Implantoplasty Enhancing Peri-implant Bone Stability Over a 3-Year Follow-up: A Case Series.

Implantoplasty has been claimed as a promising strategy to treat peri-implantitis and prevent progressive peri-implant bone loss. Consequently, the aim of the present case series is to exhibit the clinical outcomes of a 3-year-follow-up resective and implantoplasty therapy applying a novel platform-switch concept to preserve peri-implant tissue integrity and counteract progressive bone loss. Four patients who underwent dental implant therapy and were diagnosed with peri-implantitis were treated through access flap surgery, a modified implantoplasty, bone recontouring, and surface decontamination. The radiographic and clinical parameters recorded before and during the 3-year follow-up were: marginal bone loss (MBL) as the primary endpoint, bleeding on probing index (BOP), probing depth (PD), presence of suppuration, pain, mobility, and fracture. The 3-year follow-up exhibited peri-implant bone stability in all cases (100%) showing radiographically an MBL reduction (mean) of 0.8 ± 0.5 mm (mesial) and 0.5 ± 0.3 mm (distal). Mean PD reduction was 4.75 ± 1 mm and mean BOP was reduced by 71%. Pain and suppuration were resolved in all cases. None of the cases reported implant fracture or mobility after the modified implantoplasty therapy. The present case series demonstrated that this modified implantoplasty can be more than a surface decontamination therapy where the narrow and smooth exposed implant surface can counteract peri-implantitis alterations providing favorable biologic conditions to maintain stability of peri-implant tissues.

Three-Dimensional Finite Element Analysis of Stress Distribution in Zirconia and Titanium Dental Implants.

Zirconia has been presented as an alternative biomaterial to titanium, commercially presented as a single-body implant and/or as an abutment, demonstrating clinically biocompatible favorable results in white and rose esthetics. However, the number of long-term in vivo studies and mechanical tests evaluating the response of stress distribution compared with titanium implants is still limited. The aim of the study was to compare the principal peak stresses in the peri-implant bone around titanium and zirconia implants using the finite element method. Four groups of 3-dimensional models were constructed for the tests: G1, external hexagon titanium implant with a zirconia abutment; G2, zirconia implant with a zirconia abutment; G3, single-body titanium implant; and G4, single-body zirconia implant. Axial and oblique loads of 100 N at 45° were simulated in the prosthetic crown. The bone results showed that the peak stresses decreased by 12% in zirconia implants with 2 parts for axial load and 30% for the oblique load. In single-body implants, the peak stresses decreased 12% in the axial load and 34% in the oblique load when a zirconia implant was used compared with a titanium implant. Although the stress values in megapascals are similar, it can be concluded that the zirconia implants decrease the stress peaks at the peri-implant bone area around the implant platform when compared with titanium implants.

Recobrimento radicular e peri-implantar em área anterior usando a técnica de tunelização / Root and peri-implant coverage in anterior area using the tunnel technique

A estética de reabilitações dentarias e implantossuportadas se vê afetada pela exposição radicular ou da cinta metálica de pilares protéticos em situações de recessões gengivais e peri-implantares, sendo motivo de consulta dos pacientes pelo desconforto com o resultado estético, ainda mais quando este problema se apresenta na área anterior de incisivos centrais. Para resolver estas situações existem várias técnicas cirúrgicas de enxertos e manipulação de tecidos moles para otimizar esses resultados estéticos. O objetivo deste trabalho é apresentar a técnica de enxerto de tecido conjuntivo subepitelial sem desinserir as papilas, conhecida como técnica de túnel, realizada nos incisivos centrais superiores para recobrimento radicular e da cinta metálica da prótese sobre implante. Pode se concluir que a técnica de enxerto de tecido conjuntivo subepitelial tem sido utilizada com alto índice de sucesso e, para obter estética e função em Implantodontia e Periodontia, especificamente neste caso clínico, melhorou-se a situação inicial antiestética e ofereceu a vantagem de manter as papilas inseridas sem serem afetadas no procedimento cirúrgico...

In cases of gingival recession, the dental prostheses are aesthetically compromised by the exposure of dental roots or of metal strap abutments. Therefore this condition is commonly brings to the dental office patients unsatisfied with the aesthetic result, especially when it occurs on the anterior area. There are several grafting surgical techniques and tissue management to improve this situation and optimize aesthetic results. The objective of this paper is to present the sub epithelial connective tissue graft technique without detachment of the papillae (tunnel technique) performed on maxillary central incisors for root and metal strap coverage. It could be concluded that this technique has been used with high success rate for both aesthetics and function in Implantology and Periodontics. In the reported case it enabled significant, improve of the initial aesthetic condition, with the advantage of preserving the papillae unaffected in the surgical procedure...