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1.
Niger J Clin Pract ; 23(4): 456-463, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32246650

RESUMEN

Aims: The purpose of this study was to observe the stresses of all-on-four implant designs in an edentulous mandible in the implant, surrounding bone, and monolithic ceramics. Materials and Methods: In mandibular all-on-four implant models, anterior implants were placed vertically, and posterior implants were differently inclined. On the full-arch fixed prosthetic restoration monolithic zirconia framework, monolithic lithium disilicate was prepared as the superstructure. Model 1M (1M-15.5); posterior implants angled at 15° to the occlusion plane and a cantilever length of 5 mm, Model 2M; (2M-15.9), Model 3M; (3M-30.5), and Model 4M; (4M-30.9) were prepared. A total of 300 N bilateral force was applied at an angle of 30° and oblique to the occlusion plane. Stress values on dental implants, abutments, the surrounding bone, and prosthetic restorations were calculated. Results: The highest stress concentration was observed in the 2nd connector region between the canine and the 1st premolar tooth in the monolithic zirconia frameworks (457.21 MPa). Stress concentration in the cortical bone was 60.93 MPa in posterior implants. Stress was higher in posterior angled implants than straight implants. Stress at posterior angulation increased by 21 MPa in implants angled at 15°. Conclusion: In bilateral loading, the force applied to anterior implants does not have a significant effect on the bone structure. Stress concentration increases in posterior angled implants and surrounding bone. Moreover, stress concentration increases as the length of the cantilever, the weakest part in all-on-four implants, increases. As posterior implant angulation increases, stress concentration level and localization are affected.


Asunto(s)
Cerámica/química , Implantes Dentales , Prótesis Dental de Soporte Implantado/métodos , Imagenología Tridimensional/métodos , Titanio/química , Circonio/química , Diente Premolar , Arco Dental/fisiología , Modelos Dentales , Diseño de Prótesis Dental , Análisis del Estrés Dental , Análisis de Elementos Finitos , Humanos , Mandíbula/fisiología , Estrés Mecánico
2.
Biomed J ; 42(5): 358-364, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31783997

RESUMEN

BACKGROUND: Clinical studies regarding zirconia implant abutments reported good survival rates in the short-term observation period. The purpose of this study was to assess the six-year clinical performance of zirconia abutments supporting all-ceramic crowns in anterior and premolar regions. METHODS: The patients received zirconia implant abutments to support all-ceramic crowns in Chang-Gung Medical Center during the period August 2010 to August 2011 were enrolled. In the following six years of observation period after the implant-crown had finished, the clinical parameters of all of the included patients were registered on a special form. The records regarding the following variables: age, gender, implant location, the condition of edentulous site before implant placement, esthetic performance at baseline, presence or absence of technical complications, and biological outcomes were registered and scrutinized for evaluation. RESULTS: Out of the 32 zirconia implant abutments and 32 all-ceramic crowns that were followed for six years. Neither abutments nor crowns were lost, yielding 100% survival rates for both zirconia abutments and crowns. The esthetic outcomes were excellent except that a score of 2 was given to two restorations. With regard to technical complications, there was one instance of abutment screw loosening, two cases of veneering ceramic chipping, one restoration with occlusal roughness, and three instances of crowns loosening. Overall, the success rates were 96.8% and 81.2% for abutments and crowns respectively. In biological performance, only 1 implant was classified in group II (satisfactory survival) in the Misch classification, while all the others were classified in group I (excellent). CONCLUSIONS: Zirconia abutments supporting all-ceramic crowns demonstrated high survival rate, good biological and esthetic results. While some technical complications were frequently observed, the complication-free rates were 96.8% for abutments and 81.2% for crowns in the medium-term observation period.


Asunto(s)
Diente Premolar/efectos de los fármacos , Cerámica/farmacología , Prótesis Dental de Soporte Implantado , Circonio/farmacología , Adulto , Diente Premolar/metabolismo , Coronas , Prótesis Dental de Soporte Implantado/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
3.
Braz Oral Res ; 33: e110, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31778474

RESUMEN

The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was "Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?" Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Soldadura Dental/métodos , Soldadura/métodos , Técnica de Colado Dental , Adaptación Marginal Dental , Diseño de Prótesis Dental , Humanos , Ajuste de Prótesis
4.
Scanning ; 2019: 4274715, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31531155

RESUMEN

Purpose: To present a digital method that combines intraoral and face scanning for the computer-assisted design/computer-assisted manufacturing (CAD/CAM) fabrication of implant-supported bars for maxillary overdentures. Methods: Over a 2-year period, all patients presenting to a private dental clinic with a removable complete denture in the maxilla, seeking rehabilitation with implants, were considered for inclusion in this study. Inclusion criteria were fully edentulous maxilla, functional problems with the preexisting denture, opposing dentition, and sufficient bone volume to insert four implants. Exclusion criteria were age < 55 years, need for bone augmentation, uncompensated diabetes mellitus, immunocompromised status, radio- and/or chemotherapy, and previous treatment with oral and/or intravenous aminobisphosphonates. All patients were rehabilitated with a maxillary overdenture supported by a CAD/CAM polyether-ether-ketone (PEEK) implant-supported bar. The outcomes of the study were the passive fit/adaptation of the bar, the 1-year implant survival, and the success rates of the implant-supported overdentures. Results: 15 patients (6 males, 9 females; mean age 68.8 ± 4.7 years) received 60 implants and were rehabilitated with a maxillary overdenture supported by a PEEK bar, designed and milled from an intraoral digital impression. The intraoral scans were integrated with face scans, in order to design each bar with all available patient data (soft tissues, prosthesis, implants, and face) in the correct spatial position. When testing the 3D-printed resin bar, 12 bars out of 15 (80%) had a perfect passive adaptation and fit; in contrast, 3 out of 15 (20%) did not have a sufficient passive fit or adaptation. No implants were lost, for a 1-year survival of 100% (60/60 surviving implants). However, some complications (two fixtures with peri-implantitis in the same patient and two repaired overdentures in two different patients) occurred. This determined a 1-year success rate of 80% for the implant-supported overdenture. Conclusions: In this study, the combination of intraoral and face scans allowed to successfully restore fully edentulous patients with maxillary overdentures supported by 4 implants and a CAD/CAM PEEK bar. Further studies are needed to confirm these outcomes.


Asunto(s)
Diseño Asistido por Computadora/instrumentación , Técnica de Impresión Dental , Prótesis Dental de Soporte Implantado/métodos , Prótesis de Recubrimiento , Arcada Edéntula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Anciano , Femenino , Humanos , Arcada Edéntula/patología , Arcada Edéntula/cirugía , Cetonas/química , Masculino , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Polietilenglicoles/química , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
5.
J Appl Oral Sci ; 27: e20180600, 2019 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-31411262

RESUMEN

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


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Dentadura Completa , Carga Inmediata del Implante Dental/métodos , Ensayos Clínicos Controlados como Asunto , Humanos , Sesgo de Publicación , Factores de Riesgo , Resultado del Tratamiento
6.
Rev Saude Publica ; 532019 Aug 19.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31432931

RESUMEN

OBJECTIVE: To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis). METHODS: A Markov model was developed to capture long-term clinical and economic outcomes. The model's population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost - in BRL, and effectiveness - measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years. RESULTS: Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY). CONCLUSIONS: The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.


Asunto(s)
Prótesis Dental de Soporte Implantado/economía , Dentadura Parcial Fija/economía , Boca Edéntula/economía , Brasil , Análisis Costo-Beneficio , Implantes Dentales/economía , Prótesis Dental de Soporte Implantado/métodos , Humanos , Persona de Mediana Edad , Boca Edéntula/rehabilitación , Programas Nacionales de Salud
7.
Rom J Morphol Embryol ; 60(1): 233-241, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31263850

RESUMEN

The aim of this paper is to eliminate suspicions of a titanium (Ti) allergy in a rare case of "flowered" implant in a 43-year-old female patient with metal allergies and no history of bruxism, using a histological and immunohistochemical (IHC) analysis to determine the phenotype of cells that participated in the immune response; also, to assess the prognosis of a future implant treatment and to highlight the psychological impact of osseointegrated implant failure caused by fracture, and the influence that the necessity to use extensive surgical procedures for reimplantation can have on the treatment solution chosen by the patient. The results of our IHC analysis did not indicate a clear response for a potential Ti allergy; still, due to psychological reasons, the patient rejected the replantation and considered the use of other restorative option, a three-unit bridge, as being the most appropriate for her. Considering her opinion and attitude, the fixed prosthetic denture assured the therapeutic success.


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Hipersensibilidad/complicaciones , Titanio/efectos adversos , Adulto , Femenino , Humanos
8.
Oral Maxillofac Surg Clin North Am ; 31(3): 399-426, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31253346

RESUMEN

The treatment of completely edentulous or soon-to-be completely edentulous dental arches with complete-arch fixed denture restorations, supported by dental implants, are some of the more complicated patient cases in oral and maxillofacial surgery and prosthodontics. This article discusses the use of digital technologies, computerized tomographic (CT) guided planning software applications, and surgical guides in treating these complex dental implant patient cases. A discussion of the nuances and workflows of different types of treatments are provided. The importance of experience and a multi-disciplinary team approach is emphasized.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado/métodos , Arcada Edéntula , Cirugía Asistida por Computador/normas , Diseño Asistido por Computadora , Diseño de Prótesis Dental/métodos , Dentición , Humanos
9.
J Appl Oral Sci ; 27: e20180434, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31215598

RESUMEN

This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.


Asunto(s)
Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Arco Dental/patología , Prótesis Dental de Soporte Implantado/métodos , Imagenología Tridimensional/métodos , Ortodoncia Correctiva/métodos , Adolescente , Adulto , Puntos Anatómicos de Referencia , Labio Leporino/patología , Fisura del Paladar/patología , Femenino , Humanos , Masculino , Maxilar/patología , Aparatos Ortodóncicos , Valores de Referencia , Estudios Retrospectivos , Estadísticas no Paramétricas , Resultado del Tratamiento , Adulto Joven
10.
Int J Oral Maxillofac Implants ; 34(2): 451-460, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883621

RESUMEN

PURPOSE: The goal of this study was to compute the estimated cumulative survival and success rates of alumina-toughened zirconia (ATZ) abutments used for external connection-type implant-supported fixed dental prostheses (FDPs) after a mean follow-up of 6.9 years (82.3 months). MATERIALS AND METHODS: From May 1998 to July 2016, patients who provided informed consent and received implant-supported restorations with ATZ abutments were recruited. Clinical performance of zirconia abutments was evaluated using survival analysis. Failure was defined as the removal of the restoration due to zirconia abutment fracture, and complications included both failure and abutment screw problems. Survival and success were the counterparts of failure and complications, respectively. The effects of restoration-related factors (restored area, type of prosthesis, and implant system) on the survival and success of the abutments were estimated. RESULTS: A total of 231 patients were included in this study. One hundred twenty-six implant-supported single-unit and 204 multiple-unit FDPs were evaluated. All the placed implants had the external hex connection. The estimated cumulative 5-year, 7-year, and 10-year survival rates (95% confidence interval [CI]) of zirconia abutment-supported FDPs were 97.3% (95.5% to 99.1%), 96.8% (94.8% to 98.8%), and 94.1% (90.4% to 97.8%), respectively. The estimated cumulative 5-year, 7-year, and 10-year success rates (95% CI) were 94.1% (91.4% to 96.8%), 90.8% (87.3% to 94.3%), and 80.1% (73.6% to 86.6%), respectively. The type of prosthesis (P = .001) and implant system (P < .001) were the significant factors in the success of zirconia abutment-supported FDPs. CONCLUSION: Prefabricated ATZ abutments have a high predictability of survival at 10 years when used in implant-supported FDPs that replace both anterior and posterior teeth. However, the success of zirconia abutments was significantly influenced by the type of prosthesis and implant system.


Asunto(s)
Óxido de Aluminio/química , Pilares Dentales , Materiales Dentales/química , Prótesis Dental de Soporte Implantado/métodos , Circonio/química , Adulto , Anciano , Anciano de 80 o más Años , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Análisis de Supervivencia , Adulto Joven
11.
Int J Oral Maxillofac Implants ; 34(2): e17-e19, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883628

RESUMEN

Subgingival presence of remaining excess cement may lead to implant complications and failures. This is a technical report and advice on how to cement implant-supported restorations using a simple and universal method applying liquid petroleum jelly to the peri-implant sulcus after cementation. This simple and user-friendly method eliminates excess cement and should be used in the daily practice.


Asunto(s)
Cementación/métodos , Cementos Dentales , Retención de Prótesis Dentales/métodos , Prótesis Dental de Soporte Implantado/métodos , Cementos para Huesos , Humanos , Irrigación Terapéutica
12.
Int J Prosthodont ; 32(32): 214-216, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30856651

RESUMEN

Patients presenting both severe maxillary atrophy and dental malposition require a multidisciplinary treatment approach to achieve optimal esthetic and functional results. This case history report demonstrates how digital treatment planning and teeth set-up can serve as a reference for surgical, orthodontic, and prosthodontic procedures, leading to an all-ceramic full-arch implant-supported fixed prosthesis.


Asunto(s)
Periodontitis Crónica/complicaciones , Periodontitis Crónica/terapia , Prótesis Dental de Soporte Implantado/métodos , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Impresión Tridimensional , Adulto , Estética Dental , Femenino , Humanos , Maloclusión/complicaciones , Atrofia Periodontal/etiología , Pérdida de Diente/etiología , Pérdida de Diente/terapia
13.
Artículo en Inglés | MEDLINE | ID: mdl-30866465

RESUMEN

Background: The objective of this study was to compare conventional versus digital impressions for Full-Arch maxillary rehabilitations. Methods: Patients selected for this study were treated with full-arch screw-retained rehabilitations supported by six immediately loaded dental implants. Patients have been scheduled randomly into control (conventional impression group, CIG) and test (digital impression group, DIG) groups respectively for a fully conventional workflow and a fully digital workflow. In both groups, within 24 h, temporary prostheses were delivered. Four months after the implant positioning, the two groups dealt with the fabrication of definitive restorations: conventional pick-up was performed in the control group, and definitive digital impressions were carried out in the test group. The time involved following these two procedures was recorded. Patients underwent intraoral digital radiographs to evaluate the accuracy of the framework-implant connection, check for the presence of voids at the bar-implant connection and measure bone level. Criteria used to assess success at the prosthetic level were the occurrence of prosthetic maintenance, the absence of fractures of the acrylic resin superstructure and voids. Results: A total of 50 patients received immediately loaded prostheses supported by six implants (total 300 implants). A fixture and prosthetic survival rate of 100% was observed. All digital X-ray examinations revealed a bar-implant connection accuracy and no voids. Differences that were not statistically significant (p > 0.05) in marginal bone loss were found between control and test groups. Significantly less time was spent to perform digital impression procedure (p < 0.05). Conclusions: Clinical and radiological results of the test group advocate a satisfactory accuracy and predictability of the intraoral scanner (IOS) to be a reliable alternative in clinical practice for implant full-arch rehabilitations and suggest fabrication of definitive restorations with a successful marginal fit precision.


Asunto(s)
Técnica de Impresión Dental/instrumentación , Prótesis Dental de Soporte Implantado/métodos , Anciano , Tornillos Óseos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del Tratamiento
14.
Artículo en Inglés | MEDLINE | ID: mdl-30794256

RESUMEN

Implant-supported prosthetics are a suitable option for improving partially and totally edentulous patients' oral life quality, especially those patients with a history of periodontitis who experience early tooth loss and therefore require implant therapy. However, long-term clinical studies on dental implants have indicated that patients with periodontitis show more biologic complications and lower survival and success rates compared to periodontally healthy patients. The two clinical reports presented show that patients with aggressive periodontal diseases treated with a supportive periodontal therapy can be successfully rehabilitated with implant-supported double-crown restorations for a follow-up period of over 20 years.


Asunto(s)
Periodontitis Agresiva/cirugía , Coronas , Prótesis Dental de Soporte Implantado/métodos , Restauración Dental Permanente/métodos , Adolescente , Adulto , Estudios de Seguimiento , Humanos , Masculino
15.
Int J Oral Maxillofac Implants ; 34(3): 719­725, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30779822

RESUMEN

PURPOSE: To evaluate the clinical and radiographic outcomes of full-arch mandibular rehabilitation with fixed prostheses supported by three immediately loaded implants after at least 5 years of follow-up. MATERIALS AND METHODS: The sample comprised 58 patients who underwent treatment with immediate loading. Radiographic evaluation of bone loss was carried out in Adobe Photoshop CS5 by a single calibrated examiner using digitized panoramic radiographs. Clinical examination of the technical conditions of the prosthetic device assessed the condition of the acrylic resin base, dental occlusion, metal framework, presence of cover screws, screw fixation of the prosthesis and abutments, and length of cantilever and resistance arms. RESULTS: Five implants in four patients failed, for an overall success rate of 97.13%. Mean bone loss was 2.65 ± 1.06 mm around central implants and 2.11 ± 0.84 mm around distal implants. The most common complication was loss of abutment torque. Half of all patients in the sample experienced some prosthetic complication. There was no evidence of a statistically significant relationship of cantilever length with bone loss or prosthetic complications. CONCLUSION: The immediately loaded three-implant-supported fixed prosthesis protocol tested in this study proved to be a viable therapeutic strategy for mandibular rehabilitation in edentulous patients, with favorable outcomes after 5 years of clinical and radiographic follow-up.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado/métodos , Carga Inmediata del Implante Dental , Arcada Edéntula/rehabilitación , Mandíbula/cirugía , Anciano , Anciano de 80 o más Años , Tornillos Óseos , Femenino , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Masculino , Persona de Mediana Edad , Radiografía Panorámica , Estudios Retrospectivos , Torque
16.
Rom J Morphol Embryol ; 60(3): 875-881, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31912099

RESUMEN

As zirconia is today probably the dental material with the largest increase in the frequency of use in dental prosthetics, the reason for this study was based on a series of clinical observations made following its use in clinical prosthetics. Thus, we were interested in two aspects: the histological evaluation of the response of the oral soft tissues to the presence of the prosthetic structures in zirconia, and the microscopic evaluation of the abrasion lesions that appeared in the hard dental tissues of the zirconia prostheses antagonists. For the first part, samples from three zirconia-based dental prosthetics commercial products were implanted submucosal in the oral cavity of male Wistar rats. After six weeks, the oral soft tissue reaction was clinically and then histologically investigated. For the second part, we made two study groups to investigate the influence of the zirconia-glazed surface vs. polished surface to the wear pattern of the antagonist enamel, using a tribological equipment and a dedicated software. Our study showed a good clinical response of the oral soft tissues surrounding the inserted zirconia samples, with subclinical, only histological revealed, signs of inflammation, of a foreign body reaction, while polished zirconia samples determined abrasion surfaces, with a different pattern and significantly smaller dimensions, compared to zirconia glazed samples, at the level of the hard dental tissues of the antagonist teeth. Despite the generally good response of the biological structures to the presence of zirconia prosthetic structures in the oral environment, more scientifically proved information is needed to obtain the desired biological responses in all clinical situations.


Asunto(s)
Porcelana Dental/química , Prótesis Dental de Soporte Implantado/métodos , Ensayo de Materiales/métodos , Circonio/uso terapéutico , Humanos , Masculino , Microscopía Electrónica de Rastreo , Circonio/farmacología
17.
J Prosthodont ; 28(2): e675-e681, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29235192

RESUMEN

PURPOSE: To determine the ideal position of a dental implant to assist a posterior extended partial removable dental prosthesis (PRDP), through stress values, displacement values, and deformation of periodontal ligament (PDL). MATERIALS AND METHODS: A finite element analysis of different implant positions was analyzed using a 3D mandible model from a human patient. Test models were created: model A (implant in second molar area), model B (implant in the first molar area), and model C (implant in premolar area). A control model without implant support was also created. Overall displacement values, von Mises stress distribution maps, and nonlinear deformations were evaluated. RESULTS: Some differences could be observed between test models. The introduction of an implant in the edentulous area, unlike a conventional removable partial denture without implant support, decreases stress values in the biological structures such as: mandible, tooth, soft tissue, and PDL. Placing the implant in the first molar area resulted in improved displacement values, and reduced maximum stress values at the peri-implant bone area, metal structure, and implant were observed. CONCLUSIONS: Within the limitations of this study we can conclude that placing the implant in the position of the first molar improves biomechanical behavior of implant-assisted PRDPs.


Asunto(s)
Prótesis Dental de Soporte Implantado , Dentadura Parcial Removible , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Tomografía Computarizada de Haz Cónico , Modelos Dentales , Prótesis Dental de Soporte Implantado/efectos adversos , Prótesis Dental de Soporte Implantado/métodos , Análisis del Estrés Dental , Dentadura Parcial Removible/efectos adversos , Análisis de Elementos Finitos , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Masticación , Ligamento Periodontal/diagnóstico por imagen , Ligamento Periodontal/patología , Radiografía Dental
18.
J Prosthodont ; 28(2): e661-e665, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29239053

RESUMEN

PURPOSE: Improper seating of abutment on the implant is a common problem. This study investigated the effect of the type of implant/abutment interface on the complete seating of the abutments on the head of implants placed at different gingival depths. MATERIALS AND METHODS: Three implant systems with three different connections including straight external hexagon, butt-joint internal tri-lobed, and conical internal hexagon were used. Two gingival thicknesses (2 and 7 mm) were created using pink baseplate wax around the straight abutments seated on the implants. After placing the implants in acrylic blocks, the wax was replaced with the gingival mask material to simulate the gingival drape around the implant heads. Afterwards, 15 prosthodontists were asked to hand-tighten the straight abutments in the corresponding implant bodies relying only on their tactile sense. At the final stage, the gingival mask was removed, and the seating quality of the abutments on implant bodies was assessed visually. The effect of implant connection and depth on abutment seating accuracy was analyzed using Kruskal-Wallis and multiple-comparison tests. RESULTS: No significant difference was found regarding the effect of either depth or connection design on the accuracy of the abutment seating (p > 0.05); however, pairwise comparison of the combined effect of the depth and connection design was significant (p = 0.009). Accuracy of abutment seating on the Nobel Active implants at both 2 and 7 mm depths were significantly better than Replace system with 7 mm depth (p = 0.027). The same results were obtained in comparison between Nobel Active system at both 2 and 7 mm depths with Branemark system with 7 mm depth (p = 0.006). CONCLUSION: An increase in implant placement depth meant a decrease in accuracy of the abutment seating. The internal conical connection design showed the best result in abutment positioning in deep implants as compared with external and internal butt-joint connection designs.


Asunto(s)
Pilares Dentales , Diseño de Implante Dental-Pilar/métodos , Prótesis Dental de Soporte Implantado , Resinas Acrílicas , Prótesis Dental de Soporte Implantado/instrumentación , Prótesis Dental de Soporte Implantado/métodos , Humanos
19.
J Prosthodont ; 28(2): e657-e660, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29024143

RESUMEN

A standardized periapical radiograph is still the most suitable technique for monitoring peri-implant osseous destruction during long-term treatment. This article describes a new method for custom fabrication of an acrylic template with standardized reproducible assessment of implants retaining mandibular bar overdentures, without removal of the bar and regardless of the implant system used.


Asunto(s)
Prótesis Dental de Soporte Implantado , Retención de Dentadura/métodos , Prótesis de Recubrimiento , Radiografía Dental/métodos , Resinas Acrílicas , Prótesis Dental de Soporte Implantado/instrumentación , Prótesis Dental de Soporte Implantado/métodos , Retención de Dentadura/instrumentación , Humanos , Mandíbula , Oseointegración , Radiografía Dental/instrumentación
20.
J Prosthodont ; 28(2): e688-e693, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29377338

RESUMEN

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


Asunto(s)
Prótesis Dental de Soporte Implantado/métodos , Carga Inmediata del Implante Dental/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Diente Premolar , Implantes Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado/instrumentación , Femenino , Humanos , Carga Inmediata del Implante Dental/instrumentación , Masculino , Persona de Mediana Edad , Diente Molar , Ferulas Periodontales , Radiografía Dental
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