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1.
Artigo em Inglês | MEDLINE | ID: mdl-33819328

RESUMO

A postextraction socket is always open to different treatment possibilities. A straightforward clinical classification may help evaluate which surgical approach is best suited for the case being treated. Four different classes are defined on the basis of the local anatomy of the site, available bone volume, and soft tissue level. For every clinical situation, either immediate placement, early placement, alveolar ridge preservation, or staged approach can be selected as a treatment modality according to the classifications listed.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Processo Alveolar/cirurgia , Assistência Odontológica , Humanos , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
2.
Artigo em Inglês | MEDLINE | ID: mdl-33819334

RESUMO

The efficacy of the socket preservation procedure using deproteinized bovine bone mineral, bioabsorbable collagen membrane, and collagen sponge on molar extraction sites with severe periodontitis was assessed at 6 postoperative months, before implant placement. Results revealed excellent soft tissue healing without loss of keratinized tissue and no statistically significant differences in socket marginal bone changes in 20 molar extraction sockets. High levels of primary implant stability were recorded. Socket preservation using a minimally invasive surgical technique provides good soft and hard tissue healing as well as anticipated stability of implant placement at sites of extracted molars with severe periodontitis.


Assuntos
Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/prevenção & controle , Perda do Osso Alveolar/cirurgia , Animais , Bovinos , Humanos , Dente Molar/cirurgia , Periodontite/cirurgia , Extração Dentária , Alvéolo Dental/cirurgia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33819335

RESUMO

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


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Tomografia Computadorizada de Feixe Cônico Espiral , Coroas , Dente Suporte , Implantação Dentária Endo-Óssea , Humanos , Membrana Mucosa
4.
Medicine (Baltimore) ; 100(8): e24311, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663048

RESUMO

RATIONALE: Necrotizing periodontal diseases (NPDs) are a group of infectious diseases varying in severity, and microorganisms are responsible for these diseases. Currently, the oral microbiota in early disease has been poorly investigated; thus, the causative pathogen and dynamic alteration of the microbiome in NPDs remain unclear. PATIENT CONCERNS: We report a case of a 33-year-old female patient with severe gingival pain and localized necrotizing ulcerative gingival lesions. Conventional therapy was performed, but the necrotizing lesion continued to develop. DIAGNOSES: X-ray examination showed marginal alveolar bone loss in the involved teeth. Histological examination of a biopsy from the gingival lesion showed chronic inflammatory cell infiltration in the tissue, and no cancer cells were observed. Subgingival swabs were taken from the ulcerative gingiva and the gingiva that was not yet affected, and the composition of the microbiota was analyzed by targeted pyrosequencing of the V3-V4 hypervariable regions of the small subunit ribosomal RNA. We found that Neisseria spp., Corynebacterium spp., and Prevotella spp. were clearly enriched in the lesion site. However, Fusobacteria was more abundant in the not-yet-affected gingiva, and Leptotrichia spp. were the most abundant phylotype. INTERVENTIONS: After clinical assessment, a tooth with poor prognosis was extracted, and minocycline hydrochloride was locally administered in the involved tooth pocket every day. Additionally, the patient received 100 mg of hydrochloric acid doxycycline twice per day. OUTCOMES: Remarkable improvement was obtained after 3 days, and the lesion completely healed after 1 week. The follow-up examination 1 year later showed a complete recovery with no recurrent episodes of pain. LESSONS: Changes in the subgingival microbiome can occurr before clinical symptoms appears, and Fusobacteria may be involved in the imbalance of the subgingival flora in the early stage of NPDs. Moreover, Neisseria is a potential bacterial candidate that deserves further study.


Assuntos
Periodontite Crônica/microbiologia , Periodontite Crônica/patologia , Microbiota/fisiologia , Adulto , Perda do Osso Alveolar , Antibacterianos/uso terapêutico , Periodontite Crônica/tratamento farmacológico , Periodontite Crônica/cirurgia , Feminino , Humanos , Necrose
5.
Artigo em Inglês | MEDLINE | ID: mdl-33572988

RESUMO

Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner® VEGA® implants with a ContacTi® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level-not the osseointegration rate, clinical conditions, or PROMs.


Assuntos
Perda do Osso Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Falha de Restauração Dentária , Prótese Parcial Fixa , Seguimentos , Humanos , Osseointegração , Próteses e Implantes , Resultado do Tratamento
6.
J Am Dent Assoc ; 152(3): 189-201.e1, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33632408

RESUMO

BACKGROUND: The impact of hyperglycemia on dental implant therapy remains unclear. In this systematic review and meta-analysis, the authors compared the rates of implant failure and peri-implant bleeding on probing (BOP), probing depth (PD), and peri-implant bone loss (PIBL) among patients with type 2 diabetes mellitus and nondiabetic patients. The authors performed subgroup analyses based on glycemic level to evaluate whether patients with higher glycemic levels were more prone to peri-implant inflammation. TYPE OF STUDIES REVIEWED: The authors searched 4 databases for original clinical studies. Studies in which the researchers provided information on the rate of implant failure or peri-implant parameters were included. RESULTS: Nine clinical studies were identified on the basis of the inclusion criteria. No significant differences were found in rates of implant failure (P = .46) and PD (P = .1) between diabetic and nondiabetic patients. Significant differences in BOP (P < .00001) and PIBL (P = .02), favoring nondiabetic patients, were observed. Results of subgroup analyses indicated that the increase in glycemic level did not significantly influence BOP, PD, and PIBL values among diabetic patients. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Patients with type 2 diabetes mellitus seem to be able to achieve a rate of implant survival similar to that of healthy patients. Regarding peri-implant parameters, BOP and PIBL were higher in patients with type 2 diabetes mellitus, indicating that hyperglycemia is an important risk factor for peri-implant inflammation. No association was found between peri-implant parameters and glycemic level among patients with type 2 diabetes mellitus, providing oral hygiene was strictly maintained.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Diabetes Mellitus Tipo 2 , Hiperglicemia , Peri-Implantite , Índice de Placa Dentária , Diabetes Mellitus Tipo 2/complicações , Humanos , Hiperglicemia/etiologia , Índice Periodontal
7.
Artigo em Inglês | MEDLINE | ID: mdl-33528445

RESUMO

Vertical bone augmentation (VBA) procedures for dental implant placement are biologically and technically challenging. Systematic reviews and meta-analyses of studies on VBA have failed to identify clinical procedures that provide superior results for treatment of the vertical ridge deficiencies. A decision tree was developed to guide clinicians on selecting treatment options based on reported vertical bone gains (< 5 mm, 5 to 8 mm, > 8 mm). The choice of a particular augmentation technique will also depend on other factors, including the size and morphology of the defect, location, and clinician or patient preferences. Surgeons should consider the advantages and disadvantages of each option for the clinical situation and select an approach with low complications, low cost, and the highest likelihood of success.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Implantes Dentários , Perda do Osso Alveolar/cirurgia , Transplante Ósseo , Árvores de Decisões , Implantação Dentária Endo-Óssea , Humanos
8.
Artigo em Inglês | MEDLINE | ID: mdl-33528449

RESUMO

This prospective longitudinal clinical trial aimed to evaluate the success of a bone-level implant with an integrated platform-switched connection by assessing peri-implant soft tissue and marginal bone level. Twenty-six patients were treated in two different centers with implants placed in healed partially edentulous ridges. Implant success rate and marginal bone level were evaluated with photographs, radiographs, and clinical measurements, with a 6-month postloading follow-up. The esthetic appearance of the photographed peri-implant soft tissue was evaluated at 6 months via the Pink Esthetic Score applied by two calibrated operators. All of the implants except for one placed in the mandible demonstrated successful osseointegration, resulting in a success rate of 97.8% at the 6-month follow-up. Compared to historical controls, no detectable differences in peri-implant marginal bone loss or esthetic outcome were seen.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Implantação Dentária Endo-Óssea , Seguimentos , Humanos , Mandíbula/cirurgia , Osseointegração , Estudos Prospectivos
9.
Artigo em Inglês | MEDLINE | ID: mdl-33528451

RESUMO

The purpose of this prospective study was to evaluate the success rates and prosthetic complications of implants with a modified sandblasted and acid-etched (SLA) surface inserted for posterior single-implant crown restorations. Final crowns were placed 3 to 4 weeks after surgery, and patient follow-up spanned 10 years in a private practice setting. A total of 22 patients (8 women, 14 men) with 25 posterior implants placed (16 mandible, 9 maxilla) were selected, including only implants for posterior single-implant crowns with insertion torque values of ≥ 35 Ncm at placement. Twenty-one implants passed the reverse torque test at 3 to 4 weeks after implant placement, and final restorations were placed. Three patients (4 implants) had "spinners," and there was one patient dropout after completion of the final restoration. All patients were recalled for clinical exams, digital periapical radiographs, and clinical photos at short-term (≤ 5 years) and long-term (> 5 years) follow-up appointments. The Community Periodontal Index of Treatment Needs was also determined at the initial and follow-up visits. Crestal bone level was measured at crown placement (T1), short-term follow-up (T2; mean: 29.4 months), and long-term follow-up appointments (T3; mean: 114.4 months). Twenty patients (23 implants) returned for examination at T2, and 15 (18 implants) were available at T3. For the 17 implants available at all evaluations, statistically significant bone loss was found from T1 to T2 (0.23 ± 0.30 mm), and the mean crestal bone level appeared stable from T2 to T3. Based on clinical and radiographic findings, the success rate for the implants and restorations at T2 and T3 was graded as 100%. Therefore, it can be stated that an early loading protocol of 3 to 4 weeks using a modified SLA surface at premolar/molar single-tooth locations can result in favorable clinical and radiographic long-term results.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Coroas , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Osseointegração , Estudos Prospectivos , Titânio
10.
Artigo em Inglês | MEDLINE | ID: mdl-33528456

RESUMO

The aim of the present study was to retrospectively evaluate the longevity of teeth and implants during a long-term period in a cohort of periodontally compromised patients, treated and maintained in a private specialist periodontal practice, and to analyze the associated risk factors. Fifty-eight patients (30 men, 28 women) who had received active periodontal therapy (APT) and regular periodontal maintenance (PM) ≥ 10 years were included and evaluated. The following were evaluated: (1) statistically significant differences of clinical parameters assessed at six tooth or implant sites (plaque scores, bleeding score, periodontal probing depth, bleeding on probing, and gingival recession) and radiographic parameters (mesial and distal bone crest loss) between patients with and without tooth/implant loss during PM; and (2) associations between the number of teeth and implants lost and potential risk factors. During PM, the overall average tooth loss was 0.07 teeth/patient/year (0.04 teeth/patient/year for periodontal reasons), while the overall average implant loss was 0.4 implants/patient/year. The overall implant failure was 10.08%, and the rate of implant failure due to biologic reasons was 9.8%. Incidence of implant failures in patients with vs without recurrent periodontal disease was 83.3% vs 16.7% (P < .05). Results showed that in chronic periodontitis patients, ATP followed by long-term PM is successful in keeping the majority of periodontally compromised teeth. In the same patients, a higher tendency for implant loss than tooth loss was found.


Assuntos
Perda do Osso Alveolar , Periodontite Crônica , Implantes Dentários , Periodontite Crônica/complicações , Periodontite Crônica/terapia , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Manutenção , Masculino , Estudos Retrospectivos
11.
Int J Oral Maxillofac Implants ; 36(1): 59-67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600524

RESUMO

PURPOSE: Short dental implants serve as a valuable alternative for patients with limited bone height. Immediate or early provisionalization facilitates a more physiologic environment for the gingival tissues to be modeled. The purpose of this meta-analysis was to systematically review and evaluate the implant survival and marginal bone loss with immediate and early loading protocols of short dental implants (≤ 6 mm). MATERIALS AND METHODS: A literature search (electronic and manual) was conducted to identify studies with a focused PICO question: "In patients with short dental implants, does loading time affect treatment outcomes?" Studies using an immediate or early loading protocol for restoration of short implants with a mean follow-up of at least 1 year, and refraining from the use of advanced surgical procedures (sinus floor elevation, bone augmentation), were included. After evaluating patient selection and outcome reporting biases, a meta-analysis was conducted to assess implant survival and bone loss for studies fulfilling the inclusion criteria. Bone loss differences between immediate and early loading protocols were evaluated by Student t test, and Spearman correlation analysis was used to analyze the trends between crown-to-implant (C/I) ratio and bone loss. RESULTS: A total of 396 studies with patients receiving short implants (≤ 6 mm) with immediate or early prosthetic loading protocols were identified. For the 7 included studies, the pooled implant survival rate for 322 implants with a follow-up ranging from 1 to 10 years (5 years) was 91.63% (95% CI: 88% to 94%), with a mean bone loss effect estimate of 0.52 ± 0.1 mm (z = 3.07, P < .002). The differences observed in the mean bone loss for studies using immediate loading as opposed to early loading were not statistically significant. A moderate but significant positive correlation was observed between the C/I ratio and mean bone loss levels (r = 0.67, P = .02). CONCLUSION: Short implants with immediate or early loading protocols have satisfactory long-term treatment prospects with satisfactory implant survival rates and minimal bone loss.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Levantamento do Assoalho do Seio Maxilar , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos , Resultado do Tratamento
12.
Int J Oral Maxillofac Implants ; 36(1): 131-136, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600534

RESUMO

PURPOSE: The clinical long-term outcomes of short implants are controversial. The aim of this study was to perform a long-term evaluation of short implants in posterior partially edentulous areas under various conditions. MATERIALS AND METHODS: This retrospective study was conducted with patients who had received 5- to 8-mm short implants to avoid bone grafts and spare anatomical structures between November 2005 and February 2014. Clinical outcomes (primary and secondary stability, marginal bone loss, and success and survival rates) were analyzed according to predictor variables of surgical procedure (submerged vs nonsubmerged), crown/implant ratio (1.5 and 2.0), type of prosthetic (single vs splinted crown), and arch location (maxilla vs mandible). The success rate was evaluated according to Albrektsson's criteria, and 5- and 10-year cumulative survival rates were calculated using Kaplan-Meier survival curves. RESULTS: A total of 148 patients (73 men, 75 women, mean age: 59.2 years) and 225 short implants were analyzed in this study. Over an average period of 6.21 ± 3.09 years, marginal bone loss was 0.43 ± 1.01 mm, and overall success and survival rates were 93.33% ± 25.0% and 97.78% ± 14.77%, respectively. Cumulative 5- and 10-year survival rates were 99.05% ± 0.65% and 96.72% ± 1.62%, respectively. CONCLUSION: Short implants (≤ 8 mm) in posterior edentulous areas showed comparable long-term outcomes of marginal bone loss and success and survival rates with conventional implants regardless of other clinical variables such as surgical procedure, crown/implant ratio, prosthetic type, and arch location.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
13.
Int J Oral Maxillofac Implants ; 36(1): 165-176, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33600538

RESUMO

PURPOSE: This study sought to define the tissue responses at different implant-abutment interfaces by studying bone and peri-implant mucosal changes using a 5-year prospective randomized clinical trial design study. The conus interface was compared with the flat-to-flat interface and platform-switched implant-abutment systems. MATERIALS AND METHODS: One hundred forty-one subjects were recruited and randomized to the three treatment groups according to defined inclusion and exclusion criteria. Following implant placement and immediate provisionalization in healed alveolar ridges, clinical, photographic, and radiographic parameters were measured at 6 months and annually for 5 years. The calculated changes in marginal bone levels, peri-implant mucosal zenith location, papillae lengths, and peri-implant Plaque Index and bleeding on probing were statistically compared. RESULTS: Forty-eight conus interface implants, 49 flat-to-flat interface implants, and 44 platform-switched implants were placed in 141 subjects. Six platform-switched interface and eight flatto- flat interface implants failed, most of them within 3 months. After 5 years, 33 conical interface, 28 flat-to-flat interface, and 27 platform-switched interface implants remained for evaluation. Calculation of marginal bone level change showed a mean marginal bone loss of -0.16 ± 0.45 (-1.55 to 0.65), -0.92 ± 0.70 (-2.90 to 0.20), and -0.81 ± 1.06 (-3.35 to 1.35) mm for conical interface, flat-to-flat interface, and platform-switched interface implants, respectively (P < .0005). The peri-implant mucosal zenith changes were minimal for all three interface designs (0.10 mm and +0.08 mm, P > .60). Only 16% to 19% of the surfaces had presence of bleeding on probing, with no significant differences (P > .81) between groups. Interproximal tissue changes were positive and similar among the implant interface designs. CONCLUSION: Over 5 years, the immediate provisionalization protocol resulted in stable peri-implant mucosal responses for all three interfaces. Compared with the flat-to-flat and platform-switched interfaces, the conical interface implants demonstrated significantly less early marginal bone loss. The relationship of marginal bone responses and mucosal responses requires further experimental consideration.


Assuntos
Perda do Osso Alveolar , Implantes Dentários para Um Único Dente , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Coroas , Estética Dentária , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Estudos Prospectivos
14.
Quintessence Int ; 0(0): 308-316, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33533237

RESUMO

OBJECTIVES: In-vitro data have shown that cross-linked hyaluronic acid (HA) enhances the proliferative and migratory properties of cells involved in periodontal wound healing/regeneration, stabilizes the blood clot, reduces the inflammatory response, and facilitates angiogenesis. The aim of this study was to histologically evaluate the effects of cross-linked HA alone or combined with a collagen matrix (CM) on the periodontal wound healing/regeneration in intrabony defects. METHOD AND MATERIALS: Two-wall intrabony defects (5 mm wide, 5 mm deep) were surgically created at the distal and mesial aspects of mandibular premolars in six beagle dogs. The 24 defects were randomly treated as follows: open flap debridement (OFD) + HA, OFD + CM, OFD + HA + CM (HA/CM), and OFD alone (control). At 2 months, the animals were euthanized for histologic evaluation. RESULTS: The HA (2.43 ±â€¯1.25 mm) and HA/CM (2.60 ±â€¯0.99 mm) groups yielded statistically significantly (P < .05) greater formation of new attachment (ie, linear length of new cementum adjacent to newly formed bone, with inserting collagen fibers) compared with the OFD (0.55 ± 0.99 mm) group. Among the four treatment groups, the HA/CM group demonstrated the highest amount of regenerated tissues, although no statistically significant differences in any of the histometric parameters were observed between the HA and HA/CM groups. CONCLUSION: Within their limits, it can be concluded that cross-linked HA alone or combined with CM promotes periodontal wound healing/regeneration in two-wall intrabony defects in dogs.


Assuntos
Perda do Osso Alveolar , Procedimentos Cirúrgicos Reconstrutivos , Perda do Osso Alveolar/cirurgia , Animais , Regeneração Óssea , Colágeno , Cães , Regeneração Tecidual Guiada Periodontal , Ácido Hialurônico , Cicatrização
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(2): 152-157, 2021 Feb 09.
Artigo em Chinês | MEDLINE | ID: mdl-33557498

RESUMO

Objective: To evaluate the factors associated with the gingival papilla deficiencies of different degrees between maxillary anterior teeth showing alveolar ridge absorption. Methods: A total of 64 gingival papillae between maxillary anterior teeth of 14 patients with periodontitis, who received periodontal treatment and regular review in the Department of Periodontology, Peking University School and Hospital of Stomatology from June 2019 to December 2019, were observed in the present study. Indices were measured by using standardized clinical photographs and cone-beam CT images. The correlations between the gingival papilla deficiencies of different degrees and the distance from contact point to bone crest (CP-BC), the distance from proximal cemento-enamel junction to bone crest (pCEJ-BC), interproximal distance between roots (RD), the width of bone crest (BCW) and the height of gingival papilla (PH) were evaluated. Statistical analyses such as t-test, ANOVA, Pearson correlation coefficient and so on were conducted. Results: The rate of maxillary anterior gingival papilla completely filled the adjacent spaces between anterior teeth was 28% (18/64) and the rate of gingival papilla with deficiencies was 72% (46/64). The mild, moderate and severe deficiencies were 36% (23/64), 27% (17/64) and 9% (6/64) respectively. When CP-BC≥7.0 mm or pCEJ-BC≥4.5 mm, only moderate or severe deficiencies appeared. However, when CP-BC<5.0 mm or pCEJ-BC<1.5 mm, only completely filled adjacent tooth space or mild deficiency appeared. There was a strong positive correlation between CP-BC and pCEJ-BC. The Pearson correlation coefficient was 0.812 (P<0.01), and the linear fitting coefficient was 0.93 (R2=0.659) (64 gingival papillae). There was no significant difference of RD for gingival papilla deficiencies of different degrees between maxillary anterior teeth (P>0.05). BCW at the crest level increased slightly with the increase of the degree of gingival papilla deficiency, and the difference was statistically significant between completely filled adjacent tooth space and moderate or severe deficiency (P<0.05). However, PH at the crest level decreased slightly with the increase of the degree of gingival papilla deficiency, and the difference was statistically significant between completely filled adjacent tooth space and moderate or severe deficiency (P<0.05). Conclusions: When the alveolar ridge is absorbed, the rate of deficiency is significantly higher than the completely filled adjacent tooth space. The gingival papilla deficiencies of different degrees between maxillary anterior teeth are mainly associated with the absorption of bone crest.


Assuntos
Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Gengiva , Humanos , Maxila/diagnóstico por imagem , Periodontite/complicações
16.
J Oral Sci ; 63(2): 152-156, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33597334

RESUMO

PURPOSE: To determine the impact of experimentally preformed peri-implant crater-shaped bone defects on the evolution of in situ microbiota and development of bone defects compared to those induced over time by ligature placement only. METHODS: Implants were installed in the mandibles of eight dogs. Standardized bone defects were preformed in four test animals but not in the other four control animals, prior to implant (3.3 mm × 8 mm) installation. After 2 months of healing, peri-implantitis was induced with silk ligatures in both groups for 2 months. Microbial samples were obtained from implants and teeth for analysis at three time points (qPCR), and the average depths of the bone defects were measured. RESULTS: At the baseline, the total marker load of periodontal-pathogenic bacteria (TML) for teeth accounted for 5.2% (0-17.4%). After implant healing, TMLs for implants and teeth were comparable (7.1% [0.3-17.4%]). The TML of both groups was 3.5%, 2 months after ligature placement. Bone defects had a mean depth of 1.84 mm at preformed defects and 1.64 mm at control sites (P > 0.05). CONCLUSION: Preformed defects in the test group showed comparable results to the control group in terms of TML, the incidence of periodontal-pathogenic bacteria, and bone defect depth.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/etiologia , Animais , Implantes Dentários/efeitos adversos , Ligadura , Mandíbula
17.
Life Sci ; 269: 119073, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33460666

RESUMO

AIMS: Coagulation is a common event that play a double-edged role in physiological and pathological process. Anti-coagulation methods were applied in joint surgery or scaffolds implantation to encourage new vascular formation and avoid coagulation block. However, whether anti-coagulation drug perform regulatory roles in bone structure is unknown. This study aims to explore a direct thrombin inhibitor, argatroban, effects on bone marrow stromal cells (BMSCs) and decipher the underlying mechanisms. MATERIALS AND METHODS: Argatroban effects on BMSCs were investigated in vivo and in vitro. The drug was applied in periodontal disease model mice and bone loss was evaluated by µCT and histology. BMSCs were treated with different doses argatroban or vehicle. Cellular reactions were analyzed using wound healing assay, qRT-PCR, Alizarin Red S staining and western blotting. KEY FINDINGS: We demonstrated that local injection of argatroban can rescue bone loss in periodontal disease in vivo. To explore the underlying mechanism, we examined that cell proliferation and differentiation capability. Proliferation and migration of BMSCs were both inhibited by applying lower dose of argatroban. Interestingly, without affecting osteoclastogenesis, osteogenic differentiation was significantly induced by argatroban, which were shown by extracellular mineralization and upregulation of early osteoblastic differentiation markers, alkaline phosphatase, Osteocalcin, transcription factors RUNX2 and Osterix. In addition, molecular analysis revealed that argatroban promoted ß-catenin nuclear translocation and led to an increase of osteogenesis through activating canonical Wnt signaling. SIGNIFICANCE: Taken together, our results show the novel application of the anti-coagulation compound argatroban in the commitment of BMSCs-based alveolar bone regeneration and remodeling.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Arginina/análogos & derivados , Células-Tronco Mesenquimais/citologia , Osteogênese , Periodontite/complicações , Ácidos Pipecólicos/farmacologia , Sulfonamidas/farmacologia , Trombina/antagonistas & inibidores , Via de Sinalização Wnt/efeitos dos fármacos , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/metabolismo , Perda do Osso Alveolar/patologia , Animais , Antitrombinas/farmacologia , Arginina/farmacologia , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Camundongos , Camundongos Endogâmicos C57BL
18.
Clin Implant Dent Relat Res ; 23(1): 61-72, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33438320

RESUMO

BACKGROUND: Customized sealing socket abutment (SSA) has been claimed to optimize the peri-implant hard and soft tissues in type 1 implant placement. However, the evidence to claim the benefits of this technique over the use a conventional healing abutment remains weak. PURPOSE: The aim of this retrospective study was to provide a 3D-radiographic evaluation of hard tissues changes following immediate implant placement in molar sites combined to ARP technique and installation of SSA. MATERIALS AND METHODS: Baseline and follow-up (FU) CBCTs (from 1 to 5 years) of 26 patients were collected and included in the study. Baseline and FU CBCTs were superimposed and horizontal and vertical bone changes were assessed. RESULTS: A total of 26 patients and 27 implants were included. Horizontal bone remodeling was not significant in any of the measured areas except in the most cervical level, where a mean bone remodeling of 0.73 mm was found. Proximal and buccal vertical bone changes were not significant. CONCLUSIONS: Within the limits of a retrospective study, dimensional alveolar ridge changes 1 to 5 years after immediate implant placement in molar sites with simultaneous ARP technique and installation of SSA seem to be very limited.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Humanos , Estudos Retrospectivos , Extração Dentária/efeitos adversos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
19.
Quintessence Int ; 0(0): 300-306, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491382

RESUMO

Objective: To evaluate implant and patient characteristics 4 to 8 years after implant installation in a study involving immediate fixed restoration of dental implants. Method and materials: The study was a follow-up of treated generalized chronic periodontitis patients who received immediate restorations on dental implants as part of a previous study. The patients were examined clinically and radiographically at implant placement, 6 months, 1 year, and 4 to 8 years later. Supportive periodontal therapy (SPT), teeth and implant probing pocket depth (TPPD and IPPD), bleeding on probing (BOP [teeth, TBOP; implant, IBOP]), and bone level (BL) measurements around implants were documented. Cases were divided into three groups according to annual SPT rate: 0.00 to 0.99/year (SPT0), 1.00 to 1.99/year (SPT1), 2.00 or more/year (SPT2). Results: Twelve patients, with 26 implants and 242 teeth, were included. The mean ±â€¯standard deviation follow-up period was 6.08 ±â€¯1.25 years (range 4.04 to 7.94 years). All implants in the follow-up group were osseointegrated and survived during the follow-up period. The mean number of SPT appointments was 6.17 ±â€¯5.65. A weak negative correlation was found between SPT rate and ΔTPPD (-0.24, P = .0005), whereas a strong negative correlation was found between SPT rate and ΔIPPD (-0.76, P = .0005). Negative correlations were found between SPT rate and ∆TBOP (-0.20, P = .003), and between SPT rate and ∆IBOP (-0.5, P = .009). A moderate correlation was found between SPT rate and ΔBL (0.46, P = .02). Conclusion: SPT has a significant positive effect on PPD, BOP, and on implant BLs in long-term follow-up and should be an essential part of implant therapy.


Assuntos
Perda do Osso Alveolar , Periodontite Crônica , Implantes Dentários , Perda de Dente , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos , Índice Periodontal
20.
Quintessence Int ; 52(2): 112-121, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33433077

RESUMO

OBJECTIVE: Retrograde peri-implantitis (RPI) is defined as bone loss around an osseointegrated implant apex that usually appears within the first few months of its placement. This retrospective study aimed to evaluate the relationships between RPI and demographic factors, local bone and intraoral factors, and implant and surgery-related factors. METHOD AND MATERIALS: A retrospective study was conducted in 116 patients with a total of 369 implants placed between January and June 2019. The associations between RPI and the following data were evaluated: location of the recipient site, bone quality, reason for previous tooth loss, condition of adjacent teeth, marginal bone loss, immediate or late placement of implants, implant brand and size, activation of lesions, and treatment modality.
Results: Among the 14 (3.8%) implants that showed RPI, 10 (5.8%) were in the maxilla and four (?2.0%) were in the mandible, which were detected before prosthetic loading. There was no significant difference in terms of RPI between the arches. Of the 14 RPI implants, four (28.?6%) were placed into a previously periapical lesion site, three (21.4%) had endodontically treated adjacent teeth, two (14.3%) were immediately placed following extraction, three (?21.4%) revealed marginal bone loss, and one (7.1%) was lost at the abutment connection. Eight RPI implants healed spontaneously, while the remaining six were subjected to treatment (P = .05).
Conclusion: Local bone and intraoral factors, particularly the reason for tooth loss at the recipient site and the condition of the adjacent teeth, had stronger effects on RPI than other factors. (Quintessence Int 2021;52:112-121; doi: 10.3290/j.qi.a45264).


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Protocolos Clínicos , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Humanos , Mandíbula , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/terapia , Estudos Retrospectivos
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