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1.
Braz. j. oral sci ; 21: e224977, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1354723

RESUMO

Aim: This study aims to evaluate the clinical assessment results of periimplant soft tissue with morse taper (internal abutment connection). Methods: The study was conducted using a rapid review by searching the articles from PubMed NCBI and Cochrane by using keywords. All articles were selected by the year, duplication, title, abstract, full-text, and finally, all selected articles were processed for final review. Following clinical parameters were included; Periimplant Probing Pocket Depth (PPD), Plaque Score (PS), modified Plaque Index (mPI), Mucosal Thickness (MTh), Gingival Height (GH), periimplant mucosal zenith, Pink Esthetic Score (PES), Bleeding On Probing (BOP), Sulcus Bleeding Index (SBI), and modified Gingival Index (mGI). Results: 9 selected articles were obtained from the initial literature searching count of 70 articles. The overall samples included 326 morse taper implants. Based on the evaluation, 3 out of 4 articles reported pocket depth < 4 mm, no bleeding was reported in 2 out of 4 articles. 4 out of 4 articles reported low plaque accumulation, low soft tissue recession was reported in 3 out of 3 articles, and 4 out of 4 articles reported acceptable PES values. Conclusion: The evaluations indicate that the morse taper (internal abutment connection) has favorable assessment results based on various clinical parameters


Assuntos
Implantes Dentários , Dente Suporte , Lesões dos Tecidos Moles , Projeto do Implante Dentário-Pivô , Gengiva , Mucosa Bucal
2.
Int J Prosthodont ; 35(4): 387-395, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36125867

RESUMO

PURPOSE: To compare the clinical outcomes of single implants with titanium (Ti) or zirconia (Zr) abutments after up to 5 years in function. MATERIALS AND METHODS: This study was a retrospective analysis on single implants with screw-retained abutments (Zr or Ti) covered with porcelain veneer placed between 2011 and 2013 at one referral specialist clinic. Clinical data from patient records were collected from 132 patients and 174 implants. Technical complications such as fractures, chipping, and abutment screw loosening were registered. Radiographs were analyzed comparing both annual bone loss and accumulated bone loss at 5 years. In 57 patients with 85 implants, the values of accumulated bone loss at 5 years were compared to baseline. RESULTS: Technical complications occurred in 16 (9%) of the implants, most often during the first year. The following complications were found: fracture of the abutment (n = 1); loosening of the abutment screws (n = 5); and chipping of the porcelain veneer (n = 11). Ti abutments had more complications than Zr abutments (79%). Of all the implants, 45% had an annual bone loss ranging between 0.05 and 2.15 mm, and 59% had an accumulated bone loss at 5 years ranging between 0.05 and 4.25 mm. Zr abutments had a statistically significantly higher amount of yearly and accumulated bone loss at 5 years. CONCLUSION: Abutment material affected marginal bone loss. The Zr group displayed statistically more bone loss both yearly and after 5 years compared to the Ti group. Technical complications were not affected by abutment material but were affected by age of the patient.


Assuntos
Porcelana Dentária , Titânio , Coroas , Dente Suporte , Materiais Dentários , Seguimentos , Humanos , Estudos Retrospectivos , Zircônio
3.
Int J Prosthodont ; 35(4): 560-566, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36125878

RESUMO

Titanium oral implants are still considered "state of the art" in implant dentistry, with well-documented survival rates. However, their grayish color and high prevalence of peri-implant infections have resulted in controversial discussion as to whether tooth-like-colored, metal-free zirconia ceramic implants provide sufficient potential to be considered equal regarding treatment outcomes. The present position paper has been composed upon invitation by the European Association of Osseointegration in order to provide an update on the current level of evidence regarding zirconia implants in clinical trials. To date, most available and scientifically documented zirconia implant systems are one-piece implants that require an experienced surgeon and prosthodontist due to the restricted flexibility in cases of compromised angulation or vertical positioning. Taking this limitation into account, there is evidence of a comparable outcome for one-piece zirconia implants compared to titanium implants for the fixed replacement of one to three missing teeth. In contrast, currently available clinical data evaluating two-piece zirconia implants with an adhesively bonded implant-abutment interface suggest an inferior outcome. Data evaluating the clinical applicability of screw-retained solutions, even if revealing sufficient fracture resistance in laboratory investigations, are still missing. High survival rates were reported for all-ceramic reconstructions supported by zirconia implants, but with increased technical complications; ie, fractures of the ceramic veneer in the case of bilayered restorations. Sufficient clinical evidence for recommending monolithic approaches is limited to single crowns.


Assuntos
Dente Suporte , Titânio , Coroas , Zircônio
4.
Artigo em Inglês | MEDLINE | ID: mdl-36044695

RESUMO

The present study evaluated the 2-year changes in soft tissue width after implant placement in healed sites, using two different methodologies to obtain tissue healing: preformed and anatomical abutment caps for customized healing (test) vs conventional healing abutments (control). The null hypothesis was that there would be no difference between the test group and the control group. Patients who suffered from a single-tooth edentulous area in the premolar/molar region were included. Both the standard abutments and the preformed and anatomical abutment caps were immediately screwed on the implants. The final crown restoration was fabricated 3 months later. Primary outcomes (changes in the alveolar soft tissue ridge) and secondary outcomes (testing adverse events and measuring implant/prosthesis survival) were evaluated. Thirty-nine patients (24 women) with a mean age of 57.7 ± 7.1 years (range: 42.6 to 72.8 years) were included. Alveolar widths in both groups showed significant increases from baseline to the 3-month follow-up, with augmentations of 3.6 ± 0.7 mm for the test group and 1.1 ± 0.9 mm for the control group. The gain in soft tissue appeared to be statistically different between the two groups (P < .0001). Contrarily, any subsequent change in width from 3 months to 2 years was negligible and insignificant (< 0.33 mm for both groups). The technique described in the present study encourages the potential for alternative healing based on the guided soft tissue concept, as it either eliminated the need for second-stage surgery or it reduced step-by-step peri-implant soft tissue conditioning, obtaining a tissue contour immediately very similar to that of a final prosthesis.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Boca Edêntula , Estudos de Casos e Controles , Dente Suporte , Implantação Dentária Endóssea/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
BMC Oral Health ; 22(1): 362, 2022 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-36008833

RESUMO

BACKGROUND: Sealing materials are used to fill abutment screw access holes (SAH) to prevent microleakage and protect the central screws in oral implant restoration. However, thus far, no consensus has been reached on sealing material selection. In this study, a comparison of the sealing efficacy and removal convenience of different sealing materials for cement-retained implant restoration was conducted. METHODS: Various sealing materials were classified into five groups, namely, gutta-percha (GP), temporary restorative paste (TRP), vinyl polysiloxane (VPS), polytetrafluoroethylene (PTFE) tape, and onlay resin (OR), and 35 sets of analog-abutments were allocated into five groups of seven specimens. A sealing efficacy test was conducted using a modified dye-penetration method, in which a lower absorbance indicated better sealing efficacy. For the removal-convenience test, the materials were removed from each SAH after solidification, and the retrieval time was recorded. RESULTS: On days 1 and 10, PTFE exhibited the highest absorbance value with significant differences compared to the other groups. On day 30, TRP and PTFE showed significantly higher absorbance values than GP, VPS, and OR, but no significant difference was detected between TRP and PTFE (p = 0.424). The absorbance values of TRP and PTFE from days 1, 10, and 30 showed significant intragroup differences, while those of the other groups did not. In terms of the removal convenience on days 1, 10, and 30, VPS achieved the best performance, followed by PTFE, OR, TRP, and GP. CONCLUSION: Within the limitations of this experiment, VPS and OR showed better sealing efficacy against microleakage and a more convenient removal than the other materials; thus, VPS and OR are recommended for clinical use.


Assuntos
Dente Suporte , Implantes Dentários , Parafusos Ósseos , Guta-Percha , Humanos , Politetrafluoretileno
6.
Gen Dent ; 70(5): 54-57, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35993934

RESUMO

Progressive wear of the components of an implant-supported overdenture can lead to loss of denture retention, which affects masticatory function and the patient's quality of life. The primary objective of this in vitro study was to investigate frictional wear in a type of commonly used abutment and thereby estimate the general clinical lifespan of a typical stud abutment and establish a protocol for replacement. Therefore, simulated overdenture insertions and removals equivalent to 2 years of overdenture use were performed to evaluate surface changes in the metal stud abutment component. A digital caliper, scanning electron micrographs taken at ×500 magnification, and profilometer data were used to determine the wear rate and surface roughness. A universal testing machine was used to measure retention load force with 4 clear male nylon inserts (5.0-lb retention) during 2160 insertion and removal cycles. The results showed that with a 6-month replacement program for clear male nylon inserts, the frictional wear on the titanium nitride coating of abutments placed at a 0° position resulted in a decrease of up to 50% in removal forces of the inserts after a simulated 2 years of wear. The combination of wear of the titanium nitride coating and the decrease in retention load values suggests that stud abutments should be replaced after 2 years of use for optimal retention.


Assuntos
Implantes Dentários , Revestimento de Dentadura , Dente Suporte , Materiais Dentários , Prótese Dentária Fixada por Implante , Análise do Estresse Dentário , Retenção de Dentadura , Humanos , Masculino , Teste de Materiais , Nylons , Qualidade de Vida
7.
J Long Term Eff Med Implants ; 32(3): 21-28, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35993986

RESUMO

Is to measure the peripheral and internal gap at the implant-abutment interface of an implant system connected to its original or compatible non-original abutments. Twenty implants were assembled with four different types of abutments having the same conical internal interface. All abutments were considered compatible with Tx Astra Tech Implant SystemTM. Four groups were created and each group of five implants was connected to a different abutment; Ti DesignTM abutments (group A), DualTM abutments (group B), Natea plusTM abutments (group C) and ImplanetTM abutments (group D). The peripheral gaps between implant and abutment were observed in three points facing the flat surface of the abutment. The implant-abutment assemblies were then embedded in resin and grinded in the mesio-distal direction of the scalloped abutment margin using a diamond disk at very low speed and under water-cooling. The inner aspect of the implant abutment interface was observed in three different points, on the coronal border of the connection, in the middle area and on the apical border of the implant-abutment interface. The mean gap width was 0.543 ± 0.09 µm for group A and, respectively, 0.708 ± 0.1232 µm, 0.726 ± 0.0891 µm and 0.818 ± 0.0851 µm for groups B, C and D. When comparing group, A to B and C, a highly significant difference in numbers was obvious while an even higher variation was observed with group D. External and internal fit of components is better when using original components.


Assuntos
Implantes Dentários , Titânio , Dente Suporte , Humanos , Teste de Materiais , Próteses e Implantes
9.
Clin Oral Implants Res ; 33(9): 945-952, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35818785

RESUMO

OBJECTIVE: To assess the marginal and bacterial microleakage in zirconia and CAD-CAM or cast Co-Cr implant abutments. METHODS: Sixty-four conical connection implants with their respective abutments were divided into four groups (Co-Cr (milled, laser-sintered, and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs). RESULTS: Thirty (47%) implant-abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co-Cr milled, 14 Co-Cr laser-sintered and 14 cast). Seven specimens (1 Co-Cr laser-sintered and six cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co-Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/ml). The Co-Cr cast (9.39E+03 CFUs/ml) and laser-sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co-Cr cast and laser-sintered resulted in a statistically significant differences in favor of Co-CrCL (p < .05). CONCLUSIONS: The abutment material and fabrication technique affected the implant-abutment microleakage. Although the CAD-CAM abutments presented favorable results, all tested groups presented microleakage.


Assuntos
Dente Suporte , Implantes Dentários , Cobalto , Desenho Assistido por Computador , Projeto do Implante Dentário-Pivô , Teste de Materiais , Titânio , Zircônio
10.
Dent Mater ; 38(9): 1547-1557, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35909000

RESUMO

OBJECTIVES: This study aimed to investigate human osteoblasts (HOB) response towards different dental implant abutment materials. METHODS: Five dental implant abutment materials were investigated: (1) titanium (Ti), (2) titanium coated nitride (TiN), (3) cobalt chromium (CoCr), (4) zirconia (ZrO2), and (5) modified polyether ether ketone (m-PEEK). HOBs were cultured, expanded, and seeded according to the supplier's protocol (PromoCell, UK). Cell proliferation and cytotoxicity were evaluated at days 1, 3, 5, and 10 using Alamar Blue (alamarBlue) and lactate dehydrogenase (LDH) colorimetric assays. Data were analysed via two-way ANOVA, one-way ANOVA and Tukey's post hoc test (significance was determined as p < 0.05 for all tests). RESULTS: All the investigated materials showed high and comparable initial proliferation activities apart from ZrO2 (46.92%), with P% of 79.91%, 68.77%, 73.20%, and 65.46% for Ti, TiN, CoCr, and m-PEEK, respectively. At day 10, all materials exhibited comparable and lower P% than day 1 apart from TiN (70.90%) with P% of 30.22%, 40.64%, 37.27%, and 50.65% for Ti, CoCr, ZrO2, and m-PEEK, respectively. The cytotoxic effect of the investigated materials was generally low throughout the whole experiment. At day 10, the cytotoxicity % was 7.63%, 0.21%, 13.30%, 5.32%, 8.60% for Ti, TiN, CoCr, ZrO2, and m-PEEK. The Two-way ANOVA and Tukey's Multiple Comparison Method highlighted significant material and time effects on cell proliferation and cytotoxicity, and a significant interaction (p < 0.0001) between the tested materials. Notably, TiN and m-PEEK showed improved HOB proliferation activity and cytotoxic levels than the other investigated materials. In addition, a non-significant negative correlation between viability and cytotoxicity was found for all tested materials. Ti (p = 0.07), TiN (p = 0.28), CoCr (p = 0.15), ZrO2 (p = 0.17), and m-PEEK (p = 0.12). SIGNIFICANCE: All the investigated materials showed excellent biocompatibility properties with more promising results for the newly introduced TiN and m-PEEK as alternatives to the traditionally used dental implant and abutment materials.


Assuntos
Implantes Dentários , Zircônio , Dente Suporte , Materiais Dentários/toxicidade , Humanos , Cetonas/farmacologia , Teste de Materiais , Osteoblastos , Polietilenoglicóis/toxicidade , Estanho , Titânio/toxicidade , Zircônio/toxicidade
11.
J Long Term Eff Med Implants ; 32(2): 87-93, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35695631

RESUMO

Two-stage implant systems result in gaps and cavities between implant and abutment that can act as a trap for bacteria and thus possibly cause inflammatory reactions in the peri-implant soft tissues. These gaps between the components are inevitable, and their clinical significance has so far been mostly neglected by both manufacturers and clinicians. This study is thus intended to evaluate microbial leakage at implant abutment interface in different implant systems. Four different systems, the Nobel tri-channel, the Nobel conical, the Equinox, and the Straumann, were used for this study. One microliter of a fresh broth suspension of Streptococcus mutans was added to the implant fixture (implant body). The implant was immersed in fresh heart brain infusion and was incubated at 37° for 48 hours. After incubation, 10 µL of the broth was made as lawn culture on sterile agar and the colonies were counted and recorded as colony-forming units per milliliter. Statistical tests were carried out on SPSS software and tests included analysis of variance (ANOVA) and P value was derived using Tukey's honestly significant difference post hoc test. After incubation, results were analyzed by evaluating the microbial leakage from each sample and it was observed that Nobel tri-channel had the least amount of microbial leakage and Equinox had maximum microbial leakage. The difference among all implant systems was statistically significant P < 0.05. The study concluded that least micro-leakage was found in the Nobel tri-channel whereas maximum microbial leakage was present in Equinox and Straumann.


Assuntos
Implantes Dentários , Próteses e Implantes , Dente Suporte , Implantes Dentários/efeitos adversos , Humanos
12.
Int J Oral Maxillofac Implants ; 37(3): 533-542, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727245

RESUMO

PURPOSE: To determine the fracture strength and stress distribution of esthetic dental implant abutments. MATERIALS AND METHODS: Fifty specimens were prepared. Four hybrid abutment groups with titanium bases (zirconia [Z], lithium disilicate [L], ceramic-reinforced polymer [B] and [BC]) and a custom titanium abutment control group (T) were restored with monolithic zirconia crowns except BC, which was crowned with layered composite. Ceramic abutments were cemented on Ti bases with a self-curing resin cement. Polymer abutments were cemented on Ti bases with an adhesive resin cement. All crowns for T, Z, and L were cemented with another self-adhesive resin cement, while the B and BC groups were cemented with the same adhesive resin cement for the polymer. Fatigue testing was performed by a chewing simulator (CS-4.2, SD, 50 N, 240,000 cycles) followed by fracture strength testing (0.5 mm/min, 5,000 N). Failure type analysis was made by a stereomicroscope. Statistical analyses were made (SPSS 25.0, analysis of variance [ANOVA], Tukey honestly significant difference [HSD], 95% CI). Complementary finite element analyses (FEAs) were performed (Algor Fempro). RESULTS: Mean ± SD fracture strengths for T, Z, L, B, and BC were 1,522.67 ± 190.77, 1,207.76 ± 89.03, 818.81 ± 109.96, 1,126.23 ± 142.23, and 899.08 ± 60.36, respectively (P < .05). Abutment screw flexure and/or cracks or crown material fractures for T, Z, L, and B occurred, while no implant and/or abutment fractures were observed for BC except for crown fracture and Ti base flexure. FEA exhibited similar stress concentrations. CONCLUSION: Monolithic zirconia crowns on titanium abutments and hybrid zirconia abutments exhibited the highest fracture strengths. Lithium disilicate and BioHPP abutments had the lowest fracture strength, while no fractures were observed on the implant, abutment, or screw.


Assuntos
Cimentos de Resina , Titânio , Benzofenonas , Cerâmica , Coroas , Dente Suporte , Cimentos Dentários , Projeto do Implante Dentário-Pivô , Falha de Restauração Dentária , Análise do Estresse Dentário , Estética Dentária , Teste de Materiais , Polímeros , Zircônio
13.
Int J Oral Maxillofac Implants ; 37(3): 571-578, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727250

RESUMO

PURPOSE: To evaluate the effects of vertical compressive cyclic load on abutment screws and the stability of screw-retained splinted fixed dental prostheses supported by bone-level nonengaging and partially engaging abutments. MATERIALS AND METHODS: Ten standardized two-unit prostheses integrated with nonengaging and partially engaging abutments were 3D-printed and cast in nonprecious metal and attached to two implant analogs with conical connections angled 15 degrees toward the vertical axis in a resin bock. The common path of insertion for the prosthesis with partially engaging abutments to angled implant analogs was created by selectively reducing the abutment surface that obstructed the implant housing. A 500-N average load was applied to each sample while oscillating 30 degrees from the vertical axis at 60 Hz to failure. Prosthesis stability was measured by deflection from the initial position using a linear displacement measuring device. Sample groups were assessed using the independent-samples t test and one-way repeated-measures analysis of variance (ANOVA) with post hoc tests. RESULTS: The mean cycles to failure for nonengaging and partially engaging abutment groups were 27,180 ± 29,420 and 457,890 ± 265,734, respectively. Failed nonengaging samples had 9 out of 10 abutment screws fracture inside the implant housing but with minimal wear to the top of the implant analog. For partially engaging samples, 8 out of 10 implant housings and 7 out of 10 abutment screws fractured at test endpoints. There was no difference in initial deflections between groups. Prostheses supported by nonengaging abutments failed before deflection measurements could be taken after loading. Prosthesis displacement of partially engaged abutments decreased significantly from the initial position after 300,000 load cycles. CONCLUSION: Under the experimental conditions, screw-retained splinted fixed dental prostheses supported by partially engaging abutments are 17 times more stable than prostheses supported by nonengaging abutments. Abutment screw fractures are the most prevalent mode of failure for nonengaging abutments at significantly lower cycles with minimal wear on implant analogs. Partially engaging abutment groups failed from implant housing and abutment screw fractures at higher cycles. Loading appears to concentrate preferentially on the medial side on all angled implant components. Selective removal of the abutment obstruction allows a common path of insertion for multiple implants and partial engagement to implant housings.


Assuntos
Dente Suporte , Implantes Dentários , Parafusos Ósseos , Projeto do Implante Dentário-Pivô , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Análise do Estresse Dentário , Teste de Materiais , Torque
14.
Int J Prosthodont ; 35(3): 278-286, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35727261

RESUMO

PURPOSE: To evaluate the survival of implants and abutments and the incidence of mechanical complications of single posterior implant-supported restorations using prefabricated titanium abutments. MATERIALS AND METHODS: This retrospective clinical study analyzed 172 Astra Tech OsseoSpeed internal hexagon implants (Dentsply Sirona) placed in 85 patients with a follow-up between January 2009 and January 2019. All implants were restored with prefabricated titanium abutments and cement-retained metal-ceramic crowns. The clinical outcomes recorded were implant and abutment survival rates and mechanical complications (abutment/implant fractures, screw loosening/fracture, decementation of the superstructure, veneer chipping/fractures) and were analyzed according to age, sex, implant length/diameter, bone graft, arch, implant position, parafunctional habit or dental status, and opposite arch. Kaplan-Meier survival analysis was used to determine whether the distribution of time to event/failure differed based on implant position (premolar or molar), implant diameter, or abutment angulation. RESULTS: During the observation period (mean: 108 months), implant and abutment cumulative survival rates were 97.7% and 98.3%, respectively, with no statistically significant differences between implant positions (molar/premolar), implant diameters (3.5 vs 4 mm), or abutment angles (straight vs 15 degrees). Of the 172 single posterior implant-supported restorations, 14 mechanical complications (8.2%) were recorded. In particular, 3 abutment fractures (1.7%), 2 screw loosenings (1.2%), 2 screw fractures (1.2%), 1 implant fracture (0.6%), 2 chipping/fractures of veneering materials (1.2%), and 4 decementations of the superstructure (2.3%) occurred. CONCLUSION: The single posterior implant-supported restorations using prefabricated titanium abutments remain a clinically acceptable treatment in terms of prosthetic procedure and cost-effectiveness.


Assuntos
Implantes Dentários , Titânio , Coroas , Dente Suporte , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos , Estudos Retrospectivos , Titânio/química , Zircônio/química
15.
Quintessence Int ; 53(7): 590-596, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35723484

RESUMO

OBJECTIVE: To describe a procedure that uses a definitive BioHPP hybrid abutment (polyether ether ketone [PEEK] reinforced with ceramic nanoparticles), to obtain a hermetic mucous seal with the peri-implant soft tissues. Method and materials: Between July 2017 and December 2019, seven patients aged between 40 and 60 years, who needed prosthetic rehabilitation in the esthetic zone, were treated. Among the various therapeutic solutions offered, patients chose an immediate or conventional implant rehabilitation using the "one abutment-one time" technique with the hybrid SKY elegance implant abutment (bredent medical). Ten implants were placed, five with immediate loading including two postextraction, and five in a conventional/classic loading protocol. The protocol required that the finishing margin of the provisional restoration was positioned approximately 1 to 2 mm from the implant platform, allowing the tissues to heal around the ceramic-reinforced PEEK abutment. After 6 months for the implants with immediate loading, and 3 months for those with conventional loading, the provisional restorations were replaced with definitive zirconia-ceramic prostheses. RESULTS: The clinical evaluation on the 10 implants showed that the reinforced PEEK abutments integrated well with the peri-implant tissues, and were healthy, without plaque, and with no bleeding on probing. An average probing depth of 1.0 mm was observed for nine of the ten placed implants, and for the tenth the implant probing depth was 1.5 mm. CONCLUSIONS: The ceramic-reinforced PEEK abutments BioHPP SKY elegance associated with the one-time therapeutic protocol is a valid alternative to traditional implant loading procedures, leading to an effective peri-implant hermetic mucous seal. (Quintessence Int 2022;53:590-596; doi: 10.3290/j.qi.b3082565; Originally published (in Italian) in Quintenssenza Internationale 2021;35:48-57).


Assuntos
Carga Imediata em Implante Dentário , Adulto , Cerâmica , Coroas , Dente Suporte , Humanos , Pessoa de Meia-Idade
17.
J Prosthodont ; 31(5): e2-e11, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35505638

RESUMO

PURPOSE: The purpose was to investigate stress distribution among 4 different customized abutment types: titanium abutment (Ti), titanium hybrid-abutment-crown (Ti-Hybrid), zirconia abutment with titanium base (Zir-TiBase), and zirconia hybrid-abutment-crown with titanium base (Zir-Hybrid-TiBase). MATERIALS AND METHODS: To achieve this purpose, 4 types of abutment configurations were simulated. A static load of 200 N (vertical) and 100 N (oblique) were applied to the models. The volume average, maximum, and stress distribution of von Mises stress, including percentage difference, were analyzed with 3D finite element analysis. RESULTS: According to the volume average von Mises stress, the Ti and Zir-TiBase comparison group showed that the Zir-TiBase group dominantly generated the higher value at Ti-base (22.57 MPa) and screw (17.68 MPa). To evaluate the effect of the hybrid-abutment-crown on volume average von Mises stress by comparing the Ti-Hybrid and Zir-Hybrid-TiBase groups, it was revealed that the combination of abutment and crown in the Ti-Hybrid group generated the worst stress concentration at the screw (12.42 MPa), while in the Zir-Hybrid-TiBase group presented stress concentration at the implant (8.90 MPa). CONCLUSIONS: A titanium base improved stress distribution at implant in zirconia abutment with titanium base by absorbing stress itself. Customized titanium hybrid-abutment-crown and zirconia hybrid-abutment-crown with titanium base created concentrated stress at screw and implant; respectively. Both abutment types should be cautiously used and maintenanced regularly.


Assuntos
Implantes Dentários , Titânio , Coroas , Dente Suporte , Projeto do Implante Dentário-Pivô , Análise do Estresse Dentário , Análise de Elementos Finitos , Estresse Mecânico , Zircônio
18.
Int J Oral Implantol (Berl) ; 15(2): 167-179, 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35546725

RESUMO

PURPOSE: Titanium bases are used frequently in daily practice for bonding to CAD/CAM abutments or crowns. Due to intimate contact between the adhesive gap of the titanium-base abutment and the peri-implant bone, the physical and chemical characteristics of the bonding material, or the gap itself, may affect peri-implant inflammatory reactions. The present study therefore aimed to examine the long-term effects of individualised abutments bonded to titanium bases on peri-implant health. MATERIALS AND METHODS: A total of 24 patients, each with one test and one control abutment, participated in the present prospective, single-blind, randomised controlled clinical trial. The test abutments were CAD/CAM titanium abutments bonded to titanium bases. As the control abutments were individualised, one-piece CAD/CAM titanium abutments were used. Clinical and radiographic parameters were assessed at abutment insertion and then on a yearly basis over the following 5 years. RESULTS: No significant differences in marginal bone level were observed between the titanium-base and one-piece abutments at any of the follow-up time points; however, when intragroup marginal bone levels were compared to the baseline values, significant differences were found at several follow-up time points. Intergroup differences were only found to be significant for pocket depth at the 4- (P = 0.006) and 5-year follow-ups (P = 0.024), favouring titanium-base abutments. CONCLUSIONS: Within the limitations of the present study, it appears that the peri-implant tissues of this specific patient cohort responded to titanium-base abutments in a rather similar manner to one-piece abutments over a 5-year period; however, no definitive conclusions can be drawn due to the low power of the present study.


Assuntos
Implantes Dentários , Titânio , Dente Suporte , Humanos , Estudos Prospectivos , Método Simples-Cego
19.
Stomatologiia (Mosk) ; 101(3): 12-17, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35640173

RESUMO

THE AIM OF THE STUDY: Comparative study of the precision of the junction of modern implant systems with standard and custom abutments. MATERIALS AND METHODS: The study was carried out by the method of computed X-ray microtomography on an X-ray microtomograph Heliscan micro CT using the ImageJ program in the laboratory «Systems for Microscopy and Analysis¼ of the Skolkovo Technopark. The measurement of the gap width between the implant and the abutment for each sample was carried out at 20 points according to the algorithm: the total length of the connection between the implant and the abutment; step (distance) between 5 equidistant points along the contact between the abutment and the implant; the measurements were repeated in 2 perpendicular sections along the joint node axis. The study was conducted on the example of seven implant systems common in Russia. The effect on the implant-abutment assembly of a multiple functional load of 250 N at an angle of 45° (7.6 million cycles) was studied. RESULTS: It has been established that the precision of the junction of modern implants with standard abutments is different and is characterized by the length of the contact from 268 to 1300 µm, the gap at the level of the platform from 5.0 to 11.7 µm, and the asymmetry of the contact in diameter by 2.4-14.2 µm. Abutments individually made in modern CAD/CAM laboratories do not have significant dimensional differences with standard abutments, but they have technological defects. The functional load expands and deforms the gap between the implant and abutment junction in the upper half of their contact. CONCLUSION: The results obtained demonstrate the capabilities of the computer X-ray microtomography method, which can be used to control the quality of manufacturing collapsible dental implants, the accuracy of manufacturing individual abutments in CAD/CAM laboratories, as well as in the development of new dental implant systems. The dimensional parameters of the junction node determine the advantages of the deep cone connection of the implant and the abutment.


Assuntos
Projeto do Implante Dentário-Pivô , Implantes Dentários , Dente Suporte , Projeto do Implante Dentário-Pivô/métodos , Humanos , Titânio/química , Microtomografia por Raio-X
20.
Clin Oral Implants Res ; 33(7): 745-756, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35570366

RESUMO

AIM: To assess radiographic, restorative, clinical and technical outcomes as well as patient satisfaction of directly veneered zirconia restorations cemented on non-original titanium bases over 5 years. MATERIAL AND METHODS: Twenty-four patients with a single missing tooth in the aesthetic zone were recruited. All patients received a two-piece implant with a screw-retained veneered zirconia restoration cemented extraorally on a titanium base abutment. Marginal bone levels (MBL), marginal bone changes, technical complications, patient satisfaction and clinical parameters including probing depth, bleeding on probing and plaque index were assessed at crown delivery (baseline), at 1 year (FU-1) and 5 years (FU-5) of follow-up. To investigate the relationship between restorative angle and MBL as well as marginal bone changes (bone loss/bone gain), correlation tests and linear regression models were carried out. RESULTS: Twenty-two patients were available for re-examination at 5 years. The mean MBL amounted to 0.54 ± 0.39 mm at baseline, and to 0.24 ± 0.35 at FU-5 (=bone gain) (p < .001). At FU-1, a positive correlation (r = .5) between the mesial restorative angle and mesial MBL was found (p = .012). Marginal bone changes between baseline and FU-1 at mesial sites were also positively correlated with the mesial restorative angle (r = .5; p = .037). Linear and logistic regression models confirmed that mesial marginal bone loss was significantly associated with the mesial restorative angle at FU-1 (p < .05). At 5 years, these significant associations at mesial sites disappeared (p > .05). At distal sites, no correlations or associations between the restorative angle and MBL or marginal bone changes were found regardless of the time point. During the 5-year follow-up, 5 technical complications occurred, mainly within the first year and mostly chippings. All patients were entirely satisfied with their implant-supported restoration at 5 years. CONCLUSION: Within the limitations of the present study, the restorative angle of implant-supported crowns on non-original titanium bases might influence the initial marginal bone loss but without affecting their favourable long-term clinical performance. A restorative angle of <40° may limit the initial marginal bone loss at implant-supported crowns with titanium bases.


Assuntos
Prótese Dentária Fixada por Implante , Titânio , Coroas , Dente Suporte , Falha de Restauração Dentária , Estética Dentária , Humanos , Estudos Prospectivos , Zircônio
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