of using the palatal rotated pedicle graft as an effective method to avoid exposing the micromesh during guide bone regeneration procedure


Asunto(s)
Humanos , Masculino , Anciano , Regeneración Ósea , Implantación Dental Endoósea/métodos , Odontología Basada en la Evidencia/métodos , Resultado del Tratamiento , Colgajos Quirúrgicos , Pérdida de Hueso Alveolar/cirugía , Plasma Rico en Plaquetas , Cirugía Bucal
4.
Cient. dent. (Ed. impr.) ; 17(3): 215-220, sept.-dic. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-198604

RESUMEN

INTRODUCCIÓN: La dehiscencia es una pérdida de la cortical que deja expuesta parte de la raíz al medio oral. Se considera como un factor predisponente de las recesiones gingivales y, por tanto, de una alteración estética. El objetivo principal fue estudiar la relación entre la presencia o ausencia de la tabla ósea vestibular en implantes anteriores y el resultado estético valorado mediante el índice Pink Esthetic Score (PES). Los objetivos secundarios fueron analizar la opinión del paciente comparándolo además con lo valores de PES hallados por el evaluador principal. MATERIAL Y MÉTODO: Se llevó a cabo un estudio analítico, longitudinal, retrospectivo, de cohortes en un grupo de 31 pacientes quienes llevaban implantes antero-superiores con un mínimo de 3 años de carga protésica. Se realizó un TAC para valorar la presencia/ausencia de tabla ósea junto con una exploración para evaluar el PES. RESULTADOS: El índice PES fue significativamente más elevado (10,4 ± 2,3) en presencia de tabla ósea. La valoración del paciente tuvo una nota media global de 8,2 ± 1,6. No se halló correlación entre la opinión del paciente y la del evaluador. CONCLUSIONES: La ausencia de tabla ósea vestibular en implantes anteriores conlleva alteraciones estéticas de los tejidos peri-implantarios


INTRODUCTION: Dehiscence is the loss of the bone wall that leaves part of the root exposed to the oral cavity. It can be a predisposing factor of gingival recessions and therefore it is considered an aesthetic alteration. OBJECTIVES: To analyze the relationship between the presence or absence of the buccal bone table in anterior implants and the esthetic result valued using the PES index. Secondary objectives were to analyse the patient's opinion by comparing it with the PES values found by the evaluator. MATERIAL AND METHOD: An analytical, longitudinal, retrospective cohort study was performed in a group of 31 patients who had antero-superiors implants with a minimum of 3 years of crown-loading. CBCT was performed to evaluate the presence /absence of a bone table with an intraoral exploration to evaluate the PES. RESULTS: The PES index was significantly higher (10.4 ± 2.3) in presence of bone table. The patient's assessment had an overall mean score of 8.2 ± 1.6. No correlation was found between the patient's opinion and the evaluator. CONCLUSION: The absence of buccal bone table lead to aesthetic alterations of the peri-implant tissues


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Implantes Dentales , Estética Dental , Implantación Dental Endoósea/métodos , Estudios Longitudinales , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Maxilar/cirugía , Trasplante Óseo
5.
Int. j. odontostomatol. (Print) ; 14(4): 678-684, dic. 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1134557

RESUMEN

ABSTRACT: The present study aims to describe, through a case report, the functioning of bone grafts, where they are obtained including bone banks and the different dental areas in which it is used. A 50-year.old female patient HMR, sought the postgraduate college of dentistry CECAPE for oral rehabilitation. The initial clinical examination revealed the absence of several dental elements in both the maxilla and mandi ble, bone resorption in the entire maxillary extension where there was an absence of elements in the anterior region and the presence of a torus in the palatal region. Initial tomographic examinations of the maxilla and mandible were performed, looking for the best conduct regarding the diagnosis and planning of the case. After the clinical and radiographic examinations was performed, and the diagnosis was reached, it was determined as a treatment for oral rehabilitation of the maxilla, bone grafting and an Implant-supported Removable Partial Prosthesis and for the mandible a Dento-muco-supported Removable Partial Prosthesis. Dental treatments and oral rehabilitation from the use of bone tissues and bone grafting have become commonly used. Procedures that would normally lead to failure started to increase the percentage of successes due to the use of these biomaterials. The use of bone grafts in dentistry has been shown to be a very effective and useful resource, considering its great applicability in bone reconstructions in different areas of dentistry.


RESUMEN: El presente estudio tiene como objetivo describir a través de un informe de caso, el funcionamiento de los injertos óseos, donde se obtienen, incluidos los bancos de huesos y las diferentes áreas dentales en las que se emplea. Una paciente HMR, de 50 años de edad, asistió el centro universitario de posgrado CECAPE para rehabilitación oral. El examen clínico inicial reveló la ausencia de varios dientes tanto en el maxilar como en la mandíbula, la resorción ósea en toda la extensión maxilar donde había ausencia de dientes en la región anterior y la presencia de un torus en la región palatina. Se realizaron exámenes tomográficos iniciales del maxilar y mandíbula, buscando la mejor conducta con respecto al diagnóstico y la planificación del caso. Después de los exámenes clínicos y radiográficos realizados y el diagnóstico listo, se determinó como un tratamiento para la rehabilitación oral del maxilar, el injerto óseo y una prótesis removible implantosoportada y para la mandíbula una prótesis parcial removible dento-muco-soportada. Los tratamientos dentales y la rehabilitación oral a partir del uso de tejidos óseos y el injerto óseo se han utilizado comúnmente. Los procedimientos que normalmente conducirían al fracaso comenzaron a aumentar el porcentaje de éxitos debido al uso de estos biomateriales. Se ha demostrado que el uso de injertos óseos en odontología es un recurso muy eficaz y útil, considerando su gran aplicabilidad en las reconstrucciones óseas en diferentes áreas de la odontología.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Interfase Hueso-Implante/anatomía & histología , Tomografía Computarizada por Rayos X , Técnicas de Laboratorio Clínico , Mandíbula/diagnóstico por imagen , Rehabilitación Bucal
6.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e720-e727, nov. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-197178

RESUMEN

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with im-mediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p > 0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p = 0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Implantación Dental Endoósea/métodos , Extracción Dental/métodos , Implantes Dentales , Estudios Prospectivos , Factores de Tiempo , Estudios de Seguimiento , Periimplantitis/cirugía , Resultado del Tratamiento
7.
Av. odontoestomatol ; 36(2): 63-70, mayo-ago. 2020. ilus
Artículo en Español | IBECS | ID: ibc-194687

RESUMEN

Se presenta un caso clínico en el que se rehabilita a una paciente con maxilar superior atrófico mediante una combinación de implantes cigomáticos, colocados mediante una aproximación exteriorizada, e implantes anteriores convencionales palatinizados. Se realizó un procedimiento de regeneración ósea guiada alrededor de los implantes cigomáticos para obtener un mayor grosor de la cortical vestibular y palatina alrededor de los implantes del maxilar superior y mejorar el pronóstico. A un año de la carga protésica, el hueso periimplantario se mantiene estable


A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and improve the prognosis. One year after loading, the peri-implant bone remains stable


Asunto(s)
Humanos , Femenino , Anciano , Regeneración Ósea , Atrofia/diagnóstico por imagen , Implantes Dentales , Implantación Dental Endoósea/métodos , Arcada Edéntula/cirugía , Cigoma/cirugía , Atrofia/cirugía , Maxilar/anomalías , Maxilar/cirugía , Cigoma/diagnóstico por imagen
8.
Av. odontoestomatol ; 36(2): 107-115, mayo-ago. 2020. ilus
Artículo en Español | IBECS | ID: ibc-194692

RESUMEN

La evolución en los diseños de los sistemas de implantes y en la configuración de los pilares protésicos ha desarrollado el concepto de plataforma reducida que comprende la colocación de un pilar más estrecho que la plataforma del implante para aumentar su distancia de la interfase hueso-implante. La plataforma reducida es considerada un factor importante para preservar la estabilidad del hueso crestal y de los tejidos blandos y asegurar el éxito de los implantes dentales a largo plazo. La plataforma reducida reduce las fuerzas oclusales y la contaminación bacteriana en la interfase entre el hueso crestal y el implante. Los estudios experimentales en animales y clínicos en pacientes muestran su eficacia para prevenir la pérdida ósea y de los tejidos blandos periimplantarios


The evolution of designs of implant systems and abutments configurations has developed the concept of platform-switching that involves the connection of a narrower abutment to the platform implant to allow horizontal distance of the interface bone-implant. Platform-switching is considered an important factor to preserve the stability of crestal bone and soft tissue ensuring the success of dental implants in the long-term follow-up. Platform-switching reduces the forces of occlusal loading and bacterial contamination in the interface between the crestal bone and the implant. Experimental studies in animals and clinical studies in patients showed that implants with platform-switching have demonstrated the effectiveness to prevent peri-implant bone loss and subsequent soft tissue los


Asunto(s)
Animales , Perros , Implantes Dentales/veterinaria , Implantación Dental Endoósea/métodos , Implantación Dental Endoósea/veterinaria , Diseño de Implante Dental-Pilar/métodos , Diseño de Implante Dental-Pilar/veterinaria , Oseointegración
9.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e449-e454, jul. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-196495

RESUMEN

BACKGROUND: The aim of the authors was to examine the abutment-fixture interface in Morse-type conical implants in order to verify gaps at this level using a new microscopical approach. MATERIAL AND METHODS: In this in vitro study, 20 abutment-fixture complexes were prepared by sectioning (longitudinal and cross-sectional to the long axis) with a microtome and then with a focused ion beam (FIB). This is a micrometric machine tool that uses gallium ions to abrade circumscribed areas to dig deeper into the cuts obtained with the microtome in order to eliminate cut-induced artifacts. This is because the FIB abrasion is practically free from artifacts, which are normally generated by the action of the microtome blades or other techniques. Samples were then observed by scanning electron microscopy (SEM). RESULTS: The observation of the abraded parts with the FIB permitted measurement of the real gap between the implant-abutment components. A variable amount of gap was retrieved (from 0 to 3 μm) by the observations, confirming the non-hermetic nature of the connection. It has to be pointed out that in approximately 65% of cases, the gap accounted for less than 1 μm. CONCLUSIONS: The reported data confirmed that the analyzed connection system allowed for minimal gap. However, from the evidence of the present analysis, it cannot be assumed that the 2 parts of a Morse-type conical implant are fused in 1 piece, which would create a perfectly matched hermetic connection


No disponible


Asunto(s)
Diseño de Implante Dental-Pilar/métodos , Implantación Dental Endoósea/métodos , Propiedades de Superficie , Valores de Referencia , Microscopía Electrónica de Rastreo , Reproducibilidad de los Resultados
10.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e474-e480, jul. 2020. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-196499

RESUMEN

BACKGROUND: The aim of this study was to assess one-year implant survival after lateral window sinus augmentation using PRGF combined with various bone grafting materials. MATERIAL AND METHODS: This was a retrospective chart review and radiographic analysis of patients that had under-gone lateral window sinus augmentation with PRGF and had dental implants placed at least 6 months post augmentation. All implants included were followed up for at least one year after placement. Demographic, sinus and implant related characteristics (residual ridge height, sinus membrane perforation, type of graft material, implant length and width and ISQ at placement) were analyzed. RESULTS: A total of 31 patients with 39 sinus augmentations and 48 implants were included. The mean follow up was 22.8 ± 9.9 months. Implant survival was 95.8%, with 2 implants overall failing. Among all the variables assessed, the only one found to be associated with an increased risk for implant failure was the use of xenograft as bone grafting material in the sinus. CONCLUSIONS: Within the limitations of this study, dental implants placed in maxillary sinuses grafted with PRGF in combination with bone grafting materials, exhibit high implant survival rates after at least one year follow up


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Elevación del Piso del Seno Maxilar/métodos , Plasma Rico en Plaquetas , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Implantación Dental Endoósea/métodos , Estudios Retrospectivos , Sustitutos de Huesos/uso terapéutico , Resultado del Tratamiento , Factores de Tiempo , Factores de Riesgo , Tomografía Computarizada de Haz Cónico
11.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e541-e548, jul. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-196508

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


No disponible


Asunto(s)
Humanos , Revisiones Sistemáticas como Asunto , Implantación Dental Endoósea/métodos , Cigoma/cirugía , Enfermedades Maxilares/cirugía , Resultado del Tratamiento
12.
Int. j. odontostomatol. (Print) ; 14(2): 242-248, June 2020. graf
Artículo en Español | LILACS | ID: biblio-1090681

RESUMEN

Los aumentos óseos previo a la instalación de implantes son cada vez mas utilizados y el diseño de nuevas estrategias para disminuir la morbilidad deben ser considerados. El objetivo de esta investigación fue definir el aumento óseo generado con la técnica "tent pole" en sector de mandíbula posterior. Se diseño un estudio longitudinal, prospectivo para estudiar la técnica. Se incluyeron sujetos con ancho óseo no mayor a 4 mm en el sector posterior y con altura no menor a 9 mm desde el margen superior del conducto alveolar inferior. Se realizaron cirugías bajo anestesia local realizando un acceso quirúrgico; se instalaron de 2 a 4 tornillos de osteosíntesis manteniendo 4 mm del tornillo extraóseo para luego reconstruir con biomaterial alógeno y L-PRF en conjunto con una membrana biológica absorbible; después de 4 meses se realizaron las re entradas estableciendo con tomografía computadorizada de haz cónico las ganancias óseas generadas. Fueron operados 14 sujetos con 27 sitios quirúrgicos; en todos los casos se pudo realizar la instalación de implantes a los 4 meses. En la evaluación inicial, el ancho óseo observado estaba entre 1,2 y 4,0 mm (promedio de 2,95 ± 0,75 mm); después de 4 meses de realizado el aumento horizontal el ancho observado fue de 3,79 y 10,05 mm (promedio de 7,15 mm ± 1,87 mm), confirmando una ganancia ósea promedio de 4,2 ± 1,26 mm. La diferencia obtenida fue significativa (p< 0,05). Se puede concluir que la técnica "tent pole" aplicada en esta investigación es predecible en el aumento óseo y aplicable para la rehabilitación sobre implante.


Bone augmentation prior to implant placement, is among strategies that should be considered to reduce morbidity rates in these procedures. The objective of this research was to define bone augmentation generator using the "tent pole " technique in the posterior jaw. A longitudinal, prospective study was designed, and subjects were included with ridge width no greater than 4 mm, height no less than 9 mm from the upper margin of the inferior alveolar canal. Surgeries were performed under local anesthesia for surgical approach; 2 to 4 osteosynthesis screws over ridge with 4 mm of the extra osseous screws were installed and were then regenerated, using allogeneic biomaterial and L-PRF together with an absorbable biological membrane. Re-entry was performed after four months and cone beam computed tomography analysis was used to confirm bone gain. Fourteen subjects were operated with 27 surgical sites; in all the cases, implant installation was possible at 4 months. In the initial evaluation, bone width observed was between 1.2 and 4.0 mm (average of 2.95 ± 0.75 mm); after 4 months of the horizontal increase, width was recorded at 3.79 and 10.05 mm (average of 7.15 mm ± 1.87 mm), confirming an average bone increase of 4.2 ± 1.26 mm. The difference obtained was significant (p <0.05). It can be concluded that the "tent pole" technique applied in this analysis is predictable in bone augmentation and applicable for implant rehabilitation.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Implantación Dental Endoósea/métodos , Aumento de la Cresta Alveolar , Mandíbula/cirugía , Estudios Prospectivos , Estudios Longitudinales , Trasplante Óseo , Sustitutos de Huesos , Tomografía Computarizada de Haz Cónico
13.
Int. j. odontostomatol. (Print) ; 14(2): 230-235, June 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1090679

RESUMEN

La estabilidad primaria es un requisito importante para la supervivencia y éxito de los implantes durante la osteointegración. En los últimos años, los implantes inmediatos postextracción han demostrado ser una opción de tratamiento exitosa y predecible para la reposición de dientes con mal pronóstico, pero surge la duda de si dichos implantes alcanzan valores de estabilidad primaria comparables a aquellos colocados en hueso maduro. Comparar la estabilidad primaria de implantes inmediatos colocados en alveolos postextracción con la de implantes colocados en hueso maduro. Se llevó a cabo un estudio clínico retrospectivo, con los datos recogidos sobre 175 implantes, colocados en 175 pacientes. Todos los implantes colocados pertenecían al modelo Essential Cone (Klockner Implant System) y se dividieron en dos grupos: implantes inmediatos (Grupo A, n=31) e implantes colocados en hueso maduro (Grupo B, n=144). La estabilidad primaria de todos los implantes se midió mediante torque de inserción y análisis de frecuencia de resonancia con Osstell ISQ. No se encontraron diferencias estadísticamente significativas respecto a la estabilidad medida a través del torque de inserción (26,29+10,07 Vs 25,76+9,72 N/cm) pero sí que se encontraron diferencias significativas en la medida de la estabilidad primaria mediante AFR, siendo inferiores los valores correspondientes a los implantes colocados en los alveolos post exodoncia (60,74 ± 6,17 en sentido VL y 62,19 ± 7.64 en sentido MD frente a 68,34 ± 6.26 en sentido VL y 69,29 ± 7.98 en sentido MD obtenidos en los implantes colocados en hueso maduro). El torque de inserción de los implantes inmediatos es similar al de los implantes colocados en hueso maduro, pero sus valores ISQ son significativamente inferiores, lo que demuestra un mayor grado de micromovimiento, y por consiguiente, un mayor riesgo de fracaso durante el período de osteointegración.


Primary stability is an important requirement for the survival and success of implants during osseointegration. In recent years, immediate post-extraction implants have proven to be a successful and predictable treatment option for the replacement of teeth with a poor prognosis, but the question arises as to whether these implants reach primary stability values comparable to those placed in mature bone. The objective of the study was to compare the primary stability of immediate implants placed in post-extraction alveoli with that of implants placed in mature bone. A retrospective clinical study was carried out, with data collected on 175 implants, placed in 175 patients. All implants placed belonged to the Essential Cone model (Klockner Implant System) and were divided into two groups: immediate implants (Group A, n = 31) and implants placed in mature bone (Group B, n = 144). The primary stability of all implants was measured by insertion torque and resonance frequency analysis with Osstell ISQ. No statistically significant differences were found regarding the stability measured through the insertion torque (26.29 + 10.07 Vs 25.76 + 9.72 N / cm) but significant differences were found in the measurement of primary stability by means of AFR, the values corresponding to implants placed in the post-exodontic alveoli being lower (60.74 ± 6.17 in the VL direction and 62.19 ± 7.64 in the MD direction versus 68.34 ± 6.26 in the VL direction and 69.29 ± 7.98 in the MD direction obtained in implants placed in mature bone). The insertion torque of immediate implants is similar to that of implants placed in mature bone, but their ISQ values are significantly lower, which demonstrates a higher degree of micromotion, and therefore, a greater risk of failure during the period of osseointegration.


Asunto(s)
Retención de Prótesis Dentales , Implantación Dental Endoósea/métodos , Extracción Dental , Vibración , Estudios de Casos y Controles , Estudios Retrospectivos , Oseointegración , Torque , Carga Inmediata del Implante Dental , Análisis de Frecuencia de Resonancia
14.
BMC Oral Health ; 20(1): 96, 2020 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-32252728

RESUMEN

BACKGROUND: The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon's decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs. METHODS: Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled (first premolars [1P], second premolars [2P], first molars [1M], and second molars [2M]). All preoperative panoramic radiographs were evaluated under standard conditions. The postoperative estimation (under/over) was determined depending on the available bone height (ABH) measured from the apical end of the implant to the floor of the MS and the roof of the MC using cone beam computed tomography (CBCT). Any complication or side effect that associated with overestimated implants insertion was recorded. RESULTS: The study sample included 73 patients (predominantly females) who had consecutively received 148 implants, of which 68 were inserted in the posterior maxilla and 80 in the posterior mandible. Underestimation was recorded in 93.2% of the measurements. The remaining bone height after implants insertion was < 2 mm in the majority of underestimated cases (73.9%); they were significantly (P < 0.01) more than sites with remaining bone ≥ 2 mm (26.1%). In the posterior mandible, overestimation was significantly higher than posterior maxilla. Five cases with transient paresthesia were reported in the mandibular overestimated implants. CONCLUSIONS: This study specified that surgeon's choice of implants length, based on panoramic radiographs, was reliable regarding the incapability to insert implants with further length in the majority of underestimated cases, the low percent of overestimated measurements, and the minor associated complications.


Asunto(s)
Competencia Clínica , Implantes Dentales , Arcada Edéntula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Radiografía Panorámica/métodos , Cirujanos , Adolescente , Adulto , Anciano , Proceso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/métodos , Femenino , Humanos , Masculino , Nervio Mandibular/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados
15.
Int. j interdiscip. dent. (Print) ; 13(1): 44-46, abr. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1114893

RESUMEN

AIM: Short implants are manufactured for use in atrophic regions of the jaw. Therefore, the current does not sufficiently reveal a direct correlation between the impact of implant length on implant survival. The purpose of this systematic review was to compile the evidence of short implant survival in atrophied jaws. METHODS: Electronic and manual literature searches were performed by two independent reviewers in several databases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to September 2015 using the following terms in some combinations: "short implant", "mandible/atrophied jaws", and "implant survival/ survival rate/ survival analysis". RESULTS: The 19 included studies present in average 5.5 years (range 1.0-20.0 years) follow-up and 96.1% (range 73.4-100.0 percent) survival rate of the short implants in atrophied mandibular. CONCLUSIONS: This systematic review found evidences regarding to safety of short implant placement in atrophied jaws although stronger evidence is essential to confirm this finding.


Asunto(s)
Humanos , Implantes Dentales , Implantación Dental Endoósea/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Atrofia , Análisis de Supervivencia , Maxilares , Mandíbula
16.
Int. j interdiscip. dent. (Print) ; 13(1): 30-34, abr. 2020. graf
Artículo en Español | LILACS | ID: biblio-1114890

RESUMEN

INTRODUCCIÓN: La valoración particular de sitios severamente comprometidos, involucra considerar los tiempos necesarios de cicatrización, así como evidencia actual en términos de biomateriales y técnicas quirúrgicas con el fin de lograr un tratamiento exitoso. MATERIAL Y MÉTODO: Paciente sexo femenino, 28 años, asiste por dolor e infección en diente 2.1 al Postítulo de Periodoncia UDD. Se observa defecto extenso y lesión que compromete tanto las tablas óseas vestibular como palatina. El tratamiento consistió en: exodoncia y regeneración ósea, instalación del implante 6 meses después de la exodoncia y cirugía de conexión 7 meses después más injerto de tejidos blandos. RESULTADOS: El tratamiento de defectos combinados (tejidos duros y blandos), asociados a procesos infecciosos de larga data, mediante rehabilitación implanto soportada puede ser muy predecible y exitoso en la medida que se respeten los tiempos de regeneración de diferentes estructuras.


INTRODUCTION: The specific assessment of a severely compromised sites involves: the consideration of healing time according to the different kinds of tissues involved and the knowledge of the evidence available concerning biomaterials and surgical techniques. MATERIAL AND METHODS: Female patient attends the postgraduate school of periodontics, UDD University in Santiago de Chile, because of pain and chronic infection compromising tooth 2.1. At clinical evaluation, the site has an extensive defect, with active fistula that compromises the buccal and palatal bone plates. The treatment consisted of exodontia and guided bone regeneration, implantation six months after initial exodontia and abutment connection surgery seven months after implant insertion. RESULTS: the treatment of combined defects associated with a long-standing infectious process can be very predictable and successful, only if the measures of time and tissue handling are considered and applied.


Asunto(s)
Humanos , Femenino , Adulto , Extracción Dental , Regeneración Tisular Guiada Periodontal/métodos , Implantación Dental Endoósea/métodos , Estética Dental , Factores de Tiempo , Regeneración Ósea , Toma de Decisiones , Proceso Alveolar
17.
Niger J Clin Pract ; 23(3): 275-283, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32134023

RESUMEN

We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Seno Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Humanos
18.
BMC Oral Health ; 20(1): 53, 2020 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-32066431

RESUMEN

BACKGROUND: To compare tissue response to two implant systems, featuring internal hexed connections with different designs. METHODS: Patients enrolled in this randomized controlled trial were assigned to two groups. In Group 1, patients were treated with implants with a 5° conical internal hexed connection (Anyridge®, MegaGen, South Korea). In Group 2, patients were treated with implants with an internal hexed connection (Core®, Kristal, Italy). After implant placement and a provisionalisation period of 12 months, impressions were taken, stone casts were poured and digitised with a desktop scanner (D700®, 3Shape, Copenhagen, Denmark). In a digital environment, for each fixture, two values were collected at the buccal zenith: the height of the peri-implant mucosa (mucosal height; MH), calculated from the vestibular shoulder of the implant analogue to the upper gingival margin of the supra-implant tissue; and the width of the peri-implant mucosa (mucosal thickness; MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. The mean and standard deviation for MH and MT, as well as their ratios, were calculated for each group; the sectors in which the implants were placed were also considered. Finally, correlation between MH, MT, connection type and sector was assessed by Pearson's correlation coefficient, with significance level set at 0.05, and a confidence interval (CI) set at 95%. RESULTS: Data deriving from 188 implants placed in 104 patients were evaluated. The mean MH values were 3.32 (± 0.12) and 2.70 (± 0.16) mm for Groups 1 and 2, respectively. The mean MT values were 4.37 (± 0.16) and 3.93 (± 0.18) mm for Groups 1 and 2, respectively. Group 1 showed higher MH and MT values and a better ratio (1.50 ± 0.88) than Group 2 (1.81 ± 1.20). The MH, MT and MH/MT ratio were significantly influenced both by sector (p = 0.015) and group (p = 0.047). CONCLUSIONS: Within the limits of this study, the 5° connection implants supported a more extended tissue height and thickness at the buccal zenith, and a better ratio between them. TRIAL REGISTRATION: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04160689, dated 13/11/2019.


Asunto(s)
Pilares Dentales , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea/métodos , Implantes Dentales , Coronas , Humanos , Carga Inmediata del Implante Dental , Italia , República de Corea , Resultado del Tratamiento
19.
Braz Oral Res ; 34: e008, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049109

RESUMEN

This study aimed to investigate the effects of chronic restraint stress (RS) and a high-fat diet (HFD) on the osseointegration of titanium implants in a rat model. After the surgical insertion of titanium implants into the metaphysis of the tibial bone, the rats were randomly divided into four equal groups (n = 8 each): control (CNT), restraint stress (RS), high-fat diet (HFD), and restraint stress plus high fat diet (RS-HFD). CNT: Rats received no further treatment during the 92-day experimental period. RS: Stress was applied to the rats beginning from two days after the implant surgery for one hour per day for the first 30 days, two hours per day for the next 30 days, and three hours per day for the last 30 days. HFD: Rats were fed a HFD for the following 90 days starting two days after surgery. RS-HFD: Rats were fed a HFD and RS was applied to rats for the following 90 days, starting two days after surgery. At the end of the experimental period, the rats were euthanized, and the implants and surrounding bone tissues were removed for histological analysis. Statistical analysis was performed by one way ANOVA and Bonferrroni tests. There were no significant differences in the bone-implant connection levels between the groups (p > 0.05), but in the HFD and RS-HFD groups, the bone filling ratios were found to be lower compared with the controls (p < 0.05) The data analyzed in this study suggest that an HFD with or without chronic RS adversely affected bone tissue in the rats during the 90-day osseointegration period.


Asunto(s)
Prótesis Anclada al Hueso , Dieta Alta en Grasa/psicología , Oseointegración/fisiología , Estrés Psicológico/fisiopatología , Tibia/fisiopatología , Titanio , Alanina Transaminasa/sangre , Animales , Aspartato Aminotransferasas/sangre , Glucemia/análisis , Colesterol/sangre , Implantación Dental Endoósea/métodos , Femenino , Distribución Aleatoria , Ratas Sprague-Dawley , Valores de Referencia , Reproducibilidad de los Resultados , Tibia/patología , Tibia/cirugía , Factores de Tiempo , Triglicéridos/sangre
20.
BMC Oral Health ; 20(1): 15, 2020 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-31948414

RESUMEN

BACKGROUND: Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets. METHODS: A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction. RESULTS: One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results. CONCLUSIONS: Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.


Asunto(s)
Arco Dental/cirugía , Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Carga Inmediata del Implante Dental , Adulto , Anciano , Implantación Dental Endoósea/instrumentación , Retención de Prótesis Dentales , Fracaso de la Restauración Dental , Estética Dental , Femenino , Estudios de Seguimiento , Humanos , Italia , Masculino , Persona de Mediana Edad , Radiografía Panorámica , Estudios Retrospectivos , Resultado del Tratamiento
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