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1.
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
2.
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
3.
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
4.
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
5.
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
6.
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
7.
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
8.
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
9.
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
10.
Quintessence Int ; 0(0): 426-433, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491391

RESUMO

Objectives: The aim of this retrospective study was to evaluate the effect of vertical soft tissue thickness (STT) on crestal bone loss (CBL) of early loaded implants after 1 and 5 years. Method and materials: Forty-four tapered implants with platform switching and conical connection were placed in the posterior mandible and maxilla to rehabilitate edentulous sites. STT at implant sites was divided into two groups: thin (n = 21, mean STT = 2.0 ±â€¯0.3 mm) and thick (n = 23, mean STT = 3.0 ±â€¯0.8 mm). The implants were loaded after 6 to 8 weeks. Survival and success rates and CBL were measured after 1 and 5 years. Results: The survival and success rates at 1 and 5 years were 100% and 97.8%, respectively. At the 1-year follow-up, the CBL of the thin and thick gingival groups was 0.96 ±â€¯0.49 and 0.55 ±â€¯0.41 mm, respectively; the difference was statistically significant (P = .004). At 5 years, the CBL of the thin and thick gingiva groups increased to 1.12 ±â€¯0.84 and 0.65 ±â€¯0.69 mm, respectively; the difference was not statistically significant (P = .052). Conclusion: At 1 year, the CBL was more pronounced at sites with a thin gingiva; at 5 years the difference between the groups was not statisically significantly different. Within the limitations of this study, early loading of implants with platform switched and conical connection was safe.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Implantação Dentária Endo-Óssea , Humanos , Mandíbula/cirurgia , Estudos Retrospectivos
11.
Clin Oral Implants Res ; 32(3): 337-348, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33368735

RESUMO

AIM: To evaluate implant survival and marginal bone levels (MBLevel ) at least 5 years after implant installation in patients ≥65 years old. METHODS: Patient records were screened retrospectively for the following inclusion criteria: (1) ≥65 years of age at the time of implant installation, and (2) ≥5-year radiographic follow-up or registered implant loss. Association between patient- and implant-related data with radiographically assessed data [i.e. implant survival, mean MBLevel (i.e. average of mesial and distal level) and maximum marginal bone loss (i.e. either mesial or distal loss; maximum MBLoss )] were statistically evaluated by mixed effects multi-level regression models. RESULTS: Two-hundred-eighteen implants in 74 patients were included with a mean follow-up of 6.2 years (range: 5 to 10.7 years); four early and six late implant losses have been registered (implant survival rate: 95.4%). Mean MBLevel and maximum MBLoss was 1.24 ± 0.9 mm and 1.48 ± 1.0 mm, respectively. Maximum MBLoss  < 2 mm, 2 to 5 mm and ≥5 mm was found in 70.7, 28.8 and 0.5% of the implants, respectively. For both, mean MBLevel and maximum MBLoss , age presented a slightly protective effect (mean MBLevel : Coef. -0.041, p = .016; maximum MBLoss : Coef. -0.045, p = .014). CONCLUSION: The high implant survival rate (95.4%), low mean MBLevel (1.24 mm) and low frequency of maximum MBLoss  ≥ 5 mm (0.5%) observed herein after 5 to 11 years follow-up suggest that older age should not be considered as a limiting factor for implant treatment.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Estudos Retrospectivos
12.
J Periodontal Res ; 56(2): 314-329, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33314132

RESUMO

BACKGROUND AND OBJECTIVE: There is a close relationship between inflammation and bone remodeling in the periodontium. However, previous studies have not delineated the alterations in calcium (Ca) metabolism during periodontitis progression. The aim of this current investigation was to examine Ca dynamics in alveolar bone of rats during progression of ligature-induced periodontal inflammation by using 45 Ca, which is an index of hard tissue neogenesis. MATERIAL AND METHODS: To induce periodontitis, the maxillary right first molar (M1) of 8-week-old male rats was ligated with a silk suture for 1, 3, 7, and 28 days. The left M1 was not ligated as a control. To evaluate resultant changes in bone neogenesis, 45 CaCl2 was injected intraperitoneally 24 hours before euthanasia. The left-and-right palatal mucosa, molar teeth (M1 and M2), and alveolar bone were harvested for evaluation of 45 Ca radioactivity using a liquid scintillation counter. The distribution of 45 Ca in maxillary tissues was evaluated using autoradiography (ARG). In addition, we analyzed the bone volume fraction (BV/TV) and bone mineral density (BMD) of the alveolar bone by micro-computed tomography. To investigate the number of osteoclasts and osteoblasts, tartrate-resistant acid phosphatase (TRAP) and bone-specific alkaline phosphatase (BAP) were measured by an enzymatic assay and immunohistochemistry, respectively. RESULTS: 45 Ca radioactivity in the alveolar bone of the ligature side decreased by 8% compared to the unligated control-side on day 1, whereas on day 7, it markedly increased by 33%. The 45 Ca levels in the gingival tissue and molar teeth were slightly but significantly lower than the control-side on day 1 and higher from day 3 to 28. The variation in 45 Ca levels for the alveolar bone was greater and specific compared with other tissues. Furthermore, on day 7, ARG data revealed that 45 Ca on the control side was primarily localized to the periodontal ligament (PDL) space and alveolar bone crest and barely detected in the gingival tissues and deeper parts of the alveolar bone. On the ligature side, 45 Ca disappeared from the PDL and alveolar crest, but instead was broadly and significantly increased within the deeper zones of the alveolar bone and furcation areas and distant from the site of ligature placement and periodontal inflammation. In the shallow zone of the alveolar bone, these changes in 45 Ca levels on day 7 were consistent with decreases in the bone structural parameters (BV/TV and BMD), enhanced osteoclast presence, and suppressed levels of BAP expression in osteoblasts. In contrast, the deep zone and furcation area showed that TRAP-positive cells increased, but BAP expression was maintained in the resorption lacunae of the alveolar bone. CONCLUSION: During periodontitis progression in rats, 45 Ca levels in the alveolar bone exhibited biphasic alterations, namely decreases and increases. These data indicate that periodontitis induces a wide range of site-specific Ca metabolism alterations within the alveolar bone.


Assuntos
Perda do Osso Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Animais , Cálcio , Modelos Animais de Doenças , Inflamação , Masculino , Osteoclastos , Rádio (Anatomia) , Ratos , Ratos Wistar , Microtomografia por Raio-X
13.
Clin Oral Implants Res ; 32(3): 314-323, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33340414

RESUMO

OBJECTIVES: The aim of the present study was to evaluate whether clinical findings at implant sites are relevant as screening tests for a history of marginal bone loss. MATERIAL AND METHODS: 427 patients provided with implant-supported reconstructions 9 years earlier were evaluated clinically (probing pocket depth (PPD), bleeding on probing (BoP)) and radiographically. A history of bone loss was confirmed through baseline documentation. Diagnostic accuracy was evaluated through receiver operating characteristic curves and multi-level regression analyses. Results were expressed as sensitivity/specificity, area under the curve, and odds ratios. RESULTS: While the sensitivity of PPD in regard to bone loss was low, specificity was generally high. Multi-level modeling revealed that each additional millimeter of PPD corresponded to an additional bone loss of 0.30 mm (95% CI 0.27; 0.33). The sensitivity of BOP in regard to bone loss >2 mm was 80.9% (95% CI 73.9; 86.7), while the specificity was 42.2% (95% CI 39.6; 44.8). CONCLUSIONS: Clinical parameters at implant sites obtained at a single time point were associated with a history of marginal bone loss. While BoP demonstrated a high level of sensitivity, the sensitivity of PPD was generally low. The present data suggest that BoP is a relevant screening test for history of bone loss.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Implantes Dentários/efeitos adversos , Humanos
14.
Angle Orthod ; 90(3): 321-329, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378432

RESUMO

OBJECTIVES: To test the null hypothesis that there is no difference in bone dehiscence formation before and after orthodontic tooth movement through an atrophic alveolar ridge. MATERIAL AND METHODS: This longitudinal retrospective study evaluated pretreatment and posttreatment cone-beam computed tomography imaging of 15 adult patients. Twenty-five teeth were moved through the atrophic alveolar bone, whereas 25 teeth not subjected to translational movement were considered controls. The distances between the cementoenamel junction and the alveolar bone crest were assessed at the mesial, distal, buccal, and lingual surfaces of all of these teeth. Data were compared using the Wilcoxon test. The Spearman correlation test and multivariate linear regression analysis were also performed. RESULTS: In general, crestal bone height was reduced around 0.5 mm in all groups in every direction. Median buccal dehiscence increased significantly (+2.25 mm) (P < .05) in teeth moved through the atrophic ridge. Control teeth also had buccal crest loss (+0.83 mm), but this was not statistically different from that of the experimental teeth. Lingual dehiscence increased significantly for the experimental (+0.17 mm) and control (+0.65 mm) groups. Mesial bone height decreased more in the control group (-0.44mm) than in the experimental group (-0.14mm). There was moderate correlation between amount of tooth movement and alveolar bone loss. CONCLUSIONS: The null hypothesis was rejected as dehiscence increased after tooth movement through an atrophic alveolar ridge, mainly in the buccal plate.


Assuntos
Perda do Osso Alveolar , Técnicas de Movimentação Dentária , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Humanos , Estudos Retrospectivos , Técnicas de Movimentação Dentária/efeitos adversos
15.
Braz Dent J ; 31(5): 458-465, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33146327

RESUMO

This study aims to evaluate the post-extraction alveolar bone reconstruction amongst 12 patients exhibiting loss of buccal bone plate in a tooth of the anterior region of the maxilla using the prosthetically-driven alveolar reconstruction technique (PDAR). In PDAR, a partial fixed provisional prosthesis (PFPP [conventional or adhesive]) with a specially designed pontic maintains the clot in a mechanically stable position during alveolar regeneration. Moreover, the pontic design, in hourglass shape and located in the subgingival area, also prevents gingival margins from collapsing. Gingival recession was evaluated through the 6-month healing period. Cone beam computed tomography (CBCT) was performed 1 month before and 8 months after PDAR treatment. For the primary outcome, in the panoramic imaging, the central area of bone defect in each tooth was selected for linear measurements. Measurements of the vertical buccal bone gain and the gain in thickness in the alveolar bone crest were obtained 8 months after PDAR. Descriptive statistics and intraclass correlation coefficient analysis were conducted. After treatment, all patients showed bone formation (a mean vertical gain of 7.1±3.7 mm, associated with a horizontal mean gain of 4.5±1.4 mm in the alveolar bone crest). The intraclass correlation coefficient for the measurements performed using CBCT was 0.999. No gingival recession, greater than 1 mm, was observed. Lower-morbidity procedures without the use of biomaterials may be a useful in post-extraction alveolar ridge regeneration and/or preservation. PDAR promoted alveolar bone formation without flaps, grafts and membranes.


Assuntos
Perda do Osso Alveolar , Alvéolo Dental , Perda do Osso Alveolar/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Estudos Retrospectivos , Extração Dentária
16.
Clin Oral Implants Res ; 31(10): 1010-1024, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32799365

RESUMO

OBJECTIVES: The objective of this randomized controlled trial was to compare alveolar ridge preservation using a bone substitute material and covered with a synthetic or porcine collagen membrane. MATERIALS AND METHODS: Thirty-two sockets in the aesthetic maxillary region of 30 patients were randomized into two groups. Randomization was stratified according to bone wall defect. Flapless technique was used, and sockets were grafted with bi-phasic calcium phosphate particulate bone substitute and covered by synthetic polyethylene glycol (PEG; test group) or porcine-derived collagen membrane (CM; control group). No primary closure was attempted. A cone beam computed tomography (CBCT) scan was performed immediately after the surgical procedure and repeated 22 weeks later. OnDemand3D was used to superimpose scan images and assess changes. The mean vertical and horizontal percentage bone loss were calculated and implants placed after 6 months with or without additional augmentation. RESULTS: There were no baseline differences between groups or dropouts. The mean percentage loss at the labial plate and at the coronal part of the sockets was statistically significantly lower in the test group compared with controls (-2.86% [SD = 13.48] versus 7.42% [SD = 11.95]; 13.45% [SD = 11.97] versus 28.59% [SD = 16.97]). Implants were placed after 6 months, and there was no difference in need for further augmentation between PEG (n = 5) or CM (n = 4). CONCLUSION: Sites treated with PEG membrane showed less percentage loss in horizontal and vertical measurements in this trial.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/prevenção & controle , Perda do Osso Alveolar/cirurgia , Animais , Colágeno , Tomografia Computadorizada de Feixe Cônico , Estética Dentária , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Suínos , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
17.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 35-43, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32618159

RESUMO

The aim of this study was to report the use of extra-short and short implants in combination with Guided Bone Regeneration (GBR) to rehabilitate a case of severe mandibular reabsorption. A 55-yearold female patient asked for a fixed implant supported rehabilitation in 4.5 - 4.6 zone which showed severe atrophy. It was decided to use an extra-short 4 mm length and 4.1 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Regular Neck, Institut Straumann AG) in 4.5 position and a short 6 mm length and 4.8 mm Ø, Roxolid and SLActive implant (Straumann Standard Plus Wide Neck, Institut Straumann AG) in 4.6 position. The implants supported cemented fixed prosthesis. Examinations were performed at the day of the surgery and up to 7-years in function to evaluate implant stability and periapical radiography. One extra-short implant and one short implant were placed. After 7 years in function no biological or prosthetic complication were recorded. Within the limitation of this case report, the use of short and extra-short implants to support fixed prosthesis seem to be a feasible treatment alternative in severe mandibular atrophy.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Atrofia , Regeneração Óssea , Feminino , Seguimentos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Pessoa de Meia-Idade , Próteses e Implantes , Resultado do Tratamento
18.
Quintessence Int ; 51(10): 822-837, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32661522

RESUMO

OBJECTIVES: Regeneration of intrabony defects is a challenging target of periodontal therapy. The biologic rationale for regeneration not only is based on incorporating the regenerative material, but also takes into consideration the defect's inherent healing capacity. The present study was carried out to evaluate the efficacy of decortication or intramarrow penetration performed with demineralized freeze-dried bone allograft (DFDBA) in the management of intrabony defects. METHOD AND MATERIALS: Forty chronic periodontitis (stage II and III periodontitis) patients having 40 intrabony defects were randomly assigned into test group (intrabony defect filled with DFDBA after intramarrow penetration along with open flap debridement [OFD+IMP+ DFDBA]) and control group (DFDBA along with open flap debridement [OFD+DFDBA]). Primary outcome measures included probing pocket depth, clinical attachment level, and percentage bone fill (%BF). All parameters were recorded at baseline, 6 months, and 9 months postsurgical follow-up. RESULTS: Mean reduction in probing depth and gain in clinical attachment level was statistically significantly higher at the interdental defect site in the test group compared to the control group at 9 months follow-up (P = .02 and .04, respectively). In radiographic parameters, statistically significant improvements in defect depth and gain in defect area were found in the test group (P = .00 and .03, respectively). Statistically significant improvements in %BF and linear bone growth (P = .02 and .00, respectively) were also observed in the experimental group (39.47 ± 13.92% and 1.41 ± 0.54 mm) in comparison with the control group (19.29 ± 14.24%, 0.62 ± 0.49 mm). CONCLUSION: Addition of intramarrow penetration with DFDBA in surgical periodontal therapy may enhance the healing potential of periodontal intrabony defects, as observed by greater improvement in clinical and radiographic outcomes.


Assuntos
Perda do Osso Alveolar , Transplante Ósseo , Regeneração Tecidual Guiada Periodontal , Aloenxertos , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Humanos , Perda da Inserção Periodontal/cirurgia , Bolsa Periodontal/cirurgia , Resultado do Tratamento
19.
Arch Oral Biol ; 117: 104823, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32593876

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of taxifolin, a powerful antioxidant, on the progression of periodontitis by immunohistochemical and cone-beam computed tomography (CBCT) examination. DESIGN: This study was performed with 32 rats in four experimental groups: a non-ligated group (Control, n = 8), periodontitis group (Perio, n = 8), periodontitis with 1 mg/kg/day taxifolin group (Taxi-1, n = 8), and periodontitis with 10 mg/kg/day taxifolin group (Taxi-10, n = 8). A ligature-induced experimental periodontitis design was used. All rats were sacrificed at 30 days. Alveolar bone loss was determined by CBCT. Hematoxylin-eosin stained slides were examined. The expression levels of bone morphogenetic protein 2 (BMP-2), osteocalcin (OCN), alkaline phosphatase (ALP), collagen type I (Col 1), Bcl-2, Bax, and receptor activator of NF-κB ligand (RANKL) were determined immunohistochemically. RESULTS: Both doses of taxifolin showed a decrease in alveolar bone loss. The inflammatory reaction was higher in the Perio group and lower in the taxifolin groups. BMP-2, OCN, ALP, and Col 1 expression were dose-dependently elevated in the taxifolin groups. RANKL immunoexpression decreased with both doses of taxifolin. Bcl-2 expression increased and Bax expression decreased in the taxifolin groups. CONCLUSION: Taxifolin successfully reduced apoptosis and improved bone formation in alveolar bone in this experimental periodontitis model.


Assuntos
Perda do Osso Alveolar , Periodontite , Quercetina/análogos & derivados , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/tratamento farmacológico , Animais , Apoptose , Osteocalcina , Periodontite/tratamento farmacológico , Quercetina/farmacologia , Ligante RANK/metabolismo , Ratos
20.
Dentomaxillofac Radiol ; 49(6): 20190396, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32364770

RESUMO

OBJECTIVE: This research aimed to longitudinally evaluate the optical density of peri-implant alveolar bone. The data acquired from study participants previously treated with 37 osseointegrated implants were analyzed utilizing the radiographic subtraction technique. METHODS AND MATERIALS: The radiographic follow-ups were performed five times: at the implantation of the prostheses and after 15, 90, 180 and 360 days. Intraoral radiographs were obtained by the paralleling technique using individualized Hanshin-type positioners to guarantee the standardization of the images. The obtained digital images were aligned and equalized before they were submitted to the radiographic subtraction procedure. RESULTS: A significant difference was found between the distal region of Group I (patients treated with osseointegrated implants who required extraction of the dental element) and the 360 day follow-up and the distal region of Group II (patients with healed alveolar sockets) in all follow-up analyses (p < 0.05). We did not observe a significant difference between the groups analyzed and other follow-ups concerning the subcrestal and middle third regions for both the mesial and distal variables (p > 0.05). There was a statistically significant difference in the distal sites [χ2 = 5,745,, p = 0.03], showing a significant association between time and the presence of bone resorption. This association was not shown on the mesial surface (p = 0.16). CONCLUSION: We concluded that there was no statistically significant difference between groups I and II. Using this technique, we were able to quantitatively and qualitatively evaluate the changes in the proximal sites on the digital radiographic images for the analyzed data. Digital subtraction technology to measure peri-implant bone density is an accurate and reproducible technique for quantifying peri-implant bone reactions to different therapeutic modalities.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Implantes Dentários , Implantação Dentária Endo-Óssea , Seguimentos , Humanos , Maxila/diagnóstico por imagem , Radiografia Dentária Digital , Técnica de Subtração
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