Evaluation of Behavior of Castable versus Machined Solid Abutments for Morse Tapper Implant Connection: A Clinical Retrospective Study.

Objective: The primary objective of the present retrospective clinical study was to evaluate and compare the clinical performance presented by castable abutments developed for the MT system versus intermediate machined abutments, specifically regarding prosthetic or implant fractures/loss; the secondary objective was to verify the looseness of the abutments and the behavior of the peri-implant soft tissues. Methods: This clinical retrospective study was conducted on patients rehabilitated between 2019 and 2020. Inclusion criteria were patients in good general health, with an implants-supporting single crown; with solid machined abutments (control group) or castable UCLA abutments; with a connection portion (base) machined in cobalt-chrome (test group) over Morse taper DuoCone implants in the posterior mandible area; and at least two years in function. Clinical assessment was carried out by the same professional, considering the following parameters: (A) prosthetic: (i) loosening of the fixation screw, (ii) fracture of the screw and (iii) the number of times the patient had some type of complication after the installation of the prostheses were evaluated; (B) biological: (i) without keratinized mucosa (KM), (ii) 1 mm or less, (iii) between 1 and 2 mm and (iv) greater than 2 mm of KM width; and the presence or absence of mucositis. Furthermore, radiographic evaluation was performed in order to assess the marginal bone loss. These evaluations permitted to compare the groups analyzed and patients enrolled. Data were statistically analyzed, with the level of significance set at α = 0.05. Results: 79 patients with 120 MT implants were evaluated (80 castable UCLA abutments and 40 machined solid abutments). The follow-up was from 2 to 4 years. There was a 100% implant survival rate. Therefore, the control group showed two fractured abutments (5%) and no abutment loosening (95% for prosthetic survival rate), whereas the test group showed no abutment fracture but nine loosening screws (11.3%) (100% for prosthetic survival rate). Keratinized mucosa was considered thin or absent in 19 implants in the control group (47.5%) and 42 in the test group (52.5%). Mucositis was found in 11 implants in the control group (27.5%) and 27 in the test group (33.8%). A positive correlation was observed between the width of keratinized mucosa and mucositis (r = 0.521, p = 0.002). The mean marginal bone loss was 2.3 mm, ranging from 1.1 to 5.8 mm. No correlation was observed when considering marginal bone loss versus the three parameters (implant diameter, implant length and time of the prosthesis in function). Conclusions: The results suggest that UCLA-type abutments are a viable option for rehabilitating implants with Morse taper connections, suggesting lower fracture risk. Further research is necessary to confirm these findings and thoroughly evaluate the clinical performance and long-term outcomes.

Stability of implants placed in fresh sockets versus healed alveolar sites: Early findings.

OBJECTIVES: The present study measured implant stability quotient (ISQ) values at three different time points after surgical procedures to compare whether the stability values differed between implants placed in fresh extraction sockets versus healed alveolar sites. MATERIALS AND METHODS: To measure implant stability, resonance frequency analysis (RFA) was performed in 77 patients (53 women, 24 men) with a total of 120 dental implants. These implants were divided into two groups: Group 1 included 60 implants in healed alveolar sites (22 in the maxilla, 38 in the mandible), and Group 2 included 60 implants in fresh sockets (41 in the maxilla, 19 in the mandible). Implant stability was measured immediately at implant placement (baseline), 90, and 150 days later. Statistical analysis was made using a multivariate regression linear model at implant level (α = 0.05). RESULTS: Overall, the means and standard deviations of the ISQ values were 62.7 ± 7.14 (95% confidence interval [CI], 39-88) at baseline, 70.0 ± 6.22 (95% CI, 46-88) at 90 days, and 73.4 ± 5.84 (95% CI, 58-88) at 150 days. In Group 1, the ISQs ranged between 64.3 ± 6.20 and 75.0 ± 5.69, while in Group 2, presented lower values that ranged between 61.2 ± 8.09 and 71.9 ± 5.99 (P = 0.002). Anatomic location and times periods were the only identified variables with an influence on ISQ values at implant level (P < 0.0001). CONCLUSIONS: The stabilities of the implants placed in the fresh sockets and in healed sites exhibited similar evolutions in ISQ values and thus osseointegration; however, the implants in the healed alveolar sites exhibited superior values at all time points.

Sobretratamento: uma alternativa eficaz na terapia com implante em elemento unitário com reabsorção radicular em paciente portador de periodontite crônica: relato de caso / Overtreatment: an effective alternative in implant therapy on a single tooth with root resorption in patient with chronic periodontitis: a case report

Paciente do sexo masculino, 54 anos de idade, leucoderma, compareceu a uma clínica privada para tratamento odontológico. Na anamnese, verificou-se tratar de um paciente saudável sistemicamente; os exames clínico e radiográfico demonstraram reabsorção dos terços apical e médio da raiz do dente 21. A opção de tratamento foi a realização da extração do elemento dentário e realização de implante imediato com carga tardia, utilizando-se o dente do próprio paciente como provisório fixado aos dentes vizinhos. O paciente foi informado sobre os detalhes das fases pré-, trans- e pós-cirúrgica, e autorizou a execução do tratamento e da documentação fotográfica com fins de publicação e divulgação. A utilização de periótomo foi necessária para uma exodontia atraumática. Após remoção atraumática da raiz, e com o osso alveolar remanescente preservado, optou-se por realizar a instalação imediata do implante (Neodent, Curitiba/PR, Brasil), com formato cônico e encaixe cone morse. O espaço alvéolo- implante foi preenchido com Bio-Oss®; removeu-se do palato um enxerto conjuntivo subeptelial, rotacionado para vestibular, e fez-se a obliteração do alvéolo — nessa fase, é importante garantir a imobilidade do enxerto, para sua revascularização. Passou-se, então, à fase protética do provisório, utilizando a coroa do elemento extraído como provisório e estabelecendo um pôntico, afixado com resina composta nos elementos 11 e 22. Assim, após a etapa de provisório utilizando o pôntico reembasado com resina composta, começou-se a confecção da coroa protética final. Após acompanhamento de três anos do caso, foi possível concluir que a associação das técnicas obteve resultados estéticos previsíveis e satisfatórios para a prevenção da saúde peri-implantar, conforme planejado...

A male, 54‐year‐old, Caucasian patient attended a private clinic for dental treatment. Hismedical history revealed a systemically healthy patient. Clinical and radiographic examination revealed resorption in the apical and middle thirds of tooth 21 root. A treatment option was to perform extraction of tooth 21 and implant placement with late loading, using patient's own tooth as a provisional secured to adjacent teeth. The patient was made aware of the details before, during and after surgery, and authorized the implementation of treatment and photographic documentation for purposes of publication and dissemination. The use of Periotome was required for atraumatic extraction. After atraumatic removal of the root, andwith the remaining alveolar bone being preserved, we chose to perform immediate implantplacement (Neodent‐Curitiba‐PR, Brazil). The implant was of conical shape and of the MorseTaper type. The alveolar‐implant space was filled with Bio‐Oss®, subepithelial connective graftwas harvested from the palate, with buccal rotation, and alveolar obliteration was carried out. At this stage, it is important to ensure graft immobility for vascularization. Subsequently, the prosthetic phase was carried out with the crown of the extracted tooth used as a temporary tooth, establishing a provisional pontic secured to between teeth 11 and 22 with compositeresin. Accordingly, after the temporary tooth phase with a pontic secured with composite resin, the final prosthetic crown was manufactured. After a three‐year follow‐up, we conclude that the combination of techniques yielded predictable and satisfactory outcomes for themaintenance of peri‐implant health, as planned ...