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1.
Bone Joint J ; 103-B(3): 430-439, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33641410

RESUMEN

Upper limb amputations, ranging from transhumeral to partial hand, can be devastating for patients, their families, and society. Modern paradigm shifts have focused on reconstructive options after upper extremity limb loss, rather than considering the amputation an ablative procedure. Surgical advancements such as targeted muscle reinnervation and regenerative peripheral nerve interface, in combination with technological development of modern prosthetics, have expanded options for patients after amputation. In the near future, advances such as osseointegration, implantable myoelectric sensors, and implantable nerve cuffs may become more widely used and may expand the options for prosthetic integration, myoelectric signal detection, and restoration of sensation. This review summarizes the current advancements in surgical techniques and prosthetics for upper limb amputees. Cite this article: Bone Joint J 2021;103-B(3):430-439.


Asunto(s)
Amputados/rehabilitación , Miembros Artificiales/tendencias , Diseño de Prótesis/tendencias , Implantación de Prótesis/tendencias , Extremidad Superior/cirugía , Amputación , Muñones de Amputación/inervación , Humanos , Oseointegración , Sensación , Extremidad Superior/inervación
2.
Artículo en Inglés | MEDLINE | ID: mdl-33528449

RESUMEN

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


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Implantación Dental Endoósea , Estudios de Seguimiento , Humanos , Mandíbula/cirugía , Oseointegración , Estudios Prospectivos
3.
Artículo en Inglés | MEDLINE | ID: mdl-33528451

RESUMEN

The purpose of this prospective study was to evaluate the success rates and prosthetic complications of implants with a modified sandblasted and acid-etched (SLA) surface inserted for posterior single-implant crown restorations. Final crowns were placed 3 to 4 weeks after surgery, and patient follow-up spanned 10 years in a private practice setting. A total of 22 patients (8 women, 14 men) with 25 posterior implants placed (16 mandible, 9 maxilla) were selected, including only implants for posterior single-implant crowns with insertion torque values of ≥ 35 Ncm at placement. Twenty-one implants passed the reverse torque test at 3 to 4 weeks after implant placement, and final restorations were placed. Three patients (4 implants) had "spinners," and there was one patient dropout after completion of the final restoration. All patients were recalled for clinical exams, digital periapical radiographs, and clinical photos at short-term (≤ 5 years) and long-term (> 5 years) follow-up appointments. The Community Periodontal Index of Treatment Needs was also determined at the initial and follow-up visits. Crestal bone level was measured at crown placement (T1), short-term follow-up (T2; mean: 29.4 months), and long-term follow-up appointments (T3; mean: 114.4 months). Twenty patients (23 implants) returned for examination at T2, and 15 (18 implants) were available at T3. For the 17 implants available at all evaluations, statistically significant bone loss was found from T1 to T2 (0.23 ± 0.30 mm), and the mean crestal bone level appeared stable from T2 to T3. Based on clinical and radiographic findings, the success rate for the implants and restorations at T2 and T3 was graded as 100%. Therefore, it can be stated that an early loading protocol of 3 to 4 weeks using a modified SLA surface at premolar/molar single-tooth locations can result in favorable clinical and radiographic long-term results.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Coronas , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Humanos , Masculino , Oseointegración , Estudios Prospectivos , Titanio
4.
Artículo en Inglés | MEDLINE | ID: mdl-33528460

RESUMEN

This study aimed to histologically analyze the bony tissue formed around dental implants after osseointegration. A 58-year-old patient presented with pain and discomfort caused by two dental implants in her maxilla placed 8 months earlier. At clinical and radiographic analysis, the implants appeared well osseointegrated but tilted buccally, emerging in nonkeratinized mucosa. For this reason, the discomfort began right after the prosthetic load, 4 months after implant placement, and the patient felt pain when wearing the implant-supported removable prosthesis. Both implants were made of titanium, airborne-particle abraded with zirconium oxide, and etched with mineral acids. The implants were removed, preserving the bone around the implant threads, and replaced with two new implants, inserted in a prosthetically guided, correct position. The removed implants were histologically observed. Histologic analysis showed good bone-to-implant contact, mature bone with few marrow spaces, presence of direct connecting bridges between the peri-implant bone trabeculae and the implant surface, and no inflammatory cells nor connective fibrous tissue ingrowth. This study showed that dental implants coated with a rough surface were properly osseointegrated, with no inflammatory signs nor connective fibrous tissue ingrowth, 8 months after placement.


Asunto(s)
Implantes Dentales , Oseointegración , Implantación Dental Endoósea , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Femenino , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Persona de Mediana Edad , Propiedades de Superficie , Titanio
5.
Int J Oral Maxillofac Implants ; 36(1): 38-46, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600521

RESUMEN

PURPOSE: The aim of this work was to evaluate osseointegration of endosteal implants with two different surface treatments at early stages (~3 weeks) in the tibia of healthy and ovariectomized rabbits. MATERIALS AND METHODS: The study comprised 10 adult New Zealand female rabbits (Oryctolagus cuniculus; 6 months and 3.0 ± 0.5 kg). Five animals were subjected to bilateral ovariectomy to mimic osteoporotic-like conditions, and the remaining rabbits (n = 5) served as the healthy control group. After 3 months, specimens from the ovariectomized and control groups were subject to implant placement in both tibiae, using two different types of surface treatment. A total of 36 implants were placed, n = 18 acid-etched and n = 18 anodized. After 3 weeks, euthanasia of the animals was performed, and samples were obtained for processing. Bone-to-implant contact and bone area fraction occupancy were quantified to evaluate the osseointegration parameters around the implant surface and within the thread area, respectively, and nanoindentation tests were performed to determine elastic modulus and hardness of the new bone. Both analyses were performed on the entire implant (total), as well as individually within the cortical and bone marrow cavity area. RESULTS: All animals were evaluated with no signs of infection or postoperative complications. The total bone-to-implant contact and bone area fraction occupancy results, independent of surface treatment, yielded significant differences between the ovariectomized and control groups (P = .002 and P < .001, respectively). In the marrow cavity, analyzing the surface treatments independently as a function of bone condition, the only differences detected were in the anodized treatment (P = .04). Regarding the elastic modulus, differences were detected only with the anodized implants between the ovariectomized and control groups (P = .015). CONCLUSION: At 3 weeks after implant placement, there were better osseointegration values of the implants in the healthy control group compared with the ovariectomized group independent of surface treatment. Also, specifically in the medullary region of the rabbit tibia, the acid-etched implants had more uniform osseointegration values in conditions of low-quality bone in comparison to the anodized implants, histomorphometrically and biomechanically.


Asunto(s)
Implantes Dentales , Animales , Huesos , Femenino , Humanos , Oseointegración , Conejos , Propiedades de Superficie , Tibia/cirugía , Titanio
6.
Int J Oral Maxillofac Implants ; 36(1): 103-105, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33600529

RESUMEN

PURPOSE: Beneficial aspects of short and ultrashort antibiotic administration protocols could be clinically correlated to the reduced side effects on the gastrointestinal microflora. The aim of this Consensus Conference was to establish the necessity of an antibiotic prophylaxis and its dosage to reduce the risk of early implant failure in healthy (ASA 1 or 2), periodontally healthy patients, undergoing basic dental implant surgery (straightforward cases). Additionally, the need for an antiseptic protocol, used before and after the implant surgery, was evaluated. MATERIALS AND METHODS: Active members of the Italian Academy of Osseointegration (IAO), together with several worldwide-recognized key opinion experts in the field of microbiology, implant dentistry, and infectious diseases, were participants at this Consensus Conference. Two systematic reviews were carried out, before the Consensus Conference, and their results discussed in order to give guidelines on the administration of an antibiotic/antiseptic prophylaxis in implant surgery. The systematic reviews covered the following topics: (1) the use of antibiotics to reduce both implant failure rate and peri-implant infections in healthy patients and (2) the use of chlorhexidine compositions capable of reducing complications in patients undergoing surgical interventions. RESULTS: The main statements reached by the assembly were as follows: (1) Rinsing with chlorhexidine is highly recommended before and after implant surgery to minimize the bacterial load. (2) A single dose of antibiotics in straightforward cases is recommended. (3) In complex cases (long surgical time, regeneration procedures), it is advisable to continue the antibiotic administration. CONCLUSION: This Consensus Conference advocates the administration of a unique dose of antibiotics in straightforward implant cases combined with the use of chlorhexidine.


Asunto(s)
Antiinfecciosos Locales , Implantes Dentales , Antibacterianos/uso terapéutico , Antiinfecciosos Locales/uso terapéutico , Fracaso de la Restauración Dental , Humanos , Italia , Oseointegración
7.
Artículo en Inglés | MEDLINE | ID: mdl-33572988

RESUMEN

Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner® VEGA® implants with a ContacTi® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level-not the osseointegration rate, clinical conditions, or PROMs.


Asunto(s)
Pérdida de Hueso Alveolar , Pérdida de Hueso Alveolar/diagnóstico por imagen , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Estudios de Seguimiento , Humanos , Oseointegración , Prótesis e Implantes , Resultado del Tratamiento
8.
ACS Appl Mater Interfaces ; 13(4): 5782-5794, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33464812

RESUMEN

Peri-implantitis is a typical pathological condition characterized by the destructive inflammation in the soft tissue and the progressive loss of supporting bones. As the current effective treatments and preventive measures are inconsistent and unpredictable, the use of biomaterials as carriers of bioactive ion coatings is a promising approach. However, the translation from lab to large-scale production and clinical applications is difficult due to a technology barrier. Determining the effective dosage of each ion to achieve an in vivo application of the in vitro screening is challenging. Here, we selected zinc and strontium ions to provide multiple effects on antibacterial activity and osteogenesis. The optimal coating with effective release concentrations of the two ions was obtained after the two-step screening from in vitro testing. The results showed that this type of in vivo bioactive ion usage leads to an enhanced osseointegration during the immediate implantation in a periodontitis-affected environment and prevents soft tissue inflammation and bone resorption in an inflammatory environment. The new biologically active ion screening method could verify the effectiveness of this clinical translation and its potential for large-scale production and could determine the effective dosage of each ion for a specific application.


Asunto(s)
Antibacterianos/uso terapéutico , Implantes Dentales , Periimplantitis/prevención & control , Estroncio/uso terapéutico , Zinc/uso terapéutico , Animales , Células Cultivadas , Materiales Biocompatibles Revestidos/uso terapéutico , Implantes Dentales/microbiología , Perros , Humanos , Oseointegración/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Periimplantitis/microbiología , Ratas Sprague-Dawley , Estomatitis/microbiología , Estomatitis/prevención & control
9.
J Biol Regul Homeost Agents ; 35(1 Suppl. 1): 63-72, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33463144

RESUMEN

Implant dentistry has become a popular restorative option in clinical practice. Titanium and titanium alloys (TTA) are the gold standard for endo-osseus dental implants production, thanks to their biocompatibility, resistance to corrosion and mechanical properties. The characteristics of the TTA implant surface seem to be particularly relevant in the early phase of osseointegration. Furthermore, the microstructure of implant surface can largely influence the bone remodelling at the level of the bone-implant surface. Recently, research has stated on the long-term of both survival and success rates of osseointegrated implants and mainly on biomechanical aspects, such as load distribution and biochemical and histological processes at the bone-implant interface. This short review reports recent knowledge on chemical and mechanical properties, biological aspects, innovations in preventing peri-implantitis, describing clinical applications and recent improvements of TTA dental implants. In addition, it highlights current knowledge about a new implant coating that has been demonstrated to reduce the number of initially adhering bacteria and peri-implantitis.


Asunto(s)
Implantes Dentales , Aleaciones , Odontología , Humanos , Oseointegración , Periimplantitis , Propiedades de Superficie , Titanio
10.
Clin Implant Dent Relat Res ; 23(2): 159-169, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33463007

RESUMEN

BACKGROUND: Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant, despite the fact that their significance for the long-term survival of the implant has never been properly assessed. PURPOSE: To challenge the assumption that the natural course of peri-implant bone loss is the loss of the implant. MATERIALS AND METHODS: This article is a narrative review on reasons and interpretations of marginal bone level changes around dental implants. RESULTS AND CONCLUSIONS: Different views regarding the pattern and progression of marginal bone loss depending on dental specialties have been identified. However, the present finding of a negative correlation between an increasing cumulative marginal bone loss and a decreasing risk of implant failures over time indicates that peri-implant marginal bone loss does not necessarily represent a condition of disease. Reduction of marginal bone levels may be observed in a majority of patients during follow-up time, with only a minority of those patients losing implants and implant-supported prostheses in the long term. Bone level changes seem often to occur as a consequence of physiological processes and/or as an adaptation to altered external as well as host response factors. Periodical radiological assessments of implant-restorations remain a valid diagnostic tool for the detection of potential implant fractures, loss of osseointegration, screws working loose and for the detection of the few cases with advanced, continuously progressing marginal bone loss during time. The detection of peri-implant marginal bone loss at one time point should not be immediately considered as a sign of ongoing pathology and of an increased risk of future loss of the implant in question.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Oseointegración
11.
Med Oral Patol Oral Cir Bucal ; 26(2): e187-e194, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33395401

RESUMEN

BACKGROUND: To evaluate the effect of undersized drilling on the primary and secondary stability of immediate implants placed in the anterior maxilla. MATERIAL AND METHODS: A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty tapered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately after anterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis (RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation. The results were compared using parametric statistical tests. RESULTS: All implants showed adequate stability during follow-up. At implant placement, the undersized drilling group exhibited greater insertion torque values than the conventional drilling group, but stability assessed by RFA showed greater mean values in the conventional group. After 6 and 12 weeks of follow-up, both groups showed improved stability, though the RFA values remained comparatively higher in the conventional group. The differences were not statistically significant. CONCLUSIONS: Based on the results obtained, undersized drilling does not appear to afford significantly improved stability of immediate implants placed in the anterior zone of the maxilla during the osseointegration period.


Asunto(s)
Implantes Dentales , Maxilar , Adulto , Densidad Ósea , Implantación Dental Endoósea , Humanos , Maxilar/cirugía , Oseointegración , Análisis de Frecuencia de Resonancia , Torque
12.
Clin Oral Implants Res ; 32(3): 285-296, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33314332

RESUMEN

OBJECTIVES: Evaluate the effects of two different machined-collar lengths and designs on peri-implant healing. MATERIAL AND METHODS: An implant with a microtextured surface and 3.6mm-long internal-connection machined collar was compared to two implants that had an identical 1.2mm-long external-connection machined collar, but one had the microtextured surface while the other's was machined. Participants received the three implants, with microgap at the crest, alternately at five sites between mental foramen, and a full-arch prosthesis. Peri-implant bone levels were measured after 23 to 26 years of function. Keratinized tissue height, plaque, probing depth, bleeding, and purulence were also evaluated. Descriptive and mixed models for repeated\measures analyses were used, with Bonferroni correction for pairwise comparisons. RESULTS: Twenty-two participants (110 implants) were evaluated at the 25-year examination. Microtextured implants with the longer machined collar had significantly greater mean marginal bone loss (-1.77mm ± 0.18, mean ± SE) than machined (-0.85mm ± 0.18, p < .001) and microtextured (-1.00 ± 0.18mm, p < .001) implants with the shorter machined collar. Keratinized tissue height was greater for internal-connection (0.74mm ± 0.10) versus external-connection (0.51 ± 0.08, p =  0.01) microtextured implants. No differences were observed for plaque (p = 0.78), probing depth (p = 0.42), bleeding (p  = 0.07), and purulence (p = 1.00). Implant survival rate was 99%. CONCLUSIONS: Implants with the 1.2mm machined collar limited bone loss to 1mm, while those with the longer machined collar showed > 1.5mm loss after 25 years of function with microgap at the crest. Internal-connection design and fixture surface microtexturing did not result in greater bone preservation. ClinicalTrials.gov Identifier: NCT03862482.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/prevención & control , Implantación Dental Endoósea , Diseño de Prótesis Dental , Humanos , Oseointegración , Estudios Prospectivos , Propiedades de Superficie
13.
J Periodontal Res ; 56(2): 351-362, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33368275

RESUMEN

OBJECTIVE: Using a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process. BACKGROUND: Based on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short- and long-term clinical outcomes in osteoporosis is necessary. MATERIAL AND METHODS: Fifty female, 3-month-old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE-HD). Calcium (Ca) and phosphorus (P) content was measured by energy-dispersive X-ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone-to-implant contact (BIC) and bone volume fraction (BV) by nano-computed tomography (nano-CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL-1ß, IL-10, Tnf-α, and Nos2) by qRT-PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05. RESULTS: The amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE-HD compared to SAE on the intra-group analysis. Nano-CT and histology revealed more BV and BIC for SAE-HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment. CONCLUSION: Both surfaces were able to modulate bone responses toward osteoblast differentiation. SAE-HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.


Asunto(s)
Implantes Dentales , Osteoporosis , Femenino , Fémur/diagnóstico por imagen , Fémur/cirugía , Humanos , Oseointegración , Osteoporosis/genética , Ovariectomía , Propiedades de Superficie , Titanio
14.
Rev. ADM ; 77(6): 321-328, nov.-dic. 2020. ilus
Artículo en Español | LILACS | ID: biblio-1151475

RESUMEN

La periimplantitis se define como la patología inflamatoria e irreversible que afecta al hueso periimplantario y le hace perder soporte y función al implante según la definición del European Workshop on Periodontology (EWOP). La prevalencia estimada de la periimplantitis es de 28 a 77%. Los diferentes protocolos de abordaje de la periimplantitis nos ofrecen diversas posibilidades: destoxificación de la superficie y regeneración, limpieza mecánica y resección del tejido inflamado, extracción del implante, entre otros. El principal problema de los tratamientos regenerativos es limpiar y desintoxicar correctamente la superficie del implante expuesto, ya que al tratarse de superficies generalmente muy rugosas, las bacterias del medio bucal las colonizan con mucha facilidad y es prácticamente imposible eliminar por completo el biofilm. El protocolo de tratamiento para la periimplantitis se basa en un algoritmo de tratamiento, en el que se retiran los implantes gravemente afectados por periimplantitis de forma atraumática, lo cual garantiza la conservación del lecho al 100% al no retirarse volumen óseo, y cuándo deben utilizarse las trefinas, pues las que se utilizan en el protocolo únicamente rompen la unión ósea de los primeros milímetros sin retirarlo. En el siguiente caso clínico mostramos el retratamiento de un caso de periimplantitis en el que se ha realizado una nueva rehabilitación implantosoportada (AU)


Periimplantitis is defined as the inflammatory and irreversible pathology that affects the peri-implantary bone and causes it to lose support and function to the implant as defined by the European Workshop on Periodontology (EWOP). The estimated prevalence of periimplantitis figures ranging from 28 to 77%. The different protocols for approaching periimplantitis offer different possibilities: detoxification of the surface and re-generation, mechanical cleaning and resection of inflamed tissue and extraction of the implant mainly. The main problem with regenerative treatments is to correctly clean and detoxify the surface of the exposed implant, since as these are generally highly rough surfaces, bacteria in the oral environment colonise them very easily and it is practically impossible to completely eliminate the biofilm. This treatment algorithm, in which implants severely affected by periimplantitis are removed atraumatically, guarantees the conservation of the bed at 100% since no bone volume is removed and trephines must be used, since those used in the protocol only break the bone union of the first few millimetres, without removing it. In the following clinical case, we show the re-treatment of a case of peri-implantitis where a new implant-supported rehabilitation has been performed (AU)


Asunto(s)
Humanos , Masculino , Anciano , Oseointegración , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Implantación Dental Endoósea , Periimplantitis/terapia , Regeneración Ósea , Algoritmos , Protocolos Clínicos , Prótesis Dental de Soporte Implantado , Retratamiento , Rehabilitación Bucal/métodos
15.
ACS Appl Mater Interfaces ; 12(51): 56924-56934, 2020 Dec 23.
Artículo en Inglés | MEDLINE | ID: mdl-33317266

RESUMEN

The use of polyetheretherketone (PEEK) has grown exponentially in the biomedical field in recent decades because of its outstanding biomechanical properties. However, its lack of bioactivity/osteointegration remains an unresolved issue toward its wide use in orthopedic applications. In this work, graphene nanosheets have been incorporated into PEEK to obtain multifunctional nanocomposites. Because of the formation of an electrical percolation network and the π-π* conjugation between graphene and PEEK, the resulting composites have achieved 12 orders of magnitude enhancement in their electrical conductivity and thereby enabled electrophoretic deposition of a bioactive/antibacterial coating consisting of stearyltrimethylammonium chloride-modified hydroxyapatite. The coated composite implant shows significant boosting of bone marrow mesenchymal stem cell proliferation in vitro. In addition, the strong photothermal conversion effect of the graphene nanofillers has enabled laser-induced heating of our nanocomposite implants, where the temperature of the implant can reach 45 °C in 150 s. The unique multifunctionality of the implant has also been demonstrated for photothermal applications such as enhancing bacterial eradication and tumor cell inhibition, as well as bone tissue regeneration in vivo. The results suggest the strong potential of our multifunctional implant in bone repair applications as well as multimodal therapy of challenging bone diseases such as osteosarcoma and osteomyelitis.


Asunto(s)
Regeneración Ósea/efectos de los fármacos , Materiales Biocompatibles Revestidos/farmacología , Grafito/química , Cetonas/química , Nanocompuestos/química , Polietilenglicoles/química , Animales , Antibacterianos/farmacología , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Materiales Biocompatibles Revestidos/química , Materiales Biocompatibles Revestidos/efectos de la radiación , Durapatita/farmacología , Conductividad Eléctrica , Escherichia coli/efectos de los fármacos , Femenino , Grafito/efectos de la radiación , Humanos , Rayos Infrarrojos , Cetonas/efectos de la radiación , Células Madre Mesenquimatosas/efectos de los fármacos , Ratones Endogámicos BALB C , Nanocompuestos/efectos de la radiación , Neoplasias/tratamiento farmacológico , Oseointegración/efectos de los fármacos , Polietilenglicoles/efectos de la radiación , Compuestos de Amonio Cuaternario/farmacología , Staphylococcus aureus/efectos de los fármacos , Ensayos Antitumor por Modelo de Xenoinjerto
16.
Rev. Asoc. Odontol. Argent ; 108(3): 97-103, dic. 2020. ilus, graf
Artículo en Español | LILACS | ID: biblio-1147414

RESUMEN

Objetivo: Evaluar el porcentaje de implantes oseointegrados colocados en pacientes edéntulos para la confección de sobredentaduras inferiores, en el marco de la formación de recursos humanos. Materiales y métodos: Se analizaron las historias clínicas de los pacientes que recibieron dos implantes dentales inferiores para la confección de sobredentaduras en el servicio de residentes de la carrera de Especialización en Cirugía y Traumatología Bucomaxilofacial de la Facultad de Odontología de la Universidad de Buenos Aires, entre agosto de 2012 y diciembre de 2018. Se consideraron para el análisis el porcentaje de implantes oseointegrados y su relación con el tipo de operador (docente o residente), la situación del reborde óseo y el hábito de fumar. Resultados: De los 176 implantes colocados en 88 pacientes (edad promedio = 67 años), a los 3-4 meses el 98% (IC95: 94-99%) se hallaba oseointegrado. No se encontró una relación estadísticamente significativa entre el tipo de operador y el fracaso (P>0,99) Conclusión: En un servicio de formación, la tasa de éxito, evaluada en la segunda cirugía, de dos implantes dentales colocados en el maxilar inferior para sobredentaduras fue de 98%. No se hallaron diferencias entre los resultados logrados por residentes y docentes del servicio (AU)


Aim: To evaluate the percentage of osseointegrated im- plants placed in edentulous patients to restore with mandib- ular overdentures, within the post graduate dental training framework. Materials and methods: Medical records of patients who received two dental implants in the mandible for the placement of overdentures in the resident clinic of the special- ization career in Oral and Maxillofacial Surgery and Trauma- tology from the Facultad de Odontología de la Universidad de Buenos Aires, between August 2012 and December 2018. The percentage of osseointegrated implants was analysed, and the association with the variables: operator (teacher or resident), mediate or immediate placement, and smoking. Results: 176 implants were placed in 88 patients with an average age of 67 years old. 98% (IC95: 94-99%) of the implants were osseointegrated at 3-4 months. No statistically significant association was detected between the type of oper- ator and implant failure (P>0.99). Conclusion: In the teaching dental training clinic, the success rate, evaluated at the second implant stage surgery, of two dental implants placed in the mandibule for overden- tures was 98%. No differences were found between the results achieved by residents and teachers (AU)


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Boca Edéntula , Implantación Dental Endoósea , Prótesis de Recubrimiento , Educación de Posgrado en Odontología , Argentina , Facultades de Odontología , Análisis Estadístico , Estudios Retrospectivos , Oseointegración , Resultado del Tratamiento
17.
Acta Cir Bras ; 35(11): e351101, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33331451

RESUMEN

PURPOSE: To evaluate bone formation through ultrastructural analysis around titanium implants in severe alloxanic uncontrolled diabetic rats, and controlled with insulin, in comparison with nondiabetic rats. METHODS: Thirty-six male Wistar rats, weighing between 200 and 300 g, divided into three experimental groups: normal control group (G1), a diabetic group without treatment (G2), and a diabetic group treated with insulin (G3). The animals received titanium implants in the right femur, and osseointegration was evaluated at 7, 14, and 21 days after surgery, through ultrastructural analysis using scanning electron microscopy. RESULTS: The ultrastructural analysis showed a dense bone structure in the G1, few empty spaces and a small number of proteoglycans; G2 presented bone matrix with a loose aspect, irregular arrangement, thin trabeculae, empty spaces and a large number of proteoglycans; G3 obtained similar results to G1, however with a higher number of proteoglycans. CONCLUSION: Severe diabetes caused ultrastructural changes in bone formation, and insulin therapy allowed an improvement in osseointegration, but it was not possible to reach the results obtained in the control group.


Asunto(s)
Implantes Dentales , Diabetes Mellitus Experimental , Animales , Insulina , Masculino , Oseointegración , Osteogénesis , Ratas , Ratas Wistar , Tibia , Titanio
18.
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
19.
Swiss Dent J ; 130(11): 887-892, 2020 11 09.
Artículo en Alemán | MEDLINE | ID: mdl-33161691

RESUMEN

The aim of this case report was to introduce the clinical use of a prosthetic soft tissue level implant and a completely digitized workflow for the production of an individualized suprastructure fixated on prosthetic implants for orthodontic anchorage rein­forcement. A prosthetic soft tissue level implant was placed in the palatal region for orthodontic anchorage reinforcement. Based on an intraoral optical scan taken after implant osseointegration, the orthodontic suprastructure was manufactured entirely by means of computer­aided design and manufacturing (CAD/CAM). The individualized suprastructure was subsequently loaded in direct manner. The prosthetic implant was then re­moved in a non­invasive manner, similar to palatal implants.The analysis included clinical and laboratory fabrication steps. The placement of prosthetic implant in the palatal region proved to be a painless, easy and fast procedure, and provided absolute anchorage during the entire intended orthodontic treatment. Its non­invasive removal did not cause any adverse patient reactions. The digitally constructed suprastructure did not require any chairside adaptation at delivery and was suc­cessfully used for the intended orthodontic treatment.The reported case presents the successful placement, loading and removal of a prosthetic soft tissue level implant for ortho­dontic anchorage use in the palatal region. The described digital and model­free workflow provides a feasible and streamlined treatment modality for the fabrication of individualized ortho­dontic suprastructures by means of CAD/CAM for the use as or­thodontic anchorage reinforcement. This proof of principle should be substantiated with further larger­scaled investigations.


Asunto(s)
Implantes Dentales , Diseño Asistido por Computadora , Humanos , Oseointegración , Flujo de Trabajo
20.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 908-914, 2020 Nov 09.
Artículo en Chino | MEDLINE | ID: mdl-33171567

RESUMEN

Objective: To evaluate the effects of fluorinated porcine hydroxyapatite (FPHA) on guided bone regeneration of peri-implant buccal bone defects in canine mandible. Methods: Six male beagle dogs were randomly divided into two groups with different time points (4 weeks and 12 weeks after implants placement), with 3 dogs in each group. Bilateral mandibular second premolars, first molars, and second molars in each dog were extracted. The wounds were allowed to heal for 12 weeks. For each dog, four implant beds were prepared in each side and standardized peri-implant buccal bone defect was created at each implant site. After implants placement, the defect sites were randomly allocated in a split-mouth design to blank control group, deproteinized bovine bone mineral (DBBM), the porcine hydroxyapatite (PHA), FPHA and covered with collagen membranes. The animals were sacrificed 4 or 12 weeks after the surgery. Biopsies of the implant sites were obtained for micro-CT evaluation [bone volume fraction (BV/TV) and bone trabecular separation degree (Tb.Sp)] and histological analysis. Results: Micro-CT results showed that 4 weeks after implants placement, PHA, FPHA and DBBM successfully maintained the contour of alveolar ridge at the buccal aspect of the implants, while the contour of alveolar ridge collapsed in the blank control group. BV/TV in the FPHA group [(24.77±2.20) %] was significantly higher than that in the PHA group [(16.89±1.70)%] and DBBM group [(15.68±3.15)%] (P<0.05). Tb.Sp in the FPHA group (0.70±0.07) was significantly lower than that in the DBBM group (1.03±0.19) (P<0.05). Twelve weeks after implants placement, the alveolar ridge contour of the grafted sites in PHA, FPHA and DBBM group remained stable. The alveolar ridge of the blank control group was still collapsed. There was no significant difference in BV/TV and Tb.Sp between PHA group, FPHA group and DBBM group. The histomorphological analysis showed that 4 weeks after implants placement, in the central area of the defect, the amount and maturity of new bone (NB) around the material particles in FPHA group was higher than that in PHA group and DBBM group. Osseointegration could be observed between the NB and implant surface in all the four groups. Twelve weeks after implants placement, the material particles were surrounded by a large number of mature NB in PHA, FPHA and DBBM group. Conclusions: The incorporation of fluoride ion into PHA could effectively promote the repair of peri-implant bone defects in the early stage of guided bone regeneration.


Asunto(s)
Sustitutos de Huesos , Implantes Dentales , Animales , Regeneración Ósea , Bovinos , Implantación Dental Endoósea , Perros , Durapatita , Masculino , Mandíbula/cirugía , Membranas Artificiales , Oseointegración , Porcinos
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