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1.
Trials ; 22(1): 101, 2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509257

RESUMO

BACKGROUND: The volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4-6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists. METHODS/DESIGN: The study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone. DISCUSSION: The current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes. TRIAL REGISTRATION: International Clinical Trials Registry Platform ChiCTR1900020648 . Registered on 1 January 2019.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Seio Maxilar/cirurgia , Dente Molar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Extração Dentária/efeitos adversos , Adulto , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea/efeitos adversos , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Osteogênese , Cuidados Pós-Operatórios/efeitos adversos , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/efeitos adversos , Cuidados Pré-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Levantamento do Assoalho do Seio Maxilar/efeitos adversos , Resultado do Tratamento
2.
Med. oral patol. oral cir. bucal (Internet) ; 25(6): e720-e727, nov. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-197178

RESUMO

BACKGROUND: Few studies have reported the outcomes of immediate placement at infected post-extraction sites. The aim of this study was to compare clinical and radiological outcomes of immediately placed implants with im-mediate prosthetic provisionalization in sockets with or without acute periapical pathology. MATERIAL AND METHODS: A total of 100 patients with immediately placed implants with immediate provisionalization and 1- year of follow up were included (50 patients with acute periapical pathology and a control group of 50 patients without acute periapical pathology). Clinical parameters (bleeding on probing, buccal keratinized mucosa width, clinical recession, and probing depth) and radiological parameters (distance from implant shoulder to first point of bone-to-implant contact [IS-BIC]) were assessed. RESULTS: Clinical parameters showed no significant differences between the study and control groups after 1-year follow up (p > 0.05). IS-BIC presented the following values: 0.35 ± 0.51 mm (study group) and 0.15 ± 0.87 mm (control), without significant differences between the groups (p = 0.160). None of the 50 radiographs of immediate implants placed in sockets with periapical pathology revealed retrograde peri-implantitis. CONCLUSIONS: Immediate placement of implants with immediate prosthetic provisionalization at sites with acute periapical pathology can be a successful treatment modality for at least 1-year


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Implantação Dentária Endo-Óssea/métodos , Extração Dentária/métodos , Implantes Dentários , Estudos Prospectivos , Fatores de Tempo , Seguimentos , Peri-Implantite/cirurgia , Resultado do Tratamento
3.
Av. odontoestomatol ; 36(2): 63-70, mayo-ago. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194687

RESUMO

Se presenta un caso clínico en el que se rehabilita a una paciente con maxilar superior atrófico mediante una combinación de implantes cigomáticos, colocados mediante una aproximación exteriorizada, e implantes anteriores convencionales palatinizados. Se realizó un procedimiento de regeneración ósea guiada alrededor de los implantes cigomáticos para obtener un mayor grosor de la cortical vestibular y palatina alrededor de los implantes del maxilar superior y mejorar el pronóstico. A un año de la carga protésica, el hueso periimplantario se mantiene estable


A clinical case is presented in which a patient with atrophic upper jaw is rehabilitated by a combination of zygomatic implants, placed using an exteriorized approach, and conventional palatalized anterior implants. A guided bone regeneration procedure is performed around the zygomatic implants to obtain a greater thickness of the facial bone and improve the prognosis. One year after loading, the peri-implant bone remains stable


Assuntos
Humanos , Feminino , Idoso , Regeneração Óssea , Atrofia/diagnóstico por imagem , Implantes Dentários , Implantação Dentária Endo-Óssea/métodos , Arcada Edêntula/cirurgia , Zigoma/cirurgia , Atrofia/cirurgia , Maxila/anormalidades , Maxila/cirurgia , Zigoma/diagnóstico por imagem
4.
Av. odontoestomatol ; 36(2): 107-115, mayo-ago. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194692

RESUMO

La evolución en los diseños de los sistemas de implantes y en la configuración de los pilares protésicos ha desarrollado el concepto de plataforma reducida que comprende la colocación de un pilar más estrecho que la plataforma del implante para aumentar su distancia de la interfase hueso-implante. La plataforma reducida es considerada un factor importante para preservar la estabilidad del hueso crestal y de los tejidos blandos y asegurar el éxito de los implantes dentales a largo plazo. La plataforma reducida reduce las fuerzas oclusales y la contaminación bacteriana en la interfase entre el hueso crestal y el implante. Los estudios experimentales en animales y clínicos en pacientes muestran su eficacia para prevenir la pérdida ósea y de los tejidos blandos periimplantarios


The evolution of designs of implant systems and abutments configurations has developed the concept of platform-switching that involves the connection of a narrower abutment to the platform implant to allow horizontal distance of the interface bone-implant. Platform-switching is considered an important factor to preserve the stability of crestal bone and soft tissue ensuring the success of dental implants in the long-term follow-up. Platform-switching reduces the forces of occlusal loading and bacterial contamination in the interface between the crestal bone and the implant. Experimental studies in animals and clinical studies in patients showed that implants with platform-switching have demonstrated the effectiveness to prevent peri-implant bone loss and subsequent soft tissue los


Assuntos
Animais , Cães , Implantes Dentários/veterinária , Implantação Dentária Endo-Óssea/métodos , Implantação Dentária Endo-Óssea/veterinária , Projeto do Implante Dentário-Pivô/métodos , Projeto do Implante Dentário-Pivô/veterinária , Osseointegração
5.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e449-e454, jul. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-196495

RESUMO

BACKGROUND: The aim of the authors was to examine the abutment-fixture interface in Morse-type conical implants in order to verify gaps at this level using a new microscopical approach. MATERIAL AND METHODS: In this in vitro study, 20 abutment-fixture complexes were prepared by sectioning (longitudinal and cross-sectional to the long axis) with a microtome and then with a focused ion beam (FIB). This is a micrometric machine tool that uses gallium ions to abrade circumscribed areas to dig deeper into the cuts obtained with the microtome in order to eliminate cut-induced artifacts. This is because the FIB abrasion is practically free from artifacts, which are normally generated by the action of the microtome blades or other techniques. Samples were then observed by scanning electron microscopy (SEM). RESULTS: The observation of the abraded parts with the FIB permitted measurement of the real gap between the implant-abutment components. A variable amount of gap was retrieved (from 0 to 3 μm) by the observations, confirming the non-hermetic nature of the connection. It has to be pointed out that in approximately 65% of cases, the gap accounted for less than 1 μm. CONCLUSIONS: The reported data confirmed that the analyzed connection system allowed for minimal gap. However, from the evidence of the present analysis, it cannot be assumed that the 2 parts of a Morse-type conical implant are fused in 1 piece, which would create a perfectly matched hermetic connection


No disponible


Assuntos
Projeto do Implante Dentário-Pivô/métodos , Implantação Dentária Endo-Óssea/métodos , Propriedades de Superfície , Valores de Referência , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes
6.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e474-e480, jul. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-196499

RESUMO

BACKGROUND: The aim of this study was to assess one-year implant survival after lateral window sinus augmentation using PRGF combined with various bone grafting materials. MATERIAL AND METHODS: This was a retrospective chart review and radiographic analysis of patients that had under-gone lateral window sinus augmentation with PRGF and had dental implants placed at least 6 months post augmentation. All implants included were followed up for at least one year after placement. Demographic, sinus and implant related characteristics (residual ridge height, sinus membrane perforation, type of graft material, implant length and width and ISQ at placement) were analyzed. RESULTS: A total of 31 patients with 39 sinus augmentations and 48 implants were included. The mean follow up was 22.8 ± 9.9 months. Implant survival was 95.8%, with 2 implants overall failing. Among all the variables assessed, the only one found to be associated with an increased risk for implant failure was the use of xenograft as bone grafting material in the sinus. CONCLUSIONS: Within the limitations of this study, dental implants placed in maxillary sinuses grafted with PRGF in combination with bone grafting materials, exhibit high implant survival rates after at least one year follow up


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Levantamento do Assoalho do Seio Maxilar/métodos , Plasma Rico em Plaquetas , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Implantação Dentária Endo-Óssea/métodos , Estudos Retrospectivos , Substitutos Ósseos/uso terapêutico , Resultado do Tratamento , Fatores de Tempo , Fatores de Risco , Tomografia Computadorizada de Feixe Cônico
7.
Med. oral patol. oral cir. bucal (Internet) ; 25(4): e541-e548, jul. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196508

RESUMO

BACKGROUND: Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae. MATERIAL AND METHODS: Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019. RESULTS: Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality. CONCLUSIONS: Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation


No disponible


Assuntos
Humanos , Revisões Sistemáticas como Assunto , Implantação Dentária Endo-Óssea/métodos , Zigoma/cirurgia , Doenças Maxilares/cirurgia , Resultado do Tratamento
8.
Int. j. odontostomatol. (Print) ; 14(2): 242-248, June 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1090681

RESUMO

Los aumentos óseos previo a la instalación de implantes son cada vez mas utilizados y el diseño de nuevas estrategias para disminuir la morbilidad deben ser considerados. El objetivo de esta investigación fue definir el aumento óseo generado con la técnica "tent pole" en sector de mandíbula posterior. Se diseño un estudio longitudinal, prospectivo para estudiar la técnica. Se incluyeron sujetos con ancho óseo no mayor a 4 mm en el sector posterior y con altura no menor a 9 mm desde el margen superior del conducto alveolar inferior. Se realizaron cirugías bajo anestesia local realizando un acceso quirúrgico; se instalaron de 2 a 4 tornillos de osteosíntesis manteniendo 4 mm del tornillo extraóseo para luego reconstruir con biomaterial alógeno y L-PRF en conjunto con una membrana biológica absorbible; después de 4 meses se realizaron las re entradas estableciendo con tomografía computadorizada de haz cónico las ganancias óseas generadas. Fueron operados 14 sujetos con 27 sitios quirúrgicos; en todos los casos se pudo realizar la instalación de implantes a los 4 meses. En la evaluación inicial, el ancho óseo observado estaba entre 1,2 y 4,0 mm (promedio de 2,95 ± 0,75 mm); después de 4 meses de realizado el aumento horizontal el ancho observado fue de 3,79 y 10,05 mm (promedio de 7,15 mm ± 1,87 mm), confirmando una ganancia ósea promedio de 4,2 ± 1,26 mm. La diferencia obtenida fue significativa (p< 0,05). Se puede concluir que la técnica "tent pole" aplicada en esta investigación es predecible en el aumento óseo y aplicable para la rehabilitación sobre implante.


Bone augmentation prior to implant placement, is among strategies that should be considered to reduce morbidity rates in these procedures. The objective of this research was to define bone augmentation generator using the "tent pole " technique in the posterior jaw. A longitudinal, prospective study was designed, and subjects were included with ridge width no greater than 4 mm, height no less than 9 mm from the upper margin of the inferior alveolar canal. Surgeries were performed under local anesthesia for surgical approach; 2 to 4 osteosynthesis screws over ridge with 4 mm of the extra osseous screws were installed and were then regenerated, using allogeneic biomaterial and L-PRF together with an absorbable biological membrane. Re-entry was performed after four months and cone beam computed tomography analysis was used to confirm bone gain. Fourteen subjects were operated with 27 surgical sites; in all the cases, implant installation was possible at 4 months. In the initial evaluation, bone width observed was between 1.2 and 4.0 mm (average of 2.95 ± 0.75 mm); after 4 months of the horizontal increase, width was recorded at 3.79 and 10.05 mm (average of 7.15 mm ± 1.87 mm), confirming an average bone increase of 4.2 ± 1.26 mm. The difference obtained was significant (p <0.05). It can be concluded that the "tent pole" technique applied in this analysis is predictable in bone augmentation and applicable for implant rehabilitation.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Implantação Dentária Endo-Óssea/métodos , Aumento do Rebordo Alveolar , Mandíbula/cirurgia , Estudos Prospectivos , Estudos Longitudinais , Transplante Ósseo , Substitutos Ósseos , Tomografia Computadorizada de Feixe Cônico
9.
Int. j. odontostomatol. (Print) ; 14(2): 230-235, June 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1090679

RESUMO

La estabilidad primaria es un requisito importante para la supervivencia y éxito de los implantes durante la osteointegración. En los últimos años, los implantes inmediatos postextracción han demostrado ser una opción de tratamiento exitosa y predecible para la reposición de dientes con mal pronóstico, pero surge la duda de si dichos implantes alcanzan valores de estabilidad primaria comparables a aquellos colocados en hueso maduro. Comparar la estabilidad primaria de implantes inmediatos colocados en alveolos postextracción con la de implantes colocados en hueso maduro. Se llevó a cabo un estudio clínico retrospectivo, con los datos recogidos sobre 175 implantes, colocados en 175 pacientes. Todos los implantes colocados pertenecían al modelo Essential Cone (Klockner Implant System) y se dividieron en dos grupos: implantes inmediatos (Grupo A, n=31) e implantes colocados en hueso maduro (Grupo B, n=144). La estabilidad primaria de todos los implantes se midió mediante torque de inserción y análisis de frecuencia de resonancia con Osstell ISQ. No se encontraron diferencias estadísticamente significativas respecto a la estabilidad medida a través del torque de inserción (26,29+10,07 Vs 25,76+9,72 N/cm) pero sí que se encontraron diferencias significativas en la medida de la estabilidad primaria mediante AFR, siendo inferiores los valores correspondientes a los implantes colocados en los alveolos post exodoncia (60,74 ± 6,17 en sentido VL y 62,19 ± 7.64 en sentido MD frente a 68,34 ± 6.26 en sentido VL y 69,29 ± 7.98 en sentido MD obtenidos en los implantes colocados en hueso maduro). El torque de inserción de los implantes inmediatos es similar al de los implantes colocados en hueso maduro, pero sus valores ISQ son significativamente inferiores, lo que demuestra un mayor grado de micromovimiento, y por consiguiente, un mayor riesgo de fracaso durante el período de osteointegración.


Primary stability is an important requirement for the survival and success of implants during osseointegration. In recent years, immediate post-extraction implants have proven to be a successful and predictable treatment option for the replacement of teeth with a poor prognosis, but the question arises as to whether these implants reach primary stability values comparable to those placed in mature bone. The objective of the study was to compare the primary stability of immediate implants placed in post-extraction alveoli with that of implants placed in mature bone. A retrospective clinical study was carried out, with data collected on 175 implants, placed in 175 patients. All implants placed belonged to the Essential Cone model (Klockner Implant System) and were divided into two groups: immediate implants (Group A, n = 31) and implants placed in mature bone (Group B, n = 144). The primary stability of all implants was measured by insertion torque and resonance frequency analysis with Osstell ISQ. No statistically significant differences were found regarding the stability measured through the insertion torque (26.29 + 10.07 Vs 25.76 + 9.72 N / cm) but significant differences were found in the measurement of primary stability by means of AFR, the values corresponding to implants placed in the post-exodontic alveoli being lower (60.74 ± 6.17 in the VL direction and 62.19 ± 7.64 in the MD direction versus 68.34 ± 6.26 in the VL direction and 69.29 ± 7.98 in the MD direction obtained in implants placed in mature bone). The insertion torque of immediate implants is similar to that of implants placed in mature bone, but their ISQ values are significantly lower, which demonstrates a higher degree of micromotion, and therefore, a greater risk of failure during the period of osseointegration.


Assuntos
Retenção em Prótese Dentária , Implantação Dentária Endo-Óssea/métodos , Extração Dentária , Vibração , Estudos de Casos e Controles , Estudos Retrospectivos , Osseointegração , Torque , Carga Imediata em Implante Dentário , Análise de Frequência de Ressonância
10.
BMC Oral Health ; 20(1): 96, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252728

RESUMO

BACKGROUND: The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon's decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs. METHODS: Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled (first premolars [1P], second premolars [2P], first molars [1M], and second molars [2M]). All preoperative panoramic radiographs were evaluated under standard conditions. The postoperative estimation (under/over) was determined depending on the available bone height (ABH) measured from the apical end of the implant to the floor of the MS and the roof of the MC using cone beam computed tomography (CBCT). Any complication or side effect that associated with overestimated implants insertion was recorded. RESULTS: The study sample included 73 patients (predominantly females) who had consecutively received 148 implants, of which 68 were inserted in the posterior maxilla and 80 in the posterior mandible. Underestimation was recorded in 93.2% of the measurements. The remaining bone height after implants insertion was < 2 mm in the majority of underestimated cases (73.9%); they were significantly (P < 0.01) more than sites with remaining bone ≥ 2 mm (26.1%). In the posterior mandible, overestimation was significantly higher than posterior maxilla. Five cases with transient paresthesia were reported in the mandibular overestimated implants. CONCLUSIONS: This study specified that surgeon's choice of implants length, based on panoramic radiographs, was reliable regarding the incapability to insert implants with further length in the majority of underestimated cases, the low percent of overestimated measurements, and the minor associated complications.


Assuntos
Competência Clínica , Implantes Dentários , Arcada Edêntula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica/métodos , Cirurgiões , Adolescente , Adulto , Idoso , Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea/métodos , Feminino , Humanos , Masculino , Nervo Mandibular/diagnóstico por imagem , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
11.
Int. j interdiscip. dent. (Print) ; 13(1): 44-46, abr. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1114893

RESUMO

AIM: Short implants are manufactured for use in atrophic regions of the jaw. Therefore, the current does not sufficiently reveal a direct correlation between the impact of implant length on implant survival. The purpose of this systematic review was to compile the evidence of short implant survival in atrophied jaws. METHODS: Electronic and manual literature searches were performed by two independent reviewers in several databases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to September 2015 using the following terms in some combinations: "short implant", "mandible/atrophied jaws", and "implant survival/ survival rate/ survival analysis". RESULTS: The 19 included studies present in average 5.5 years (range 1.0-20.0 years) follow-up and 96.1% (range 73.4-100.0 percent) survival rate of the short implants in atrophied mandibular. CONCLUSIONS: This systematic review found evidences regarding to safety of short implant placement in atrophied jaws although stronger evidence is essential to confirm this finding.


Assuntos
Humanos , Implantes Dentários , Implantação Dentária Endo-Óssea/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Atrofia , Análise de Sobrevida , Arcada Osseodentária , Mandíbula
12.
Int. j interdiscip. dent. (Print) ; 13(1): 30-34, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1114890

RESUMO

INTRODUCCIÓN: La valoración particular de sitios severamente comprometidos, involucra considerar los tiempos necesarios de cicatrización, así como evidencia actual en términos de biomateriales y técnicas quirúrgicas con el fin de lograr un tratamiento exitoso. MATERIAL Y MÉTODO: Paciente sexo femenino, 28 años, asiste por dolor e infección en diente 2.1 al Postítulo de Periodoncia UDD. Se observa defecto extenso y lesión que compromete tanto las tablas óseas vestibular como palatina. El tratamiento consistió en: exodoncia y regeneración ósea, instalación del implante 6 meses después de la exodoncia y cirugía de conexión 7 meses después más injerto de tejidos blandos. RESULTADOS: El tratamiento de defectos combinados (tejidos duros y blandos), asociados a procesos infecciosos de larga data, mediante rehabilitación implanto soportada puede ser muy predecible y exitoso en la medida que se respeten los tiempos de regeneración de diferentes estructuras.


INTRODUCTION: The specific assessment of a severely compromised sites involves: the consideration of healing time according to the different kinds of tissues involved and the knowledge of the evidence available concerning biomaterials and surgical techniques. MATERIAL AND METHODS: Female patient attends the postgraduate school of periodontics, UDD University in Santiago de Chile, because of pain and chronic infection compromising tooth 2.1. At clinical evaluation, the site has an extensive defect, with active fistula that compromises the buccal and palatal bone plates. The treatment consisted of exodontia and guided bone regeneration, implantation six months after initial exodontia and abutment connection surgery seven months after implant insertion. RESULTS: the treatment of combined defects associated with a long-standing infectious process can be very predictable and successful, only if the measures of time and tissue handling are considered and applied.


Assuntos
Humanos , Feminino , Adulto , Extração Dentária , Regeneração Tecidual Guiada Periodontal/métodos , Implantação Dentária Endo-Óssea/métodos , Estética Dentária , Fatores de Tempo , Regeneração Óssea , Tomada de Decisões , Processo Alveolar
13.
Niger J Clin Pract ; 23(3): 275-283, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32134023

RESUMO

We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Humanos
14.
Braz Oral Res ; 34: e008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32049109

RESUMO

This study aimed to investigate the effects of chronic restraint stress (RS) and a high-fat diet (HFD) on the osseointegration of titanium implants in a rat model. After the surgical insertion of titanium implants into the metaphysis of the tibial bone, the rats were randomly divided into four equal groups (n = 8 each): control (CNT), restraint stress (RS), high-fat diet (HFD), and restraint stress plus high fat diet (RS-HFD). CNT: Rats received no further treatment during the 92-day experimental period. RS: Stress was applied to the rats beginning from two days after the implant surgery for one hour per day for the first 30 days, two hours per day for the next 30 days, and three hours per day for the last 30 days. HFD: Rats were fed a HFD for the following 90 days starting two days after surgery. RS-HFD: Rats were fed a HFD and RS was applied to rats for the following 90 days, starting two days after surgery. At the end of the experimental period, the rats were euthanized, and the implants and surrounding bone tissues were removed for histological analysis. Statistical analysis was performed by one way ANOVA and Bonferrroni tests. There were no significant differences in the bone-implant connection levels between the groups (p > 0.05), but in the HFD and RS-HFD groups, the bone filling ratios were found to be lower compared with the controls (p < 0.05) The data analyzed in this study suggest that an HFD with or without chronic RS adversely affected bone tissue in the rats during the 90-day osseointegration period.


Assuntos
Prótese Ancorada no Osso , Dieta Hiperlipídica/psicologia , Osseointegração/fisiologia , Estresse Psicológico/fisiopatologia , Tíbia/fisiopatologia , Titânio , Alanina Transaminase/sangue , Animais , Aspartato Aminotransferases/sangue , Glicemia/análise , Colesterol/sangue , Implantação Dentária Endo-Óssea/métodos , Feminino , Distribuição Aleatória , Ratos Sprague-Dawley , Valores de Referência , Reprodutibilidade dos Testes , Tíbia/patologia , Tíbia/cirurgia , Fatores de Tempo , Triglicerídeos/sangue
15.
BMC Oral Health ; 20(1): 53, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066431

RESUMO

BACKGROUND: To compare tissue response to two implant systems, featuring internal hexed connections with different designs. METHODS: Patients enrolled in this randomized controlled trial were assigned to two groups. In Group 1, patients were treated with implants with a 5° conical internal hexed connection (Anyridge®, MegaGen, South Korea). In Group 2, patients were treated with implants with an internal hexed connection (Core®, Kristal, Italy). After implant placement and a provisionalisation period of 12 months, impressions were taken, stone casts were poured and digitised with a desktop scanner (D700®, 3Shape, Copenhagen, Denmark). In a digital environment, for each fixture, two values were collected at the buccal zenith: the height of the peri-implant mucosa (mucosal height; MH), calculated from the vestibular shoulder of the implant analogue to the upper gingival margin of the supra-implant tissue; and the width of the peri-implant mucosa (mucosal thickness; MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. The mean and standard deviation for MH and MT, as well as their ratios, were calculated for each group; the sectors in which the implants were placed were also considered. Finally, correlation between MH, MT, connection type and sector was assessed by Pearson's correlation coefficient, with significance level set at 0.05, and a confidence interval (CI) set at 95%. RESULTS: Data deriving from 188 implants placed in 104 patients were evaluated. The mean MH values were 3.32 (± 0.12) and 2.70 (± 0.16) mm for Groups 1 and 2, respectively. The mean MT values were 4.37 (± 0.16) and 3.93 (± 0.18) mm for Groups 1 and 2, respectively. Group 1 showed higher MH and MT values and a better ratio (1.50 ± 0.88) than Group 2 (1.81 ± 1.20). The MH, MT and MH/MT ratio were significantly influenced both by sector (p = 0.015) and group (p = 0.047). CONCLUSIONS: Within the limits of this study, the 5° connection implants supported a more extended tissue height and thickness at the buccal zenith, and a better ratio between them. TRIAL REGISTRATION: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04160689, dated 13/11/2019.


Assuntos
Dente Suporte , Projeto do Implante Dentário-Pivô , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Coroas , Humanos , Carga Imediata em Implante Dentário , Itália , República da Coreia , Resultado do Tratamento
16.
BMC Oral Health ; 20(1): 15, 2020 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-31948414

RESUMO

BACKGROUND: Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets. METHODS: A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction. RESULTS: One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results. CONCLUSIONS: Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.


Assuntos
Arco Dental/cirurgia , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Prótese Dentária Fixada por Implante , Carga Imediata em Implante Dentário , Adulto , Idoso , Implantação Dentária Endo-Óssea/instrumentação , Retenção em Prótese Dentária , Falha de Restauração Dentária , Estética Dentária , Feminino , Seguimentos , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica , Estudos Retrospectivos , Resultado do Tratamento
17.
Artigo em Inglês | MEDLINE | ID: mdl-33542168

RESUMO

Computer aided implantology is the safest way to perform dental implants. The research of high accuracy represents a daily effort. The validated method to assess the accuracy of placed dental implants is the superimposition of a pre-operative and a post-operative cone beam computed tomography (CBCT) with planned and placed implants. This procedure is accountable for a biologic cost for the patient. To investigate alternative procedure for accuracy assessment, fifteen resin casts were printed. For each model, six implants were digitally planned and then placed following three different approaches: (a) template guided free hand, (b) static computer aided implantology (SCAI), and (c) dynamic computer aided implantology (DCAI). The placement accuracy of each implant was performed via two methods: the CBCT comparison described above and a matching between implant positions recovered from the original surgical plan with those obtained with a post-operative intraoral scan (IOS). Statistically significant mean differences between guided groups (SCAI and DCAI) and the free hand group were found at all considered deviations, while no differences resulted between the SCAI and DCAI approaches. Moreover, no mean statistically significant differences were found between CBCT and IOS assessment, confirming the validity of this new method.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Cirurgia Assistida por Computador/instrumentação , Cirurgia Assistida por Computador/métodos , Desenho Assistido por Computador , Modelos Dentários , Humanos , Técnicas In Vitro , Reprodutibilidade dos Testes
18.
Actual. osteol ; 15(3): 225-236, Sept-Dic. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1116171

RESUMO

Bone grafting is important to preserve the alveolar bone ridge height and volume for dental implant placement. Even though implant-supported overdentures present highly successful outcomes, it seems that a great number of edentulous individuals have not pursued implant-based rehabilitation. The cost of the treatment is one of the reasons of discrepancy between highly successful therapy and its acceptance. Therefore, the development of biomaterials for bone grafting with comparable characteristics and biological effects than those renowned internationally, is necessary. In addition, domestic manufacture would reduce the high costs in public health arising from the application of these biomaterials in the dental feld. The purpose of this clinical case report is to provide preliminary clinical evidence of the efficacy of a new bovine bone graft in the bone healing process when used for sinus floor elevation. (AU)


El uso de injertos óseos es importante para preservar la altura y el volumen de la cresta alveolar para la colocación de implantes dentales. Si bien las sobredentaduras implanto-soportadas presentan resultados altamente exitosos, la mayoría de las personas desdentadas no han sido rehabilitadas mediante implantes dentales. Uno de los principales motivos por los cuales los pacientes no aceptan este tipo de tratamiento, altamente exitoso, es el elevado costo del mismo. Por ello, es necesario el desarrollo de biomateriales de injerto óseo con características y efectos biológicos comparables a los reconocidos internacionalmente. Asimismo, la fabricación nacional reduciría los altos costos en Salud Pública derivados de la aplicación de estos biomateriales en el campo dental. El objetivo de esta comunicación es presentar un caso clínico a fin de proporcionar evidencia preliminar acerca de la eficacia de un nuevo injerto de hueso bovino en el proceso de cicatrización ósea en el levantamiento del piso del seno maxilar. (AU)


Assuntos
Humanos , Animais , Feminino , Pessoa de Meia-Idade , Bovinos , Ratos , Transplante Ósseo/métodos , Arcada Parcialmente Edêntula/reabilitação , Levantamento do Assoalho do Seio Maxilar/métodos , Osteogênese , Argentina , Materiais Biocompatíveis , Bovinos/fisiologia , Carticaína/administração & dosagem , Clorexidina/administração & dosagem , Naproxeno/administração & dosagem , Saúde Pública/economia , Osseointegração , Dentaduras , Transplante Ósseo/tendências , Arcada Parcialmente Edêntula/patologia , Arcada Parcialmente Edêntula/terapia , Durapatita/uso terapêutico , Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Implantação Dentária Endo-Óssea/métodos , Levantamento do Assoalho do Seio Maxilar/tendências , Aloenxertos/imunologia , Aloenxertos/transplante
19.
Biomed Res Int ; 2019: 2797210, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781606

RESUMO

Background: Endoscopy has seen a significant development over recent years in various medical fields with its application expanding from the support of minimal invasive surgery to in situ imaging. In this context, the application of endoscopic techniques to assess the quality of the regenerated bone in situ in the drill hole before implant placement is an appealing approach. Aim: The aim of this study was to use short distance support immersion endoscopy (SD-SIE) to compare the quality of regenerated bone in healed postextraction sites, which are grafted with an in situ hardening ß-TCP, against ungrafted sites, before implant placement. This assessment was based on microscopic bone analysis in combination with the blood vessel count. Method: 13 spontaneously healed and 13 grafted postextraction sites in 3 men and 6 women, aged 26-83 years, were evaluated using SD-SIE after 4-6 months. SD-SIE was applied in drill holes before implant placement, and videos were taken from representative central buccal areas. The video recordings were analyzed using Image J software for (1) number of blood vessels per area (NBV), (2) relative area of vessels (VA), (3) relative area of mineralized bone (MBA), (4) relative area of unmineralized bone (UMBA), and (5) relative area of bone substitute (BSA). Results: The grafted sites showed more (1) NBV as well as (2) VA (8.6 ± 1.1; 2.03 ± 0.28%) than the ungrafted sites (2.5 ± 0.6; 1.18 ± 0.36%) (independent t-test; p < 0.05); (3) MBA and (4) UMBA were similar to those in the grafted sites (86.3 ± 2.2 %; 13.7 ± 2.2 %) and to the ungrafted sites (89.5 ± 3.7%; 10.5 ± 3.6%) (independent t-test; p > 0.05); and (5) BSA in the grafted sites was 18.2 ± 5.4%. Conclusion: SD-SIE is an interesting new approach for in situ assessment of bone quality and blood supply before implant placement. The regenerated bone in ß-TCP grafted extraction sockets showed an increased vascularization compared to ungrafted sites providing a vital support for subsequent implant placement.


Assuntos
Perda do Osso Alveolar/cirurgia , Perda do Osso Alveolar/terapia , Processo Alveolar/cirurgia , Regeneração Óssea/ética , Substitutos Ósseos/administração & dosagem , Fosfatos de Cálcio/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Processo Alveolar/efeitos dos fármacos , Materiais Biocompatíveis/administração & dosagem , Regeneração Óssea/efeitos dos fármacos , Estudos de Casos e Controles , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Endoscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Extração Dentária/métodos
20.
BMC Oral Health ; 19(1): 222, 2019 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623636

RESUMO

BACKGROUND: This study evaluated the operating performance of an implant navigation system used by dental students and dentists of prosthodontic background with varying levels of experience. A surgical navigation system and optical tracking system were used, and dentists' accuracies were evaluated in terms of differences between the positions of actually drilled holes and those of the holes planned using software before surgeries. METHODS: The study participants were 5 dental students or dentists who had studied in the same university and hospital but had different experience levels regarding implants. All participants were trained in operating the AqNavi system in the beginning of the study. Subsequently, using 5 pairs of dental models, each participant drilled 5 implant holes at 6 partially edentulous positions (11, 17, 26, 31, 36, and 47). In total, each participant conducted 30 drilling tests. RESULTS: In total, 150 tests among 5 dentists at 6 tooth positions (11, 17, 26, 31, 36, and 47) were conducted. Although a comparison of the tests revealed significant differences in the longitudinal error (P < .0001) and angular error (P = .0011), no significant difference was observed in the total error among the dentists. CONCLUSIONS: A relatively long operating time was associated with relatively little implant experience. Through the dental navigation system, dental students can be introduced to dental implant surgery earlier than what was possible in the past. The results demonstrated that the operational accuracy of the dental implant navigation system is not restricted by participants' implant experience levels. The implant navigation system assists the dentist in the ability to accurately insert the dental implant into the correct position without being affected by his/her own experience of implant surgery.


Assuntos
Competência Clínica , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Modelos Dentários , Odontólogos/psicologia , Boca Edêntula , Cirurgia Assistida por Computador/métodos , Adulto , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Cirurgia Assistida por Computador/instrumentação
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