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1.
Artigo em Inglês | MEDLINE | ID: mdl-34547068

RESUMO

This study evaluated the influence of different implant types on (1) radiographic marginal bone levels after healing and (2) radiographic and histomorphometric tissue levels and characteristics following ligature-induced peri-implantitis. Four implant types (Standard Plus, Straumann [S]; NobelReplace Tapered, Nobel Biocare [N]; In-Kone Universal, Global D [I]; and twinKon, Global D [T]) were randomly placed in the edentulous healed mandibular ridge of six dogs (T0), for a total of 57 implants placed. After 10 weeks, a peri-implantitis was ligature-induced (T1). After 12 weeks, biopsy samples were processed for histomorphometric analysis (T2). Standardized radiographs were taken at T0, T1, and T2 for imaging analysis. Statistical analysis was performed using mixed-effects linear modeling. After healing (T1), the radiographic marginal bone level was more coronal for implants I, T, and S compared to N. Following peri-implantitis (T2), the histologic marginal bone level was more coronal for implants I, T, and S compared to N, and for implants I and T compared to S. Also at T2, the radiographic marginal bone level was more coronal at implants I, T, and S compared to N. Implant type may influence bone remodeling during healing and bone loss during the early stages of experimental peri-implantitis.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Animais , Implantes Dentários/efeitos adversos , Cães , Ligadura , Mandíbula , Peri-Implantite/diagnóstico por imagem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34547078

RESUMO

To improve the adaptation to bone level discrepancies of sloped alveolar crests, an implant with a sloped implant-abutment interface has been developed. In a previously reported international multicenter study, 65 sloped implants replaced single teeth with a buccolingual bone level discrepancy at least 3 months after tooth loss. The present study reports the long-term outcomes of one study center and also evaluates marginal bone and keratinized mucosa alterations around sloped implants in healed, sloped crests in a long-term follow-up. Implant survival, marginal bone levels, and buccal bone dimensions in relation to the implant shoulder level (assessed by periapical radiographs and CBCT), width of keratinized mucosa, and probing depths were observed. Two patients did not present for follow-up examinations. No implants were lost. The remaining 13 implants were followed for a mean period of 123 months. Mean marginal bone levels were maintained slightly coronal to implant shoulder level at the interproximal (0.13 mm) and the buccal aspects (0.57 mm). The width of keratinized mucosa improved significantly from delivery (1.85 mm) to the 1-year follow-up (3.39 mm) and was thereafter unchanged. Placing implants with a sloped shoulder in a healed crest with lingual-buccal bone level discrepancy resulted in circumferential marginal bone maintenance and improved width of the keratinized mucosa.


Assuntos
Perda do Osso Alveolar , Implantes Dentários para Um Único Dente , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Estudos de Coortes , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Seguimentos , Humanos , Membrana Mucosa
3.
Int J Mol Sci ; 22(15)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34360988

RESUMO

Replacement and inflammatory resorption are serious complications associated with the delayed replantation of avulsed teeth. In this study, we aimed to assess whether deferoxamine (DFO) can suppress inflammation and osteoclastogenesis in vitro and attenuate inflammation and bone resorption in a replanted rat tooth model. Cell viability and inflammation were evaluated in RAW264.7 cells. Osteoclastogenesis was confirmed by tartrate-resistant acid phosphatase staining, reactive oxygen species (ROS) measurement, and quantitative reverse transcriptase-polymerase chain reaction in teeth exposed to different concentrations of DFO. In vivo, molars of 31 six-week-old male Sprague-Dawley rats were extracted and stored in saline (n = 10) or DFO solution (n = 21) before replantation. Micro-computed tomography (micro-CT) imaging and histological analysis were performed to evaluate inflammation and root and alveolar bone resorption. DFO downregulated the genes related to inflammation and osteoclastogenesis. DFO also reduced ROS production and regulated specific pathways. Furthermore, the results of the micro-CT and histological analyses provided evidence of the decrease in inflammation and hard tissue resorption in the DFO group. Overall, these results suggest that DFO reduces inflammation and osteoclastogenesis in a tooth replantation model, and thus, it has to be further investigated as a root surface treatment option for an avulsed tooth.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Anti-Inflamatórios/uso terapêutico , Desferroxamina/uso terapêutico , Osteogênese , Avulsão Dentária/tratamento farmacológico , Perda do Osso Alveolar/etiologia , Animais , Anti-Inflamatórios/farmacologia , Regeneração Óssea , Desferroxamina/farmacologia , Masculino , Camundongos , Osteoclastos/citologia , Osteoclastos/efeitos dos fármacos , Osteoclastos/metabolismo , Células RAW 264.7 , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Avulsão Dentária/complicações
4.
Pan Afr Med J ; 38: 378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34367457

RESUMO

Introduction: implant supported prosthesis has become a viable treatment option for missing teeth. An important tool to detect early changes around implants is the standardized assessment of peri-implant hard and soft tissue parameters. The purpose of this prospective study was to clinically and radiographically assess the soft and hard tissues around implants. Methods: ten (10) patients with 13 implant supported prosthesis were included in the study. Clinical parameters plaque index (PI), gingival index (GI), modified sulcus bleeding index (mSBI), peri-implant Probing Depth (PD), gingival margin Level, width of keratinized mucosa (WKM) and implant mobility were measured at loading and at 3 and 6 months. The radiographic crestal bone loss and peri-apical implant radiolucencies were also evaluated at loading and at 3 and 6 months. Student paired t test and correlation and regression analysis was done to evaluate the effect of clinical variables over bone loss. Results: there was decrease in the site specific PI, GI, mSBI and peri-implant PD and an increase in the gingival recession from baseline to 6 months. The WKM remained stable throughout the study. Significant crestal bone loss was observed around implants more on the distal as compared to the mesial aspect. No mobility or peri-apical implant radiolucency was observed. Regression analysis of the confounding variables with bone loss showed no significant effect. Conclusion: the occlusal loading of implants after 6 months showed significant bone loss (<1mm), which was within acceptable limits and the soft tissues around implants were in good health.


Assuntos
Prótese Dentária Fixada por Implante/efeitos adversos , Falha de Restauração Dentária , Arcada Parcialmente Edêntula , Adolescente , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Planejamento de Prótese Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Adulto Jovem
5.
Int J Oral Maxillofac Implants ; 36(4): 779-786, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34411220

RESUMO

PURPOSE: The aim of this retrospective study was to evaluate the clinical performance of two implants supporting mandibular overdentures by means of clinical and radiologic parameters, and also to explore the relationship of marginal bone loss with implant-/patient-related factors and soft tissue parameters. MATERIALS AND METHODS: Data of patients who had undergone insertion of two implants into the interforaminal region between November 2012 and December 2016 using three different implant systems were retrieved from the archival records. Age, sex, implant length, implant diameter, observation period, mobility, and soft tissue parameters were recorded. Marginal bone levels and interimplant distances were measured with computer software on panoramic radiographs obtained at 3 months and at the recall session. RESULTS: A total of 43 patients with 86 implants were included in the study. Patients were evaluated with an average observation period of 41.79 months. Among the evaluated parameters, Gingival Index, Bleeding Index, and implant diameter were found to have significant effects on the marginal bone loss (P < .05). However, no significant effects of sex, age, implant length, observation period, and interimplant distance were observed on the marginal bone loss. No implants showed peri-implantitis or mobility, while eight implants showed peri-implant mucositis. CONCLUSION: Within the limitations of this study, it can be concluded that peri-implant soft tissue health and the diameter of the implant have an important effect on the marginal bone loss as well as the success of two-implant-supported mandibular overdentures.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantes Dentários/efeitos adversos , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Estudos Retrospectivos
6.
Clin Oral Implants Res ; 32(10): 1241-1250, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34352125

RESUMO

OBJECTIVES: This randomized controlled trial aimed to compare crestal bone loss (CBL) and buccal bone thickness (BBT) around triangular cross-section neck (TN) to round neck (RN) implants retaining mandibular overdentures one year after loading, using cone beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN and TN groups. Clinical buccal bone thickness (CBBT) around the implants was measured with a caliper at baseline. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the baseline and two months after insertion. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also recorded at postoperative months 2, 6, and 12. CBCT was used to evaluate proximal CBL and BBT at three levels (0, -2, and -4 mm) one year after loading. RESULTS: No implant loss was observed during the follow-up period. No significant differences in CBBT, ISQ values, and scores for PPD, PI, and GI between the two groups were observed at any time (p > .05). BBT was also comparable one year after loading (p > .05). The mean ± SD proximal CBL one year after loading was 0.58 ± 0.36 mm for TN and 0.91 ± 0.59 mm for RN (p < .01). CONCLUSIONS: This study found better crestal bone preservation in the implants with the novel neck design than conventional neck design in the anterior mandible after a follow-up of one year. However, it may not be clinically noticeable.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Tomografia Computadorizada de Feixe Cônico , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Seguimentos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Boca
7.
J Biol Regul Homeost Agents ; 35(2 Suppl. 1): 155-161, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34281312

RESUMO

Tooth extraction produces alveolar bone resorption and soft tissue remodelling, so identification of adequate technique for alveolar ridge preservation after tooth extraction is fundamental for all specific cases. Among the several biomaterials, CGF can represent an ideal alternative considering its and its mechanical and biological properties. In this preliminary study we compared the effectiveness of the use of two different parts of CGF (WP-White Part and BC-Buffy Coat) versus natural healing (CTR) by a split-mouth randomized clinical design. Four healthy patients who needed extraction of three teeth were selected. Post-extractive alveolar sockets were filled randomly with CGF-WP, CGF-BC or nothing for CTR. After 60 days, before implant placement, a biopsy for each alveola was obtained for quantitative histomorphometric analysis. The data obtained showed that the use of CGF-WP could achieve good regenerative results, supporting the use of this part for the preservation of the post-extractive alveolar socket.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/cirurgia , Transplante Ósseo , Humanos , Boca , Extração Dentária , Alvéolo Dental/cirurgia
8.
Clin Implant Dent Relat Res ; 23(3): 298-308, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34076941

RESUMO

PURPOSE: To evaluate the effect of early bone loss (EBL), on long-term bone stability and future peri-implantitis development. MATERIALS AND METHODS: Patients referred for implant placement between 2005 and 2009 were consecutively treated and followed for 10 years. After 10 years, patients were invited for a scientific diagnostic visit to evaluate implant survival and bone loss. Bone level changes were compared with baseline. Non-parametric testing was performed in cross-tabs (Pearson Chi-square and Fishers's exact test). Kaplan-Meier-estimated survival curves were plotted for different thresholds for EBL at different timepoints. Generalized linear mixed models with binomial distribution and logit link for peri-implantitis were fitted. An adjusted logistic mixed model was made to evaluate peri-implantitis, in relation with smoking status, history of periodontitis, and EBL > 0.5 mm. RESULTS: Four hundred and seven patients (mean age of 64.86 years [range 28-92, SD 10.11]), with 1482 implants, responded to the 10-year recall invitation. After an average follow-up time of 10.66 years (range 10-14, SD 0.87), implant survival was 94.74%. Mean crestal bone loss after 10 years was 0.81 mm (SD 1.58, range 0.00-17.00). One hundred and seventy five implants in 76 patients had peri-implantitis (11.8% on implant level, 18.7% on patient level). EBL of 0.5, 1, and 2 mm were significant predictors for peri-implantitis and implant loss after 10 years. Implants with EBL ≥0.5 mm during the first year of function showed a 5.43 times higher odds for future peri-implantitis development. Probability in developing peri-implantitis was 52.06% when smoking, Periodontal history and EBL of >0.5 mm was combined. CONCLUSION: The present study suggests that EBL is a predictor for long-term peri-implant pathology, with a significant higher risk for peri-implantitis when early bone loss exceeds the thresholds of 0.5 and 1 mm, especially when additional risk factors such as smoking or susceptibility for periodontal disease prior to implant treatment are present. Clinical trial registration number B670201524796.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Periodontite , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda do Osso Alveolar/etiologia , Implantes Dentários/efeitos adversos , Humanos , Pessoa de Meia-Idade , Peri-Implantite/etiologia , Estudos Prospectivos , Fatores de Risco
9.
Clin Implant Dent Relat Res ; 23(4): 579-592, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34159704

RESUMO

BACKGROUND: Alveolar ridge preservation can effectively decrease alveolar ridge resorption following tooth extraction, but it can be limited by reducing new bone formation and residual bone graft material. Efforts to develop more efficacious approaches are thus an area of active research. PURPOSE: To assess the impact of autologous concentrated growth factors (CGF) on alveolar ridge absorption and osteogenesis following posterior tooth extraction. MATERIALS AND METHODS: Fifty patients were randomly assigned to have extraction sockets treated with CGF or no treatment. At 10 days, 1 month, and 3 months postextraction, soft tissue color and texture were examined and evaluated with healing score. Cone-beam computed tomography (CBCT) scans were performed before and 3 months after extraction, while radiographic analyses were used to assess vertical and horizontal bone changes. Bone samples were collected from the extraction sockets during implant placement, and micro-computed tomography (micro-CT) scans and histological analysis were performed to evaluate new bone formation. t-Test or Mann-Whitney U test was used to compare data and the level of statistical significance was set at 0.05 for all analyses. RESULTS: Forty-six patients completed the trial. Sockets in the experimental group exhibited significantly better healing score on Day 10 postextraction relative to the control group, whereas comparable healing was observed in both groups at 1 and 3 months postextraction. Experimental group exhibited reduced vertical bone changes relative to the control (p < 0.05). Significant reductions were observed in ridge width changes at 1 and 2 mm apical to the crest (p < 0.05), although differences at 3 and 5 mm apical to the crest were not significant. Significant differences of bone mineral density (BMD) and microarchitecture of trabecular bone were observed via micro-CT analyses, and the experimental group had better results. CONCLUSION: CGF application following posterior tooth extraction may reduce vertical and horizontal bone resorption and promote new bone formation.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Humanos , Estudos Prospectivos , Extração Dentária/efeitos adversos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Microtomografia por Raio-X
10.
Med Oral Patol Oral Cir Bucal ; 26(5): e611-e618, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34162823

RESUMO

BACKGROUND: Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP. MATERIAL AND METHODS: An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome variable was the maximum compression force (Fmax) of implants when subjected to static resistance to fracture tests. Implant fractures were subsequently analyzed by scanning electron microscopy. A descriptive and bivariate analysis of the data was performed. RESULTS: Significant changes in implant width were observed after IP (p<0.05). No significant differences between IP and control implants were recorded in terms of the Fmax values in the two bone loss subgroups (3 mm: control 854.37N 195.08 vs. IP 752.12N 186.13; p=0.302, and 7.5 mm: control 548.82N 80.02 vs. IP 593.69N 111.07; p=0.370). Greater bone loss was associated to a decrease in Fmax, which proved significant for the control implants (p=0.001). Fractures were more frequently located in the platform (n=13). CONCLUSIONS: Implants with more apical bone levels appear to be more susceptible to fracture. On the other hand, IP does not seem to significantly decrease the fracture resistance of narrow (3.5 mm) platform dental implants with external hexagonal connections. The fact that most fractures occur in the platform area indicates that the latter is exposed to more mechanical stress.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantes Dentários/efeitos adversos , Humanos , Estresse Mecânico
11.
Clin Oral Implants Res ; 32(8): 998-1007, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34115893

RESUMO

OBJECTIVE: This prospective study aims to assess the 5-year clinical performance of implants with internal conical connection and platform-switched abutments in the posterior mandible. MATERIAL AND METHODS: Healthy adults missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent implants. After a transmucosal healing period single crown restorations were cemented on platform-switched abutments. Changes in marginal bone levels were investigated in standardized periapical radiographs from surgery and loading (baseline) to 60-months post-loading. RESULTS: Twenty-four patients received 52 implants. Bone remodelling took place between surgery and loading (mean:-0.5, SD:±0.4 mm). From loading to 60 months, there was a mean bone change of 0.27 (SD:±0.47 mm) which stabilized 24 months after prosthesis delivery (mean:0.2, SD:±0.46 mm). 71.7% of all implants presented bone preservation at 60 months irrespective of the initial insertion depth. Two implants were lost after 5 years and the success rate was 95.1%. Patient enquiry revealed high satisfaction. CONCLUSION: Internal conical connection implants with platform-switched abutments presented a high success rate and preservation of marginal bone levels at the implant shoulder after 5 years of loading.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Seguimentos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Estudos Prospectivos
12.
Int J Oral Maxillofac Implants ; 36(3): 574-580, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34115074

RESUMO

PURPOSE: To evaluate marginal bone level changes over 3 years around platform-shifting implants with internal conical connections, and to identify the factors relating to bone level changes. MATERIALS AND METHODS: Systemically healthy patients who lost one tooth or two consecutive teeth were enrolled in the study. The subjects received one or two implants with platform-shifting and internal conical connections in healed bone in a submerged manner. Digital standardized periapical radiographs were obtained at the time of implant placement, at prosthesis delivery, at 1 year, and at 3 years after the definitive restorations. Marginal bone level changes were measured at the mesial and distal aspects of each implant. Spearman correlation coefficients were calculated to examine the correlation between marginal bone level changes and clinical factors (age, vertical mucosal thickness, implant length and diameter, insertion torque value, and vertical implant position). RESULTS: Twenty-five patients with 30 implants (8 men and 17 women, mean age: 61.24 ± 13.18 years) were followed up to 3 years after the definitive restorations. The implant survival rate was 100%, and no remarkable complications were found. Mean peri-implant marginal bone level changes were -0.41 ± 0.61 mm (from placement to prosthesis delivery: C1); -0.08 ± 0.54 mm (from prosthesis delivery to 1 year: C2); -0.04 ± 0.95 mm (from prosthesis delivery to 3 years: C3); and 0.04 ± 0.60 mm (from 1 year to 3 years: C4), respectively. Statistically significant differences in bone level changes were observed between C1 and C3, and C1 and C4. Significant correlations of marginal bone level changes with implant diameter in C1 and with vertical implant position in C2 and C3 were observed. CONCLUSION: Within the limitations of this study, platform-shifting implants with internal conical connections appeared to prevent marginal bone resorption, especially after delivery of definitive prostheses, although marginal bone resorption attributed to the reestablishment of biologic width following subcrestal placement might be unavoidable.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Torque
13.
Artigo em Inglês | MEDLINE | ID: mdl-34076631

RESUMO

This case control study measured early crestal bone changes around subcrestally placed platform-switched implants surrounded by thin soft tissue and compared them with regular, matching-platform implants placed in a supracrestal position and surrounded by thick soft tissue. Sixty-six patients received two-piece internal hex dental implants. Control group patients (n = 33) received implants that had a horizontally matching implant-abutment connection and were placed approximately 0.5 to 1 mm supracrestally. Test group patients (n = 33) received platform-switched implants that were placed about 1.5 mm subcrestally. Clinical examinations were conducted, intraoral radiographs were taken, and statistical analysis was performed. After 2 months, the mean bone loss was 0.2 mm (SD: 0.22 mm; range: 0.1 to 1.2 mm) in the control group and -0.69 mm (SD: 0.65 mm; range: 0 to 2.6 mm) in the test group; this difference was found to be statistically significant (P < .05). After 1 year, mean bone loss was 0.28 mm (SD: 0.36 mm; range: 0.1 to 1.63 mm) in the control group and -0.6 mm (SD: 0.55 mm; range: 0.05 to 1.8 mm) in the test group. Platform-switched implants placed in a subcrestal position in vertically thin soft tissues showed statistically significantly more bone loss than non-platform-switched implants placed supracrestally with vertically thick tissues.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Osso e Ossos , Estudos de Casos e Controles , Implantação Dentária Endo-Óssea , Humanos
14.
Artigo em Inglês | MEDLINE | ID: mdl-34069084

RESUMO

INTRODUCTION: The aim of this retrospective study was to analyze the radiographic peri-implant bone loss of bone level implants and tissue level implants with a convergent neck in screw-retained single crowns and in screw-retained fixed partial prostheses, after two years of functional loading. MATERIALS AND METHODS: The sample was divided into two groups according to their type: Group I: supracrestal implants with convergent transmucosal neck; Group II: crestal implants. In each group we distinguish two subgroups according to the type of prosthetic restoration: single crowns and a three-piece fixed partial prosthesis on two implants. To quantify bone loss, parallelized periapical radiographs were analyzed at the time of implant placement and after two years of functional load. RESULTS: A total of 120 implants were placed in 53 patients. After statistical analysis it was observed that for each type of implant bone loss was 0.97 ± 0.91 mm for bone level and 0.31 ± 0.48 mm for tissue level. No significant differences were found regarding the type of prosthesis and the location (maxilla or mandible) of the implants. CONCLUSIONS: Tissue level implants with a convergent transepithelial neck exhibit less peri-implant bone loss than bone level implants regardless of the type of prosthesis.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantes Dentários/efeitos adversos , Falha de Restauração Dentária , Seguimentos , Humanos , Mandíbula/cirurgia , Maxila , Estudos Retrospectivos , Resultado do Tratamento
15.
Clin Implant Dent Relat Res ; 23(3): 432-443, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33949080

RESUMO

BACKGROUND: The current evidence regarding the alterations experienced by the alveolar ridge (hard tissue changes) after implant removal due to peri-implantitis is limited. PURPOSE: To assess the hard tissue dimensional changes following implant removal due to peri-implantitis. MATERIAL AND METHODS: Clinical records were examined to identify patients with implants that had to be removed due to a hopeless prognosis secondary to peri-implantitis due to expendability of peri-implantitis implants for functional reasons. Patients with preoperative and postoperative cone-beam computed tomography (CBCT) scans were included. Patient-related, implant-related, and surgery-related factors were assessed based on the clinical records. Linear measurements were made to evaluate the influence of bone plate thickness (BPT), ridge width (RW), and ridge height (RH) at various levels upon the outcome of implant removal. A descriptive statistical analysis of the quantitative and qualitative variables was performed. Correlations of the variables with the primary outcome (dimensional changes) were tested using univariate and multivariate analyses (multinomial random intercept mixed model linear regressions). RESULTS: A total of 26 patients (nimplants = 79) met the eligibility criteria. The mean decrease in RW at 1 and 3 mm below the crest was 11.3% and 4.4%, respectively (P < 0.001). Buccal and lingual RH was significantly reduced by 2.2% and 6.3%, respectively (P < 0.001). Few patient-related, implant-related, and surgery-related factors appeared to have an impact upon the hard tissue dimensional changes. Bone regeneration simultaneous to implant removal minimized the dimensional changes of the ridge both vertically (5% lesser buccal RH reduction) and horizontally (12% lesser RW reduction) when compared with spontaneous healing. The use of a reverse-torque removal kit seemed to be critical in limiting the dimensional changes of the ridge. CONCLUSIONS: Minimal hard tissue changes can be expected following implant removal due to peri-implantitis. Simultaneous bone regeneration procedures and the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Regeneração Óssea , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/diagnóstico por imagem , Peri-Implantite/etiologia , Estudos Retrospectivos
16.
Int J Oral Maxillofac Implants ; 36(2): 355-360, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909727

RESUMO

PURPOSE: The objective of this study was to report implant survival rates, marginal bone loss, and the impact of prosthesis type among patients with type 2 diabetes mellitus (DMT2), with high hemoglobin A1C (HbA1c) values. MATERIALS AND METHODS: This retrospective study utilized patient medical records from an oral surgeon's office. Patients who had moderately or poorly controlled DMT2 with HbA1c values up to 10% were reviewed. Inclusion criteria were partially or fully edentulous patients diagnosed with DMT2 who were subsequently treated with implant-supported prosthetic restorations. Patients were at least 18 years of age. Exclusion criteria were patients who did not present for annual follow-up visits, patient records with incomplete surgical or restorative data, or nondiagnostic radiographs. All the fixed restorations were cement-retained, and the removable restorations were supported by two to six implants. Marginal bone loss and the consequences of prosthetic type were assessed from the last available radiograph compared with the one taken after the surgical procedure. RESULTS: Data of 357 implants were extracted from the records of 38 patients with HbA1c values (6.9% to 10.0%). The mean follow-up was 7.3 years, with a minimum of 5 years. Six implants failed, yielding a 98.4% overall implant survival rate. The patients were divided into two groups according to the HbA1c values before implant placement. The moderately controlled group included 25 patients with DMT2, with HbA1c values of 6.9% to 8.0%, and the poorly controlled group included 13 patients, with HbA1c values of 8.1% to 10.0%. The overall mean bone loss was 2.02 ± 2.43 mm. In both groups, the maxilla demonstrated more bone loss than the mandible (P < .05). Marginal bone loss in moderately controlled and poorly controlled groups was 1.86 (± 2.21) mm and 2.33 (± 2.85) mm, respectively (P < .05). Removable prostheses also revealed greater bone loss rates compared with fixed prostheses in both groups (P < .05). CONCLUSION: Patients with high HbA1c values (8.1% to 10.0%) had more marginal bone loss than those with lower HbA1c values. Removable dentures should be reconsidered as a standard treatment option in these patients.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Diabetes Mellitus Tipo 2 , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Diabetes Mellitus Tipo 2/complicações , Seguimentos , Hemoglobina A Glicada , Humanos , Estudos Retrospectivos
17.
BMC Oral Health ; 21(1): 214, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33906655

RESUMO

BACKGROUND: The influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents. METHODS: In this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal-Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons. RESULTS: After a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P < 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P < 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P < 0.05) and GLP-1 group (P < 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P > 0.05). CONCLUSIONS: The radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone. Clinical trial registration number ChiCTR2000034211 (retrospectively registered).


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Diabetes Mellitus Tipo 2 , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Coroas , Implantação Dentária Endo-Óssea , Prótese Dentária Fixada por Implante , Diabetes Mellitus Tipo 2/tratamento farmacológico , Seguimentos , Humanos , Hipoglicemiantes/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento
18.
BMC Oral Health ; 21(1): 171, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794841

RESUMO

BACKGROUND: This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). METHODS: This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. RESULTS: A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient's age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). CONCLUSIONS: Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Coroas , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Prótese Parcial Fixa , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Clin Oral Implants Res ; 32(7): 786-798, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33755997

RESUMO

OBJECTIVES: Clear guidelines when to remove an implant are missing. The aim of this study was to evaluate the amount of peri-implant bone loss at explantation by specialists. MATERIAL AND METHODS: Implantology specialists were asked to provide implants explanted due to peri-implantitis with related clinical information. Early failures (survival time <12 months) were analyzed separately. Questionnaires inquired age, sex, smoking, implant location, usage of bone substitutes, and implant brand. Explants were measured and bone loss was assessed using radiographs. Covariate-adjusted mixed-effects models were evaluated for bone loss and survival time. RESULTS: Twelve dental offices provided 192 explants from 161 patients with 99 related radiographs. Thirty-three (17.2%) explants were early failures. Excluding early failures, average survival time was 9.5 ± 5.8 years with absolute and relative bone loss of 7.0 ± 2.7 mm and 66.2 ± 23.7%, respectively. Late failures were removed at mean bone loss of 57.7% in the maxilla and 73.7% in the mandible irrespective of survival time. In fully adjusted mixed-effects models, only age at implantation (B = -0.19; 95% CI: -0.27, -0.10) remained a significant factor for survival time. Implants exhibited significantly more relative bone loss if they were positioned in the mandible (B = 17.3; 95% CI: 3.91, 30.72) or if they were shorter (B = -2.79; 95% CI: -5.50, -0.08). CONCLUSIONS: Though the mean bone loss (66.2%) at which implants were explanted was in accordance with the literature, its wide variation and differentiation between jaws showed that the profession has no universally accepted threshold beyond which an implant cannot be preserved.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Implantação Dentária Endo-Óssea/efeitos adversos , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Seguimentos , Humanos
20.
Pharmacology ; 106(5-6): 294-304, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33735887

RESUMO

INTRODUCTION: Periodontitis is a lifestyle-related disease that is characterized by chronic inflammation in gingival tissue. Febuxostat, a xanthine oxidase inhibitor, exerts anti-inflammatory and antioxidant effects. OBJECTIVE: The present study investigated the effects of febuxostat on periodontitis in a rat model. METHODS: Male Wistar rats were divided into 3 groups: control, periodontitis, and febuxostat-treated periodontitis groups. Periodontitis was induced by placing a ligature wire around the 2nd maxillary molar and the administration of febuxostat (5 mg/kg/day) was then initiated. After 4 weeks, alveolar bone loss was assessed by micro-computed tomography and methylene blue staining. The expression of osteoprotegerin (OPG), a bone resorption inhibitor, was detected by quantitative RT-PCR and immunological staining, and the number of osteoclasts in gingival tissue was assessed by tartrate-resistant acid phosphatase staining. The mRNA and protein expression levels of the proinflammatory cytokines, tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1ß), in gingival tissue were measured using quantitative RT-PCR and immunological staining. Oxidative stress in gingival tissue was evaluated by the expression of 4-hydroxy-2-nonenal (4-HNE), and 8-hydroxy-2-deoxyguanosine (8-OHdG). To clarify the systemic effects of periodontitis, blood pressure and glucose tolerance were examined. RESULTS: In rats with periodontitis, alveolar bone resorption was associated with reductions in OPG and increases in osteoclast numbers. The gingival expression of TNF-α, IL-1ß, 4-HNE, and 8-OHdG was up-regulated in rats with periodontitis. Febuxostat significantly reduced alveolar bone loss, proinflammatory cytokine levels, and oxidative stress. It also attenuated periodontitis-induced glucose intolerance and blood pressure elevations. CONCLUSION: Febuxostat prevented the progression of periodontitis and associated systemic effects by inhibiting proinflammatory mediators and oxidative stress.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Febuxostat/farmacologia , Periodontite/tratamento farmacológico , Periodontite/metabolismo , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Animais , Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Modelos Animais de Doenças , Febuxostat/uso terapêutico , Gengiva/metabolismo , Gengiva/patologia , Resistência à Insulina , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Ligadura/efeitos adversos , Masculino , Osteoclastos/efeitos dos fármacos , Osteoprotegerina/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Periodontite/etiologia , Ratos Wistar , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismo , Microtomografia por Raio-X , Xantina Desidrogenase/efeitos dos fármacos , Xantina Desidrogenase/genética
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