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1.
Quintessence Int ; 51(3): 230-237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020133

RESUMO

OBJECTIVES: Severe atrophied edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal may require transposition of the inferior alveolar nerve in order to insert dental implants. Mandibular fractures are considered a rare complication of this procedure. Implant-related spontaneous fractures of the mandible represent 0.2% of patients with inserted implants in an edentulous mandible. This report presents two cases of mandibular fractures that occurred 3 to 4 weeks after inferior alveolar nerve transposition, and were managed successfully by conservative nonsurgical treatments. METHOD AND MATERIALS: Overall, 132 procedures of inferior alveolar nerve transposition in 98 patients were performed over a period of 10 years with 379 dental implants inserted in one stage with the procedure. Patients were examined every 2 weeks. The inferior alveolar nerve function was evaluated with various sensory tests. Panoramic radiographs were obtained immediately, at 3 months, and at 1 year after the surgery. The patients received implant-supported fixed prostheses after 3 to 5 months. RESULTS: The healing process was uneventful in 96 patients; however, in two patients (1.5%) spontaneous fracture of the treated site was observed 3 and 4 weeks postoperatively. The fractures lines occurred at a failed implant site. Both cases were treated conservatively. CONCLUSIONS: Spontaneous fractures following inferior alveolar nerve transposition are an important but rare complication. Conservative treatment modalities might be useful and indicated in some of those cases.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Fraturas Espontâneas , Fraturas Mandibulares , Tratamento Conservador , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Humanos , Mandíbula , Nervo Mandibular
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(1): 58-63, 2020 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-32071464

RESUMO

OBJECTIVE: To evaluate the short-term outcome of regenerative surgery for peri-implantitis therapy. METHODS: From March 2018 to January 2019, 9 patients with 10 implants who suffered from peri-implantitis were included in the present research. Vertical bone defect at least 3mm in depth with 2 or more residual bone walls was confirmed around each implant by radiographic examination. Restorations were replaced by healing abutments on 3 implants with the consent of the patients. Guided bone regeneration surgery was performed after a hygienic phase. During surgery, full thickness flaps were elevated on both buccal and lingual aspects. Titanium curette was used for inflammatory granulation tissue removal and implant surface cleaning. The implant surface was decontaminated by chemical rinsing with 3% hydrogen peroxide solution. After being thoroughly rinsed with saline, the bone substitutes were placed in bone defects which were covered by collagen membranes. 6 months after non-submerged healing, the clinical parameters including peri-implant probing depth (PD, distance between pocket bottom and peri-implant soft tissue margin) and radiographic bone level (BL, distance form implant shoulder to the first bone-to-implant contact) were used to evaluate the regenerative outcome. PD was measured at six sites (mesial, middle and distal sites at both buccal and lingual aspects) around each implant, and BL was measured at the mesial and distal surfaces of each implant on a periapical radiograph. RESULTS: The deepest PD and largest BL of each implant ranged from 6-10 mm and 3.2-8.3 mm respectively. All the implants healed uneventfully after surgery. The mean peri-implant PD at baseline and 6 months after surgery were (6.2±1.4) mm and (3.1±0.6) mm respectively, and a mean (3.0±1.5) mm radiographic bone gain was observed, P<0.01. Treatment success was defined as: no sites with residual PD≥6 mm, no bleeding on probing, and BL elevation of at least 1 mm. Nine implants from 8 patients fulfilled the success criteria. Residual pockets with 6 mm in depth and bleeding on probing could be detected in only one implant. CONCLUSION: Within the limitation of the present research, guided bone regeneration surgery can be used for the treatment of bone defect that resulted from peri-implantitis. Significant PD reduction and radiographic bone gain can be obtained after 6 months observation.


Assuntos
Perda do Osso Alveolar , Substitutos Ósseos , Implantes Dentários , Peri-Implantite , Colágeno , Humanos , Retalhos Cirúrgicos , Resultado do Tratamento
3.
Quintessence Int ; 51(2): 118-126, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942573

RESUMO

OBJECTIVE: Marginal bone loss (MBL), a prognostic parameter for implant success, is associated with implant- and patient-related variables. The purpose of this study was to analyze the effects of the crown-to-implant ratio and independent factors of implant diameter, implant length, implant type, location, and platform switching on distal and mesial MBLs at the 6-, 12-, 24-, and 36-month recall sessions of single crown implant-supported restorations. METHOD AND MATERIALS: Radiographic and clinical data of patients treated with single crown implants were collected. MBL was measured at the baseline and recall sessions on panoramic radiographs. The crown-to-implant ratio was calculated by dividing the length of the crown by that of the dental implant. RESULTS: The crown-to-implant ratio had a moderately positive correlation with distal MBL at the 6-month recall session (P < .05, r = 0.469) and a weakly positive correlation at the 12- (P < .05, r = 0.220), 24- (P < .05, r = 0.214), and 36- (P < .05, r = 0.250) month recall sessions. Distal and mesial MBL did not significantly differ among the four implant types at any recall session (P > .05). The crown-to-implant ratio had no significant correlation with mesial MBL at the 12-, 24-, or 36-month recall session (P > .05), and a moderately positive correlation at the 6-month recall session (P < .001, r = 0.434). CONCLUSIONS: MBL was similar among different implant types in the short and medium terms. There was a positive correlation between distal MBL and the crown-to-implant ratio.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Coroas , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Estudos Retrospectivos
4.
Quintessence Int ; 51(2): 128-141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942574

RESUMO

OBJECTIVES: The aim of this study was to determine the influence of patient-related systemic factors, local bone and intraoral factors, and implant-related factors on peri-implant marginal bone loss (MBL). METHOD AND MATERIALS: The following data were collected from patients who received dental implants and were recalled for examinations at least 3 years after treatment completion: medical history, age, sex, habits, periodontal health, implant size and surface, surgical procedure, prosthesis type, implant failure, Plaque Index, and oral hygiene. MBL was investigated using both baseline and follow-up panoramic radiographs. RESULTS: The study included 1,126 dental implants placed in 304 patients (185 [60.9%] women and 119 [39.1%] men). The mean age was 54.30 ± 13.52 years (range 22 to 83 years). The mean follow-up period was 58.8 ± 11.2 months. The MBL was observed in 271 (24.1%) implants, of which 160 (14.2%) were ≤ 2 mm and 111 (9.9%) were > 2 mm. Respective mean MBL values on mesial and distal sides were 0.42 ± 1.03 mm and 0.42 ± 1.02 mm. Of the implants, 19 (1.7%) were lost, leading to an implant success rate of 98.3%. Age, history of hysterectomy, history of periodontitis, oral hygiene, abrasions, smoking, implant location, implant surface, implant length, surgical procedure type, and prosthesis type were all found to be statistically significant for MBL (P < .05). Certain combinations of these factors resulted in increased MBL. CONCLUSION: In the present study, local factors had more significant effects on MBL than did systemic factors, and combinations of these factors had greater effects on MBL.


Assuntos
Perda do Osso Alveolar , Doenças Ósseas Metabólicas , Implantes Dentários , Adulto , Idoso , Idoso de 80 Anos ou mais , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Panorâmica , Estudos Retrospectivos , Adulto Jovem
5.
Int J Oral Maxillofac Implants ; 35(1): 25-38, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923287

RESUMO

PURPOSE: To examine the effect of controlled progressive orthodontic loading on bone around implants subjected to overloading forces. MATERIALS AND METHODS: Bilateral edentulous alveolar ridges were created in the posterior maxilla of five beagle dogs and left to heal for an 8-week period, after which 40 implants were placed. In the overloading group (OL), 16 implants were inserted and left to osseointegrate for 16 weeks; impressions were made, and metal crowns were mounted on with supraocclusal contacts with the antagonist teeth. Implants were exposed to dynamic overloading for 16 weeks. In the progressive loading + overloading group (PL+OL), 16 implants were left to osseointegrate for 8 weeks, and custom abutment cores were fabricated and coupled by pairs with Ni-Ti orthodontic springs. Ascending static forces of 100g, 200g, and 300g were each applied for a 3-week period, for a total 9-week progressive loading period. Thereafter, metal crowns with supraocclusal contacts were adapted, and a 16-week overloading protocol for implants was followed as for the overloading group. In the unloaded control group (UL), eight implants were inserted and left uncovered and unloaded for 32 weeks, that is, until the end of the experimental period, at which point all 40 implants were removed with the surrounding bone. Histologic, histomorphometric, and statistical analysis followed. RESULTS: Higher bone-to-implant contact percentage was reported for the OL group (P = .006) and PL+OL group (P < .001) compared with the UL group. Between the OL and PL+OL groups, the addition of progressive loading did not increase the bone-to-implant contact percentage (P = .225). Bone density 1 mm and 2 mm distant to the threads did not differ significantly between the three groups. Significantly lower crestal bone resorption was detected around OL group implants (P = .006) and PL+OL group implants (P = .004) compared with the UL group implants. The implant success rate was 87.5% for the UL group, 67.5% for the OL group, and 87.5% for the PL+OL group. CONCLUSION: The application of controlled progressive orthodontic loading on osseointegrated implants preceding overloading forces did not increase bone-to-implant contact. When applied, overloading significantly increased bone-to-implant contact compared with the unloaded implants. A significantly higher implant success rate was reported in the PL+OL group compared with the OL group.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Animais , Implantação Dentária Endo-Óssea , Cães , Implantes Experimentais , Mandíbula , Maxila , Osseointegração
6.
Int J Oral Maxillofac Implants ; 35(1): 52-62, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923289

RESUMO

PURPOSE: Among all previous studies, history of periodontitis (HP) has been regarded as a negative indicator for peri-implant health. However, the role of HP under regular supportive post-implant treatment (SPT) has not yet been evaluated. The aim of this review was to evaluate whether HP remains a negative indicator even under regular SPT in terms of clinical outcomes. MATERIALS AND METHODS: Two independent reviewers conducted electronic and manual searches of the literature in English from January 2003 to May 2018. Human clinical studies including both patients with and without HP under SPT with more than 1-year follow-up and complete information about peri-implant conditions were included. Risk ratio (RR) for implant survival rate, weighted mean difference (WMD) for radiologic marginal bone loss, pocket depth, bleeding on probing, and Plaque Index were analyzed to compare the outcomes in patients with and without HP. RESULTS: Thirteen human studies fulfilling the inclusion criteria were selected. Based on the results of meta-analyses, in implants with a rough surface, even under the regular SPT, the HP group showed a lower implant survival rate (RR: 0.96, 95% confidence interval [CI]: 0.94 to 0.98, P < .001) and more radiologic marginal bone loss (WMD: 0.34 mm, 95% CI: 0.20 to 0.48, P < .001), pocket depth (WMD: 0.47 mm, 95% CI: 0.19 to 0.74, P < .001), and bleeding on probing (WMD: 0.08 mm, 95% CI: 0.04 to 0.11, P < .001) than the non-HP group. In implants with a machined surface, HP also showed a negative effect on bone loss (WMD: 0.88 mm, 95% CI: 0.65 to 1.11, P < .001). However, in implants with a machined surface, no statistical significance in survival rate was found between HP and non-HP patients (RR: 0.98, 95% CI: 0.92 to 1.04, P = .895). CONCLUSION: Within the limitations of this review, HP remains a negative indicator for implant survival even under regular supportive post-implant treatment coverage in rough-surfaced implants.


Assuntos
Implantes Dentários , Perda do Osso Alveolar , Índice de Placa Dentária , Humanos , Periodontite , Fatores de Risco
7.
Int J Oral Maxillofac Implants ; 35(1): 130-134, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923296

RESUMO

PURPOSE: Proton pump inhibitors (PPIs) are prescribed for the treatment of gastric reflux disease, but such medications might also influence bone metabolism. Therefore, the primary goal of this study was to determine if bone loss severity at dental implants could be associated with PPI use. MATERIALS AND METHODS: Dental, medical, and radiographic history records of patients receiving dental implants at the University at Buffalo, School of Dental Medicine from 2000 to 2017 were reviewed in this retrospective clinical study. Bone loss around each implant was evaluated radiographically by direct measurement of crestal bone loss and by counting the number of radiographically evident exposed threads. PPI use was confirmed by medical record examination. The effects of systemic factors were assessed. Confidence intervals (CI) and P values of mean differences between PPI and non-PPI groups were computed via IBM SPSS Statistics v.25. RESULTS: A total of 1,480 implants from 635 patients were used in this study. Greater crestal implant bone loss was associated with patients with a history of PPI medication use. Mean crestal bone loss of 1.60 mm was noted at implants from PPI patients, in contrast to 1.01 mm of crestal implant bone loss at implants from the non-PPI group (group difference = 0.59 mm, 58.40% increase, P = .024, CI [95%] = 0.08 to 1.09 mm). Following adjustment for systemic factors, those effects persisted, with crestal implant bone loss of 1.87 mm from PPI patients, in contrast to 1.04 mm from non-PPI patients (group difference = 0.83 mm, 79.80% increase, P = .028, CI [95%] = 0.09 to 1.56 mm). Similarly, 0.63 exposed threads per implant were found in the PPI group, in contrast to 0.38 supracrestal implant threads in the non-PPI patient group (mean difference = 0.25 exposed threads, 65.8% increase, P = .039, CI [95%] = 0.01 to 0.50 mm). After excluding systemic factors, a similar pattern was observed with 0.79 vs 0.36 threads exposed from subjects taking PPIs, compared with those not taking PPIs, respectively (mean difference = 0.43 exposed threads, 119.4% increase, P = .014, CI [95%] = 0.09 to 0.77 mm). CONCLUSION: The data suggest that PPI medications are related to more loss of crestal bone at implant sites. Patients receiving implant therapy might require more frequent periodontal maintenance.


Assuntos
Implantes Dentários , Perda do Osso Alveolar , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Humanos , Inibidores da Bomba de Prótons , Estudos Retrospectivos
8.
Int J Oral Maxillofac Implants ; 35(1): 178-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923300

RESUMO

PURPOSE: The aim of this investigation was to compare the chewing efficiency after immediate and delayed loading of mini-implants that served as supplementary support for removable partial dentures (RPDs). MATERIALS AND METHODS: In this four-center randomized trial, patients who had RPDs in arches with unfavorable tooth distributions, ie, no canine and at most two posterior teeth in one or both quadrants, received strategic mini-implants with ball abutments. The mini-implants in group A were loaded immediately either by housings with O-rings (insertion torque ≥ 35 Ncm) or by soft relining material (insertion torque < 35 Ncm). In group B, the RPDs were only hollowed over the balls. After 4 months, the soft relined RPDs and all RPDs of group B received the housings. Masticatory efficiency was evaluated with a validated mixing ability test of two-colored chewing gum before surgery and 14 days, 4 months (before housing pickup), 4.5 months, and 12 months after surgery. The circular variance of hue was the measure of mixing. RESULTS: From 76 participants with 79 RPDs, 38 each were randomly allocated to group A or B. In group A, the housings in six participants were picked up immediately, and the remaining RPDs were primarily soft relined. There was a significant group difference only after 4 months. The mixing ability was better after immediate loading than after delayed loading (P < .0001). In group B, the chewing efficiency was notably deteriorated after the RPDs were hollowed over the ball abutments. However, immediately after all housings were picked up, the chewing efficiency in both groups was substantially improved, and the variance of hue values after 1 year were very similar in the groups. CONCLUSION: The chewing performance can be improved by inserting supplementary mini-implants under existing RPDs with unfavorable tooth support. This improvement occurred faster by immediate loading than by delayed loading.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Prótese Parcial Removível , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mastigação
9.
J Oral Sci ; 62(1): 98-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996534

RESUMO

This study evaluated marginal bone loss and prosthetic complications associated with single implant-retained mandibular overdentures (1-IODs) with locator attachments. The 1-IOD was placed in the mandibular midline by using a conventional loading protocol in 22 patients with an edentulous mandible. Marginal bone loss at the start of loading and 12 months postoperatively was assessed by radiographic and crestal bone evaluation. The crestal bone was defined as the distance between the customized abutment shoulder and the top of the bone, as indicated by probing. In addition, implant stability quotient and prosthetic complications were recorded. The cumulative implant survival rate was 95.5%. Median implant stability quotient remained greater than 80, and median radiographic bone loss was 0.56 mm. Crestal measurement showed a median crestal bone loss of 0.16, 0.43, 0.39, and 0.52 mm on the buccal, right, lingual, and left sides, respectively. Both radiographic and crestal bone loss values significantly differed between the start of implant loading and 12 months postoperatively (except on the buccal and lingual sides; P < 0.05). The need to replace the nylon insert was the most common complication. Conventional loading of a 1-IOD with a locator attachment resulted in a high survival rate, good implant stability, and acceptable marginal bone loss.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Mandíbula
10.
J Prosthodont ; 29(2): 101-106, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31916642

RESUMO

PURPOSE: To retrospectively evaluate the treatment outcome of immediate implants placed in fresh extraction sockets without bone augmentation after 22 years of function. MATERIALS AND METHODS: The study group received implant therapy in 1997, including surgical placement and prosthodontic rehabilitation. The mean age of the subjects at the time of implant placement was 40 ± 5.54 years. A total of 35 subjects received 36 implants in fresh extraction sockets without bone augmentation. Definitive prostheses were placed 4 to 6 months after implant placement. Implant treatment outcomes were evaluated using clinical and radiographic parameters obtained during follow-up visits at 1, 5, 10, 15, 20, and 22 years after prosthetic loading. RESULTS: Among the 35 treated subjects, five patients moved out of the country and could not be evaluated at the follow-up times. A total of 29 subjects were included in the study with a drop-out rate of 14.1%. Of these, one patient lost the implant during the osseointegration period before prosthodontic treatment. No other implant failure or complication during the rest of the follow-up period was reported, thus giving a cumulative survival rate of 97.2% during the 22-year follow-up. The change in marginal bone level was less than 2 mm in most subjects at the 22-year examination. The mean bone loss from baseline to 22-year follow-up was 1.61 mm, and the mean bone level at the 22-year follow-up examination was situated at 2.13 ± 0.023 mm from the implant platform, which was used as the reference point. CONCLUSIONS: Immediate implant placement in extraction sockets exhibits excellent prognosis even when bone augmentation is not performed.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Adulto , Implantação Dentária Endo-Óssea , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Extração Dentária , Alvéolo Dental , Resultado do Tratamento
11.
Quintessence Int ; 51(2): 142-150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31781692

RESUMO

OBJECTIVE: High levels of primary implant stability have been advocated particularly for immediate loading protocols. Current implant systems and drill protocols are intended not to cause excessive stress on bone during implant insertion as resorptive processes might compromise esthetics and function. The goal of this narrative review was to summarize current data on the effect of mechanical stress on alveolar bone. METHOD AND MATERIALS: PubMed was searched (final search conducted on 30 September 2019) applying the user query "(dental implant insertion) AND (mechanical stress) AND (bone)." The papers identified were grouped according to the research methodology applied (in vitro studies and finite element analysis, animal studies, and clinical trials). RESULTS: In total, 176 articles were identified, of which 58 were included. A clear tendency towards increased stress in bone resulting from the use of undersized osteotomies was shown. Depending on the degree of undersizing, the inner parts of implant threads create healing chambers in which bone formation seems to progress very well, while areas of direct contact between implant body and alveolar bone experience resorption during healing. More resorption seems to occur when implants have been placed with higher insertion torque, although these implants maintain greater total bone-to-implant contact during initial healing. Clinically, mobile implants seem to have a compromised prognosis and high insertion torques seem not to guarantee successful osseointegration. Marginal bone level changes obviously have a tendency of being greater in implants inserted with high levels of torque. CONCLUSION: Clinicians should be cautious during implant surgery not to overstress bone. Future implant systems should focus on optimized drill protocols and apply macrodesigns that also derive stability from trabecular bone as well, instead of merely compressing the cortical layer.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Animais , Implantação Dentária Endo-Óssea , Osseointegração , Estresse Mecânico , Torque
12.
J Appl Oral Sci ; 28: e20190140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31800874

RESUMO

OBJECTIVE: The goal of the present study was to determine the effect of systemic and topical ozone application on alveolar bone loss (ABL) by evaluating the effect of Hypoxia-inducible factor -1 alpha (HIF-1-α) and receptor activator of NF-kB ligand (RANKL)-positive cells on histopathological and immunohistochemical changes in a rat periodontitis model. METHODOLOGY: Thirty male Wistar rats were divided into three groups: 1) Group C (control group); 2) Group SO (systemic ozone group) and 3) Group TO (topical ozone group). Experimental periodontitis was induced with a 3/0 silk suture placed at the mandibular left first molars of rats, and the suture was removed 14 days later. Ozone gas was injected intraperitoneally (0.7 mg/kg) in SO group. Topical ozone application protocol was performed using an ozone generator at 80% concentration (4th grade) 90- degree probe for the duration of 30 s. Both ozone applications were carried out for two weeks at intervals of two days. Histomorphometric and immunohistochemical analysis were performed. RESULTS: ABL was significantly lower in Group SO compared to Group C (p: 0.0052). HIF-1α- positive cells were significantly lower in Group TO than in Group C (p: 0.0043). RANKL-positive cells were significantly lower in Group SO and in Group TO compared to the control group (p: 0.0033, p: 0.0075, respectively). CONCLUSION: Both ozone applications decreased RANKL-positive cell counts, TO application decreased HIF-1-α positive cells counts, and SO application was found to be more effective in reducing ABL compared to control group.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Perda do Osso Alveolar/patologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/análise , Ozônio/administração & dosagem , Periodontite/tratamento farmacológico , Periodontite/patologia , Administração Tópica , Animais , Contagem de Células , Imuno-Histoquímica , Masculino , Ligante RANK/análise , Ratos Wistar , Reprodutibilidade dos Testes , Resultado do Tratamento
13.
Clin Oral Implants Res ; 31(1): 64-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31605405

RESUMO

OBJECTIVE: The aim of this multicenter parallel-group randomized controlled trial is to compare 6-mm-short with 11-mm-long implants in the rehabilitation of totally edentulous mandible in a completely comparable clinical situation, from anatomical, surgical, and prosthetic point of view. MATERIAL AND METHODS: Thirty patients were selected in three study centers to receive a fixed full-arch mandibular rehabilitation supported by five inter-foraminal implants. Patients were randomly allocated, at the time of surgery, half to the test group (6-mm-long implants) and half to the control group (11-mm-long implants). No bone augmentation procedure was performed. After 3 months, a screw-retained full-arch prosthesis with distal cantilevers was positioned (baseline). Peri-implant marginal bone level change (MBLc), implant and prosthesis survival rate, and biological/technical complications were evaluated after 1 and 3 years. RESULTS: Thirty subjects (150 implants) were evaluated after 1 year and 28 (140 implants) after 3 years. No implant or prosthesis loss occurred. No significant inter-group difference for biological/technical complications was registered. No statistically significant (p > .025) intra-group or inter-group difference in the mean MBLc values was registered. The mean MBLc was 0.01 ± 0.19 mm and -0.04 ± 0.21 mm at 1 year, and -0.10 ± 0.24 mm and 0.02 ± 0.25 mm at 3 years (test and control groups, respectively). CONCLUSIONS: 6-mm-short implants may be a reliable option when used in the rehabilitation of total edentulous mandibles. These results need to be confirmed by longer follow-up data from well-designed randomized controlled clinical trials.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Arcada Edêntula , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Mandíbula , Resultado do Tratamento
14.
Odontology ; 108(1): 133-142, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31278484

RESUMO

The objective of the current study was to demonstrate the 6-year clinical and radiological treatment outcomes of the technique performed by immediately loading of three implants (single straight in the mid-line and two tilted distal implants) for the management of total edentulous mandibles and introduce a simple decision matrix for selection of the most appropriate protocol in cases with insufficient length of the interforaminal area. Re-assessments were performed over a total observation period of 6 years after surgery via measurement of bone resorption around implants, bleeding on probing, plaque accumulation, periodontal probing depth, bite force measurements and oral health impact profile. A total of 29 patients (45% women and 55% men) with a mean age of 65 ± 6 years enrolled in the study. 14 patients received an acryl-based bridge as definitive prosthetic restoration and 15 patients received a ceramic-based restoration. Both during the immediate loading phase and during the 6-year follow-up, there was no implantation loss. Regardless of the implant position, all implants showed continuous bone loss over the observation time. The bone loss around dental implants during observation period was only maximum 1.0 ± 1 mm and it remained well within the limits for 'success' according to the 2007 Pisa consensus (< 2 mm). The plaque index showed no significant fluctuations between the implant positions and the individual examination times. The approach described herein might help the surgeon by avoiding unnecessary loss of bone strength, selecting implant sites, and establishing the biomechanical advantage of increased A-P spread for immediate function.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Arcada Edêntula , Idoso , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Resultado do Tratamento
15.
Int J Oral Maxillofac Surg ; 49(1): 121-134, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31255443

RESUMO

The aim of this study was to analyse the influence of different loading protocols on marginal bone loss (MBL). The outcomes of different implant loading protocols were assessed at 1year after implantation, with focus on MBL; protocols included immediate, immediate non-occlusal, early, and conventional loading. The search strategy resulted in 889 studies. Twenty-two of these studies fulfilled the inclusion criteria. Among the included studies, the lowest MBL was for immediately loaded implants (0.05±0.67mm) and the highest for immediate non-occlusally loaded implants (1.37±0.5mm). The results of the meta-analysis showed an estimated mean MBL of 0.457mm (95% confidence interval (CI) 0.133-0.781) for immediate loading, 0.390mm (95% CI 0.240-0.540) for immediate non-occlusal loading, 0.488mm (95% CI 0.289-0.687) for early loading (>2 days to <3 months), and 0.852mm (95% CI 0.429-1.275) for conventional loading (>3 months) implant protocols. The lowest decrease in 1-year implant survival per millimetre increase in MBL was observed for immediate loading and the highest for conventional loading. Conventional loading showed a significantly higher MBL than the other three loading protocols. This systematic review and meta-analysis indicates that the immediate loading protocol is a reasonable alternative to the conventional loading protocol.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Fatores de Tempo
16.
Clin Oral Implants Res ; 31(1): 1-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31472087

RESUMO

OBJECTIVES: The aim of this randomized, controlled, parallel-arm study was to evaluate the (a) radiographic bone dimensional changes, (b) postoperative discomfort, and (c) early soft tissue wound healing outcomes, following extraction of maxillary anterior teeth (central and lateral incisors) and treatment with alveolar ridge preservation (ARP) with and without the adjunctive use of enamel matrix derivative (EMD). METHODS: Thirty extraction sockets were randomly assigned to two groups: deproteinized bovine bone mineral with 10% collagen covered with collagen membrane with the adjunctive use of EMD (test group) and without EMD (control group). Bone dimensional changes were measured using cone beam computed tomography at 3 and 5 months after ARP. The severity and duration of pain and swelling were evaluated using self-reported questionnaires, and soft tissue wound healing outcomes were assessed clinically. Chi-square tests and t tests were conducted to compare differences between the two groups. RESULTS: Radiographic and clinical analyses showed no significant differences in horizontal and vertical bone dimensional changes and soft tissue wound healing outcomes (including spontaneous bleeding, persistent swelling, and ulceration) between the two groups. There were no significant differences in the severity of pain and swelling between the two groups, but the durations of pain (difference [df] = 1.20, 95% CI = 0.33-2.06; p = .008) and swelling (df = 1.06, 95% CI = 0.11-2.01; p = .029) were significantly reduced in the test group. CONCLUSION: Alveolar ridge preservation with the adjunctive use of EMD reduced the durations of postoperative pain and swelling following maxillary anterior teeth extraction.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Processo Alveolar , Animais , Bovinos , Humanos , Maxila , Extração Dentária , Alvéolo Dental
17.
Med Oral Patol Oral Cir Bucal ; 25(1): e117-e123, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31880284

RESUMO

BACKGROUND: Titanium- prepared platelet rich fibrin (T-PRF) is an autologous hemo-component with a high concentration of platelets that also incorporates leukocytes, and growth factors into the dense fibrin matrix and can be used as a healing biomaterial. This study assesses the adjunctive use of T-PRF in intrabony defects (IBDs) with open flap debridement (OFD) in comparison with guided tissue regeneration (GTR) as a gold standard and OFD alone as a control. MATERIAL AND METHODS: A total of 45 patients (15 per group) were randomized as either T-PRF (test group), GTR (test group), or OFD alone (control group) sites. Probing depth (PD), clinical attachment level (CAL), and IBD were recorded. The radiographic depth of IBD was also measured. Primary outcomes assessed were changes in PD, CAL, and radiographic IBD that were assessed at the beginning and nine months later.  Results: The PRF and GTR group showed significant improvement in clinical parameters compared with the OFD alone (control group) at nine months. While there were no significant differences in PD and CAL between test groups (T-PRF and GTR groups), the significant difference was found in radiographic IBD depth. CONCLUSION: T-PRF may give similar successful results as GTR in the treatment of IBDs with endo-perio lesions.


Assuntos
Perda do Osso Alveolar , Fibrina Rica em Plaquetas , Desbridamento , Regeneração Tecidual Guiada Periodontal , Humanos , Titânio , Resultado do Tratamento
18.
Arch Oral Biol ; 110: 104624, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31841964

RESUMO

Dexamethasone has been widly used in oral and maxillofacial surgery for controlling of postoperative surgical inflammation. Despite its clinical effectiveness, several studies have demonstrated the negative impact of this drug on the healing of soft and hard tissues. This study aimed to assess the effects of different pre-operative doses of dexamethasone on alveolar repair. Sixty rats were divided into four groups of 15 animals each. Single pre-operative doses of dexamethasone equivalent to human doses of 4 mg (Group 4 mg), 8 mg (Group 8 mg), and 12 mg (Group 12 mg), calculated by allometric dose extrapolation, were administered; and rats in the Control Group were injected with saline solution. The animals were anesthetized, and their left mandibular first molars (M1) were removed. After three, seven, and 40 days, 5 animals from each group were euthanized, and bone samples of M1 alveolus were collected for radipgraphic, histomorphological and histometric evaluation of the early and late phases of alveolar healing. At three days, Group 12 mg presented reduced radiographic density, percentage of collagen, and connective matrix compared with the Control Group. At 7 days, the percentage of bone was increased in the Control Group compared to Groups 8 mg and 12 mg (P < 0.05). It can be concluded that a single pre-operative dose of 12 mg of dexamethasone affected the early stages of alveolar repair in rats.


Assuntos
Anti-Inflamatórios , Dexametasona , Mandíbula , Extração Dentária , Alvéolo Dental , Perda do Osso Alveolar , Animais , Anti-Inflamatórios/farmacologia , Colágeno , Dexametasona/farmacologia , Humanos , Mandíbula/efeitos dos fármacos , Dente Molar , Ratos
20.
Int J Prosthodont ; 33(1): 111-115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860921

RESUMO

The primary concern in carrying out dental implant treatment in patients with chronic myelogenous leukemia is the development of peri-implantitis. However, currently, the advent of molecular-targeted drugs such as nilotinib markedly improves the survival rates in such patients, and it is reported that remission status can be maintained for a long time without abnormalities such as a decrease in white blood cell count. This case history report discusses an 8-year follow-up of implant treatment administered during the remission phase of chronic myelogenous leukemia maintained using nilotinib. A 56-year-old male patient who was undergoing treatment for chronic myelogenous leukemia at the Department of Hematology requested a dental consultation for the treatment of a mastication disorder due to loss of mandibular left molars. After confirming via oral and radiographic examination that there were no abnormalities such as periodontal disease, temporomandibular joint symptoms, or metal allergy, two Brånemark System Mk III implants with diameters of 3.75 and 5 mm and lengths of 10 and 8.5 mm, respectively, were embedded in the defect. Following this, no problems were observed in the general condition, esthetics, or oral function around the implant. Further, symptoms such as mobility of the implant body or inflammation of the surrounding tissue have not appeared to this day, as the molecular-targeted drug decreases the occurrence of immunosuppression, which could not be achieved conventionally. Although this is only one instance, the possibility of implant treatment for chronic myelogenous leukemia patients in the remission phase has been presented in this case.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Leucemia Mielogênica Crônica BCR-ABL Positiva , Peri-Implantite , Implantação Dentária Endo-Óssea , Estética Dentária , Humanos , Masculino , Pessoa de Meia-Idade
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