Risk indicators for Peri-implantitis. A cross-sectional study with 916 implants.

OBJECTIVES: The aim of this study was to identify systemic and local risk indicators associated with peri-implantitis. MATERIAL AND METHODS: One hundred eighty-three patients treated with 916 osseointegrated titanium implants, in function for at least 1 year, were included in the present study. The implants were installed at the Foundation for Scientific and Technological Development of Dentistry (FUNDECTO) - University of Sao Paulo (USP) - from 1998 to 2012. Factors related to patient's systemic conditions (heart disorders, hypertension, smoking habits, alcoholism, liver disorders, hepatitis, gastrointestinal disease, diabetes mellitus I and II, hyperthyroidism or hypothyroidism, radiation therapy, chemotherapy, menopause, osteoporosis, active periodontal disease, history of periodontal disease and bruxism), implant's characteristics (location, diameter, length, connection, shape, and antagonist), and clinical parameters (wear facets, periodontal status on the adjacent tooth, plaque accumulation on the adjacent tooth, modified plaque index, sulcus bleeding index, probing depth, bleeding on probing, width of keratinized tissue and marginal recession). RESULTS: An increased risk of 2.2 times for history of periodontal disease (PD), 3.6 times for cemented restorations compared to screw-retained prostheses, 2.4 times when wear facets were displayed on the prosthetic crown and 16.1 times for total rehabilitations when compared to single rehabilitations were found. Logistic regression analysis did not show any association between the implant's characteristics and peri-implantitis. CONCLUSIONS: A history of periodontal disease, cemented prostheses, presences of wear facets on the prosthetic crown and full mouth rehabilitations were identified as risk indicators for peri-implantitis. Implants' characteristics were not related to the presence of peri-implantitis.

As características protéticas das reabilitações implantossuportadas podem influenciar no sangramento a sondagem? Um estudo retrospectivo em 916 implantes / Does the prosthesis type over implant-supported rehabilitations can infl uence on bleeding on probing? A retrospective study with 916 dental implants

Objetivos: avaliar se a união entre implantes e/ou a presença de gengiva artifi cial infl uencia no sangramento a sondagem dos tecidos peri-implantares. Material e métodos: foram incluídos pacientes tratados com implantes de titânio (Implacil De Bortoli, São Paulo, Brasil), instalados no período de 1998 a 2012, na Universidade de São Paulo (USP). Os implantes foram examinados para avaliação do sangramento a sondagem, sendo divididos de acordo com o tipo de prótese: unitárias (n=167), parciais (n=522) e totais (n=227); e de acordo com a ausência (n=674) ou presença (n=242) de gengiva artifi cial. O teste estatístico com equação de estimativa generalizada foi usado para testar possíveis associações. Resultados: foram examinados 183 pacientes reabilitados com 916 implantes em função, pelo menos por um ano. Ao menos um ponto de sangramento a sondagem foi detectado em 85 (50,9%), 304 (58,2%) e 129 (56,8%) implantes das próteses unitárias, parciais e totais, respectivamente. Em relação à gengiva artificial, 378 (56,1%) dos implantes sem e 140 (57,9%) dos implantes com esta característica apresentaram sangramento a sondagem. Não foram verificadas diferenças significativas entre os grupos. Conclusão: a união dos implantes ou a presença de gengiva artificial não foram associadas com os resultados de sangramento a sondagem nos implantes em função.

Objective: to evaluate whether the prosthesis type (single, partial, complete) and/or the presence of artifi cial gingiva can influence on bleeding on probing of peri-implant tissues. Material and methods: patients treated with titanium dental implants (Implacil De Bortoli, São Paulo, Brazil) between 1998 to 2012 at the University of Sao Paulo (USP) were included in this study. The implants were divided according the following prosthodontic types: single (n=167), partial (n=522), and complete (n=277), and also regarding the presence (n=674) or absence (n=242) or artificial gingiva. The generalized estimating equation test was used to verify possible associations. Results: 183 patients and 916 implants at least 1 year in function were screened. At least one bleeding point was detected in 85 (50.9%), 304 (58.2%), and 129 (56.8%) implants for single, partial, and complete prostheses, respectively. 378 (56.1%) and 140 (57.9%) implant from groups without and with artificial gingiva presented bleeding on probing. No significant differences were identified among groups. Conclusion: the prosthesis design and/or artifi cial gingiva were not associated to bleeding on probing for dental implants in function.

Implante imediato com estética imediata, definitiva e acompanhamento tomográfico da tábua óssea vestibular û relato de caso / Immediate implant, immediate aesthetic and final restoration with tomographic follow-up of the buccal plate û case report

O resultado da terapia com implantes osseointegrados não é apenas mensurado pela taxa de sobrevivência, mas também pela estabilidade/ integridade estética e funcional dos tecidos peri-implantares a longo prazo. A técnica do implante imediato tornou-se uma opção viável para a manutenção da arquitetura peri-implantar, além de reduzir significantemente o tempo do tratamento. O presente caso clínico descreve a resolução de um único elemento dentário maxilar anterior perdido (elemento 22), através da instalação de implante imediato pós-exodontia sem retalho, estética imediata e definitiva, com acompanhamento tomográfico de 6 meses e 1 ano das alterações da tábua óssea vestibular. Este tipo de abordagem de tratamento diminui o número de intervenções cirúrgicas, bem como o tempo de instalação da restauração protética final, aumentando a satisfação estética e funcional do paciente. É evidente que o sucesso desta técnica requer a seleção correta dos casos, exodontia atraumática e estabilidade primária.

The outcome of the therapy with osseointegrated implants is not only measured through survival rate, but also through aesthetic and function stability of the peri-implant tissue during long-term. Immediate implants technique has become an option for maintaining the peri-implant architecture and reduce the time of treatment. This case report presents the complete resolution of a single anterior maxillary tooth loss (element 22), by installing an implant immediately after tooth extraction without flap, immediate and definitive aesthetic, with 6 months and 1 year CT scan follow-up to analyze alterations on the buccal bone plate. This type of approach reduces the number of surgical interventions, as well as the installation time of final prosthetic restoration, increasing functional and aesthetic satisfaction of the patient. It is evident that the success of this technique requires proper selection of cases, atraumatic extraction of the tooth and primary stability of the implant.

Prevalence of Peri-implant Diseases: Analyses of Associated Factors.

UNLABELLED: AIM. Identify the relationship between specific factors (age, sex, smoking, time of prosthesis in function, implant location, and width of peri-implant keratinized mucosa) and peri-implant diseases in patients from the Center of Research and Continuing Education in Implant Dentistry (CEPID) at the Federal University of Santa Catarina (UFSC), Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted in 193 patients that had received 725 external-hexed cylindrical implants supporting functional prosthesis for at least 1 year (range from 1-9 years). Clinical examination included probing depths, bleeding on probing and/or suppuration. Radiographic exam was conducted to measure peri-implant bone levels. RESULTS: There was no statistically significance in the association between prevalence of peri-implant diseases and age, sex, time with prostheses in function and implant location variables independently. There was a statistically significant association between the independent variables of smoking and the width of keratinized peri-implant mucosa less than 2mm, and the presence of peri-implant diseases. When all the categories were evaluated together in relation with the peri-implant diseases, the prostheses in function for 5 years and more had association with presence of both, peri-implant mucositis an peri-implantitis. Peri-implantitis prevalence was higher for males with the prostheses in use for 5 years or more. Peri-implant mucositis was more associated with the participants over 57 years of age, with systemic disease and with the prostheses in function for more than 5 years. CONCLUSIONS: Smoking habits and the width of peri-implant keratinized mucosa as independent variables were associated with the prevalence of peri-implant diseases.

Extensão da reabilitação protética implantossuportada e a relação com o índice de placa modificado / The relationship between the extent of implant-supported posthetic rehabilitation with the modified plaque index

Objetivo: avaliar retrospectivamente a relação da extensão da reabilitação protética com o índice de placa modificado. Material e métodos: pacientes tratados com implantes (Implacil De Bortoli, São Paulo, Brasil) na Fundecto (USP), no período de 1998 a 2012, foram incluídos neste estudo. Três grupos foram formados, de acordo com a extensão da reabilitação protética (unitária, parcial ou total). O parâmetro clínico índice de placa modificado foi utilizado para comparação entre os grupos. Para análise estatística, a equação de estimativa generalizada (GEE) foi utilizada. Resultados: foram examinados 183 pacientes, reabilitados com 916 implantes em função por pelo menos um ano. A taxa de sobrevivência dos implantes foi de 98,28%. Observou-se que havia placa bacteriana abundante (escore 3) ao redor de 30% (n=68) dos componentes protéticos de implantes pilares de reabilitações totais fixas sobre implantes. Já para os grupos de reabilitações parciais e unitárias, os valores foram de 3,6% (n=19) e 0,6% (n=1), respectivamente. Conclusão: componentes protéticos de implantes pilares de próteses totais fixas implantossuportadas apresentaram maior acúmulo de placa bacteriana abundante em sua superfície.

Objective: to retrospectively evaluate the relationship between the extent of prosthetic rehabilitation with modified plaque index. Material and methods: patients treated with osseointegrated implants (Implacil De Bortoli, Sao Paulo, Brazil) at Fundecto (USP) from 1998 to 2012 were included in this study. Three groups were formed according to the extent of prosthetic rehabilitation (single, partial or total). The modified plaque index was used for comparison among groups. Generalized estimating (GEE) equation was used for statistical evaluation. Results: 183 patients with 916 implants with at least 1 year in function were examined. The implant survival rate was 98.28%. Abundant soft matter (score 3) around 30% (n=68) of the prosthetic abutments from implants supporting total rehabilitations was seen. For the groups that comprised partial and single rehabilitations, the values were 3.6% (n=19) and 0.6% (n=1), respectively. Conclusion: prosthetic abutments from implants supporting total rehabilitations presented the greatest values for abundant bacterial plaque accumulation.

Does the number of implants have any relation with peri-implant disease?

OBJECTIVE: The aim of this study was to evaluate the relationship between the number of pillar implants of implant-supported fixed prostheses and the prevalence of periimplant disease. MATERIAL AND METHODS: Clinical and radiographic data were obtained for the evaluation. The sample consisted of 32 patients with implant-supported fixed prostheses in function for at least one year. A total of 161 implants were evaluated. Two groups were formed according to the number of implants: G1) ≤5 implants and G2) >5 implants. Data collection included modified plaque index (MPi), bleeding on probing (BOP), probing depth (PD), width of keratinized mucosa (KM) and radiographic bone loss (BL). Clinical and radiographic data were grouped for each implant in order to conduct the diagnosis of mucositis or peri-implantitis. RESULTS: Clinical parameters were compared between groups using Student's t test for numeric variables (KM, PD and BL) and Mann-Whitney test for categorical variables (MPi and BOP). KM and BL showed statistically significant differences between both groups (p<0.001). Implants from G1 - 19 (20.43%)--compared with G2 - 26 (38.24%)--showed statistically significant differences regarding the prevalence of peri-implantitis (p=0.0210). CONCLUSION: It seems that more than 5 implants in total fixed rehabilitations increase bone loss and consequently the prevalence of implants with periimplantitis. Notwithstanding, the number of implants does not have any influence on the prevalence of mucositis.

Passo a passo de sele‡Æo de componentes prot‚ticos / Step by step of abutment selection

Para as restaura‡ães prot‚ticas implantossuportadas alcan‡arem sucesso com longevidade e previsibilidade, ‚ de fundamental importƒncia a sele‡Æo adequada do sistema de reten‡Æo/conexÆo com o implante. O objetivo deste estudo foi esclarecer e fornecer embasamento cient¡fico aos cirurgiães dentistas para escolha adequada do tipo de restaura‡Æo implantossuportada nas mais variadas situa‡ães cl¡nicas. Segundo a revisÆo da literatura ‚ imprescind¡vel o conhecimento de fatores, como posicionamento do implante, aspectos oclusais, espa‡o interoclusal, requisitos est‚ticos, tecidos moles peri-implantares, necessidade de manuten‡Æo e reversibilidade da restaura‡Æo. Os profissionais da Implantodontia devem atentar para a enorme variedade de componentes prot‚ticos, bem como estarem aptos a realizar sua correta indica‡Æo e utiliza‡Æo.

In order to achieve success with predictability and longevity of implant restorations the proper selection of the retention system is extremely important. The objective of this study was to clarify and provide a scientific basis to guide dentists on the choice of the most appropriate type of implant supported restoration in different clinical situations. According to the literature it is essential to know factors, such as positioning of the implant, occlusal aspects, interocclusal space, aesthetic requirements, peri-implant soft tissues, maintenance and restoration of reversibility, prosthetic components and existing abutments. The professional must consider the variety of prsothetics components available, and be able to prescribe and utilize them properly.

Does the number of implants have any relation with peri-implant disease?

Objective: The aim of this study was to evaluate the relationship between the number of pillar implants of implant-supported fixed prostheses and the prevalence of periimplant disease. Material and Methods: Clinical and radiographic data were obtained for the evaluation. The sample consisted of 32 patients with implant-supported fixed prostheses in function for at least one year. A total of 161 implants were evaluated. Two groups were formed according to the number of implants: G1) ≤5 implants and G2) >5 implants. Data collection included modified plaque index (MPi), bleeding on probing (BOP), probing depth (PD), width of keratinized mucosa (KM) and radiographic bone loss (BL). Clinical and radiographic data were grouped for each implant in order to conduct the diagnosis of mucositis or peri-implantitis. Results: Clinical parameters were compared between groups using Student’s t test for numeric variables (KM, PD and BL) and Mann-Whitney test for categorical variables (MPi and BOP). KM and BL showed statistically significant differences between both groups (p<0.001). Implants from G1 – 19 (20.43%) – compared with G2 – 26 (38.24%) – showed statistically significant differences regarding the prevalence of peri-implantitis (p=0.0210). Conclusion: It seems that more than 5 implants in total fixed rehabilitations increase bone loss and consequently the prevalence of implants with periimplantitis. Notwithstanding, the number of implants does not have any influence on the prevalence of mucositis. .

Prevalence of peri-implantitis in patients with implant-supported fixed prostheses.

OBJECTIVE: The purpose of this study was to evaluate periimplantitis prevalence in patients using implant-supported fixed prostheses that did not have any routine maintenance care. METHOD AND MATERIALS: A total of 161 implants (27 patients) were evaluated in patients using implant-supported fixed prostheses. Collected data included information related to patient general health and local factors such as characteristics of implants, time in function, type of loading, positioning, Modified Bleeding Index, bacterial plaque, bleeding on probing (BOP), marginal recession, probing depth (PD), keratinized mucosa, and radiographic bone loss (BL). Factors related to the prostheses were also evaluated. The exclusion criteria were patients that have had any follow-up visit for plaque control of the prosthesis and/or the implants. RESULTS: From a total of 161 implants, 116 (72%) presented without peri-implantitis (PD > 4 mm + BOP + BL > 2 mm) while 45 (28%) had some sign of the disease. Implants placed in the maxilla were 2.98 times more likely to develop the disease (P < .05). Moreover, patients aged ≤ 60 years old were 3.24 times more likely to develop peri-implantitis (P < .05). Another analysis with statistical relevance (P < .05) was that implants with less than 3 mm interimplant distance were three times more likely to have peri-implantitis. There was no statistical relevance considering other analyses. CONCLUSION: It can be concluded that patients aged ≤ 60 years have a greater chance of presenting periimplantitis, as well as for implants positioned in the maxilla and those placed with an interimplant distance < 3 mm.

Relação entre o índice de placa modificado e a prevalência das doenças peri-implantares ao redor de implantes osseointegrados / Relationship between modified plaque index and the prevalence of peri-implants diseases around osseointegrated implants

O objetivo deste artigo é avaliar a relação entre o índice de placa modificado (IPM) e a prevalência das doenças peri-implantares ao redor de implantes osseointegrados. Foram examinados 172 pacientes (627 implantes) reabilitados com próteses implantossuportadas. Os pacientes foram divididos em dois grupos de acordo com o índice de placa modificado: G1) presença de biofilme bacteriano (escore 1, 2 ou 3) e G2) ausência de biofilme bacteriano (escore 0). O índice de placa modificado foi classificado como presente (escore 1, 2 ou 3) ou ausente (escore 0). A presença de placa bacteriana teve relação direta com a prevalência da mucosite (p< 0.05). Já com relação à peri-implantite, os resultados obtidos não apresentaram relevância estatística (p>0.05). Conclui-se que implantes com índice de placa modificado (IPM) 0 possuem menor propensão ao desenvolvimento da mucosite peri-implantar.

The aim of this paper is to evaluate the relationship between modified plaque index (MPI) and the prevalence of peri-implants diseases around osseointegrated implants. There were examined 172 patients (627 implants) rehabilitated with implant-supported prostheses. Patients were divided into two groups regarding modified plaque index: G1) presence of bacterial plaque (score 1, 2 or 3) and G2) absence of bacterial plaque (score 0). Modified plaque index (mPI) was classified as present (score 1, 2 or 3) or absent (score 0). The presence of bacterial plaque had direct relation with the prevalence of mucositis (p< 0.05). Considering peri-implantitis, the obtained results have not shown statistical relevance (p>0.05). It can be concluded that implants with MPI zero have less susceptibility to the development of periimplant mucositis.

Relação entre extensão do cantilever e complicações biológicas em implantes distais de próteses totais fixas / Relation between cantilever extension and biological complication of distal implants in full fixed prostheses

Este estudo tem como objetivo avaliar a relação entre a extensão do cantilever em próteses totais fixas e a presença de peri-implantite e perda óssea peri-implantar em implantes distais. A amostra consistiu em 32 pacientes portadores de prótese total fixa implantossuportada instalada há, pelo menos, 1 ano. Os implantes foram divididos em dois grupos conforme a extensão do cantilever: G1) ≤10 mm (43 implantes) e G2) ≤10 mm (21 implantes). Os dados coletados inclu¡ram parâmetros clínicos, tais como profundidade de sondagem (PS), sangramento … sondagem (SS) e perda óssea (PO). Esses dados foram agrupados para cada implante a fim de conduzir o diagnóstico de peri-implantite e perda óssea. Não houve diferença estatística (p<0,05) para os parâmetros clínicos avaliados ou para a presença da doença entre G1 – 8 (18,60%) com peri-implantite e 32 (74,42%) implantes com perda óssea e G2 – 3 (14,29%) implantes com peri-implantite e 19 (90,48%) implantes com perda óssea. Conclui-se que a extensão do cantilever não foi relacionada com peri-implantite e perda óssea nos implantes distais

This study aimed to evaluate the relationship between cantilever extension and the prevalence of peri-implantitis and peri-implant bone loss around the distal implants of full fixed prostheses. The sample consisted of 32 patients using full fixed prostheses for at least 1 year. Implants were divided into two groups regarding cantilever extension: G1 ≤ 10 mm (43 implants) and G2 >10 mm (21 implants). Data collection included clinical parameters, like probing depth (PD), bleeding on probing (BOP), and bone loss (BL). All the data were pooled for each group in order to conduct to diagnosis of peri-implantitis and bone loss. As a result, there was no statistical relevance (p<0.05) for the clinical parameters previously evaluated nor for the presence of the disease between G1 – 8 subjects (18.60%) with peri-implantitis and 32 implants (74.42%) with bone loss, and G2 – 3 subjects (14.29%) with peri-implantitis and 19 implants (90.48%) with bone loss. It was concluded that the cantilever extension in full fixed prostheses was not related with peri-implantitis nor with bone loss in the distal implants

A gengiva artificial pode influenciar na prevalência das doenças peri-implantares? Estudo transversal / Does artificial gingiva may influence the prevalence of peri-implant disease? A cross-sectional study

Objetivos: analisar a relação da gengiva artificial com a prevalência de mucosite e peri-implantite. Material e Métodos: foram selecionados 41 pacientes com próteses em função há pelo menos um ano, totalizando 215 implantes. Foram formados dois grupos, de acordo com a presença (G1) ou ausência (G2) de gengiva artificial. A coleta de dados incluiu profundidade de sondagem (PS), sangramento a sondagem (SS) ou supuração a sondagem (S), e perda óssea radiográfica (PO). Os dados clínicos e radiográficos foram agrupados para conduzir ao diagnóstico de tecido saudável, mucosite ou peri-implantite. Resultados: os grupos G1 e G2 apresentaram-se respectivamente com 52,11% e 50,68% de implantes saudáveis; 39,44% e 31,51% com mucosite; 8,45% e 17,81% com peri-implantite. Não houve diferença estatística significativa entre os grupos teste qui-quadrado (p > 0,05). Conclusão: a confecção de próteses com gengiva artificial não apresentou relação com a prevalência das doenças peri-implantares

Objectives: to evaluate the influence of artificial gingiva in the prevalence of mucositis and peri-implantitis. Material and methods: forty-one patients – 215 implants – were selected using implant-supported prosthesis in function for at least one year. Two groups were formed according to the presence (G1) or absence (G2) of artificial gingiva. Data collection included probing depth (PD), suppuration on probing (SOP), bleeding to probing (BOP), bone loss (BL) and periapical radiographs. Clinical and radiographic data were grouped in order to verify the diagnosis of healthy, mucositis and peri-implantitis. Results: G1 and G2 groups were considered 52.11% and 50.68% healthy, 39.44% and 31.51% with mucositis, and 8.45% and 17.81% with peri-implantitis. There was no statistically significant difference between the two groups (chi-square test, p >.05). Conclusion: artificial gingiva did not have an influence in the prevalence of peri-implant disease

Avaliação transversal retrospectiva do desempenho clínico dos parafusos protéticos do sistema Implacil De Bortoli com cinco ou mais anos em função / A cross-sectional retrospective evaluation on the clinical performance of prosthetic screws of Implacil De Bortoli System with five or more years in function

Objetivos: relatar as falhas nos parafusos protéticos de um sistema de implantes com o tempo em função. Material e métodos: foram incluídos nesta avaliação transversal retrospectiva 183 pacientes, reabilitados com 916 implantes (Implacil De Bortoli) em função por pelo menos um ano. Dois grupos foram formados de acordo com o tempo em função: até cinco anos (G1) e mais de cinco anos (G2). A relação entre as falhas e o tempo de uso foi analisada pelo teste qui-quadrado (nível de significância 5%). Resultados: dos 916 implantes pesquisados, 836 (91,3%) não apresentaram falhas de parafuso e 80 (8,7%) mostraram algum problema relacionado. O grupo G1 apresentou 416 implantes, sendo que 404 implantes (97,1%) não apresentaram problemas e 12 implantes (2,9%) apresentaram falha de parafuso protético. No G2, foram selecionados 500 implantes, dentre os quais 432 (86,4%) apresentavam-se sem falhas de parafuso e 68 (13,6%) com presença de afrouxamento e/ou fratura do parafuso da prótese. Houve diferença estatística significante entre os grupos (p < 0,001). Conclusão: ambos os grupos apresentaram baixos índices de falhas nos parafusos. Entretanto, o G2 (próteses com mais de cinco anos) apresentou maior percentual dessas falhas, demonstrando que as mesmas aumentam com o tempo em função das reabilitações implantossuportadas.

Objectives: to report prosthetic screw implant failures over time periods. Material and methods: one-hundred and eighty-three patients receiving 916 implants (Implacil De Bortoli, Sao Paulo, Brazil) with at least one year to follow-up were included in this cross-sectional retrospective study. Prosthetic screws were divided into two groups: G1 (≤ 5 years) and G2 (> 5 years in function). The chi-square test was used to analyze relationship between failures and time in function (5% level of significance). Results: out of the 916 examined implants, 836 (91.3%) did not present prosthetic screw failures and 80 (8.7%) reported some problem. The G1 presented with 416 implants, being 404 (97.1%) with no problems and 12 (2.9%) with some type of failure. At G2, 500 implants were selected, being 432 (86.4%) presenting no failures and 68 (13.6%) with screw loosening and/or fracture. A statistically significant difference was observed between groups (p < 0,001). Conclusions: both groups presented low index failures for prosthetic screws. However, more failures were seen at G2 (> 5 years of follow-up), corroborating the findings that those increase according to time in function for oral, implant-supported rehabilitations.

Tipo de reabilitação protética implantossuportada versus histórico de doença periodontal e higiene oral: estudo transversal com 916 implantes, com pelo menos um ano em função / Implant-supported rehabilitation type versus history of periodontal disease and oral hygiene levels: a cross-sectional study with 916 implants for at least one year in function

Objetivo: verificar se existe associação entre o tipo de reabilitação protética implantossuportada (unitária, parcial ou total), a presença de doença periodontal e o perfil do paciente para controle do biofilme. Material e métodos: pacientes tratados com implantes de titânio Implacil (De Bortoli, São Paulo, Brasil), na Fundecto-USP, no período de 1998 a 2012, foram incluídos neste estudo. As características da restauração protética, o histórico de doença periodontal, a dificuldade de higiene relatada pelo paciente e as consultas periódicas de manutenção profissional foram avaliados pelo teste qui-quadrado (nível de significância 5%). Resultados: foram examinados 183 pacientes (69 homens, 114 mulheres; média de 59 anos de idade). Dos 938 implantes colocados, 16 foram perdidos e seis foram sepultados pelo mau posicionamento (taxa de sobrevida: 98,28%). A média de acompanhamento foi de cinco anos (1-15 anos). A amostra final foi constituída de 916 implantes (723 implantes ≤ 3,75 mm de diâmetro; 193 implantes > 3,75 mm de diâmetro) em função por pelo menos um ano, distribuídos entre 413 restaurações (167 próteses unitárias, 202 próteses parciais e 44 próteses totais). Houve diferença estatística positiva para todas as variáveis. O histórico de doença periodontal foi progressivo para pacientes reabilitados com próteses unitárias (10,18%), parciais (17,82%) e totais (25,99%), respectivamente (p < 0,001). Pacientes com restaurações totais relataram maior dificuldade de higiene para desorganização do biofilme (p < 0,001), e realizaram menor número de consultas periódicas para profilaxia profissional em relação aos pacientes reabilitados com próteses unitárias e parciais (p < 0,001). Conclusão: o tipo de reabilitação protética pode estar associado ao maior risco de desenvolvimento das doenças peri-implantares.

Objectives: to verify whether associations regarding the type of implant-supported rehabilitation (single, partial or total), history of periodontal disease, and patient’s profile on biofilm control are positive. Material and methods: patients treated with titanium implants (Implacil De Bortoli, Sao Paulo, Brazil) installed at Fundecto (University of Sao Paulo, USP), from 1998 to 2012, were included in this study. The type of prosthetic rehabilitation, history of periodontal disease, hygiene difficulty reported by the patient, and the frequency of professional maintenance care were evaluated using the chi-square test (5% significance level). Results: 183 patients (69 men, 114 women; mean age of 59 years-old) were examined. Out of the 936 implants placed, 16 were lost and 6 buried due to mal-positioning. (survival rate: 98.28%). Mean follow-up period was 5 years (1-15 years). The final sample was composed of 916 implants (723 implants ≤ 3.75 mm diameter; 193 implants > 3.75 mm diameter) in function for at least one year, distributed among 413 restorations (167 single-, 202 partial-, and 44 total implant-supported prostheses). The history of periodontal disease was progressive for patients rehabilitated with single (10.18%), partial (17.82%), and total (25.99%) prostheses, respectively (p < 0.001). Also, patients with total implant-supported rehabilitations reported higher hygiene difficulties regarding biofilm removal (p < 0.001) and these had less professional maintenance care when compared with patients rehabilitated with single and partial prostheses (p < 0.001). Conclusion: the type of prosthetic rehabilitation may be associated with an increased risk of peri-implant diseases.

Existe associação entre pilares angulados e doenças peri-implantares? Estudo clínico transversal / Is there association between angulated abutments and peri-implant diseases? A clinical cross-sectional study

Objetivos: avaliar a prevalência de mucosite e peri-implantite em implantes restaurados compilares retos ou angulados. Material e métodos: foram avaliados 291 implantes, em função por pelo menos um ano, instalados em 56 pacientes. Dois grupos foram formados de acordo com o pilar instalado na reabilitação protética: reto (G1) e angulado (G2). A coleta de dados incluiu profundidade de sondagem (PS), sangramento ou supuração (SS) a sondagem e perda radiográfica (PO). Os dados clínicos e radiográficos foram agrupados para conduzir ao diagnóstico de saudável, mucosite ou peri-implantite. Resultados: G1 apresentou 141 implantes saudáveis (56,18%), 89 implantes com mucosite (35,46%) e 21 implantes com peri-implantite (8,37%). G2 apresentou 12 implantes saudáveis (30%), 23 implantes com mucosite (57,5%) e cinco com peri-implantite (12,5%). Não houve diferença estatística entre os grupos. Conclusão: os achados clínicos não mostraram associação da prevalência das doenças peri-implantares com pilares retos ou angulados.

Análise da frequência de ressonância de implantes zigomáticos submetidos à função imediata / Analysis of resonance frequency of zygomatic implants submitted to immediate function

O objetivo do estudo foi analisar a evolução da estabilidade de implantes zigomáticos submetidos à função imediata ou tardia e comparar com implantes convencionais instalados na região anterior da maxila. Foram instalados 50 implantes: 18 zigomáticos (Nobel Biocare, Suécia) e 32 convencionais MKIII (TiUnite, Nobel Biocare, Suécia) submetidos a carga imediata (grupo teste) e carga tardia (grupo controle). A estabilidade foi mensurada por meio da análise de frequência de ressonância (AFR) para obtenção de índices de coeficiente de estabilidade (ISQ) dos implantes nos períodos de 0, 90 e 180 dias após a instalação. Os dados foram submetidos aos testes não-paramétricos U de Mann-Whitney, Wilcoxon e Friedman. Os valores médios de ISQ para os implantes zigomáticos na função imediata foram superiores aos tardios, semelhantes aos convencionais e apresentaram elevação contínua durante o período de reparo ósseo inicial. Os implantes zigomáticos na região da maxila posterior apresentaram valores de ISQ médios semelhantes aos implantes convencionais na região anterior de maxila

The aim of this study was to analyze the evolution of zygomatic implants’ stability that have been submitted to immediate or late loading and compare with conventional implants installed in the anterior maxilla. There were installed 50 implants: 18 zygomatic (Nobel Biocare, Sweden) and 32 conventional MKIII (TiUnite, Nobel Biocare, Sweden) that were subjected to immediate loading (test group) and late loading (control). The stability was measured by means of resonance frequency analysis (RFA) in order to obtain the implant stability quotient index (ISQ) in the following periods 0, 90, and 180 days after installation. Data were submitted to non-parametric tests such as U Mann-Whitney, Wilcoxon and Friedman. Mean values of ISQ for zygomatic implants in immediate loading were higher than for those in late loading, similar to conventional implants, and also showed continuous rise during the period of early bone repair. Zygomatic implants placed in the posterior maxilla displayed resembling mean values of ISQ if compared with conventional implants situated in the anterior maxilla

Impact of local and systemic factors on additional peri-implant bone loss.

OBJECTIVE: To assess the impact of local and systemic factors on additional peri-implant bone loss. METHOD AND MATERIALS: From a total of 253 patients, 193 were selected (126 women) and restored with 722 implants, in place for at least 1 year. Patients had previously attended the supportive periodontal/peri-implant therapy program at the Department of Implant Dentistry at the Federal University of Santa Catarina, Brazil. The study was divided according to physiologic (PBL < 2 mm) or additional bone loss (ABL >= 2 mm) evaluated from the time of prosthesis placement to the reassessment visit. Data collection and analysis included evaluation of systemic factors, such as history of periodontal disease, heart disease, hypertension, diabetes mellitus, hyperthyroidism/hypothyroidism, osteoporosis, kidney disease, alcohol abuse, smoking habits, chemotherapy, radiation therapy, menopause, and hormone replacement. Analysis of local factors included implant platform, diameter, location, time in function, and type of prosthesis. RESULTS: No systemic factors influenced ABL (P > .05). Considering local factors, only time in function and type of prosthesis influenced ABL (P < .05). CONCLUSION: Fixed partial dental prostheses and full-arch fixed prostheses present higher rates of ABL. In addition, all types of prostheses showed greater ABL when in function for more than 4 years.

Importância da mucosa ceratinizada e da localização do implante no sangramento à sondagem ao redor dos implantes osseointegrados / The importance of keratinized mucosa and implant location on the bleeding on probe around dental implants

Introdução: o objetivo do estudo foi determinar a associação entre a faixa de mucosa ceratinizada (MC) e a localização dos implantes, com o sangramento à sondagem (SS) do tecido mole ao redor dos implantes osseointegráveis. Métodos: um total de 172 pacientes, apresentando 635 implantes em função, foram examinados. A faixa de MC, a localização do implante e a associação dessas análises, foram divididas em quatro grupos. G1 - Região anterior com MC ≥ 2mm; G2 - região anterior com MC < 2mm; G3 - região posterior com MC ≥ 2mm; e G4 - região posterior com MC < 2mm. Resultados: não houve significância estatística em nenhum dos grupos avaliados (p > 0,05). Conclusão: a faixa de MC e a localização do implante não tem qualquer influência sobre o SS ao redor dos implantes osseointegrados.

Existe relação entre a doença peri-implantar e a manutenção oral periódica de consultório? / Is there any relationship between peri-implant disease and professional periodic oral maintenance care?

Determinar a relação entre profilaxia e doenças peri-implantares. Material e Métodos: foram examinados 64 pacientes reabilitados com 249 implantes dentários em função por pelo menos um ano. Dois grupos foram formados de acordo com a realização (grupo teste – GT: 35 pacientes e 130 implantes) ou não de profilaxias (grupo controle – GC: 29 pacientes e 119 implantes). Os dados coletados incluíram placa bacteriana (PB), sangramento a sondagem (SS), profundidade de sondagem (PS) e perda óssea (PO). Os dados clínicos e radiográficos foram agrupados, a fim de conduzir o diagnóstico de saúde peri-implantar, mucosite ou periimplantite. Resultados: dentre os pacientes saudáveis, 18 eram do GT (90 implantes) e 14 do GC (94 implantes). Para mucosite, 11 pacientes do GT (26 implantes) e 10 do GC (19 implantes). Para peri-implantite, seis pacientes do GT (14 implantes) e 5 do GC (6 implantes). Não houve significância estatística em qualquer avaliação para a realização de profilaxias periódicas (teste qui-quadrado, p > 0,05). Conclusão: a realização de profilaxias periódicas não influenciou na prevalência da doença peri-implantar...

To evaluate the relationship between professional prophylaxis and peri-implant disease. Material and Methods: sixty-four patients rehabilitated with 249 dental implantes were examined. The evaluated implants had to be in function for at least one year. Two groups were formed according to the performance of prophylaxis (test group – TG: 35 patients and 130 implants) or not (control group – CG: 29 patients and 119 implants). Data collection included bacterial plaque (PB), bleeding on probing (BOP), probing depth (PD) and bone loss (BL). Clinical and radiographic data were grouped in order to conduct the diagnosis of peri-implant health, mucositis or peri-implantitis. Results: among healthy patients, 18 were from TG (90 implants) and 14 were from CG (94 implants). For mucositis, 11 patients were from TG (26 implants) and 10 were from CG (19 implants). For peri-implantitis, six patients were from TG (14 implants) and five were from CG (six implants). There was no statistical significance among the analyses (Chi-square test – p > 0.05). Conclusions: periodic professional prophylaxis did not have any infl uence in the prevalence of peri-implant disease...

Fatores que influenciam na fratura coronal em próteses totais fixas implantossuportadas / Factors affecting coronal fractures in implant-supported fixed prosthesis

Este artigo avaliou a prevalência e fatores clínicos relacionados com fratura coronal em próteses totais fixas implantossuportadas. Foram examinados 26 pacientes, portadores de 148 implantes osseointegrados e 264 unidades dentais em função. Os fatores analisados incluíram sexo, idade, número de unidades dentárias, localização, tempo em função e antagonista. Foi aplicado o teste estatístico qui-quadrado. Vinte e seis fraturas de coroa protética (9.85%) ocorreram em 10 pacientes (38.46%). A localização, o tempo em função e o antagonista foram os fatores relacionados com a maior prevalência de fraturas (p<0.05). Assim, as fraturas de coroa protética em próteses totais fixas implantossuportadas metaloplásticas estão relacionadas com região superior e anterior, menos de 5 anos em função e com próteses fixas implatossuportadas como antagonistas

This article has evaluated the prevalence and clinical factors related with coronal fractures in implant-supported fixed prosthesis. Twenty six patients were examined, with a total of 148 osseointegrated implants and 264 dental units in function. The analyzed factors included gender, age, number of dental units, positioning, time in function and antagonist. Chi-square test was applied for statistical analysis. Twenty six prosthetic crown fractures (9.85%) occurred in 10 patients (38.46%). Positioning, time in function and antagonist were the factors related with the highest prevalence of fractures (p<0.05). Prosthetic crown fractures in metalloplastic implant-supported fixed prosthesis are associated with anterior maxilla region, less than 5 years in function and antagonists being implant-supported fixed prosthesis