Effect of Flavonoid Supplementation on Alveolar Bone Healing-A Randomized Pilot Trial.

We investigated the effects of two common dietary supplements on bone healing in dental extraction sockets in humans. In this randomized pilot trial, male subjects took Grape Seed Extract [GSE] or Grapefruit Extract [GFE] starting two weeks prior to dental extraction and maintained this regimen for sixty days after surgery. Extraction sockets were filled with a collagen plug. After 24 h, a socket sample was collected and processed for quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) and an 84-gene wound healing assay. Sixty days after tooth extraction, a core of newly formed bone was obtained prior to dental implant placement and processed for histology. qRT-PCR revealed that GFE led to a significant decrease in platelet-derived growth factor and interleukin (IL)1-ß compared to GSE, and a significant decrease in IL-6 and CXCL2 compared to control. GSE led to a significant increase in coagulation factor Von Willebrand and inflammatory marker IL1-ß compared to GFE. WISP1 and CXCL5 were upregulated in both groups. Overall, GFE showed a downregulation of inflammation and GSE led to a decrease in collagen density and increased osteoclasts. This pilot trial highlights the need for further investigation on the mechanism of action of such supplements on bone healing and oral health.

A Step-by-Step Management of Extraction Sites in Areas of Maxillary Sinus Pneumatization: A Literature Review and a Case Presentation of a New Surgical Technique.

INTRODUCTION: The rehabilitation of the posterior maxilla with implant-supported prosthesis is often complicated by pneumatization of the maxillary sinus. Bone grafting is commonly required in these cases. Over the years, a number of techniques have been developed for this type of reconstruction. AIM: Present and discuss the possibility of alveolar bone regeneration for subsequent placement of oral implants using Fugazzotto's technique in combination with particulate autograft harvested from the mandibular ramus and a connective tissue pedicle flap to cover the graft. METHODS: A case of a 37-year-old woman with a molar perforated during endodontic treatment and indicated for extraction and implant placement is reported. RESULT AND CONCLUSION: The clinical case showed the possibility of grafting of extraction sites combined with atraumatic elevation of the maxillary sinus floor can be achieved using non-conventional techniques such as Fugazzotto's technique associated with alveolar bone regeneration.

Failure of prosthetic screws on 971 implants

Abstract Aim: To evaluate the presence of failures in prosthetic screws and whether these failures are related to the type of prosthesis, abutment angulation and presence or not of intermediate. Methods: Two-hundred and sixty-seven patients were evaluated at the Federal University of Santa Catarina, totaling 971 external hexagonal implants in place for at least one year. A Tobit regression model for censored variables was used and the explanatory variables were subjected to percentage analysis. Results: The results demonstrated a relationship between the failure in prosthetic screws and the investigated factors with a significance of F=0.003 and p<0.05. The percentage analysis showed that the prosthetic screw failed in 8.82% of 238 unitary prostheses and 10.1% of 773 multiple prostheses. Among 912 abutments, 9.43% failed and in the 59 angled abutments, failures appeared in 15.25%. A total of 200 prostheses were placed over the implant platform and 13% failed. A total of 771 prostheses were made over abutment and 8.95% of these screws failed. Conclusions: Through multiple linear regression it could be concluded that the type of prosthesis showed no significant influence on the prosthetic screw failure, but other variables were related to this mechanical failure. There was a significant relationship among the variables, demonstrating the need for greater attention in choosing the type of prosthesis, the abutment angulation and whether the prosthesis will be placed directly on the implant platform or on the abutment.

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.

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.

Creeping attachment involving dental implants: two case reports with a two-year follow-up from an ongoing clinical study.

Introduction. This paper describes case reports where coronal growth of soft tissue on implant threads was observed after surgery for soft tissue graft. This phenomenon is known as "creeping attachment." Methods. Two patients were submitted to gingival graft procedure including subepithelial connective tissue graft and masticatory mucosal graft. A two-year follow-up appointment was performed. Results. After a two-year follow-up gingival growth over titanium surfaces characterizing the "creeping attachment" phenomenon was observed. This gingival growth happened over abutment and threads surfaces. Conclusion. The creeping attachment phenomenon is possible over titanium surfaces and has not yet been reported in the relevant literature over this kind of structure.

Correção de sorriso gengival com osteotomia sem retalho: previsibilidade com o mínimo de morbidade / Correcting gingival smile through flapless osteotomy:predictability with minimal morbidity

O aumento de coroa clínica estético pode ser uma das alternativas para correção ou minimização do sorriso gengival, ou para pequenas discrepâncias estéticas na margem gengival. Tradicionalmente, esse procedimento é realizado por meio da elevação do retalho e posterior osteotomia/osteoplastia. Porém, em casos bem indicados, é possível realizar tal procedimento, via sulco gengival, com microcinzéis, sem a necessidade de elevação do retalho. Esse artigo demonstra, indica e discute, a partir de um relato de caso, a possibilidade de correção do sorriso gengival por meio da técnica de osteotomia sem retalho (Flapless)...

Esthetic crown lengthening might be a possible alternative to correct or minimize gingivalsmile or slight discrepancies in esthetic gingival margin. Traditionally, this procedure is performedusing flap elevation and subsequent osteotomy/osteoplasty. However, in very specific cases,such procedure can be performed through the gingival sulcus with micro-chisels and without theneed for flap elevation. This article demonstrates, indicates and discusses, based on a case report,the possibility of correction of gingival smile by means of the flapless osteotomy technique...

Técnica do conjuntivo rotacionado palatino para fechamento de alvéolos pós-extração / Technique of rotational palatal connective closure of post extraction sockets

O completo selamento marginal do alvéolo, por tecido mole, após a instalação imediata de implantes e/ou regeneração óssea guiada, é fundamental. Entre as técnicas para fechamento de alvéolo, destacam-se os retalhos pediculados. Objetivos: descrever e elucidar a técnica do conjuntivo rotacionado palatino para fechamento de alvéolo. Métodos: relato de um caso de agenesia do elemento 15, em que se realizou extração atraumática do dente 55 e a técnica de conjuntivo rotacionado palatino. Resultados: o paciente apresentou pós-operatório de sete dias muito satisfatório. Conclusão: a técnica apresentada apresenta excelência estética associada à função e homeostasia marginal, possui uma fonte de nutrição extra, proveniente do pedículo, além de possuir menor morbidade e ausência de área doadora isolada...

Complete marginal soft tissue sealing of the socket after immediate implantplacement and / or guided bone regeneration is essential. Among the techniques of socket closure, we highlight the pedicle flaps. Objectives: To describe and explain the technique of rotational palatal connective closure of post extraction sockets. Methodology: Case report of agenesis of tooth #15 treated by means of atraumatic extraction of tooth #55 and the technique of rotational palatal connective closure. Results: The patient had a very satisfactory 7-day postoperative follow-up. Conclusion: The technique presents esthetic excellence associated with marginal function and homeostasis, an extra source of nutrition from the pedicle, lower morbidity and absenceof an isolated donor site...

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

Treatment of odontogenic myxoma: a multidisciplinary approach-6-year follow-up case.

The most aggressive diseases that affect the oral environment are considered tumors of the jaw. The surgical treatment is preferably done by surgical resection of the lesion, resulting in a great loss of tissue and esthetics. Multidisciplinary planning is required for the rehabilitation of these cases. Autogenous grafting techniques or vascularized flaps allow ridge reconstruction for implant placement, restoring function, and esthetics. This paper reports a 6-year follow-up case of an odontogenic myxoma treated with wide resection and mandibular bone reconstruction for posterior rehabilitation with dental implants.

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

Accident in implant dentistry: involuntary screwdriver ingestion during surgical procedure. A clinical report.

Although unusual, foreign body ingestion occurs in dentistry and may result in serious complications, such as intestinal perforation. The presence of the foreign body should be confirmed with the use of radiographs. The exam will allow the correct diagnosis and the treatment to be conducted according to the specific situation of the object in the gastrointestinal (GI) tract. The orientation of the patient as well as the awareness of the patient's medical history are key factors in preventing serious complications. Generally, instruments that enter the GI tract pass asymptomatically and atraumatically within 4 days to 2 weeks. Sometimes, a surgical approach is necessary to remove the instrument when there is bleeding, obstruction, or impaction in the GI tract. Thus, a correct diagnosis is vital to avoid unnecessary surgical interventions. The aim of this article is to report an accidental ingestion of a screwdriver by a patient who had previously undergone a hemi-mandibulectomy and its medical resolution.

Relationship between smoking and bleeding on probing.

The objective of this study was to assess and compare bone loss (BL) around the dental implant platform as well as the presence of bacterial plaque (PBP), bleeding on probing (BOP), and periodontal probing depths (PD) of teeth and dental implants of smokers and nonsmokers. Three hundred forty-seven teeth and 98 implants of 20 randomly selected patients were assessed (12 smokers and 8 nonsmokers). The specimens were divided into 4 groups according to the site probed. Group 1 included smoker implant sites, group 2 included smoker tooth sites, group 3 included nonsmoker implant sites, and group 4 included nonsmoker tooth sites. The presence/absence of visible bacterial plaque, presence/absence of BOP, PD ≤ 3 mm or >3 mm, and BL around the dental implant platform were the data assessed. The PBP and BL showed statistical significance between smokers and nonsmokers. Bleeding on probing and PD ≤ 3 mm showed statistical significance between groups 1, 3, and 4. Comparing sites with BOP and PD > 3 mm, there was no statistical significance except for group 1, which did not present sites with these characteristics. Comparing sites with BOP and PD ≤ 3 mm, there was statistical significance between group 2 and groups 3 and 4. When comparing the prevalence of sites without BOP and PD > 3 mm, there was statistical significance between groups 1, 3, and 4. Smoking promotes a greater BL around the dental implant platform and results in vasoconstriction of the peri-implant and periodontal tissues.

Implantes curtos como alternativa contra procedimentos invasivos: relato de caso / Short dental implant as an alternative to invasive procedures: case report

A utilização de implantes curtos (6,0–8,5mm) no tratamento reabilitador vem sendo bastante empregada em locais onde a altura óssea é limitada ou em regiões próximas a estruturas anatômicas importantes. Historicamente, o uso de implantes curtos tem sido associado a menores taxas de sucesso quando comparados com implantes de comprimento convencional. Entretanto, estudos clínicos recentes mostram uma similaridade na taxa de sucesso de implantes curtos e convencionais. Tanto para o clínico quanto para o paciente, esse tratamento apresenta-se como uma alternativa simples e segura, devido à redução dos custos, procedimentos cirúrgicos, morbidade e tempo de tratamento. Devido à similaridade nas taxas de sucesso, a indicação de implantes curtos pode ser feita em praticamente todos os casos, assim substituindo a realização de procedimentos invasivos para reconstrução do volume ósseo. O presente artigo apresenta uma resolução clínica que mostra a utilização de implantes curtos em mandíbula e maxila.

Short dental implants (6.0-8.5 mm) have been widely used in the rehabilitation of atrophic areas or in sites close to important anatomic structures. Historically, short implants were associated with lower success rates when compared with the treatment using long implants (>8.5 mm). However, recent clinical researches show similar success rates to short and long implants. Moreover, this sort of treatment is considered a simple and safe option for both patients and surgeons. It has the potential of decreasing costs, number of surgical interventions, treatment time and morbidity. Due to the similarity between both types of implants, short implants have been largely used as a substitute for invasive surgical interventions for bone volume reconstruction. This paper shows short dental implants as a safe clinical option for the rehabilitation of atrophic maxilla and mandible.

Estética e previsibilidade dos enxertos conjuntivos subepiteliais no recobrimento radicular / Aesthetics and predictability of subepithelial conective graft on root coverage: clinical case report

O crescente interesse pela estética periodontal e a necessidade da resolução de problemas como a sensibilidade dentinária favoreceram o desenvolvimento de diversas técnicas cirúrgicas de recobrimento radicular. De fato, esses procedimentos mucogengivais têm sido utilizados para restabelecer a arquitetura e recobrir a superfície da raiz desnuda, o que possibilita a recuperação do conforto em relação à sensibilidade e à devolução da estética do sorriso. Entre as alternativas existentes, a técnica de enxerto de tecido conjuntivo subepitelial (ETCS) tem atingido altas taxas de sucesso no recobrimento radicular. O propósito deste artigo foi relatar um caso clínico com a técnica clássica de ETCS, visando ao completo recobrimento radicular bilateral e consequente devolução da estética e eliminação da hipersensibilidade radicular.

Papel da mucosa ceratinizada peri-implantar na manutenção de saúde: dados preliminares / The role of keratinized mucosa on peri-implant health status maintenance: preliminary data

A presença da mucosa ceratinizada (MC) ao redor de implantes como fator importante para a manutenção da saúde peri-implantar ainda é questionável. Dessa forma, o objetivo deste estudo piloto foi avaliar o grau de influência da MC nos níveis de acúmulo de placa e de sangramento a sondagem em implantes. Foram examinados 132 implantes, nos quais foram feitas sondagens em seis pontos (distovestibular, vestibular, mésiovestibular, distolingual/palatina, lingual/palatina, mésiolingual/palatina), tendo sido obtido o índice gengival, com valor zero para ausência e um para presença de sangramento, após a sondagem em cada um desses pontos. Também foi obtido o índice de placa, tendo sido atribuídos os valores zero para ausência de placa visível no implante e um para presença. Os implantes foram distribuídos em três grupos: com ausência de MC (G1); com faixa de MC menor ou igual a 2 mm (G2); com faixa de MC maior que 2 mm (G3). Os resultados mostraram que a presença de mucosa ceratinizada influencia diretamente no acúmulo de placa, porém, não foram encontradas diferenças estatisticamente significativas quando comparadas a presença de mucosa ceratinizada e o sangramento a sondagem. Tais valores indicam que a mucosa ceratinizada tem influência no acúmulo de placa e não tem papel nos níveis de sangramento a sondagem.

The presence of keratinized mucosa (KM) around implants as an important factor for the maintenance of peri-implant health is still questionable. Thus, the aim of this pilot study is to assess the degree of influence of the KM in the levels of plaque accumulation and bleeding on implant probing. One-hundred, thirty-two implants were examined. Inspections were made at six sites (disto-buccal, buccal, mesio-buccal, disto-lingual, lingual, mesio-lingual), using gingival indexes from 0 (absence) and 1 (presence) of bleeding on probing in each of these points. Plaque index values of 0 (for absence) and 1 (for presence) of visible plaque were also measured. The implants were divided into three groups: absence of KM (G1) with KM range less than or equal to 2 mm (G2) and with KM range greater than 2 mm (G3). The results show that the presence of keratinized mucosa directly influences plaque accumulation, but there were no statistically significant differences when comparing the presence of keratinized mucosa and bleeding on probing. These values indicate that keratinized mucosa influences plaque accumulation; however, has no role in the levels of bleeding on probing

Relação de falhas funcionais de próteses sobreimplantes com parâmetros clínicos / Relationship of functional failures of implant-supported prostheses with clinical parameters

O objetivo deste artigo foi relacionar as fraturas de coroas ou falhas de parafusos protéticos (fratura e/ou afrouxamento) de próteses sobreimplantes com parâmetros clínicos. Foram avaliados 43 pacientes - portadores de 213 implantes osseointegrados em função - que apresentaram algum tipo de falha protética funcional. Foram formados dois grupos: G1 - fratura de coroa protética; G2 - falha do parafuso protético (fratura e/ou afrouxamento). Os fatores analisados incluíram localização, tempo de prótese em função, fase protética, tipo de prótese, tipo de pilar e material de revestimento estético. Observaram-se 46 fraturas de coroa protética e 51 falhas de parafuso. Houve diferença estatística quanto à localização, tipo de prótese e material de revestimento estético entre os grupos 1 e 2 (p < 0,05). Concluiu-se que as fraturas de coroa protética estão relacionadas às próteses totais confeccionadas em acrílico localizadas na região superior e anterior. Falhas do parafuso protético estão relacionadas às próteses unitárias confeccionadas em cerâmica localizadas na região inferior e posterior.

The aim of this paper is to relate the incidence of crown fractures or prosthetic screw failures (fracture and/or loosening) with clinical parameters. Forty-three patients (213 implants) that presented some kind of prosthetic functional failure were evaluated. The study was divided into two groups: G1 - fracture of the prosthetic crown and G2 - failure of the prosthetic screw (fracture and/or loosening). The parameters analyzed included implant positioning, time, prosthetic phase, prosthesis type, abutment, and the veneering material. Forty-six fractures of the prosthetic crown and 51 screw failures were reported. There was statistical difference regarding positioning, prosthesis, and veneering material between groups 1 and 2 (p < 0.05). It can be concluded that fractures of the prosthetic crown are related to full dentures made with acrylic teeth and positioned in the anterior site of the upper jaw. Meanwhile, the prosthetic screw failures are related to ceramic single crowns positioned in the posterior site of the lower jaw.