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1.
Polymers (Basel) ; 14(1)2022 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-35012210

RESUMO

The aim of the present study was to evaluate the use of collagen, elastin, or chitosan biomaterial for bone reconstruction in rats submitted or not to experimental alcoholism. Wistar male rats were divided into eight groups, submitted to chronic alcohol ingestion (G5 to G8) or not (G1 to G4). Nasal bone defects were filled with clot in animals of G1 and G5 and with collagen, elastin, and chitosan grafts in G2/G6, G3/G7, and G4/G8, respectively. Six weeks after, all specimens underwent radiographic, tomographic, and microscopic evaluations. Bone mineral density was lower in the defect area in alcoholic animals compared to the abstainer animals. Bone neoformation was greater in the abstainer groups receiving the elastin membrane and in abstainer and alcoholic rats receiving the chitosan membrane (15.78 ± 1.19, 27.81 ± 0.91, 47.29 ± 0.97, 42.69 ± 1.52, 13.81 ± 1.60, 18.59 ± 1.37, 16.54 ± 0.89, and 37.06 ± 1.17 in G1 to G8, respectively). In conclusion, osteogenesis and bone density were more expressive after the application of the elastin matrix in abstainer animals and of the chitosan matrix in both abstainer and alcoholic animals. Chronic alcohol ingestion resulted in lower bone formation and greater formation of fibrous connective tissue.

2.
J Craniomaxillofac Surg ; 49(2): 104-109, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33349509

RESUMO

The aim of this study was to evaluate the level of mineralized tissue and expression of bone markers in sockets grafted with platelet-rich fibrin and bone marrow aspirate concentrate (BMAC). Patients requiring extraction of one maxillary anterior tooth were randomized into three groups. After tooth extraction, the sockets in the control group (CG) were permitted to fill with blood clot. In the platelet-rich fibrin group (PRFG), after blood processing, the sockets were grafted with PRF plug. In the bone marrow aspirate concentrate combined with platelet-rich fibrin group (BM/PG), after blood and bone marrow processing, the sockets were grafted with a mixture of PRF plug and BMAC. After 6 months, the sites were reopened and bone cores were harvested and prepared for histomorphometric and immunohistochemical evaluation. The following levels were measured: mineralized tissue, expression of RUNX-2, and osteocalcin. Fifteen patients were included in this study. The histomorphometric analysis showed a more pronounced level of mineralized tissue in PRFG and BM/PG (54.20 ± 4.31% and 64.70 ± 6.74%, respectively) when compared with CG (40.60 ± 5.98%) (p = 0.0283 and p = 0.0090, respectively). The expression of RUNX-2 was very low in BM/PG (0.80 ± 0.84%) and absent in CG and PRFG (p = 0.0528). Osteocalcin expression was higher for BM/PG (23.40 ± 1.52%) when compared with CG and PRFG (18.40 ± 2.07% and 16.20 ± 1.92%, respectively) (p = 0.0117 and p = 0.0088, respectively). This preliminary study indicates that clinical use of bone marrow aspirate concentrate, when combined with platelet-rich fibrin as a carrier, might have some potential to increase mineralization in fresh extraction sockets.


Assuntos
Fibrina Rica em Plaquetas , Extração Dentária , Alvéolo Dental , Medula Óssea , Humanos , Alvéolo Dental/cirurgia , Cicatrização
3.
Int J Oral Maxillofac Implants ; 35(6): 1141-1148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33270054

RESUMO

PURPOSE: The purpose of this study was to determine the minimum torque required to attach the transducer to the implant to measure the implant stability quotient (ISQ) with two different devices and to estimate if finger-generated torque would be reliable for this purpose. MATERIALS AND METHODS: One hundred implants were inserted into a uniform polyurethane block. The implants were distributed into 10 groups, with 10 implants each. The transducers were manually attached by a female operator (G female) and by a male operator (G male) using the standard connector provided by the manufacturers. For the remaining groups, the transducers were placed using a connector adapted to a digital torque wrench with different torque settings: 3 Ncm (G 3Ncm), 4 Ncm (G 4Ncm), 5 Ncm (G 5Ncm), 6 Ncm (G 6Ncm), 10 Ncm (G 10Ncm), 13 Ncm (G 13Ncm), 17 Ncm (G 17Ncm), and 20 Ncm (G 20Ncm). The stability was measured for all groups using both the Osstell and the Penguin resonance frequency analyzers. The minimum, medium, and maximum finger grip torque were accessed on 100 volunteers. RESULTS: For Osstell, the conjugated confidence intervals were homogenous for four groups (G 10Ncm, G 13Ncm, G 17Ncm, and G 20Ncm), and for Penguin, they were homogenous for six groups (G 5Ncm, G 6Ncm, G 10Ncm, G 13Ncm, G 17Ncm, and G 20Ncm). The minimum finger-generated force was 2.18 ± 1.05 Ncm, the medium force was 4.25 ± 1.57 Ncm, and the maximum force was 7.51 ± 2.52 Ncm, measuring with a digital torque meter. CONCLUSION: For an accurate measurement of ISQ, the minimum torque necessary to insert the transducer into the implant for Osstell was 10 Ncm, while for Penguin, it was 5 Ncm. Therefore, when using Osstell to assess implant stability, the authors suggest the use of a torque wrench to ensure 10 Ncm of force is applied when tightening the transducer into the implant to obtain accurate stability measurements. When using Penguin, the maximum finger-generated tightening force is enough.


Assuntos
Implantes Dentários , Análise de Frequência de Ressonância , Implantação Dentária Endóssea , Feminino , Dedos , Humanos , Masculino , Torque , Transdutores
4.
Braz Oral Res ; 34: e016, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130363

RESUMO

Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.


Assuntos
Perda do Osso Alveolar/epidemiologia , Perda do Osso Alveolar/patologia , Processo Alveolar/patologia , Boca Edêntula/epidemiologia , Boca Edêntula/patologia , Adolescente , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Aumento do Rebordo Alveolar , Brasil/epidemiologia , Osso Esponjoso/diagnóstico por imagem , Osso Esponjoso/patologia , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca Edêntula/diagnóstico por imagem , Prevalência , Estudos Retrospectivos , Adulto Jovem
5.
Int J Oral Maxillofac Implants ; 34(4): 886­890, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30934030

RESUMO

PURPOSE: The purpose of this in vitro study was to determine the minimum installation torque required to attach the transducer (measuring peg) to the implant to provide an accurate assessment of implant stability using resonance frequency analysis. MATERIALS AND METHODS: One hundred 4 ×11-mm screw-shaped titanium implants were inserted into a uniform polyurethane block with similar density to bone in a standardized surgical protocol. The implants were distributed into 10 groups, with 10 implants each (G1 to G10). In G1, the transducer was manually attached by a female operator and in G2 by a male operator using the manual connector provided by the manufacturer. For the remaining groups (G3 to G10), the transducers were installed using a connector adapted to a digital torque wrench with different torque settings: 3 Ncm (G3), 4 Ncm (G4), 5 Ncm (G5), 6 Ncm (G6), 10 Ncm (G7), 13 Ncm (G8), 17 Ncm (G9), and 20 Ncm (G10). Stability was measured for all groups using the Osstell equipment (Diagnosis of Integration) and the implant stability quotient (ISQ) annotated for statistical comparison between the groups. RESULTS: The mean ± standard deviation ISQ values for groups G1 to G10 were 9.50 ± 5.54, 19.05 ± 2.67, 29.25 ± 4.22, 26.55 ± 5.37, 40.90 ± 0.99, 69.60 ± 2.41, 71.30 ± 0.82, 71.20 ± 1.32, 72.40 ± 0.97, and 70.90 ± 0.88, respectively. Statistical comparisons determined that the amplitudes of the confidence intervals, relative to the standard deviations, were lowest for groups G5, G7, G8, G9, and G10. For the means, the lowest amplitudes of the confidence intervals were observed in G6, G7, G8, G9, and G10. When checking the conjugated confidence intervals (mean and standard deviation), the results were homogenous for G7, G8, G9, and G10. When the torque of 20 Ncm was reached, the connection between the transducer and the implant failed. CONCLUSION: In this in vitro model experiment, transducer torques between 10 and 17 Ncm appear to be adequate for accurate measurement of implant stability, allowing more precise comparisons without damaging the prosthetic connection in the implant.


Assuntos
Implantes Dentários , Transdutores , Implantação Dentária Endóssea , Feminino , Humanos , Masculino , Análise de Frequência de Ressonância , Titânio , Torque
6.
Braz Oral Res ; 32: e21, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29641640

RESUMO

The lack of guidelines for bone augmentation procedures might compromise decision making in implantology. The objective of this study was to perform a retrospective study to verify the outcomes of horizontal bone reconstruction in implant dentistry with different types of materials and amounts of native bone in the recipient bed to allow for a new guideline for horizontal bone reconstruction. One hundred preoperative CT scans were retrospectively evaluated and categorized in accordance to horizontal bone defects as presence (Group P) or absence (Group A) of cancellous bone in the recipient bed. Different approaches were used to treat the edentulous ridge and the outcomes were defined either as satisfactory or unsatisfactory regarding the possibility of implant placement. The percentage distribution of the patients according to the presence or absence of cancellous bone was 92% for Group P and 8% for Group A. In Group P, 98% of the patients had satisfactory outcomes, and the use of autografts had 100% of satisfactory outcomes in this group. In Group A, 37.5% of the patients had satisfactory outcomes, and the use of autografts also yielded 100% of satisfactory outcomes. The use of allografts and xenografts in Group A had 0% and 33.3% of satisfactory outcomes, respectively. Therefore, it seems reasonable to speculate that the presence of cancellous bone might be predictive and predictable when the decision includes bone substitutes. In cases of absence of cancellous bone in the recipient bed, the use of a vitalized graft seems to be mandatory.


Assuntos
Aumento do Rebordo Alveolar/métodos , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Mandíbula/transplante , Maxila/transplante , Enxerto de Osso Alveolar/métodos , Perda do Osso Alveolar/cirurgia , Autoenxertos/transplante , Regeneração Óssea/fisiologia , Osso Esponjoso/cirurgia , Tomografia Computadorizada de Feixe Cônico , Humanos , Arcada Parcialmente Edêntula/cirurgia , Satisfação do Paciente , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
7.
Braz. oral res. (Online) ; 32: e21, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-889464

RESUMO

Abstract: The lack of guidelines for bone augmentation procedures might compromise decision making in implantology. The objective of this study was to perform a retrospective study to verify the outcomes of horizontal bone reconstruction in implant dentistry with different types of materials and amounts of native bone in the recipient bed to allow for a new guideline for horizontal bone reconstruction. One hundred preoperative CT scans were retrospectively evaluated and categorized in accordance to horizontal bone defects as presence (Group P) or absence (Group A) of cancellous bone in the recipient bed. Different approaches were used to treat the edentulous ridge and the outcomes were defined either as satisfactory or unsatisfactory regarding the possibility of implant placement. The percentage distribution of the patients according to the presence or absence of cancellous bone was 92% for Group P and 8% for Group A. In Group P, 98% of the patients had satisfactory outcomes, and the use of autografts had 100% of satisfactory outcomes in this group. In Group A, 37.5% of the patients had satisfactory outcomes, and the use of autografts also yielded 100% of satisfactory outcomes. The use of allografts and xenografts in Group A had 0% and 33.3% of satisfactory outcomes, respectively. Therefore, it seems reasonable to speculate that the presence of cancellous bone might be predictive and predictable when the decision includes bone substitutes. In cases of absence of cancellous bone in the recipient bed, the use of a vitalized graft seems to be mandatory.


Assuntos
Humanos , Aumento do Rebordo Alveolar/métodos , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Mandíbula/transplante , Maxila/transplante , Enxerto de Osso Alveolar/métodos , Perda do Osso Alveolar/cirurgia , Autoenxertos/transplante , Regeneração Óssea/fisiologia , Osso Esponjoso/cirurgia , Tomografia Computadorizada de Feixe Cônico , Arcada Parcialmente Edêntula/cirurgia , Satisfação do Paciente , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
8.
Implant Dent ; 26(6): 915-921, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29095784

RESUMO

OBJECTIVES: To evaluate bone allograft associated to bone marrow aspirate concentrate (BMAC), in maxillary reconstructions. MATERIALS AND METHODS: Ten patients with alveolar bone deficiency in the anterior maxilla were randomly divided into control group (CG) and test group (TG). A bone block allograft was placed in both groups, but the graft was impregnated with BMAC only in TG. Computed tomography was performed 7 days (T1) and 6 months (T2) after the grafting procedure, and volume and bone density measurements were carried out. Histomorphometric analysis was performed at T2. RESULTS: Bone volume loss from T1 to T2 was significant only in TG. The bone density in the buccal region of the graft was significantly higher in TG than in CG. There was no significant difference between the groups, in respect to mineralized tissue (MT) and nonmineralized tissue (NMT), in that MT values were 37.77% ± 15.19% and 43.85% ± 10.94%, and NMT values were 62.15% ± 14.90% and 56.30% ± 10.72%, respectively, for CG and TG. The intragroup difference for the MT/NMT ratio was statistically significant in CG but not significant in TG. CONCLUSIONS: The use of BMAC resulted in an improved pattern of bone formation, with higher bone density in the peripheral regions of the graft.


Assuntos
Aumento do Rebordo Alveolar/métodos , Transplante de Medula Óssea/métodos , Transplante Ósseo/métodos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Adulto , Aloenxertos , Densidade Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
9.
Dental Press J Orthod ; 22(5): 83-89, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29160348

RESUMO

OBJECTIVE: To assess the distribution of stress produced on TMJ disc by chincup therapy, by means of the finite element method. METHODS: a simplified three-dimensional TMJ disc model was developed by using Rhinoceros 3D software, and exported to ANSYS software. A 4.9N load was applied on the inferior surface of the model at inclinations of 30, 40, and 50 degrees to the mandibular plane (GoMe). ANSYS was used to analyze stress distribution on the TMJ disc for the different angulations, by means of finite element method. RESULTS: The results showed that the tensile and compressive stresses concentrations were higher on the inferior surface of the model. More presence of tensile stress was found in the middle-anterior region of the model and its location was not altered in the three directions of load application. There was more presence of compressive stress in the middle and mid-posterior regions, but when a 50o inclined load was applied, concentration in the middle region was prevalent. Tensile and compressive stresses intensities progressively diminished as the load was more vertically applied. CONCLUSIONS: stress induced by the chincup therapy is mainly located on the inferior surface of the model. Loads at greater angles to the mandibular plane produced distribution of stresses with lower intensity and a concentration of compressive stresses in the middle region. The simplified three-dimensional model proved useful for assessing the distribution of stresses on the TMJ disc induced by the chincup therapy.


Assuntos
Análise do Estresse Dentário/métodos , Aparelhos de Tração Extrabucal , Disco da Articulação Temporomandibular/fisiologia , Simulação por Computador , Análise de Elementos Finitos , Humanos , Modelos Biológicos
10.
Dental press j. orthod. (Impr.) ; 22(5): 83-89, Sept.-Oct. 2017. graf
Artigo em Inglês | LILACS | ID: biblio-891101

RESUMO

ABSTRACT Objective: To assess the distribution of stress produced on TMJ disc by chincup therapy, by means of the finite element method. Methods: a simplified three-dimensional TMJ disc model was developed by using Rhinoceros 3D software, and exported to ANSYS software. A 4.9N load was applied on the inferior surface of the model at inclinations of 30, 40, and 50 degrees to the mandibular plane (GoMe). ANSYS was used to analyze stress distribution on the TMJ disc for the different angulations, by means of finite element method. Results: The results showed that the tensile and compressive stresses concentrations were higher on the inferior surface of the model. More presence of tensile stress was found in the middle-anterior region of the model and its location was not altered in the three directions of load application. There was more presence of compressive stress in the middle and mid-posterior regions, but when a 50o inclined load was applied, concentration in the middle region was prevalent. Tensile and compressive stresses intensities progressively diminished as the load was more vertically applied. Conclusions: stress induced by the chincup therapy is mainly located on the inferior surface of the model. Loads at greater angles to the mandibular plane produced distribution of stresses with lower intensity and a concentration of compressive stresses in the middle region. The simplified three-dimensional model proved useful for assessing the distribution of stresses on the TMJ disc induced by the chincup therapy.


RESUMO Objetivo: avaliar, por meio do método dos elementos finitos, a distribuição das tensões no disco articular produzidas pela mentoneira ortopédica. Métodos: um modelo tridimensional simplificado do disco articular foi desenvolvido com o software Rhinoceros 3D e exportado para o software ANSYS. Uma carga de 4,9 N (500 gf) foi aplicada na superfície inferior do modelo, com inclinação de 30, 40 e 50o em relação ao plano mandibular Gônio-Mentoniano (GoMe). O ANSYS analisou, por meio do método dos elementos finitos, a distribuição das tensões presentes no modelo do disco articular para as diferentes angulações. Resultados: os resultados mostraram que a concentração das tensões de tração e compressão foi maior na superfície inferior do modelo. A tensão de tração foi mais presente na região média-anterior do modelo, e sua localização não se alterou nas três direções da aplicação da carga. A tensão de compressão foi mais presente nas regiões média e média-posterior do modelo, mas quando a carga a 50o foi aplicada, ela se concentrou na região média. As intensidades das tensões de tração e compressão diminuíram progressivamente à medida que a carga foi aplicada mais verticalmente. Conclusão: as tensões induzidas pela mentoneira ortopédica se localizaram principalmente na superfície inferior do modelo. As cargas com maior angulação em relação ao plano mandibular produziram uma distribuição de tensões com menor intensidade e uma concentração da tensão de compressão na região média do modelo. Um modelo tridimensional simplificado se mostrou útil na avaliação da distribuição das tensões no disco articular induzidas pela mentoneira ortopédica.


Assuntos
Humanos , Disco da Articulação Temporomandibular/fisiologia , Análise do Estresse Dentário/métodos , Aparelhos de Tração Extrabucal , Simulação por Computador , Análise de Elementos Finitos , Modelos Biológicos
11.
Contemp Clin Dent ; 8(2): 248-252, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28839411

RESUMO

AIM: The aim of this study was to analyze and follow-up implants placed in the posterior maxillary regions previously grafted with homologous bone. MATERIALS AND METHODS: Forty-one grafts with homologous bone blocks were performed in maxillary sinuses, and 121 implants were placed in premolar and molar regions approximately 6 months after the grafts. Patients were followed up for periods varying from 12 to 124 months after rehabilitation. RESULTS: The results showed two implant failures, for a 98.3% success rate during the follow-up period. DISCUSSION: The implants placed had an average torque of 40 N-cm, regardless of the, design, diameter, and length of the implants used. CONCLUSION: After following up on the implants placed in this study, we concluded that those placed in regions of the maxillary sinuses previously grafted with homologous bone blocks had high long-term success rates and met the functional masticatory requirements.

12.
Int J Oral Maxillofac Implants ; 31(6): e155-e161, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27861655

RESUMO

PURPOSE: This study analyzed the use of bone marrow-derived mesenchymal stem cells and adipose tissue-derived stem cells, associated with xenograft, in appositional reconstructions in rabbit calvaria using histomorphometry. MATERIALS AND METHODS: Fifteen New Zealand rabbits, weighing 3.5 to 4.0 kg and aged between 10 and 12 months, were randomly divided into three groups. Appositional bone reconstruction situations were created in the calvaria of the animals using titanium cylinders, fitted with titanium occlusive caps. Bone decortication was performed to promote bleeding. Inside the cylinders, only xenograft was positioned in the control group (CG; n = 5); xenograft combined with mesenchymal bone marrow-derived stem cells was positioned in group 1 (G1; n = 5), and a xenograft combined with adult mesenchymal stem cells derived from adipose tissue was positioned in group 2 (G2; n = 5). After 56 days, all rabbits were euthanized and their parietal bones processed for histomorphometric analysis, and the following parameters were evaluated: newly formed bone; residual graft particles; soft tissue; vital bone titanium contact, also called the level of osseointegration; and the level of bone volume contained inside the cylinders, also called the internal bone volume. RESULTS: The histomorphometric study revealed the following for CG, G1, and G2: newly formed bone of 18.96% ± 9.00%, 27.88% ± 9.98%, and 22.32% ± 7.45%; residual graft particles of 28.43% ± 2.44%, 23.31% ± 3.11%, and 27.58% ± 3.98%; soft tissue of 52.61% ± 10.80%, 50.23% ± 8.72%, and 49.90% ± 8.76%; vital bone titanium contact of 4.98% ± 4.30%, 34.91% ± 7.82%, and 20.87% ± 5.43%; and internal bone volume of 88.36% ± 25.97%, 98.73% ± 19.05%, and 98.52% ± 19.87%, respectively. No statistical difference between groups for newly formed bone, residual graft particles, soft tissue, and internal bone volume (P > .05) were verified. CONCLUSION: Regarding vital bone titanium contact, it was observed that the use of bone marrow mesenchymal stem cells, when compared with the adipose mesenchymal stem cells, showed the highest level of osseointegration, and both of them obtained superior levels to the xenograft alone.


Assuntos
Tecido Adiposo/citologia , Células da Medula Óssea , Interface Osso-Implante/patologia , Implantes Dentários , Transplante de Células-Tronco Mesenquimais/métodos , Animais , Regeneração Óssea/fisiologia , Xenoenxertos , Osseointegração/fisiologia , Osteogênese/fisiologia , Osso Parietal/fisiologia , Coelhos , Procedimentos Cirúrgicos Reconstrutivos , Crânio/cirurgia , Titânio , Transplante Heterólogo
13.
ImplantNewsPerio ; 1(8): 1533-1541, nov.-dez. 2016. il
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-848537

RESUMO

A substituição de um elemento dental por um implante em pacientes que apresentam tecido gengival delgado gera uma preocupação devido à translucidez gengival, onde a coloração acinzentada do titânio pode levar ao fracasso estético do tratamento. Desta maneira, os implantes de zircônia se diferenciam principalmente por sua coloração clara, a qual se aproxima das características de cor da raiz, e por sua biocompatibilidade, além de possibilitarem a escolha do paciente por um tratamento totalmente livre de metal. Portanto, este relato de caso clínico demonstrou uma inovação técnica por meio da utilização de um implante confeccionado em zircônia para solução de um caso clínico de alta complexibilidade estética em uma paciente jovem, com fenótipo gengival delgado e alto grau de exigência estética. O caso foi finalizado com prótese cimentada e facetas metal free confeccionadas por meio de cerâmica injetada. Após a finalização do caso, concluiu-se que, apesar da desvantagem relacionada à sensibilidade técnica, o implante confeccionado em zircônia possibilitou a solução estética deste caso clínico de fenótipo gengival delgado, sem a necessidade de utilização de enxertos gengivais.


The replacement of a dental element in patients with thin gingival tissue generates a concern due to gingival translucency, where the titanium gray coloration can lead to failure of the treatment. Thus, the zirconia implants are distinguished primarily by their coloration and their biocompatibility, in addition to enabling the selection of a totally metal-free treatment. Therefore, this clinical report, showed an innovative technique using a zirconia implant in a clinical situation with high complex esthetic needs for in a young patient with thin gingival phenotype and high level of aesthetic requirement. The clinical case was concluded with cemented prosthesis and metal-free veneers made by pressed ceramics. After the end of the case, it was concluded that, despite the disadvantage related to the technical sensitivity, the zirconia implant provided an aesthetic solution of this clinical case of thin gingival phenotype, without the need of gingival grafts.


Assuntos
Humanos , Feminino , Cerâmica , Implantes Dentários para Um Único Dente , Prótese Dentária Fixada por Implante , Facetas Dentárias , Estética Dentária , Zircônio
14.
Cell Tissue Bank ; 17(3): 465-72, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27151133

RESUMO

It has been related in orthopedic surgeries the HLA sensitization. Thus, we evaluate if the use of fresh-frozen homologous bone (FFHB) for dental implant placement induce anti-HLA sensitization. Six patients were treated with FFHB corticocancellous block grafts. After 6 months, bone biopsies were harvested during implant placement to allow histomorphometric analysis. Vital mineralized tissue (VMT), non-vital mineralized tissue (NVMT) and non-mineralized tissue (NMT) were quantified histomorphometrically. Peripheral blood was collected from the patients before FFHB placement and 6 months after the surgery for anti-HLA analysis. The histomorphometric analysis showed the presence of VMT, NVMT and NMT in 45.56 ± 15.72 %, 14.16 ± 13.39 % and 40.29 ± 12.60 %, respectively. The baseline and 6 months postoperative CTs revealed bone thickness in the order of 5.66 ± 0.67 mm and 8.71 ± 1.52 mm (3.05 ± 1.39 mm). The anti-HLA analysis revealed that two of the six patients (33.3 %) became sensitized, however this was not associated with any FFHB incorporation loss (p > 0.05). A total of 24 implants were placed all of which were osseointegrated after 6 months. Although FFHB-related HLA sensitization does not appear to affect bone incorporation when treating insufficient bone thickness for implant placement, further follow-up is required to determine whether there is an association between HLA sensitization and long-term graft survival.


Assuntos
Transplante Ósseo , Implantes Dentários , Antígenos HLA/imunologia , Parafusos Ósseos , Humanos , Titânio/farmacologia , Tomografia Computadorizada por Raios X , Transplante Homólogo
15.
Contemp Clin Dent ; 7(1): 21-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27041895

RESUMO

OBJECTIVE: To evaluate bony reconstruction of the atrophic anterior maxilla using particulate grafts with or without autologous bone marrow aspirate concentrate (BMAC). MATERIALS AND METHODS: Eight patients with atrophy of the anterior maxilla due to teeth loss were selected and split into groups according to the type of material used: Control Group (CG) (n = 4) - particulate xenograft only and Test Group (TG) (n = 4) - a combination of particulate xenograft and BMAC. Both groups received a collagen membrane to cover the xenograft. After 4 months, during implant placement, a sample of bone was removed from the graft area using a 2 mm diameter trephine bur. The specimens were fixed and preserved for histomorphometric evaluation, which included the following parameters: Mineralized tissue (MT) and non-MT (NMT). Cone beam computed tomography was performed at 3 time intervals to measure bone thickness: (1) Before grafting, (2) 4 months and (3) 8 months postgrafting, using localized bone gain (mm) as the outcome variable. RESULTS: Tomographic analysis revealed bone gain in CG of 3.78 ± 1.35 mm and 4.34 ± 1.58 mm at 4 and 8 months, respectively. TG showed an increase of 3.79 ± 0.52 mm and 4.09 ± 1.33 mm after 4 and 8 months, respectively. Histomorphometric analysis revealed that, for CG, MT- and NMT-related values were 52.3% ± 16.78% and 47.70% ± 5.55%, respectively, whereas for TG, they were 65.04% ± 20.98% and 34.96 ± 10.38, respectively. CONCLUSION: Although radiographic bone gain appeared similar between the groups, the use of BMAC obtained via the BMAC(®) method revealed an increased mineralization trend in the anterior maxilla. It must be highlighted, however, that this is a preliminary study with a relatively small sample population and further studies with larger sample sizes are needed to verify these results.

16.
J Prosthodont ; 25(4): 335-40, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26633080

RESUMO

This clinical report describes how to achieve predictable outcomes for anterior teeth esthetic restorations with porcelain laminate veneers by associating the digital planning and design of the restoration with interim restorations. The previous digital smile design of the restoration eliminates the communication barrier with the patient and assists the clinician throughout patient treatment. Interim restorations (diagnostic mock-ups) further enhance communication with the patient and prevent unnecessary tooth reduction for conservative tooth preparation. Adequate communication between patient and clinician contributes to successful definitive restorations and patient satisfaction with the final esthetic outcome.


Assuntos
Porcelana Dentária , Facetas Dentárias , Preparo do Dente , Planejamento de Prótese Dentária , Estética Dentária , Humanos
17.
Int J Biomater ; 2015: 121286, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26543482

RESUMO

Purpose. To investigate the regenerative results obtained with the association of bone marrow aspirate concentrate using the Bone Marrow Aspirate Concentrate (BMAC) method to a xenogeneic bone graft (Bio-Oss) in sinus floor elevation. Materials and Methods. Using a randomized controlled study design in eight consecutive patients (age of 55.4 ± 9.2 years), 16 sinus floor lift procedures were performed with Bio-Oss alone (control group, CG, n = 8) or combined with bone marrow aspirate concentrate obtained via the BMAC method (test group, TG, n = 8). Six months after the grafting procedures, bone biopsies were harvested during implant placement and were analyzed by histomorphometry. Results. Histomorphometric analysis revealed a significantly higher amount (p < 0.05) of vital mineralized tissue in TG when compared to the CG (55.15 ± 20.91% and 27.30 ± 5.55%, resp.). For nonvital mineralized tissue, TG presented a statistically higher level of Bio-Oss resorption (p < 0.05) when compared with the CG (6.32 ± 12.03% and 22.79 ± 9.60%, resp.). Both groups (TG and CG) showed no significantly different levels (p > 0.05) of nonmineralized tissue (38.53 ± 13.08% and 49.90 ± 7.64%, resp.). Conclusion. The use of bone marrow concentrate obtained by BMAC method increased bone formation in sinus lift procedures.

18.
PróteseNews ; 2(3a): 39-50, jul.-set. 2015. ilus, tab
Artigo em Português | BBO - Odontologia | ID: biblio-853960

RESUMO

A manutenção das restaurações implantossuportadas depende do equilíbrio e da manutenção da homeostasia dos tecidos peri-implantares, sendo assim, dependente de uma oclusão ajustada a cada situação. Conceitos oclusais, assim como relacionados a restaurações unitárias, serão discutidos e apresentados por meio de casos clínicos.


Assuntos
Humanos , Adulto , Bruxismo , Implantação Dentária , Oclusão Dentária , Prótese Dentária Fixada por Implante , Placas Oclusais
19.
ImplantNews ; 12(5): 621-628, 2015. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-767512

RESUMO

Os avanços na Implantodontia em busca de resultados previsíveis que possam alinhar estética e função têm levado ao desenvolvimento de sistemas virtuais de planejamento e confecção de guias computadorizados. As cirurgias sem retalho promovem maior conforto aos pacientes, além de apresentarem melhores resultados na manutenção da perda óssea. Entretanto, alguns sistemas ainda apresentam limitações, o que pode levar a diferenças entre o planejamento e o resultado final. Este trabalho teve como objetivo apresentar um caso clínico de instalação de implante com ativação imediata, através do sistema de tecnologia digital de alta precisão DIOnavi (Busan, Coreia). Através de imagens obtidas em tomografias computadorizadas e escaneamento intraoral, o planejamento foi realizado através de um software e um guia cirúrgico, obtido a partir de impressão 3D. Após a instalação do implante, foi instalado um abutment personalizado em titânio e uma coroa provisória cimentada, ambos previamente preparados. O sistema se mostrou eficiente quanto à precisão dos instrumentos e componentes, podendo ser aplicado em diversas situações clínicas, em vista das características.


Advances on implant dentistry aiming predictable results on esthetics and function has led to the development of virtual planning systems and fabrication of computerized surgical guides. Flapless procedures provide more comfort and better results regarding bone loss preservation. However, some systems still have limitations, which can result on differences when the initial and final outcomes are compared. This paper presents a clinical case of immediate implant placement and function using the high-precision digital technology system (DIOnavi, Busan Korea). By means of CBCT and intra-oral scanning, a computer program was used to idealize the surgical guide, with the digital information sent to a 3D-printing machine. After implant placement, the pre-fabricated customized titanium abutment and the cement-retained provisional crown were delivered. This system demonstrated effi ciency related to precision of surgical and prosthetic components and can be recommended for several clinical situations.


Assuntos
Humanos , Feminino , Adulto , Implantes Dentários , Osseointegração , Cirurgia Assistida por Computador
20.
ImplantNews ; 12(3): 357-363, 2015. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-759662

RESUMO

A Odontologia digital proporciona ao clínico novas possibilidades para planejar e fabricar as restaurações utilizadas na clínica diária. O planejamento virtual das restaurações é uma excelente ferramenta para prever o resultado final do tratamento, proporcionando maior segurança para o clínico e para o paciente. Este trabalho teve como objetivo descrever os passos do fluxo de trabalho necessário para a moldagem intraoral digital, planejamento virtual da restauração e fabricação pelo método CAD/CAM com o auxílio de um caso clínico em que o primeiro pré-molar superior foi restaurado. As arcadas digitalizadas foram utilizadas para planejar virtualmente as dimensões e os aspectos oclusais e estéticos da restauração, para a fabricação de modelo fresado das arcadas dentárias e para a posterior confecção da restauração com o auxílio do método CAD/CAM. Devido à digitalização de todos os passos até a confecção da prótese, a comunicação com o paciente foi facilitada, possibilitando a visualização adequada do proposto para a restauração. Pôde-se concluir que, uma vez dominado o uso da tecnologia digital, as restaurações podem ser consistentemente planejadas e fabricadas com o auxílio dos avançados métodos de fabricação atualmente disponíveis, levando a resultados altamente previsíveis e satisfatórios clinicamente.


Digital dentistry allows clinicians to design and fabricate predictable restorations for daily clinics. Virtual design of the restoration is an excellent tool to predict the fi nal outcome of the rehabilitation by the clinician and the patient. This study will describe the workflow for digital fabrication of dental restorations, including the digital intraoral impression, virtual design, and CAD/CAM fabrication of the restoration of a first maxillary premolar. The digital tooth arches were used to virtually plan the dimensions and the occlusal and esthetic aspects of the restoration. Milled dental models were also fabricated. Patient communication was improved by using the virtual design of the final restoration. It can be concluded that digital dentistry can allow the fabrication of consistent and highly predictable dental restorations.


Assuntos
Humanos , Masculino , Adulto , Técnica de Moldagem Odontológica , Porcelana Dentária , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante
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