An Evaluation of the Effects of Photobiomodulation Therapy on the Peri-Implant Bone Healing of Implants with Different Surfaces: An In Vivo Study.

(1) Background: This study evaluates the effects of photobiomodulation (PBM) therapy on the peri-implant bone healing of implants with a machined surface (MS) and treated surface (TS). (2) Methods: Topographic characterization of the surfaces (scanning electron microscopy [SEM]- energy dispersive X-ray spectroscopy [EDX]) was performed before and after implant removal. Twenty rabbits were randomly divided into four groups: MS and TS groups (without PBM therapy) and LMS and LTS groups (with PBM therapy). After implant placement, the stability coefficient (ISQ) was measured. In the periods of 21 and 42 days, the ISQ was measured again, followed by biomechanical analysis. (3) Results: The surfaces of the TS implants showed topographic differences compared with MS implants. The ISQ values of the LMS were statistically significant when compared with those of the MS at 42 days (p < 0.001). The removal torque values of the LMS were statistically significant when compared with those of the MS at 21 days (p = 0.023) and 42 days (p = 0.023). For SEM, in general, the LMS, TS and LTS presented high bone tissue coverage when compared to MS. (4) Conclusions: The PBM therapy modulated the osseointegration process and was evidenced mainly on the machined surface.

Evaluation of bone availability for grafts in different donor sites, through computed tomography.

OBJECTIVE: To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap. METHODOLOGY: For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered. RESULTS: The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained. CONCLUSIONS: Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.

Evaluation of bone availability for grafts in different donor sites, through computed tomography

Abstract Objective To quantify the bone volume that can be safely withdrawn from 3 donor sites: (1) the mandibular symphysis, (2) the oblique mandibular line and (3) the skullcap. Methodology For the symphysis, 200 tomographic exams were evaluated by the extension of the anterior loop of mental foramen, by the nerve, by the distance of the foramens, by the distance between the vestibular cortical and the lingual plates and by the distance between the apexes, or lower anterior teeth, and the mandibular base, using the "distance" tool of the I-CAT Vision, in the panoramic and parasagittal reformations. For the oblique line, 70 TCFC exams were analyzed retrospectively in panoramic and parasagittal reformations, evaluating the thickness of the vestibular cortical and the distance between the cortical and the mandibular canal. For the cranial bone, a hexagonal donor site located in parietal area was considered. Results The average dimensions of the bone blocks that can be safely removed from the region of the mandibular symphysis are: 32.27 mm in length, 4.87 mm in height and 4 mm in thickness, providing a volume of 628.61 mm3 available for grafting. In the oblique line, the available bone volume for grafting was 859.61 mm3. In the region of the cranial vault, multiplying the average bone thickness by the area of the hexagon, an average volume of 2,499 mm3 was obtained. Conclusions Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.

Critical Defect Healing Assessment in Rat Calvaria Filled with Injectable Calcium Phosphate Cement.

(1) Background: The tissue engineering field has been working to find biomaterials that mimic the biological properties of autogenous bone grafts. (2) Aim: To evaluate the osteoconduction potential of injectable calcium phosphate cement implanted in critical defects in rat calvaria. (3) Methods: In the calvarial bone of 36 rats, 7-mm diameter critical size defects were performed. Afterwards, the animals were randomly divided into three groups according to filler material: a blood clot group (BC), blood clot membrane group (BCM), and an injectable ß-tricalcium phosphate group (HBS) cement group. After periods of 30 and 60 days, the animals were euthanized, the calvaria was isolated, and submitted to a decalcification process for later blades confection. Qualitative and quantitative analysis of the neoformed bone tissue were conducted, and histometric data were statistically analyzed. (4) Results: Sixty days post-surgery, the percentages of neoformed bone were 10.67 ± 5.57 in group BC, 16.71 ± 5.0 in group BCM, and 55.11 ± 13.20 in group HBS. The bone formation values in group HBS were significantly higher (p < 0.05) than in groups BC and BCM. (5) Conclusions: Based on these results, it can be concluded that injectable calcium phosphate cement is an osteoconductive material that can be used to fill bone cavities.

Evaluation of Osteoconduction of Biphasic Calcium Phosphate Ceramic in the Calvaria of Rats: Microscopic and Histometric Analysis.

(1) Background: Evaluate the osteoconduction capability of a biphasic calcium phosphate (BCP) ceramic composed of hydroxyapatite and ß-tricalcium phosphate 60%/40% in a rat model. (2) Methods: In the calvarial bone of 54 adult male rats, 7-mm diameter critical size defects were performed. The animals were randomly allocated to three experimental groups according to the type of material: blood clot (BCG), blood clot covered with a bovine-derived collagen membrane (MBCG), and BCP ceramic covered with a bovine-derived collagen membrane (BCPG). In each group, 6 animals were euthanatized at post-operative days 7, 30, and 60 for histological and histometric analysis. (3) Results: The qualitative analysis revealed the persistence of the collagen membrane at seven days, with no relevant newly bone formation in all groups. At 30 days, centripetal bone formation was observed residual particles of the biomaterial surrounded by fibroblasts noted in the BCPG. At 60 days, while BCG and MBCG showed a partial maturation with the central part of the defect populated by a fibrous connective tissue, in the BCPG the critical area was entirely occupied by newly formed bone. In the intra groups analysis was noted a significant increase in new bone formation during the experimental period (p < 0.05). At 60 days, BCPG showed a higher percentage area of new bone formation (p < 0.05). (4) Conclusion: BCP promoted a new bone formation by osteoconduction and might be considered a valid alternative in bone regeneration procedures.

Practice-Based Clinical Evaluation of Dental Implants Placed with Immediate or Delayed Loading Protocols: One-Year Follow-Up.

We evaluate bone remodeling and prostheses survival of immediately provisionalized with occlusal loading and delayed loading (DL) single implants placed in the posterior region after 1-yr follow-up in dental practices. Included in the study are patients selected to receive one regular implant (4 × 10 mm) for single tooth replacement in healed ridge sockets in the mandible and maxilla. Implants are immediately loaded or delayed functionally loaded with metal ceramic crowns, depending on peak insertion torque value. All implants are clinically and radiographically evaluated at T1, immediately postoperatively; T2, 60 d; T3, 180 d; and T4, 360 d. Measurements between implant platform and top of alveolar bone crest at distal and mesial areas are performed using periapical radiographs. Data are statistically evaluated through two-way repeated measures of analysis of variance following post hoc comparisons using the Tukey test (p < 0.05). Ten specialists working in ten different practices treat 36 patients who receive one implant each with internal conical connection (hybrid implant system, 4 × 10 mm) (Emfils; Itu, Brazil). Results show that bone-level alterations in immediate (IM; 0.56 mm; confidence interval [CI]: ± 0.21 mm) and delayed (0.65 mm; CI: ± 0.19 mm) groups are not significantly different (p = 0.515) during the course of the 1-yr observation period. In both groups, statistically significant progressive bone-level remodeling occurs through the evaluated follow-up time points (p < 0.047). All prostheses are rated "alpha," presenting 100% success at 1-yr follow-up. The loading method does not influence bone-remodeling levels around IM or DL at the posterior region after 1-yr follow-up. No prostheses complications are reported.

Alveolodental ankylosis: biological bases and diagnostic criteria / Anquilose alveolodentária: bases biológicas e critérios para o diagnóstico

ABSTRACT Alveolodental ankylosis is the fusion of cementum or root dentin with the alveolar bone in both deciduous and permanent teeth. This leads to important clinical and radiographic changes in the affected teeth. Moreover, knowledge of the biological principles involved allows adequate management of teeth affected by this phenomenon.

RESUMO A anquilose alveolodentária consiste na fusão do cemento ou dentina radicular com o osso alveolar tanto em dentes decíduos como nos dentes permanentes. Isto leva a uma série de alterações clínicas e radiográficas importantes para o diagnóstico. Além disso, o conhecimento dos princípios biológicos envolvidos irá permitir o controle adequado dos dentes acometidos por este fenômeno.

Preservation of Dental Sockets Filled with Composite Bovine Bone. A Single-Blind Randomized Clinical Trial.

The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.

Preservation of dental sockets filled with composite bovine bone. A single-blind randomized clinical trial

Abstract The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.

Resumo O objetivo deste estudo foi avaliar em humanos a manutenção do volume em alvéolos frescos preenchidos por osso integral de origem bovina por meio de um estudo clínico randomizado com monocegamento. Quarenta dentes uni radiculares foram extraídos em 40 pacientes (um dente em cada participante), e apos estes pacientes foram divididos aleatoriamente em 2 grupos: indivíduos que tiveram o alvéolo fresco preenchido por osso integral de origem bovina (Grupo Biomaterial) ou por coagulo sanguíneo (Grupo Controle). Apos a exodontia os alvéolos foram medidos em suas maiores distancias mesio-distal (MD) e vestíbulo lingual/palatina (VL/P) por meio de compasso de ponta seca. O fechamento primário dos alvéolos foi realizado com um tampão fibromucoso. Apos 120 dias pós-operatórios durante o procedimento de reabertura foram obtidas novamente as maiores medidas MD e VL/P para calcular em porcentagem o nível de remodelação do osso alveolar. No grupo biomaterial observou-se uma redução em porcentagem de 1,62% e 3,29% nas medidas MD e VL/P 120 dias apos as extrações, enquanto no grupo controle houve uma redução de 4,97% e 7,18% nas medidas MD e VL/P no mesmo período. Houve diferença estatisticamente significante (p<0,05) entre os dois grupos para as medidas vestíbulo/palatina e mesiodistal na maxila. Diante dos resultados obtidos conclui-se que o osso integral de origem bovina limitou, mas não impediu a remodelação óssea alveolar.

Tomographic late evaluation of xenogeneic bone grafts in sockets of impacted third molars.

OBJECTIVE: It is necessary to preserve height and thickness of the alveolar bone to facilitate rehabilitation with osteointegratable implants or simply to maintain bone integrity after extraction. Biomaterials associated with resorbable or non-resorbable membranes, when placed in the region of the socket, may contribute to avoid this unwanted reabsorption. OBJECTIVE: The objective of this study was to evaluate the distance of the crest of alveolar ridge to the cementoenamel junction (CEJ) of the lower second molars and the bone density of the third molar socket filled with Gen-Tech®, 5 years after an exodontia using cone beam computed tomography (CBCT) to visualize the central region of the sockets, without overlapping of the buccal and lingual cortical bones. MATERIAL AND METHODS: A total of 12 individuals from an initial group of 39 patients submitted to extraction of the unruptured lower third molars and grafting of an association of inorganic bovine bone matrix, organic bovine bone matrix, collagen and bone morphogenetic proteins (BMP) (Gen-Tech®) on one side and the contralateral sockets filled only by clot, returned to control after 5 years, and were submitted to CBCT. The distance from the crest of alveolar bone to the CEJ and the bone density (BD) were measured using the i-CAT Vision Software. RESULTS: The results showed that the distance from the crest of alveolar bone to the CEJ in the control group was similar to that observed before the exodontia; in the experimental group, this distance was smaller. Considering the BD measurement, a significantly higher density was observed in the experimental group (p<0.05). CONCLUSION: Part of the biomaterial was not absorbed and allowed the stability of the evaluated parameters after 5 years, being able to be used as a bone substitute in the socket.

Influência do número de roscas e da densidade dos blocos de poliuretano na estabilidade primária de implantes do sistema intraoss / The influence of implant thread number and polyurethane block density on primary stability values of the Intraoss implant system

Objetivo: avaliar e comparar a estabilidade primária dos implantes cilíndricos de 3,75 mm x 11 mm Titaoss e Titaoss dupla rosca, do Sistema Intraoss, instalados em blocos de poliuretano com baixa densidade. Material e métodos: foram realizadas 32 cavidades em dois blocos de poliuretano, simulando as densidades de ossos tipo III e IV. As estabilidades dos implantes foram mensuradas por meio do torque de inserção e frequência de ressonância. Resultados: os implantes Titaoss instalados no osso tipo III apresentaram valores de torque de inserção de 43,1 ± 14,87 Ncm, enquanto os valores dos implantes Titaoss dupla rosca foram 46,9 ± 5,3 Ncm. No osso tipo IV, os implantes Titaoss apresentaram valores de 30 ± 0,0 Ncm e os dupla rosca de 29,4 ± 1,77 Ncm. Não houve diferença significante na estabilidade primária entre os grupos dos implantes (p > 0,05) instalados no mesmo tipo de osso. Os implantes Titaoss instalados no osso tipo III apresentaram valores de ISQ de 57,3 ± 4,69, ao passo que os valores para os implantes Titaoss dupla rosca foram 54,9 ± 3,98. No osso tipo IV, os implantes Titaoss apresentaram valores de 48,4 ± 4,07 ISQ e os dupla rosca de 50,8 ± 3,98 ISQ. As estabilidades primárias dos implantes foram maiores no osso tipo III quando comparado ao IV (p < 0,05). Conclusão: os dois desenhos de implantes permitem a obtenção da estabilidade primária para a técnica da carga mediata. No entanto, para submeter esses tipos de implante à carga imediata, indica-se a técnica da subfresagem.

Objectives: this in vitro study aimed to evaluate and compare the primary stability of the cylindrical implants (3.75 mm x 11 mm) Titaoss and Titaoss double thread from Titaoss System placed in cavities made of low-density polyurethane blocks. Material and methods: 32 cavities were made in two types of polyurethane blocks simulating the type III and IV bone densities. The implant stability values were measured using the final insertion torque and resonance frequency analysis. Results: the Titaoss implants placed in type III bone achieved 43.1 ± 14.87 Ncm, while the double-thread values were 46.9 ± 5.3 Ncm. For bone type IV, the Titaoss implants reached 30Ncm and the double thread 29.4± 1.77 Ncm. No statistically significant differences on implant stability were seen for both groups (p > 0.05) for the same bone type. the Titaoss implants in bone type III had 57.3 ± 4.69 and the double thread 54.9 ± 3.98 ISQ values. In type IV bone, Titaoss reached 48.4 ± 4.07 and the double thread 50.8 ± 3.98 ISQ units. The primary stability values were greater at type III than type IV bone (p < 0.05). Conclusion: both implant designs allow for primary stability. However, the use of an underpreparation technique is recommended in cases of immediate loading protocols.

Tomographic late evaluation of xenogeneic bone grafts in sockets of impacted third molars

Abstract It is necessary to preserve height and thickness of the alveolar bone to facilitate rehabilitation with osteointegratable implants or simply to maintain bone integrity after extraction. Biomaterials associated with resorbable or non-resorbable membranes, when placed in the region of the socket, may contribute to avoid this unwanted reabsorption. Objective The objective of this study was to evaluate the distance of the crest of alveolar ridge to the cementoenamel junction (CEJ) of the lower second molars and the bone density of the third molar socket filled with Gen-Tech®, 5 years after an exodontia using cone beam computed tomography (CBCT) to visualize the central region of the sockets, without overlapping of the buccal and lingual cortical bones. Material and Methods A total of 12 individuals from an initial group of 39 patients submitted to extraction of the unruptured lower third molars and grafting of an association of inorganic bovine bone matrix, organic bovine bone matrix, collagen and bone morphogenetic proteins (BMP) (Gen-Tech®) on one side and the contralateral sockets filled only by clot, returned to control after 5 years, and were submitted to CBCT. The distance from the crest of alveolar bone to the CEJ and the bone density (BD) were measured using the i-CAT Vision Software. Results The results showed that the distance from the crest of alveolar bone to the CEJ in the control group was similar to that observed before the exodontia; in the experimental group, this distance was smaller. Considering the BD measurement, a significantly higher density was observed in the experimental group (p<0.05). Conclusion Part of the biomaterial was not absorbed and allowed the stability of the evaluated parameters after 5 years, being able to be used as a bone substitute in the socket.

Comparação entre os implantes dentários e implantes ortopédicos / Comparison between dental implants and orthopedic implants ­ literature review

Objetivo: revisar as semelhanças e diferenças entre os implantes dentários osseointegráveis e os implantes ortopédicos. Material e métodos: apesar da escassez de dados, foram construídos quatro tópicos: 1) materiais dos implantes osseointegráveis e ortopédicos; 2) técnicas cirúrgicas na Odontologia e na Ortopedia; 3) possíveis causas e efeitos do aquecimento; e 4) análise do insucesso dos implantes nas duas áreas. Resultados: 1) nenhum dos biomateriais metálicos usados na Ortopedia apresenta osseointegração conforme o conceito atualmente usado na Odontologia e, sob alto carregamento, estas ligas estão submetidas ao stress shielding em função do seu módulo de elasticidade ser muito acima do osso; 2) na Implantodontia, a estabilidade primária é fundamental e os procedimentos são mais delicados, enquanto na Ortopedia os implantes são cimentados (estabilizados) e os procedimentos ortopédicos são mais agressivos, estando entre os maiores índices de perdas advindas de complicações pós-cirúrgicas; 3) as condições de realização da cirurgia para inserção de implantes ortopédicos são mais críticas em relação aos dentários, devido ao maior volume de osso que é removido, maiores dimensões da prótese, menor vascularização do local e ausência de irrigação do meio durante a cirurgia, com temperaturas médias (70oC) acima do que se observa na Implantodontia odontológica (43oC); 4) a propensão ao insucesso nos implantes ortopédicos parece maior pela chance de carregamento 3-5 vezes maior em áreas corporais (quadril e joelho) que sustentam o peso do corpo. Conclusão: melhorias contínuas nos materiais, procedimentos e treinamento fornecerão taxa menor de reposição de implantes dentários e, especialmente, dos implantes ortopédicos.

Objective: to review the similarities and differences between osseointegrated dental and orthopedic implants. Material and methods: besides data paucity, four topics were created: 1) materials for osseointegrated and orthopedic implants; 2) surgical techniques in Dentistry and Orthopedics; 3) possible causes and effects of heating; and 4) failures analyses in both areas. Results: 1) none of the metallic biomaterials for Orthopedics present osseointegration according to the concept developed for dentistry and, under high loading, alloys are subjected to stress shielding due to their elastic moduli being higher than the bone; 2) for implant dentistry, primary stability is fundamental and the procedures are more delicate, whereas in Orthopedics the implants are cemented (stabilized) and the procedures have a more aggressive nature, within the highest levels of post-surgical complications; 3) surgical conditions for Orthopedics are more critical than in the dental field, due to a greater bone volume, prosthesis size, less local vascularization and lack of irrigation, with mean temperatures (70oC) well-above compared to the implant dentistry (43oC); 4) the failure of orthopedic implants seems higher due to the 3-5 times chance of loading at corporal bearing structures (hips and knees). Conclusion: continuous improvement on materials, procedures, and training will provide less replacement rates for dental implants and specially for orthopedic devices.

Evaluation of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries / Avaliação de dois protocolos de amoxicilina para profilaxia antibiótica em cirurgias de instalação de implantes

ABSTRACT Objective The aim of this study was to evaluate the effectiveness of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries. Methods A clinical study was performed with 66 volunteers of both genders (mean 51,9 ± 2,5 years) that met the inclusion criteria and were randomly assigned into 2 groups: Group 1 (n=35) - oral administration of amoxicillin (2g) 1 hour before the surgical procedure and Group 2 (n=31) oral administration of amoxicillin (2g) 1 hour before the surgical procedure and 500mg every 8 hours during 7 days after the surgeries. The following clinical parameters were evaluated: adverse reactions, pain and implants failure. The pain was evaluated in the surgery day (before, immediately after and at night), 24h, 48h, 72h and one week after the surgery and other clinical parameters were evaluated in daily appointments until the third postoperative day, 7 days and three months after the surgeries. Data were analyzed and statistical significance was 5%. Results Adverse reactions (headache, diarrhea, stomachache and nauseas) and implant failure occurred only in G2 (4 volunteers and 3 implants, respectively). Regarding pain, higher values for G2 on "at the night (p=0.0043), 24h (p=0.0013), 48h (p=0.0187) e 72h (p=0.0445) were observed. Conclusion The present study showed that a single dose of amoxicillin was effective in antibiotic prophylaxis in implant placement surgeries, suggesting that the use of amoxicillin in the postoperative period did not bring additional benefit.

RESUMO Objetivo Avaliar a eficácia de dois protocolos de amoxicilina em cirurgias para instalação de implantes. Métodos Foi realizado um estudo clinico com 66 voluntários de ambos os gêneros (idade média 51,9±2,5 anos) que atenderam aos critérios de inclusão e que foram distribuídos por sorteio em 2 grupos: Grupo 1 (n=35) - amoxicilina (2g) por via oral 1h antes da cirurgia e Grupo 2 (n=31) - amoxicilina (2g) por via oral 1h antes da cirurgia e 500mg a cada 8 horas durante 7 dias. Os parâmetros avaliados no pós-operatório foram ocorrência de reações adversas, dor e perda de implantes. A dor foi avaliada no dia da cirurgia (antes, imediatamente após e à noite), 24h, 48h, 72h e 1 semana após as cirurgias, e os demais parâmetros foram avaliados em consultas diárias até o terceiro dia pós-cirúrgico, 7 dias e 3 meses após as cirurgias. Os resultados foram submetidos à análise estatística com nível de significância de 5%. Resultados Reações adversas (cefaleia, diarréia, dor estomacal e náusea) e perda de implantes ocorreram apenas em G2 (4 voluntários e 3 implantes, respectivamente), e em relação à dor foram observados valores maiores para G2 nos tempos "à noite (p=0,0043), 24h (p=0,0013), 48h (p=0,0187) e 72h (p=0,0445). Conclusão Os dados sugerem que a dose única de amoxicilina (2g) foi eficaz na profilaxia antibiótica para cirurgias de implantes, e que a amoxicilina no período pós-operatório não proporcionou benefício adicional.

Taxa de sobrevivência de implantes e biomateriais no levantamento do seio maxilar com pneumatização significativa: um estudo retrospectivo com 79 pacientes, durante seis meses a dez anos / Survival rate of immediate dental implants and biomaterials after large sinus lifting procedures: a retrospective study on 79 patients with a 6-month to 10-year follow-up

Objetivo: avaliar retrospectivamente a taxa de sucesso de implantes e biomateriais após o levantamento do seio maxilar. Material e métodos: foram utilizados prontuários de pacientes tratados entre 1998 e 2014, incluídos os que possuíam rebordo maxilar com altura menor do que 5 mm. Todos os procedimentos de enxertia foram realizados com instalação de implante de forma mediata e acesso ao seio maxilar pela janela óssea lateral, colocação do biomaterial, membrana e sutura. Resultados: foram analisados 79 pacientes, tendo sido utilizados dois biomateriais. O tempo de reavaliação variou de seis meses a dez anos. Nos dados de altura óssea radiográfica antes e depois do procedimento (70 implantes, 36 pacientes), houve um aumento médio de altura na região do seio maxilar com o Bio-Oss de 17,23 mm e com o Orthogen de 13,12 mm (p < 0,05), sendo a média geral de 15,17 mm. Na relação sobrevida do implante e enxerto utilizado (92 implantes, 43 pacientes), os valores foram de 96,8% (autógeno) e 98,3% (autógeno + biomaterial). Conclusão: os resultados permitiram concluir que tanto os enxertos autógenos como os biomateriais são alternativas viáveis para os seios maxilares com grande pneumatização.

Objective: to retrospectively evaluate the success rate of implants and biomaterials after maxillary sinus lift. Material and methods: records of patients treated between 1998 and 2014 were used, including those with maxillary ridge height less than 5 mm. All grafting procedures were performed with implant placement and access to the maxillary sinus through the lateral bony window, placement of the biomaterial, membrane and suture. Results: 79 patients were analyzed and two biomaterials were used. The follow-up period ranged from six months to ten years. In the radiographic bone height data before and after the procedure (70 implants, 36 patients), there was a mean increase in height in the maxillary sinus region with the Bio-Oss of 17.23 mm and with the Orthogen of 13.12 mm (p < 0.05), the overall mean being 15.17 mm. Regarding implant and graft survival (92 implants, 43 patients), the values were 96.8% (autogenous) and 98.3% (autogenous + biomaterial). Conclusion: both autogenous grafts and biomaterials are viable alternatives for the maxillary sinuses with great pneumatization.

Avaliação in vivo do torque de inserção do novo sistema de implantes Emfils / In vivo insertion torque assessment of the new dental implant system Emfi ls

Objetivo: avaliar o torque de inserção de um novo desenho de implante. Material e métodos: pacientes foram recrutados para instalação de implantes, no período de março a dezembro de 2015. Dados como o diâmetro, o comprimento do implante, a sequência de fresagem, a área de instalação e o torque atingido foram considerados. A avaliação do torque foi realizada com um torquímetro cirúrgico. Resultados: foram avaliados 82 implantes, com diâmetros entre 3,5 mm e 5 mm, e comprimentos entre 7 mm e 16 mm, sendo instalados 46 implantes na mandíbula e 36 implantes na maxila. Os torques (média ± desvio-padrão) alcançados foram de 53 ± 9,9 Ncm para maxila e 57 ± 11,3 Ncm para mandíbula. Conclusão: o sistema de implantes Novo Colosso promoveu torque de inserção adequado, com boa estabilidade primária nos implantes.

Objective: to evaluate the insertion torque of a new implant design. Material and methods: patients were recruited for implant placement from March to December 2015. Data such as diameter, implant length, drilling sequence, installation area, and torque reached were considered. Torque evaluation was performed with a surgical torque wrench. Results: 82 implants were evaluated, with diameters between 3.5 mm and 5.0 mm, and lengths between 7 mm and 16 mm, with 46 implants in the mandible and 36 implants in the maxilla. The torques (mean ± standard deviation) reached 53 ± 9.9 Ncm for maxilla and 57 ± 11.3 Ncm for mandible. Conclusion: the Novo Colosso implant system promotes adequate insertion torque with good primary implant stability.

Novo componente de transferência para implantes. Estudo in vitro / New transfer component for dental implants. In vitro study

Os autores avaliaram, em um microscópio eletrônico de varredura (MEV), a precisão da moldagem de transferência de implantes de hexágono externo por meio de um novo modelo de transferente, comparando-o com a técnica do transferente quadrado. Foram realizadas 40 moldagens, 20 com componente de transferência quadrado (grupo-controle) e 20 com o componente de transferência implant smart transfer ­ IST (grupo-teste), a partir de um modelo acrílico padronizado com três réplicas de implantes de hexágono externo posicionados na região posterior, simulando uma condição clínica em mandíbula. Uma estrutura metálica padrão em liga de titânio foi parafusada sobre os análogos dos modelos obtidos sob torque de 10 Ncm. Foram realizadas leituras na face vestibular e na face lingual do conjunto análogo/estrutura padrão, tendo a posição central como ponto de eleição. Os resultados foram analisados estatisticamente (p-valor=0,05) e, embora tenham havido diferenças médias entre os grupos, as mesmas não foram estatisticamente significantes. Foi possível concluir que não existe diferença na precisão das moldagens de implantes realizadas com componente de transferência quadrado e o modelo implant smart transfer para prótese parcial fixa.

The authors evaluated by scanning electron microscopy (SEM), precision impression transfer of external hex implants through a new transfer model by comparing it with the technical square transfer. Fourty impressions were made; 20 with square transfer component (control) and 20 with the IST transfer component (test) from a standard acrylic model with three external hexagon implant replicas positioned in the posterior region simulating a clinical jaw condition. A titanium framework was screwed onto the implant analogs with a 10 Ncm torque. Three measurements were performed on the buccal aspect and three on the lingual surface, with the middle position as election point. The results were analyzed statistically (p=0.05), although there have been average differences between the groups, they were not statistically significant. It was concluded there was no difference in the accuracy of impression made with square transfer component and implant smart transfer model for fixed partial dentures.

Análise retrospectiva da taxa de sobrevivência de 221 implantes de titânio do sistema Pross / Retrospective analysis of the survival rates of 221 Pross dental implant system

Objetivo: analisar a taxa de sobrevivência dos implantes de titânio de um sistema comercialmente disponível recentemente no mercado. Material e métodos: foi realizada uma análise retrospectiva dos implantes de hexágono externo instalados pelos alunos do curso de especialização (entre os anos de 2012 e 2014) nas diversas regiões da cavidade bucal, considerando as dimensões, o leito ósseo (osso nativo ou enxertado), o sexo e possíveis fatores associados a estas falhas. A sobrevivência foi avaliada durante a reabertura dos implantes para colocação dos cicatrizadores ou no pós-operatório, com as próteses provisórias imediatas, ou das próteses em carga imediata, bem como na instalação da prótese definitiva destas restaurações. Resultados: foram avaliados 221 implantes osseointegráveis instalados em 64 pacientes (16 homens, 48 mulheres) com idades entre 38 e 74 anos. O índice de sobrevivência foi de 96,83% (n=214), 96% em mandíbula e 97,9% em maxila. Foram realizados 175 implantes (79,19%) em duas fases (um implante perdido na região mandibular posterior em osso nativo, torque > 45 Ncm) e 46 implantes (20,81%) com carga imediata (três implantes perdidos na região mandibular anterior e um na região mandibular posterior). Os implantes realizados em área enxertada (n=8; 3,62% do total) apresentaram duas falhas na região anterior da maxila (índice de sobrevivência de 75% para implantes com enxerto; e 97,65% em osso nativo). Conclusão: de acordo com os resultados obtidos no presente trabalho, o implante osseointegrável do sistema Pross apresentou índice de sobrevivência adequado para sua utilização clínica.

Objective: to analyze the survival rate of a titanium implant system recently launched in the market. Material and methods: a retrospective analysis was made on external hex implants placed by students of a Specialization course (2012-2014) at several oral regions, considering its dimensions, the recipient site (native or grafted), gender, and possible factors associated to failures. The survival rate was evaluated on implant exposure for healing attachment or at the postoperative period, with immediate provisional or immediate loaded restorations, as well as immediate loaded definitive restorations. Results: 221 dental implants were installed in 64 patients (16 men, 48 women) within 38 to 74 years-old. The survival rate was 96.83% (n=214), being 96% in the mandible and 97,9% in the maxilla. 175 implants (79.19%) were placed in a two-stage way (1 lost at the posterior mandibular native bone, torque > 45 Ncm) and 46 implants (20.81%) with immediate loading (3 lost in the anterior and 1 lost at the posterior mandibular regions). The implants placed into grafted bone (n=8; 3.62%) presented two failures in the anterior maxillary region (grafted sites: 75%, non-grafted sites: 97.65%). Conclusion: within the limits of this study, the Pross dental implant system presented adequate survival results for clinical applications.

Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State-Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p =0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation.

Estudo retrospectivo comparativo com dois biomateriais diferentes para enxerto sinusal maxilar ­ cinco anos de acompanhamento / Comparative retrospective study on two different biomaterials for sinus grafting ­ 5 years of follow-up

Objetivo: avaliar o índice de sobrevida de implantes osseointegráveis instalados em maxilas submetidas previamente ao enxerto sinusal e à remodelação óssea, ocorrida após o período de reparo do enxerto. Material e métodos: foram selecionados 12 pacientes que receberam implantes osseointegráveis em maxilares submetidos à elevação de membrana sinusal, seguido da aplicação de substituto ósseo heterógeno composto de origem bovina (GenMix, Baumer, Mogi Mirim, Brasil) ou do biomaterial sintético à base de fosfato ß-tricálcio (Cerasorb, Curasan AG, Kleinostheim, Alemanha). Foi avaliado o índice de sobrevida dos implantes e o nível da remodelação óssea vertical. Foram digitalizadas radiografi as panorâmicas, e mensuradas a extensão linear vertical do remanescente ósseo (T0) e a extensão linear vertical, após o período de incorporação do enxerto ósseo (T1) e após período de osseointegração do implante (T2). Resultados: o índice de sobrevida dos implantes no período de 60 a 84 meses foi de 90% nos seios maxilares, preenchidos por substituto ósseo heterógeno composto de origem bovina. Nos seios preenchidos por biomaterial sintético à base de fosfato ß-tricálcio, o índice de sobrevida dos implantes no período de 60 a 76 meses foi de 88,89%. Foram perdidos dois implantes, um em seio preenchido por osso heterógeno composto e o outro em seio preenchido por fosfato ß-tricálcio. O nível de remodelação óssea foi de 3,29 mm e 1,6 mm, respectivamente, para o osso heterógeno composto de origem bovina, e para o biomaterial sintético a base de fosfato ß-tricálcio. Não houve diferenças estatisticamente signifi cativas entre o nível de remodelação dos dois biomateriais. Conclusão: diante dos resultados obtidos, concluiu-se que ambos os materiais mostraram-se adequados para ossificação intrasinusal, por meio da técnica de elevação da membrana sinusal.

Objective: to evaluate the survival rate of osseointegrated implants placed on maxillary arches submitted to sinus graftings and also the bone remodeling after the graft repair period. Material and methods: twelve patients were selected to receive maxillary osseointegrated implants after the use of a bovine composite bone (GenMix, Baumer, Mogi Mirim, Brazil) or a synthetic ß-tricalcium phosphate biomaterial (Cerasorb, Curasan AG, Kleinostheim, Germany). The implant survival and bone remodeling rates were evaluated on digitized panoramic radiographs being measured the linear extension of the remaining bone (T0), the vertical linear extension after graft incorporation (T1), and after the implant osseointegration period (T2). Results: the implant survival rates were 90% after 60-84 months (bovine composite bone) and 88.89% after 60-76 months (ß-tricalcium phosphate) of follow-ups. Two implants were lost (1 for each group). The bone remodeling values were 3.29 mm and 1.6 mm for the composite bovine bone and the ß-tricalcium phosphate materials. No statistically signifi cant differences were observed between these materials regarding the bone remodeling process. Conclusion: within the results of this study, it can be concluded that both materials are adequate for intrasinus ossification in the sinus lifting membrane technique.