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1.
Int J Periodontics Restorative Dent ; 41(5146): 217-224, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33819326

RESUMO

One of the chronic problems with traditional cement or screw retention of crowns to implants is the development of biologic and technical complications, including soft tissue complications, bone loss, screw loosening, loss of retention, and veneering material fractures. The purpose of this case series report is to document preliminary results, specifically crown retention, using a friction-fit connection of crown to abutment. A sample composed of patients who had one or more implants restored between July 1, 2019, and October 30, 2019, were enrolled in this retrospective case-control series. Each patient had their crown connected to the implant abutment using a friction-fit system. Patients were seen for routine follow-up for documentation of crown retention, and 24 crowns were followed. After 6 months of follow-up, 100% of the crowns retained retention and did not become loose under normal masticatory function. The use of a friction-fit connection provided excellent retention of the crown to the abutment over the 6-month follow-up period.


Assuntos
Coroas , Cimentos Dentários , Parafusos Ósseos , Dente Suporte , Prótese Dentária Fixada por Implante , Fricção , Humanos , Estudos Retrospectivos
2.
Artigo em Inglês | MEDLINE | ID: mdl-33819330

RESUMO

Immediate implant placement in molar sites has the potential to improve the patient experience by reducing the number of appointments and the overall treatment time. However, primary closure remains a technical challenge. The present prospective case series evaluated the soft tissue contours and the radiographic bone levels of 17 patients who received immediate implants in molar sites and a digitally customized CAD/CAM sealing socket abutment. At the 2-year follow-up, the mean buccal tissue contours at the most coronal portion were reduced horizontally by an average of 1 mm at 1, 2, 3, and 4 mm below the gingival margin. A mean 0.53-mm apical migration of the gingival margin was seen, and the mean interproximal bone level at the 2-year follow-up was 0.89 mm. The use of CAD/CAM-generated customized healing abutments in immediate molar sites yielded minimal hard and soft tissue changes at the 2-year follow-up.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Dente Suporte , Implantação Dentária Endo-Óssea , Humanos , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Estudos Prospectivos , Alvéolo Dental/cirurgia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33819335

RESUMO

This study aimed to evaluate facial peri-implant tissue dimensions for implants connected to either convex or concave final abutments. Patients (n = 28) were randomly allocated to receive a single implant with an abutment of either convex (Group CX) or concave (Group CV) emergence shape. Twelve months after implant placement, CBCT scans were taken and reference points were identified: first visible bone-to-implant contact, implant shoulder (IS), bone crest (BC), and marginal mucosal level (MML). Mucosal thickness was evaluated at the level of IS (MT1), above the level of BC (MT2), and at the mid-distance of BC-MML (MT3). The mean total vertical peri-implant mucosa height was 3.26 ± 0.77 mm for Group CX and 3.70 ± 0.99 mm for Group CV (P = .23). The mean vertical peri-implant mucosa height below the bone crest was 0.62 ± 0.57 mm for Group CX and 1.26 ± 0.95 mm for Group CV (P = .04). Group CV had greater mean MT2 (4.09 ± 0.72 mm vs 3.36 ± 0.81 mm; P = .02) and MT3 (2.81 ± 0.66 mm vs 2.03 ± 0.60 mm; P = .005) compared to Group CX. Abutment macrodesign may have an effect on vertical and horizontal peri-implant tissue dimensions.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Tomografia Computadorizada de Feixe Cônico Espiral , Coroas , Dente Suporte , Implantação Dentária Endo-Óssea , Humanos , Membrana Mucosa
4.
Compend Contin Educ Dent ; 42(2): 86-92, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33735581

RESUMO

A customized healing abutment may be used to create a soft-tissue emergence profile that is more realistic looking compared to when a commercially available stock healing abutment is used. This article describes a workflow for the design and fabrication of a customized healing abutment based on the anticipated final restoration. Utilizing dental CAD/CAM software, a dynamic navigation virtual treatment plan, and 3D printing, this workflow can be accomplished in an all-digital, presurgical fashion.


Assuntos
Dente Suporte , Implantes Dentários , Desenho Assistido por Computador , Assistência Odontológica , Humanos , Fluxo de Trabalho
5.
Prim Dent J ; 10(1): 96-100, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33722138

RESUMO

Fabricating a crown for a tooth that serves as an abutment for an existing removable partial denture (RPD) provides a restorative challenge. Typically, the compromised tooth requiring an extra-coronal restoration is initially restored. It is followed by the construction of a new RPD that accurately fits the restored abutment. An increasingly common scenario is that the existing RPD is deemed clinically acceptable and, therefore, does not require replacing. This results in the clinical dilemma of fabricating a crown for an abutment tooth, while also considering how the contours of this restoration will fit with the RPD's clasps and rests. This can be achieved through the use of various techniques subdivided into indirect, direct and combined indirect-direct. This article describes an indirect-direct technique used in conjunction with the functionally generated path technique to achieve accurately a stable record of the patient's occlusion in the fabrication of a new crown to an existing RPD.


Assuntos
Prótese Parcial Removível , Dente , Coroas , Dente Suporte , Humanos
6.
Am J Dent ; 34(1): 39-43, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33544987

RESUMO

PURPOSE: To characterize the color outcome on different zirconia types of various colored titanium backgrounds produced with a newly developed anodized technique. METHODS: Blue, green, pink and gold-colored titanium backgrounds were produced via different anodization voltage values. Non-anodized grey colored titanium was used as a control. A total of 40 disc-shaped zirconia specimens were prepared from four different zirconia types (Cercon HT, Noritake Alliance, Prettau, and Ice Zirkon). The zirconia specimens were placed on different titanium backgrounds to evaluate color differences (ΔE) by recording the L, a and b values. ΔE, ΔL, Δa and Δb values were compared for different titanium backgrounds and zirconia types. To analyze the results, repeated measures ANOVA and Bonferroni adjustments for pairwise comparison were used (α= 0.05). RESULTS: The Cercon HT group had the highest ΔE value, while the Noritake group showed the lowest ΔE value (P< 0.05). ΔL, Δa and Δb values showed significant color changes depending on the color of the titanium background, the sintering procedure of zirconia and the zirconia ingredients (P< 0.05). CLINICAL SIGNIFICANCE: Anodized titanium abutments may improve color in esthetic regions when a ceramic abutment cannot be used. The study showed that the gold-colored titanium produced via anodization was better than other colors at producing a tooth-like color for implant-supported zirconia restorations. Also, by adjusting the color of zirconia restorations, the effect of the background could be altered using the zirconia sintering protocol.


Assuntos
Dente Suporte , Titânio , Cor , Teste de Materiais , Zircônio
7.
Int J Oral Maxillofac Implants ; 36(1): 47-54, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600522

RESUMO

PURPOSE: The aim of this in vitro study was to evaluate the mechanical behavior regarding dynamic fatigue of different implant-abutment connections and the unitary indication of abutments for all regions of the mouth. MATERIALS AND METHODS: This experimental study developed according to international standards (ISO 14801:2007) was performed using five types of implants and abutments: G1-external hex smart implant and 17-degree universal abutment (EHS); G2-cortical external hex implant and 17-degree universal abutment (EHTi); G3-internal hex implant and 30-degree universal abutment (IH); G4-Morse taper implant (11.5 degrees) and 17-degree universal abutment (MT11.5); and G5- Morse taper implant (16 degrees) and 30-degree universal abutment (MT16). A 15-Hz cyclic loading was applied to the specimens with the maximum number of cycles set at 5 × 106. Success was defined when three samples supported 5 million cycles without failure. The maximum load supported from each group after dynamic loading was recorded. The Spearman correlation and the Lowess method were used to analyze the correlation between the number of cycles and the applied load, and the Kruskal-Wallis and Nemenyi tests were used for comparison between the abutments when reaching 5 million cycles. RESULTS: There was a negative correlation (r < 0.00) and significant difference (P < .05) between the number of cycles and the load for each type of implant and abutment. The load values supported by each group after cyclic loading to achieve 5 million cycles were as follows: EHS, 225 N; EHTi, 215 N; IH, 220 N; MT11.5, 210 N; and MT16, 240 N. The MT16 implant-abutment assembly presented a significantly higher load (P = .024) than the MT11.5 implant-abutment assembly. CONCLUSION: All implant-abutment connections investigated in this study resisted average occlusal force values reported as acceptable in the literature and may be indicated for any region of the mouth.


Assuntos
Coroas , Projeto do Implante Dentário-Pivô , Dente Suporte , Projeto do Implante Dentário-Pivô/efeitos adversos , Análise do Estresse Dentário , Fadiga , Humanos , Teste de Materiais , Reprodutibilidade dos Testes
8.
J Prosthet Dent ; 125(4): 682.e1-682.e10, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33551133

RESUMO

STATEMENT OF PROBLEM: Tissue-level internal connection implants are widely used, but the difference in abutment screw stability because of the shoulder coverage formed by the contact between the shoulder of the implant collar and the abutment remains unclear. PURPOSE: The purpose of this finite element analysis (FEA) and in vitro study was to investigate stress distribution and abutment screw stability as per the difference in shoulder coverage of the abutment in tissue-level internal connection implants. MATERIAL AND METHODS: Abutments were designed in 3 groups as per the shoulder coverage of the implant collar, yielding complete coverage (complete group), half coverage (half group), no coverage (no group) groups. In the FEA, a tightening torque of 30.0 Ncm was applied to the abutment screw, a force of 250 N was applied to the crown at a 30-degree angle, and the von Mises stresses and the stress distribution patterns were evaluated. In the in vitro study, the groups were tested (n=12). A total of 200 000 cyclic loads were applied at 250 N, 14 Hz, and at a 30-degree angle. Removal torque values and scanning electron microscopy (SEM) images were assessed. Removal torque values were analyzed by ANOVA and paired t tests. RESULTS: The maximum von Mises stress of the abutment screw was the lowest in the complete group, slightly higher in the half group, and highest in the no group. High stresses were concentrated in 1 location in the implant abutment connection area of the no group. The removal torque values after loading were significantly lower in the no group than in the complete group (P=.047). The SEM images revealed concentrated structural loss and wear in 1 location of the no group. CONCLUSIONS: FEA and in vitro studies confirmed that the shoulder coverage of the abutment in the tissue-level internal connection implant helped improve screw stability. Cyclic loading reduced the removal torque of the abutment screw.


Assuntos
Projeto do Implante Dentário-Pivô , Implantes Dentários , Parafusos Ósseos , Dente Suporte , Análise do Estresse Dentário , Análise de Elementos Finitos , Torque
9.
Int J Oral Maxillofac Implants ; 36(1): 55-58, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600523

RESUMO

PURPOSE: The purpose of this in vitro study was to evaluate the load-to-fracture values of cement-, screw-, and multiscrew-retained abutments for implant-supported fixed partial dentures (FPDs). MATERIALS AND METHODS: Thirty-six implants with a diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based upon the variations on abutment design, the FPDs were divided into three categories as follows: cement-retained, screw-retained, and multiunit screw-retained abutments. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with a load of 70 N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done, and fracture-load values were recorded as means and corresponding standard deviations; group comparisons were done using one-way analysis of variance and Tukey post hoc tests. A P value < .01 was considered as an indicator of statistical significance. RESULTS: The fracture-load values for cement-, screw-, and multiunit screw-retained abutments were 2,109.2 ± 139.6 N, 3,888.8 ± 70 N, and 3,319.4 ± 218.9 N, respectively. The load-to-fracture values were significantly higher in screw-retained abutments (3,888.8 ± 70 N; P < .001) than in cement-retained (2,109.2 ± 139.6 N) and multiunit screw-retained abutments (3,319.4 ± 218.9 N). CONCLUSION: Screw-retained implant-supported FPDs withstand higher occlusal forces compared with cement- and multiunit screw-based retention techniques. However, the results should be cautiously interpreted, as they were based on a relatively small sample size.


Assuntos
Implantes Dentários , Falha de Restauração Dentária , Parafusos Ósseos , Dente Suporte , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Prótese Parcial Fixa , Humanos , Teste de Materiais
10.
Int J Oral Maxillofac Implants ; 36(1): 68-74, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600525

RESUMO

PURPOSE: The aim of this study was to test in vitro the bacterial microleakage at the Morse taper implant-abutment connection with switched platform subjected to functional load and thermocycling. MATERIALS AND METHODS: A total of 48 Morse taper implant-abutment connections with switched platforms (12 implants per group) were used. The abutments were attached to implants and presented in four groups: group 1, control; group 2, subjected to thermocycling; group 3, subjected to cyclic compressive loading; and group 4, subjected to thermocycling and cyclic compressive loading. All groups were then inoculated in Eppendorf tubes including three types of bacterial suspensions: Enterococcus faecalis, Staphylococcus aureus, and Pseudomonas aeruginosa for 7 and 14 days to detect possibility of bacterial infiltration from outside to the internal chamber of the implant. RESULTS: Implants not exposed to cyclic loading and thermocycling (group 1) and those exposed to thermocycling (group 2) exhibited no infiltration of E faecalis, S aureus, and P aeruginosa from outside to the inner chamber of the implant, while infiltration of P aeruginosa was only observed in implants subjected to cyclic loading only (group 3) and those subjected to cyclic loading in conjunction with thermocycling (group 4). CONCLUSION: Microbial leakage at the implant-abutment connection is influenced by the applied load alone and in combination with thermocycling; however, E faecalis and S aureus did not leak at the implant-abutment connection even under these circumstances. Only P aeruginosa infiltrated inside the implant-abutment connection, which might be caused by its swarming motility.


Assuntos
Implantes Dentários , Infiltração Dentária , Dente Suporte , Projeto do Implante Dentário-Pivô/efeitos adversos , Implantes Dentários/efeitos adversos , Infiltração Dentária/etiologia , Enterococcus faecalis , Humanos , Teste de Materiais
11.
Int J Oral Maxillofac Implants ; 36(1): 177-181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600539

RESUMO

PURPOSE: Abutment screw loosening is a frequently encountered prosthetic complication in implant dentistry. Due to the detection of preload loss soon after initial torque application, abutment screw retightening 10 minutes after initial tightening has been recommended. The aim of this clinical study was to assess preload maintenance in the abutment screws of single posterior implants after 1 month of use by employing screw-cement-retained prostheses and a clinical assessing method, with the ultimate goal of helping to improve the clinical workflow of implant-based restorations. MATERIALS AND METHODS: In total, 158 patients treated using three implant systems were divided randomly into two groups in which abutment screws were and were not retightened, respectively, approximately 10 minutes after initial torque application. Screw-cement-retained prostheses, which permitted the assessment of abutment screw preload maintenance and screw retightening after 1 month of use, were used. Preload loss at 1 month was defined as the failure to achieve the torque recommended for the abutment screws after 90-degree clockwise rotation of the screwdriver. The data were analyzed using binary logistic regression, with a significance level of P ≤ .05. RESULTS: No preload loss was detected 10 minutes after initial screw tightening. Preload loss was detected in 16 (10.13%) cases at 1 month after initial tightening, with no significant difference according to the implant system used, the presence or absence of retightening at 10 minutes after initial tightening, or implant position (premolar or molar). CONCLUSION: Under the experimental conditions of this study, abutment screws in some bone-level, internal tapered-connection, platform-switching implant systems showed preload loss at 1 month after abutment placement for single posterior implant-based restorations, regardless of implant system or whether abutment screws had been retightened 10 minutes after abutment placement, or implant position (premolar or molar). It is necessary to retorque the abutment screws 1 month after initial torque. The screw-cement-retained prostheses used in this study permit abutment screw retightening at that time and have advantages over traditional methods.


Assuntos
Dente Suporte , Implantes Dentários , Parafusos Ósseos , Projeto do Implante Dentário-Pivô , Análise do Estresse Dentário , Humanos , Manutenção , Torque
12.
Niger J Clin Pract ; 24(2): 220-224, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33605912

RESUMO

Objective: The objective was to in-vitro evaluate the mode of failure of abutments supporting fixed partial dentures (FPDs) via different retention techniques. Materials and Methods: Thirty-six implants with diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based on the variations on abutment's design, the FPDs were divided into three groups: Group A is cement-based retention; Group B is screw-based retention; and Group C is multiunit screw-based retention. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with the load of 70N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done and fracture-load values were recorded as means and corresponding standard deviations; and group comparisons were done using one-way analysis of variance and Tukey's post hoc tests. A P value below 0.01 was nominated as an indicator of statistical significance. Results: In total, 36 samples (12 implant-abutment connections per group) were assessed. Abutment bending was observed in 6 (50%), 6 (50%) and 6 (50%) samples in groups A, B and C, respectively. De-attachment of the FPD form the abutment occurred in 5 (41.7%) and 5 (41.7%) samples in groups A and C, respectively. Screw fracture and fracture of FPD at the connector side occurred in 1 (8.3%) and 1 (8.3%) sample in groups A and C, correspondingly. Failure of the FPD was more often encountered in groups A (100%) and C (100%), compared to group B (50%). Conclusion: All abutments underwent failures under cyclic loading with abutment bending being the most common failure mode. Cement- and multi-screw-supported abutments fail more often than screw-supported abutments.


Assuntos
Prótese Parcial Fixa , Dente , Dente Suporte , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Análise do Estresse Dentário , Humanos , Mastigação , Teste de Materiais
13.
Clin Implant Dent Relat Res ; 23(2): 216-227, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33533116

RESUMO

BACKGROUND: Digitally customized abutments are increasingly used in contemporary implant prosthodontics. PURPOSE: This systematic review and meta-analysis aimed at comparing the peri-implant clinical outcomes of digitally customized and prefabricated abutments. MATERIALS AND METHODS: The search strategies included electronic databases (PubMed, Embase, Scopus, and Cochrane clinical trials database) and related journals up to September, 2020. A qualitative and quantitative synthesis was performed on data extracted from the included studies. RESULTS: Three RCTs (number of patients = 120; number of dental implants = 120) and two prospective cohort studies (number of patients = 144; number of dental implants = 144) with one to three-year follow-up periods were included. The quantitative analyses did not demonstrate a significant difference between digitally customized and prefabricated abutments for peri-implant pocket depth (P = 0.62), plaque index (P = 0.67), bleeding on probing (P = 0.43), keratinized mucosa width (P = 0.75), and pink aesthetic score (P = 0.30) at one-year follow-up visit. The qualitative analyses for marginal bone level change, calculus accumulation, implant survival rate, implant success rate, white aesthetic score, and patient-reported outcomes did not demonstrate a significant difference between two groups during 1 to 3-year follow-up visits. CONCLUSION: The current data do not provide evidence of significant differences between two abutment fabrication methods in terms of peri-implant clinical outcomes within short-term period (CRD42020170807).


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Dente Suporte , Estética Dentária , Humanos , Estudos Prospectivos
14.
Clin Implant Dent Relat Res ; 23(2): 197-207, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33543600

RESUMO

BACKGROUND: Shifts in microbial communities are common over time, but they may disturb the host-microbiome homeostasis and result in inflammation of the peri-implant issues if a dysbiotic biofilm is established. PURPOSE: Considering that different oral substrate surfaces may have a relevant impact on the microbial adhesion and colonization, the aim of this study was to investigate the microbial communities of the biofilm formed on single-implant restorations using titanium or zirconia abutments and how they correlate with clinical parameters after 3-years of implant loading. MATERIALS AND METHODS: MiSeq sequencing of 16S rRNA amplicons was used to characterize the oral biofilms of individuals (n = 20) who were sampled longitudinally during 3 years of masticatory loading. Bioinformatics analysis and multivariate statistical analysis were used to evaluate the microbial diversity and clinical outcomes. RESULTS: Microbiomes of both abutment materials presented high alpha-diversity indices during all the experimental period, irrespective of the time of sampling. Microbial communities of titanium and zirconia were quite different over time, differing about 30% after 3 years of functional loading. Similarity of microbiomes between tested abutments and contralateral teeth was also low, ranging between 45% and 50% after 3 years of investigation. Periodontal pathogens commonly associated with peri-implantitis were found in both groups. Furthermore, both abutment materials presented strong correlations of diversity indices and microbial taxa with clinical outcomes. CONCLUSIONS: The type of abutment substrate significantly influenced diversity and clustering of communities during 3 years of functional loading. The time of sampling had no effect on the variables. Large correlations were found between microbial findings and clinical outcomes.


Assuntos
Implantes Dentários , Microbiota , Dente Suporte , Projeto do Implante Dentário-Pivô , Humanos , Estudos Prospectivos , RNA Ribossômico 16S/genética , Titânio , Zircônio
15.
J Prosthet Dent ; 125(4): 683.e1-683.e8, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33583618

RESUMO

STATEMENT OF PROBLEM: Although luting space is related to the marginal fit of indirect restorations, information on its influence on the marginal fit and tensile strength of zirconia abutments bonded to titanium bases is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the influence of luting space on the marginal discrepancy and tensile strength of zirconia abutments bonded to a titanium base after dynamic loading. MATERIAL AND METHODS: Ninety implant replicas were embedded in resin blocks to attach 4-mm-high titanium luting bases. Zirconia abutments (Ceramill Zolid FX) were fabricated with different internal luting spaces: 25 µm (G25), 50 µm (G50), or 75 µm (G75). The zirconia abutments were cemented on the titanium bases by using a resin cement (Panavia F 2.0) under a constant load of 20 N. The marginal discrepancy and internal fit of 10 random specimens from each group were evaluated with a stereoscopic microscope at ×50 magnification. The remaining specimens were submitted to the tensile strength test in which half were evaluated after dynamic loading (1.2 million cycles of 200 N at 3.8 Hz) in a mechanical fatigue machine. The tensile strength test was performed using a pullout apparatus coupled to a universal testing machine at a crosshead speed of 0.5 mm/min. The mode of failure was determined by observation at ×50 magnification under a stereomicroscope and classified into adhesive or mixed. The groups were compared by using 2-way ANOVA and the Tukey HSD test (α=.05). RESULTS: Increase in the luting space did not influence the marginal discrepancy (P>.05). All zirconia abutments exhibited lower pullout strength after fatigue simulation (P<.05). G75 demonstrated lower tensile strength than G25 and G50 before and after loading (P<.05). Most failures were adhesive at the zirconia-cement interface. CONCLUSIONS: The increase of the luting space to 75 µm did not influence marginal discrepancy; however, it reduced the tensile strength of a zirconia abutment bonded to a titanium base.


Assuntos
Dente Suporte , Colagem Dentária , Análise do Estresse Dentário , Teste de Materiais , Propriedades de Superfície , Resistência à Tração , Titânio , Zircônio
16.
Artigo em Inglês | MEDLINE | ID: mdl-33528454

RESUMO

Implant position and soft tissue thickness have a direct influence on implant abutment design. The goal is to place the implant in the optimal spatial position to maintain the adjacent bone and soft tissues. When the implant is not placed ideally, prosthetic variations to abutments and restorations must be made, which may limit the esthetic appearance of the final restoration or alter the biologic environment of the bone and tissues. This article illustrates and explains the effect of different implant positions on the emergence profile design in order to assist the clinician with treatment planning and selection in various clinical situations.


Assuntos
Dente Suporte , Implantes Dentários , Estética Dentária , Humanos , Planejamento de Assistência ao Paciente
17.
Artigo em Inglês | MEDLINE | ID: mdl-33528462

RESUMO

Conical retention with antirotational features (Acuris abutment) has been recently proposed for restorations of healed single implants. The conometric abutments use the retentive force of the coping-abutment system to retain the prosthetic crown without the use of cement or screws. This retentive force must be overcome to obtain detachment of the relined provisional crown in immediate restorations. The present article describes the use of digital scanning technology to virtually plan computer-guided implant placement and restoration with conical indexed abutments in postextraction sites. Importing the scan data of both matrix and patrix abutments that are seated on the definitive cast into the computer-aided design software provides a workflow to preoperatively mill a crown that perfectly fits the abutment into the postextraction site. This technique simplifies the provisional crown relining onto the conometric indexed abutment and reduces the intraoperative time.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Desenho Assistido por Computador , Coroas , Dente Suporte , Projeto do Implante Dentário-Pivô , Humanos , Tecnologia
18.
Int J Prosthodont ; 34(1): 88-100, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33570524

RESUMO

Emerging evidence implies significant interrelations between the condition of the peri-implant tissues and the implant-abutment-prosthesis complex. A new paradigm for studying the peri-implant tissues in close interrelation with the implant-abutment-prosthesis complex in the presence of the oral biofilm is essential. The aims of this paper are to introduce the concept of the "implant supracrestal complex" (ISC) and to describe the critical elements that define it as a unique anatomical and functional system of human tissues, mechanical components, and oral bacteria/biofilm. This paper reviews recent evidence to identify the impact of design features on short-term clinical outcomes and long-term health of the peri-implant bone and soft tissues. Prosthetic-driven implant placement is a prerequisite for proper ISC design, which in turn can indirectly influence the structure and dimensions of the peri-implant soft tissues. Design features of the implant-prosthesis-abutment complex, such as the emergence profile, emergence angle, and cervical margin, as well as the design of the implant-abutment and abutment-prosthesis junctions and their locations in relation to the tissues of the ISC, can have a significant impact on the maintenance of stable and healthy peri-implant tissues in the long term.


Assuntos
Dente Suporte , Implantes Dentários , Projeto do Implante Dentário-Pivô , Humanos
19.
J Esthet Restor Dent ; 33(1): 173-184, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33470498

RESUMO

OBJECTIVE: Emergence profile design is important for stable peri-implant tissues and esthetically pleasing results with dental implant restorations, influenced by factors, such as, implant position and surrounding soft tissues. Different aspects of the emergence profile have been described, but detailed explanations of the different zones and corresponding designs are missing. This article describes the esthetic biological contour concept (EBC), differentiating important areas of the emergence profile and recommending particular designs for those zones. OVERVIEW: The EBC concept considers specific parameters for proper design of the emergence profile of implant-supported restorations. Understanding the different zones of the emergence profile and their relation to factors like implant position, implant design, and soft tissue thickness is key. The suggested guidelines are geared toward providing more stable and esthetic results when restoring dental implants in the esthetic zone. CONCLUSIONS: Each of the zones described in the EBC concept have a specific function in the design of the emergence profile. Understanding the importance and specific design features of the EBC zones facilitates esthetic and biologically sound treatment outcomes with interim and definitive implant restorations. CLINICAL SIGNIFICANCE: Proper emergence profile design supports esthetic outcomes and provides favorable biological response to implant-supported restorations.


Assuntos
Implantes Dentários , Prótese Dentária Fixada por Implante , Dente Suporte , Estética Dentária
20.
J Prosthodont ; 30(4): 363-366, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33438256

RESUMO

This technique article describes an efficient, cost effective and time saving procedure using the fractured abutment as a custom cast post and core when an overdenture abutment is fractured and attempts to retrieve the fractured segment fail.


Assuntos
Projeto do Implante Dentário-Pivô , Implantes Dentários , Dente Suporte , Prótese Dentária Fixada por Implante , Revestimento de Dentadura
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