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1.
Shanghai Kou Qiang Yi Xue ; 29(2): 162-167, 2020 Apr.
Artículo en Chino | MEDLINE | ID: mdl-32626879

RESUMEN

PURPOSE: To investigate the gross manifestation and tissue destruction at different inflammatory periods of ligature-induced peri-implantitis in mice model, and to evaluate the changes of interleukins level in the gingival crevicular fluid of implants at different stages. METHODS: Forty 4-week-old male C57BL/6N mice (18-22 g) were used and the maxillary right first molars were extracted, custom-made pure titanium machined screw type implants (1 mm×1.5 mm) were placed immediately, one implant per animal. Four weeks later, the mice were randomly divided into experimental and control group. 5-0 cotton ligatures were applied around implant necks in the experimental group to induce peri-implantitis. Alveolar bone loss and clinical index records of the soft and hard tissue were assessed every 5 days following ligature.According to the measured data, the stages of peri-implantitis were ascertained. The gingival crevicular fluid of implants in the early, middle and late stages in the experimental group was extracted and the expression of IL-1α, IL-1ß, IL-6 and IL-17A was detected. SPSS 22.0 software package was used to analyze the data. RESULTS: Alveolar bone absorption of all the mice in the experimental group reached 25% 10 days after ligature. This time point was early stage of peri-implantitis. On day 20, the alveolar bone loss around implant in 95% of mice in the experimental group reached 25%-50%, which was identified as middle stage. The alveolar bone loss of all mice in the experimental group was over 50% 30 days following ligature, which was confirmed as late stage. Compared with the early stage, the expression of IL-1α and IL-6 decreased significantly in the middle stage; while the expression levels of IL-1α, IL-6 and IL-17A decreased significantly in the late stage. CONCLUSIONS: Mice models with peri-implantitis of various stages were successfully established by ligature and the expression of IL-1α, IL-1ß, IL-6 and IL-17A in different stages of disease was detected, which provided a basis for further research the relationship between interleukin content and peri-implantitis development.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Animales , Interleucinas , Masculino , Ratones , Ratones Endogámicos C57BL
2.
Acta Odontol Latinoam ; 33(1): 50-55, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32621600

RESUMEN

The purpose of this study was to evaluate aortic wall thickness after periodontal disease and/or obesity induction in a Wistar rat model.Sixty male Wistar rats were randomly divided into four groups: control (CT), periodontal disease (PD), obesity (OB), and obesity plus periodontal disease (OB+PD). Groups OB and OB+PD received cafeteria diet for 17 weeks. After they had acquired obesity (week 12), periodontal disease was induced by placing a silk ligature on the maxillary right second molar of groups PD and OB+PD. During the experimental period, body weight and Lee index were assessed. Mean alveolar bone loss (ABL) was evaluated, and aortas were prepared for histometric analysis of the aortic wall by ImageJ software. Body weight and Lee index increased in rats exposed to cafeteria diet. Mean ABL was higher in Groups PD and OB+PD than in control and OB (p<0.05). ABL was 18% higher in Group OB+PD than in Group PD, with statistically significant difference (p<0.001). Aortas were thicker in Groups OB and OB+PD than in control and PD groups, respectively (2.31mm ± 0.28 and 2.33 ± 0.29 vs. 2.18 ± 0.26 and 2.14 ± 0.27). Group OB differed significantly from the control group (p=0.036), and OB+PD and OB differed significantly from PD (p=0.004 and p= 0.001, respectively). Obesity alters aortic wall thickness in Wistar rats. However, the presence of periodontal disease did not affect the aortic wall thickness under the conditions of the present study.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Aterosclerosis , Ligadura/efectos adversos , Obesidad/complicaciones , Periodontitis/complicaciones , Pérdida de Hueso Alveolar/patología , Animales , Modelos Animales de Enfermedad , Masculino , Periodontitis/patología , Ratas , Ratas Wistar
3.
Int J Prosthodont ; 33(4): 373-379, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32639696

RESUMEN

PURPOSE: To evaluate the influence of the cervical crown contour on marginal bone loss and soft tissue health around platform-switched, posteriorly placed, two-piece implants. MATERIALS AND METHODS: A dataset from two previously conducted studies was used. Patients with single two-piece, platform-switched implants in between two natural teeth or adjacent to one natural tooth were included. Clinical parameters and standardized periapical radiographs from 1 month and 5 years after final crown placement were assessed. A new measurement method was developed to analyze geometric values of the cervical crown contour. Inter- and intraexaminer reliability were assessed. Emergence angles were measured at 1, 2, and 3 mm above the implant shoulder. Linear correlations between variables were determined by calculating Pearson correlation coefficients. RESULTS: A total of 64 patients with 67 posterior implants met the inclusion criteria. At 1, 2, and 3 mm above the implant shoulder, mean emergence angles at the mesial implant sites were 0.5 ± 2.8, 12.8 ± 12.8, and 18.0 ± 11.3 degrees, respectively. At the distal sites, the corresponding values were 2.8 ± 8.3, 16.2 ±16.6, and 18.7 ± 13.8 degrees, respectively. Mean marginal bone loss between 1 month and the 5-year evaluations was 0.14 ± 0.34 mm at the mesial aspect and 0.26 ± 0.47 at the distal aspect of implants. No correlation with peri-implant bone loss or soft tissue health could be found. No implants showed signs of peri-implantitis. CONCLUSION: The cervical crown contour at platform-switched, posteriorly placed, two-piece implants showed no correlation with peri-implant marginal bone loss or soft tissue health up to 5 years after implant placement.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Implantes Dentales , Estudios Transversales , Coronas , Estudios de Seguimiento , Humanos , Reproducibilidad de los Resultados
4.
Stomatologiia (Mosk) ; 99(4): 27-32, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32692516

RESUMEN

THE AIM OF THE STUDY: Was to analyze possible correlation between the concentration of the pro-inflammatory cytokine interleukin-6 and the activation marker of osteoclasts cathepsin K in the gingival fluid during osteoresorption of inflammatory (periimplantitis, chronic generalized periodontitis) and malignant oncological origin (malignant neoplasm of gums). MATERIALS AND METHODS: The study comprised 87 individuals of both sexes aged 30 to 60: 20 patients (group 1) with periimplantitis, 30 people with chronic generalized periodontitis (CGP) (group 2), 22 patients with squamous cell carcinoma of the upper and lower alveolar bone gingiva (group 3), 15 healthy individuals without periodontal disease. RESULTS: The concentration of interleukin-6 (IL-6) and cathepsin K was determined in the gingival fluid by enzyme-linked immunosorbent assay. The examination revealed that during CGP and peri-implantitis the accumulation of IL-6 in the contents of periodontal and peri-implantation pockets was a pathogenetic factor for the activation of osteoclasts and their secretion of proteolytic enzymes osteoresorption. In cancer the increase of cathepsin K expression was a lot higher than the accumulation of IL-6 in the gingival fluid reducing the dependence of the activation of osteoclasts on the local accumulation of pro-inflammatory cytokines. Conclusion. To formulate the prognosis of progressive bone loss in patients with peri-implantitis it is necessary to control the concentration of IL-6 and cathepsin K in the peri-implantation pocket, in case of CGP the concentration of IL-6 in the exudate of the periodontal pocket and in patients with cancer of the alveolar processes the content of cathepsin K of gingival fluid.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis Crónica , Periimplantitis , Adulto , Femenino , Líquido del Surco Gingival , Humanos , Masculino , Persona de Mediana Edad
5.
Compend Contin Educ Dent ; 41(7): 368-376; quiz 377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687381

RESUMEN

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


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Arcada Edéntula/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
6.
Compend Contin Educ Dent ; 41(7): 378-383, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687382

RESUMEN

Based on a high level of success, dental implant therapy has become a preferred means of treatment for a wide variety of oral problems related to historic or impending tooth loss. Peri-implantitis is a biologic complication that can threaten the survival of dental implants. Many systematic reviews and meta-analyses that have evaluated the varying treatment options available to manage this problem suggest that dental implants have questionable to poor prognoses when the bone loss becomes moderate to advanced. This article presents two case reports that demonstrate successful treatment of peri-implantitis. A commonality in both cases was the implementation of thorough surface decontamination and ablation of soft tissues for residual bacteria or particulate matter.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Pérdida de Diente , Humanos
7.
Compend Contin Educ Dent ; 41(7): 384-386, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32687383

RESUMEN

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


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Diseño de Prótesis Dental , Encía , Humanos , Osteotomía , Torque
8.
Quintessence Int ; 51(7): 546-553, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32500862

RESUMEN

OBJECTIVES: In the present pilot, multicenter, randomized, single-blinded, controlled study, surgical treatment with or without the administration of D-PLEX500 (a biodegradable prolonged release local doxycycline formulated with ß-tricalcium phosphate bone graft) was accessed for the treatment of peri-implantitis. METHOD AND MATERIALS: Subjects undergoing surgical treatment for intrabony peri-implantitis defects after flap elevation were randomly assigned, to adjunct D-PLEX500 placement group or to control group. Clinical and radiographic parameters were measured at 6 and 12 months. RESULTS: Twenty-seven subjects (average age: 64.81 ± 7.61 years) were enrolled; 14 patients (18 implants) were randomized to the test group and 13 (14 implants) to the control group. There was no difference in plaque scores between the groups. There was no difference in the changes of mean periodontal probing depth between the test and control groups between baseline and the 6-month follow-up, whereas statistically significant difference was observed after 12 months' follow-up when analyzed for all sites averaged. There was a statistically significant difference in the changes of clinical attachment levels and radiographic bone levels between the groups between baseline and 12 months. These improvements were demonstrated when analyzed at both implant and subject levels. Only D-PLEX500 treatment led to improved bone levels at both time points. The improvement in bone levels was significant in the D-PLEX500 treatment group already after 6 months, and further improved over the 12-month follow-up. Implants were lost only in the control group (14%). CONCLUSIONS: D-PLEX500 sustained release local antibiotic formulated with bone filler showed promising results in enabling healing of peri-implantitis lesions. The antibacterial component of the bone graft material might create favorable conditions that enable implant surface decontamination and soft and hard tissue healing over a prolonged period.


Asunto(s)
Pérdida de Hueso Alveolar , Antibacterianos , Implantes Dentales , Doxiciclina , Periimplantitis , Anciano , Trasplante Óseo , Humanos , Persona de Mediana Edad , Resultado del Tratamiento
9.
J Oral Sci ; 62(3): 298-302, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32581177

RESUMEN

In this study, a Porphyromonas gingivalis (P.g.)-infected mouse periodontitis model was used to investigate the effect of omega-3 fatty acid intake on differentiation and maturation of cultured osteoclast. Four-week-old C57BL/6JJcl mice were divided into four groups according to the diets they were fed from the beginning of the experiment (i.e., food containing omega-3 or omega-6 fatty acids) and whether they were orally administered P.g. Thirty-three days after beginning the experiment, bone marrow cells were sampled from the femoral bone of mice from each group and differentiated into osteoclasts; the effects of the ingestion of different fatty acids were subsequently investigated. There was no statistical interaction between the different fatty acids and P.g. infection on the number of osteoclasts (P = 0.6). However, the fatty acid type affected the number of osteoclasts in mice (P = 0.0013), with the omega-3 groups demonstrating lower osteoclast numbers than the omega-6 groups. Furthermore, the addition of resolvin E1 (RvE1), which is an omega-3 fatty acid-derived lipid mediator, suppressed the differentiation of mouse cultured osteoclasts (P < 0.0001). Therefore, the ingestion of omega-3 fatty acids may suppress osteoclast differentiation while inhibiting bone resorption and tissue destruction due to periodontitis.


Asunto(s)
Pérdida de Hueso Alveolar , Ácidos Grasos Omega-3 , Animales , Diferenciación Celular , Ratones , Ratones Endogámicos C57BL , Osteoclastos , Porphyromonas gingivalis
10.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(3): 338-342, 2020 Jun 01.
Artículo en Chino | MEDLINE | ID: mdl-32573145

RESUMEN

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


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Proceso Alveolar , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Mandíbula/cirugía
11.
J Contemp Dent Pract ; 21(4): 404-409, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32584277

RESUMEN

AIM: The aim of this study was to analyze, by the aid of microbiological analysis and the field emission scanning electron microscopical (FE-SEM) analysis, the role of high-density polytetrafluoroethylene (d-PTFE) membranes in avoiding the microbial colonization of a nanocrystalline hydroxyapatite (nc-HA) bone graft and the involvement of this colonization in the healing process. MATERIALS AND METHODS: Six patients underwent extraction of unrecoverable teeth, and a socket preservation technique was carried out with nc-HA synthetic bone graft and then covered with a d-PTFE membrane. After 28 days from surgery, FE-SEM analysis and BioTimer assay technique to assess the microbiological count of streptococci species were carried out. Data were collected and analyzed by the Student's t test (confidence interval: 95%). RESULTS: The mean amount of bacteria measured on the upper side of the membrane was 6.52 ± 0.50 CFU, while on the lower side, it was 6.59 ± 0.40 CFU. Significant differences were not found between the two sides of the membrane or between the different sectors (p > 0.05). The FE-SEM analysis revealed structured biofilms on both sides of the membrane: species of cocci, bacilli, and fusobacteria were recognizable in occasional settled vegetations. CONCLUSION: Since the amount of bacteria found was low, the improved impermeability of the d-PTFE membrane permitted the healing process to proceed uneventful and without signs of infection or inflammation. CLINICAL RELEVANCE: The infection of the graft site could lead to a failure of the socket preservation technique which could delay or compromise the rehabilitation following procedures. The use of d-PTFE can improve the bone regeneration thanks to its antimicrobial properties.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Durapatita , Humanos , Membranas Artificiales , Microscopía Electrónica de Rastreo , Politetrafluoroetileno , Extracción Dental , Alveolo Dental/cirugía
12.
J Contemp Dent Pract ; 21(4): 463-470, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-32584287

RESUMEN

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


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Remodelación Ósea , Prótesis Anclada al Hueso , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos
13.
Artículo en Inglés | MEDLINE | ID: mdl-32559030

RESUMEN

The aim of this retrospective study was to evaluate long-term clinical and radiologic outcomes of submerged and nonsubmerged guided bone regenerative treatments for peri-implantitis lesions. Strict methods of implant-surface decontamination and detoxification were performed. Data on clinical probing depth, soft tissue measures, and marginal bone level that were documented by comparative radiographs were obtained from 45 patients, for a total of 57 implants prior to treatment and at the latest follow-up. The average follow-up period was 6.9 years (range: 2 to 21 years). Analysis of implant-based data revealed a success rate of 70.2% for a total of 40 implants. Recurrence of peri-implantitis was observed on 9 implants, and 8 implants were removed. The regenerative procedures, under a strict periodontal control, were effective in the treatment of moderate to advanced peri-implantitis lesions.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Humanos , Estudios Retrospectivos , Resultado del Tratamiento
14.
Int J Esthet Dent ; 15 Suppl 1: S88-S97, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32467939

RESUMEN

It is common knowledge that dental implants should not be inserted in adolescents, before completion of skeletal growth, because they behave as ankylosed teeth and remain in a fixed position while the surrounding bone and teeth are still developing, with consequential worsening esthetic damage. However, there is growing evidence that this phenomenon may continue throughout life in a large number of adult patients, although with a great variability in onset, progression, and extent. Infraocclusion and interproximal contact loss are the more common complications, and the majority of clinically significant cases are located in the anterior maxilla. The esthetic impact is mostly minimal, but in some cases the patient's smile may be severely compromised. Therefore, adult patients need to be informed when dental implants are considered to replace anterior missing teeth.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Adolescente , Adulto , Implantación Dental Endoósea , Estética Dental , Humanos , Incisivo , Maxilar , Erupción Dental
15.
Int J Oral Implantol (Berl) ; 13(2): 173-184, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32424383

RESUMEN

PURPOSE: This long-term cohort study investigated the prevalence of mucositis, peri-implantitis, bone loss and survival of turned surface implants in partially edentulous patients treated for periodontitis. MATERIALS AND METHODS: 19 patients treated for generalised chronic periodontitis (GCP) and 20 patients treated for generalised aggressive periodontitis (GAP) were orally rehabilitated with a total of 126 dental implants. Examinations were performed before implant insertion, at the time of superstructure insertion, and in the subsequent years during a 3-month recall schedule over a 10- to 20-year period. At every session, clinical parameters were recorded. Intraoral radiographs were taken after insertion of superstructures and 1, 3, 5, 10, 15 and 20 years later. RESULTS: In total, nine implants were lost during the 20-year observation period. The implant survival rate was 92.1% (GCP patients) and 90.1% (GAP patients). After 10 years, mucositis was present in 21.9% and 21.2% of implants in GCP and GAP patients, respectively. The risk of mucositis was significantly lower in patients with a removable superstructure (OR = 0.061 with P = 0.001). Peri-implantitis was present in 12.2% implants (GCP patients) and 14.1% implants (GAP patients). Implants inserted in bone quality grade 3 showed a significantly higher risk of peri-implantitis (OR = 5.658 with P = 0.003). After 10 years, implants in GAP patients did not show a significant higher bone loss (1.87 ± 1.40 mm) compared with implants in GCP patients (1.50 ± 1.30 mm). After 20 years, the total mean peri-implant bone loss was 1.98 ± 1.64 mm, almost every fifth implant revealed a bone loss > 3 mm. CONCLUSIONS: The implant survival rate in both patient groups was > 90%, and implants showed a moderate mucositis (< 30%) and peri-implantitis (< 25%) rate. Bone quality and type of superstructure seem to have had an influence on peri-implant health. These results suggest that patients with a history of periodontitis treated in a tight recall schedule can be successfully rehabilitated with turned surface implants for a follow-up period of 10 to 20 years.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Periimplantitis , Estudios de Cohortes , Humanos , Estudios Prospectivos
16.
J Contemp Dent Pract ; 21(1): 28-35, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32381797

RESUMEN

INTRODUCTION: Alveolar split crest is an established surgical technique to enable implant insertion into narrow and atrophic alveolar crest. This surgical technique is adopted to position standard or large implants so that postextractive anatomy compromises with this attempt. The aim of this study was to evaluate the horizontal alveolar bone augmentation and its stability along time with a minimally invasive flapless technique. MATERIALS AND METHODS: Twenty-four implants were inserted in 10 patients during a 15-month period. Clinical parameters such as horizontal bone augmentation, intrasurgical complications, patient morbidity, implant loss, and vertical bone loss (VBL) were recorded in the first 3 years after surgery. Using cone-beam computed tomography (CBCT), alveolar bone width was measured for both implants position and bone reconstructions. 6 months later, at the time of implant integration, a new low-dose CBCT was performed. Implant survival (IS) and VBL were evaluated radiographically for 3 years. RESULTS: The initial bone thickness measured on the ridge is between 0.82 mm and 5.40 mm (average 2.43 mm), after the split crest the bone width is between 4.65 mm and 8.09 mm (average 6.39 mm). This leads to an increase in the alveolar bone width of between 0.80 mm and 6.01 mm (average 3.71 mm) on the ridge. No implant was lost at 3 years, and all implants are stable at the end of the study. Three years after the surgery, controls showed a VBL of between 0.0 mm and 1.2 mm (average 0.63 mm) around the inserted implants. These parameters suggest using a flapless technique to reduce bone resorption around the implant neck. CONCLUSION: A minimally invasive approach allows to reduce the surgical trauma and postsurgical discomfort. The complete vascular supply is maintained, the bone resorption is reduced, and the connective epithelium does not undergo postsurgical retraction, achieving the full maintenance of the residual keratinized gingiva. CLINICAL SIGNIFICANCE: A technique such as split crest can be a valid option to avoid autologous or heterologous bone grafts.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Implantes Dentales , Proceso Alveolar , Trasplante Óseo , Humanos
17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(2): 332-338, 2020 Apr 18.
Artículo en Chino | MEDLINE | ID: mdl-32306019

RESUMEN

OBJECTIVE: To observe and investigate the effect of vertical soft tissue thickness on the peri-implant tissue condition and the prevalence of peri-implant disease in patients with history of periodontitis. METHODS: Among 210 patients who showed initial interest of implant therapy, 92 patients were included in this study and received implant surgery during 2010 and 2015. Sixty-six patients with 66 implants finally came back for T2 evaluation. Prior to the implant therapy, all the patients had received periodontal treatment. During the implant placement surgery, the distance from palatal soft tissue edge to the alveolar crest, which was defined as vertical soft tissue thickness (VT), was measured after the buccal full thickness flap was elevated. According to the cut off point which was adopted from the operating characteristic curve, 66 implants within 66 patients were divided into two groups, which were called normal group (VT≤4.5 mm) and thick group (VT>4.5 mm), respectively. Information of the patient's general status, periodontal situation and implant information were recorded. After a follow-up period of 42.9 months, the parameters of peri-implant tissue and condition of peri-implant disease were recorded. Mann-Whitney U test as well as Chi-square test were used to compare the parameters between two groups. Moreover, Kaplan-Meier method was chosen to draw the event(peri-implantitis)-free survival curve. RESULTS: The survival rate of the implants was 100%. At the end of the follow-up examination(T2), the parameters including max PDi, mean PDi, max BIi, mean BIi, mean MBL, MBL at distal side, MBL at mesial side, mean PLIi presented significantly higher values in thick group than in normal group (P < 0.05). Moreover, the prevalence of peri-implantitis and peri-implant disease (peri-implant mucositis & peri-implantitis) in thick group was respectively 34.8% and 73.9%, which was significantly higher than 2.3% and 48.8% respectively in normal group (P<0.05). The prevalence of peri-implant mucositis did not show significant difference in the two groups. In addition, Kaplan-Meier analysis showed that there was significant difference between the event-free survivals of the two groups. CONCLUSION: The vertical soft tissue thickness around implants in patients with periodontitis has a significant effect on the health of the peri-implant tissue. Excessive vertical soft tissue thickness may result in deeper peri-implant probing depth as well as more peri-implant marginal bone loss, and eventually increase the risk of peri-implant disease. The vertical remodeling of soft tissue may be a new direction to indicate the role of periodontitis in peri-implant tissue condition. Moreover, the biological mechanism of the association between soft tissue thickness and peri-implantitis risk as well as effective approaches to prevent the adverse effect of excessive soft tissue thickness on peri-implant tissue is necessary to be investigated.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Mucositis , Periimplantitis , Periodontitis , Diente , Proceso Alveolar , Humanos
18.
Compend Contin Educ Dent ; 41(4): e7-e18, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32250126

RESUMEN

OBJECTIVE: The aim of this clinical study was to retrospectively evaluate changes in bone following final abutment insertion and functional loading and to evaluate bone status relative to implant type, width, and length; placement into healed bone and extraction sockets; immediate provisionalization; abutment type (single-unit, multi-unit, cementable stock abutment, custom abutment, ti-base, UCLA); cementable restoration, screw-retained restoration, splinted restoration, and single-unit restoration. MATERIALS AND METHODS: Fifty consecutive patients with 87 implants were evaluated radiographically following final abutment insertion and functional loading to their latest follow-up radiograph. Follow-up evaluation time from final abutment insertion ranged from 11 months (335 days) to 4 years (1,484 days), with an average of 831 days (2.3 years). Mesial and distal surfaces were examined and graded as bone improved, bone maintained, and bone decreased. A total of 174 surfaces were graded (87 implants). RESULTS: Thirty percent of implant surfaces showed bone improvement following restoration, 62% of implant surfaces showed bone maintenance, and 8% showed bone decrease (range 0.1 mm to 1 mm). CONCLUSIONS: This retrospective study showed an unusual phenomenon of bone improvement following restoration for 30% of implant surfaces. Eight percent of the surfaces showed bone decrease but at a maximum of 1 mm. This places 100% of the followed implants well within established criteria for successful implant bone maintenance. There was no statistical difference among the groups in age, gender, implant diameter, implant length, implant location (maxilla versus mandible, anterior versus posterior), and prosthetic procedures. Additional highly controlled prospective studies are being planned to validate and further the authors' knowledge.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Extracción Dental
19.
Int J Periodontics Restorative Dent ; 40(3): e119-e126, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32233192

RESUMEN

This study evaluates the microbial colonization in the peri-implant sulci and in implant-abutment interfaces of Laser-Lok implants (BioHorizons) with laser-microgrooved abutments (test group) and machined abutments (control group) 18 months after functional loading Real-time polymerase chain reaction revealed significantly greater total and specific microbial load in both the peri-implant sulcus and implant-abutment interface in the control group (P ≤ .05) Similarly, there was a significant reduction in the radiographic crestal bone loss in the test group (P ≤ .05) In total, 14 patients were assessed for clinical and radiographic parameters and microbial evaluation Peptostreptococcus micros and Porphyromonas gingivalis were positively correlated with site-specific plaque scores and bleeding scores, and mean crestal bone loss, respectively Hence, the authors propose using Laser-Lok implants with laser-microgrooved abutments to reduce microbial colonization and consequently preserve the crestal bone levels.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pilares Dentales , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea , Humanos , Índice Periodontal
20.
Artículo en Inglés | MEDLINE | ID: mdl-32233195

RESUMEN

Maintaining soft and hard tissues around dental implants after tooth extraction is one of the major challenges in implant dentistry. After tooth extraction, the subsequent loss of bone and soft tissue is inevitable due to the partial resorption of the buccal bone plate. The recently described socket shield technique addresses the problem by maintaining the buccal piece of the tooth in the extraction socket in order to preserve the buccal bone. As with every new technique, specific complications, like infection of the buccal piece of the tooth, can occur. Herein, the authors present a clinical case that developed a complication with the socket shield technique and the consequential surgical management.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Implantes Dentales , Boca , Extracción Dental , Alveolo Dental
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