Research progress of superhydrophilic implants / 中国基层医药

In the past few decades, some studies reported that changing the specific surface properties of titanium implants, such as surface morphology, surface chemistry, surface charge and wettability, improved the bone bonding ability of titanium implants. Based on the existing evidence, this review paper analyzes the methods and characteristics of surface chemical modification of the superhydrophilic implants (Thommen INICELL?) that were listed in China in recent years, and clarifies the process of early osseointegration from the viewpoint of histomorphology, and evaluates its clinical application effects.

One-year retrospective radiographic assessment of marginal bone loss around basal implants and impact of multiple risk factors using multivariate analysis / Evaluación radiográfica retrospectiva de un año de la pérdida ósea marginal alrededor de los implantes basales y el impacto de múltiples factores de riesgo mediante análisis multivariado

Background: Factors like medical and periodontal conditions, implant location and smoking can affect marginal bone loss (MBL) of basal implants. Objectives: The purpose of this study is to explore the association of MBL with multiple variables including gender, age, smoking status, diabetes, implant placement protocol, location of implant, and type of prosthesis. Material and Methods: A total of 156 single-piece basal implants (Dr. Ihde Dental AG in Gommiswald, Switzerland) were placed in 44 patients. Dental panoramic tomographs were obtained postoperatively and following a one-year of service to determine MBL on mesial and distal sides. The association of MBL with the multiple variables was analysed using the multivariate and the random forest analysis. Results: The mean mesial and distal MBL was 0.64 millimetres. None of the implants presented MBL exceeding 1 millimetre. All implants were retained without complications during the firstyear of service. The MBL was remarkably associated with the smoking status, diabetes, location of implant and implant placement protocol. Diabetes mellitus is the most vital parameter in predicting MBL. Conclusion: The mean MBL of all implants did not exceed the threshold of 1 millimetre during the first year of service. When placing implants in patients who smoke and have diabetes, care should be taken.

Antecedentes: Factores como las condiciones médicas y perio-dontales, la ubicación del implante y el tabaquismo pueden afectar la pérdida marginal de hueso (PMH) de los implantes basales. Objetivo: La finalidad de este estudio es explorar la asociación de PMH con múltiples variables, incluido el sexo, la edad, el tabaquismo, la diabetes, el protocolo de colocación del implante, la ubicación del implante y el tipo de prótesis. Material y Métodos: Se colocaron 156 implantes basales de una sola pieza (Dr.Ihde Dental AG, Gommiswald, Suiza) en 44 pacientes. Se obtuvieron tomografías panorámicas dentales después de la operación y después de un año de servicio para deter-minar la MBL en los lados mesial y distal. La asociación de la PMH con las múltiples variables se analizó mediante el análisis multivariado y de bosque aleatorio. Resultados: La PMH media mesial y distal fue de 0,64 milímetros. Ninguno de los implantes presentó PMH superior a 1 milímetro. Todos los implantes se mantuvieron sin complicaciones durante el primer año de servicio. La PMH se asoció nota-blemente con el tabaquismo, la diabetes, la ubicación del implante y el protocolo de colocación del implante. La diabetes mellitus es el paráme-tro más importante para predecir la MBL. Conclusion: La PMH media de todos los implantes no superó el umbral de 1 milímetro durante el primer año de servicio. Se debe tener especial cuidado al colocar implantes en pacientes que fuman y tienen diabetes.

Bacterial Colonization and Dental Implants: A Microbiological Study

Abstract Objective: To compare colony forming unit (CFU) of oral bacterial from buccal mucosa and lingual buccal tongue among patients with a dental implant and normal oral hygiene individuals without a dental implant. Material and Methods: Twenty-six individuals with a dental implant and twenty-six individuals without dental implants were included in this study. The samples were sent to the laboratory to culture with Brain Heart Infusion Broth (BHI), prepared serial dilution and then spread to the blood agar. CFU was counted when a single layer of bacteria is formed on the blood agar at any dilution level. An independent-T test was used to compare the means different of CFU oral bacterial between control and test groups from buccal mucosa and lingual buccal mucosa, respectively. Results: Buccal mucosa control group (186.19 ± 5.61) and test group (186.65 ± 6.24) (p>0.05). The result from the lingual buccal tongue control group (198.38 ± 6.12) and test group (197.96 ± 6.50) (p>0.05). There was no significant difference between the control group and test group CFU bacterial load. Conclusion: The presence of implants in the oral cavity do not interfere or worsen the oral condition; nevertheless, the effect of implants surrounding oral flora is similar to natural teeth.

Uso do guia endodôntico para resolução de canais calcificados: relato de caso / Use of endodontic guide for resolution of calcified root canals: case report

Introdução: a ciência endodôntica tem como objetivo a manutenção do elemento dentário em função no sistema estomatognático, por meio de procedimentos de sanificação, modelagem e obturação dos condutos radiculares. Porém, o sucesso do tratamento pode estar comprometido devido à presença de obliterações parciais ou totais da cavidade pulpar, que dificultam ou, até mesmo, impedem o procedimento. Recentemente, os avanços tecnológicos possibilitaram a transposição dessas barreiras com a confecção de um guia que permite o acesso retilíneo e direciona ao forame apical do canal obliterado. Métodos: o presente estudo descreve o uso do guia endodôntico em um paciente do sexo masculino, de 54 anos de idade, diagnosticado com necrose pulpar no elemento #14, com obliteração do conduto palatino. Resultados: o sucesso do tratamento pôde ser observado após seis meses de controle radiográfico e ausência de sintomatologia. Conclusões: o tratamento endodôntico de canais calcificados por meio da Endodontia guiada demonstrou ser uma abordagem clinicamente viável para localizar canais radiculares obliterados e prevenir acidentes e complicações nos dentes que não podem ser acessados de forma previsível por meio da terapia endodôntica tradicional (AU).

Introduction: Endodontic science aims to maintain the dental element in function in the stomatognathic system, through procedures of sanification, modeling and obturation of the root conduits. However, the success of the treatment may be compromised due to the presence of partial or total obliterations of the pulp cavity, which hinder and even impede the procedure. Recently, the technological advance made it possible to transpose these barriers with the creation of a guide that allows rectilinear access and directs to the apical foramen of the obliterated canal. Methods: The present study describes the use of the endodontic guide in a 54-year-old male patient, diagnosed with pulp necrosis in element 14, with obliteration of the palatine conduit. Results: The success of the treatment could be observed after six months of radiographic control and absence of symptomatology. Conclusions: Endodontic treatment of calcified canals through guided endodontics demonstrates a clinically viable approach to locate obliterated root canals and prevent accidents and complications in teeth that cannot be predictably accessed through traditional endodontic therapy (AU).

Comparative evaluation of implant stability in two different implant systems at baseline and 3–4 months intervals using RFA device (OSSTELL ISQ)

Introduction: Osseointegration as formulated by Alberktson is crucial for implant survival and success. Osseointegration is a measure of implant stability. Measuring implant stability helps to arrive at decisions as to loading of an implant, allows protocol choice on a patient to patient basis and provides enhanced case documentation. The RFA technique provides with clinically relevant information about the state of the implant–bone interface at any stage after implant placement. Aim: Evaluation of primary and secondary stability between implants of two different systems by resonance frequency analysis device. Methodology: This study was conducted among 17 patients divided into two groups. Group 1 (n = 10) receiving 20 MIS seven implants and Group 2 (n = 7) received 20 Alphadent active implants. The primary implant stability was measured at the time of implant placement and secondary stability is measured at 3–4 months interval using RFA device OSSTELL ISQ. Statistical analysis was performed using paired t test for intra group and independent sample test for intergroup comparisons. Results: No statistically significant differences in primary and secondary stabilities were found between the implant systems at either time intervals (P > 0.05). A positive correlation was noticed between mesiodistal stability and implant diameter in MIS seven group (P < 0.05). A positive correlation was noticed between mesiodistal, labiolingual stabilities and implant diameter in Alphadent group (P = 0.03). A positive correlation was noticed between mesiodistal, labiolingual stabilities and implant length in Alphadent group (P = 0.03). Conclusion: From the present data, it can be concluded that within the limitations of study, implant systems used and their design features showed no significant correlation to implant stability between the groups. More studies are required to assess the effect of implant designs and surface conditions on implant stability on a long-term basis.

Histometry Analysis of Osteoclasts, Osteoblasts and Fibroblasts in Immediate Placement Implants with Addition of Aloe Vera Extract

Objective: To analyze the effect of immediate placement of implants with extract from the new bone formation histometically. Material and Methods: In this true-experimental design with randomized post test control group, 9 mongrel dogs weighing 10 to 12 kg were used, which were divided into 3 groups, based on observation time of 14 days, 28 days and 56 days. On the installation of implants (∅3.5x10 mm) sequentially, the former socket extraction of the lower jaw's right second premolar tooth in the study sample injected 10% Aloe vera gel extract and left second left premolar tooth without injection of 10% Aloe vera extract. To compare independent groups use the Mann-Whitney test. All analysis were carried out using SPSS version 20. Results: There was an increase in the number of osteoblast cells in both treatment and control groups, but the value of the treatment group was greater. There were significant differences in the number of osteoblast cells between the treatment and control groups 14 days (p=0.019), 28 days: (p=0.018), and 56 days (p=0.009). There were no significant differences in the number of fibroblast cells between the treatment and control groups (p>0.05). But at observations 28 and 56 days, it was showed a significant difference in the number of fibroblast cells between the treatment and control groups (p=0.353 and p=0.024, respectively). Conclusion: Immediate placement of implants with 10% Aloe vera extract gel on extracted socket increases the number of osteoblasts and suppresses the number of osteoclasts and fibroblasts.

Evaluation of Frontal Teeth Stabilization after Root Apex Resection among the Ukrainian Young People

Objective: To develop a protocol of improved stabilization of teeth after root apex resection among young people using endodonto-endoossal implants and assessing its effectiveness. Material and Methods: Thirty-six patients were previously selected and divided into Group 1 (without additional stabilization) and Group 2 (with additional stabilization). The efficacy of treatment in both clinical groups was estimated at 90, 180 and 360 days, respectively. The results were evaluated on the Miller scale in the Flesrar modification. Density of bone tissue was expressed in Hounsfield units. Results: The average mobility indices over 90 days indicate a significant lower mobility of teeth in patients in Group 2, where as an advanced method, the RTR with an additional filling of the bone marrow defect with an osteoplastic material was chosen as the method of treatment (+ 18.0 ± 0.21 U.M. 10.0 ± 0.8 µm, p<0.05). In Group 1, 90 and 180 days after surgery, the density of bone tissue in the defect area was 756.3 ± 2.45 HU and 880.1 ± 4.34 HU. In Group 2, these indices were insignificantly higher and amounted to 834.3 ± 4.35 HU and 880.4 ± 2.56 HU. After 360 days after treatment in the first clinical group the bone density index was 957.4 ± 2.45 HU, while in the second group - 1003.3 ± 4.38 HU. Conclusion: The mobility of teeth among patients on 90-th day corresponded to level 1, and on 360-th day corresponded to level 0, indicating the effectiveness of the proposed method. The biomechanical stabilization of the teeth was confirmed by the results of densitometry among patients of both groups, in particular, the recovery of bone density in the affected site was observed after 360 days.

Clinical evaluation of two transalveolar methods for sinus augmentation with placing 1 204 implants immediately / 中华口腔医学杂志

Objective@#To compare the clinical outcomes of posterior maxillary implant surgery when using the regular transalveolar approach or with the crestal approach-sinus (CAS-KIT), a device for maxillary sinus membrane elevation by the crestal approach using a special drilling system and hydraulic pressure.@*Methods@#In this retrospective study 887 patients during Jan 2012 to July 2015 in Hangzhou Dental Hospital with underwent either regular transalveolar approach or CAS-KIT approach for maxillary augmentation; whereas 11 patients dropped out for the reason of serious membrane perforations. Totally, 876 patients with 1 204 plants, placed immediately after transalveolar maxillary augmentation, were included in this study. The data analysis was performed by radiological measures to assess the changes in height of maxillary sinus floor after the transalveolar augmentation at different time points. In addition, the complications after surgery, failure rates, osseointegration condition and the performance of rehabilitation were evaluated as well.@*Results@#Five hundred and three patients were experienced with regular transalveolar approach, and 7 patients were drop out for the serious membrane perforations. Thus, 496 patients received 653 implants in this group; the average lifted range in maxillary sinus floor height changes was (4.08±3.45) mm. The complications were minor membrane perforations during procedure in 64 patients, postoperative maxillary sinus infection happening in 2 patients and 13 patients experienced rehabilitation failure. Three hundred and eighty-four patients had CAS-KIT approach with 4 patients dropped out. Three hundred and eighty patients get 551 implants with the mean lifted range of (8.36±4.07) mm in maxillary sinus floor height changes. Minor membrane perforations during procedure occurred in 31 people and 2 got postoperative maxillary sinus infection. The 4 year overall survival rate of 1 204 implants was 97.26%, with four implants fell off after 3 months of rehabilitation and one implant occurred after one year of rehabilitation.@*Conclusions@#The regular transalveolar sinus lift technique is easier and time saving, but the compromised lifting range in maxillary sinus floor height and the comparatively high occurrence of intraoperative membrane perforations should be concerned. Using CAS-KIT could be an alternative method to perform maxillary sinus augmentation with a reduced incidence of complications. There was no statistically difference in implant failure rates and incidence of postoperative maxillary sinus infection between two groups.

Short-term and mid-term follow-up study of 34 cases of maxillary posterior teeth deletion treated by orthotopic implantation combined with maxillary sinus floor elevation at the same time / 中国基层医药

Objective To investigate the application value and short-term and mid-term prognosis of orthotopic implantation combined with maxillary sinus floor elevation in the treatment of patients with maxillary posterior teeth deletion at the same time.Methods A total of 68 patients with maxillary posterior teeth deletion in the Integrated Traditional Chinese and Western Medicine Hospital of Shanxi Province from June 2014 to June 2016 were selected and randomly divided into the control group(n=34)and the study group(n=34)according to the digital table.The control group was treated with dental implant technology to repair,and the study group was treated with implanted orthotopic implantation combined with maxillary sinus floor elevation at the same time.The follow-up was continued for 3-12 months after operation.The degree of postoperative pain,the incidence of complications,the satisfaction of the treatment,and the prognosis of the two groups after 12 months of operation(the exfoliation of implant and the loosening of the implant)were statistically analyzed.Results The good rate of pain in the study group was 97.06％(33/34),which was higher than that of the control group [76.47％(26/34)](P<0.05).There was no statistically significant difference in the incidence rate of complications between the study group [5.88％(2/34)]and control group[8.82％(3/34)](P>0.05).The treatment satisfaction of the study group [97.06％(33/34)] was higher than that of the control group [70.59％(24/34)](χ2 =8.758,P<0.05).The incidence rate of poor prognosis of the study group[2.94％(1/34)]was lower than that of the control group [23.53％(8/34)](χ2 =4.610,P <0.05).Conclusion Orthotopic implantation combined with maxillary sinus floor elevation in the treatment of patients with maxillary posterior teeth deletion at the same time has less postoperative pain and high treatment satisfaction.And the complications and incidence of exfoliation and loosening of implants are low after 12 months of operation.

Oral implant osseointegration model in C57Bl/6 mice: microtomographic, histological, histomorphometric and molecular characterization

Abstract Despite the successful clinical application of titanium (Ti) as a biomaterial, the exact cellular and molecular mechanisms responsible for Ti osseointegration remains unclear, especially because of the limited methodological tools available in this field. Objective: In this study, we present a microscopic and molecular characterization of an oral implant osseointegration model using C57Bl/6 mice. Material and Methods: Forty-eight male wild-type mice received a Ti implant on the edentulous alveolar crest and the peri-implant sites were evaluated through microscopic (μCT, histological and birefringence) and molecular (RealTimePCRarray) analysis in different points in time after surgery (3, 7, 14 and 21 days). Results: The early stages of osseointegration were marked by an increased expression of growth factors and MSC markers. Subsequently, a provisional granulation tissue was formed, with high expression of VEGFb and earlier osteogenic markers (BMPs, ALP and Runx2). The immune/inflammatory phase was evidenced by an increased density of inflammatory cells, and high expression of cytokines (TNF, IL6, IL1) chemokines (CXCL3, CCL2, CCL5 and CXC3CL1) and chemokine receptors (CCR2 and CCR5). Also, iNOS expression remained low, while ARG1 was upregulated, indicating predominance of a M2-type response. At later points in time, the bone matrix density and volume were increased, in agreement with a high expression of Col1a1 and Col21a2. The remodelling process was marked by peaks of MMPs, RANKL and OPG expression at 14 days, and an increased density of osteoclasts. At 21 days, intimate Ti/bone contact was observed, with expression of final osteoblast differentiation markers (PHEX, SOST), as well as red spectrum collagen fibers. Conclusions: This study demonstrated a unique molecular view of oral osseointegration kinetics in C57Bl/6 mice, evidencing potential elements responsible for orchestrating cell migration, proliferation, ECM deposition and maturation, angiogenesis, bone formation and remodeling at the bone-implant interface in parallel with a novel microscopic analysis.

Clinical study of custom abutment and digital provisional crown in implant denture gingival formation / 中国基层医药

Objective To analyze the effect of custom abutment and computer aided design and computer aided manufacturing(CAD/CAM) provisional crown on gingival shaping around the implant,and to research the main effect of the custom abutment in the formation of gingival.Methods According to the wishes of patients,fifteen patients were divided into two groups.Gingival molding used CAD/CAM in the observation group(n=7) to design and make custom abutment and provisional crown.The control group(n=8) used the prefabricated abutment and the hand-made self-curing resin temporary crown.Immediately after inserting of final insertion and three months later,pink esthetic score(PES) was calculated in both two groups.Results The labial gingiva curve of the observation group was (1.93±0.27)points,which was higher than (1.56±0.51)points of the control group,there was significant difference between the two groups(t=2.496,P0.05).The PES score of the observation group was (8.50±1.09)points,which was higher than (7.75±1.13)points of the control group,but the difference was not statistically significant(P>0.05).Conclusion The effect of the custom abutment on curvature of facial mucosa is significant.The combination of custom abutment and digital provisional crown can achieve better soft tissue stability and ideal aesthetic effect in a short time.

Comportamiento del proceso de osteointegración en implantes transalveolares inmediatos / Osseointegration of Immediate Transalveolar Implants

Fundamento: la osteointegración es un requisito primordial para comenzar la rehabilitación protésica sobre implantes. Objetivo: describir el comportamiento del proceso de osteointegración en implantes transalveolares inmediatos. Métodos: estudio prospectivo, de serie de casos, en el periodo de enero 2012 a diciembre del 2013. Se trabajó con la totalidad de los pacientes (75 pacientes con 79 implantes) que acudieron a la consulta de Prótesis Dental. La edad, sexo, osteointegración, causa de la pérdida dentaria, región implantada, diente específico, nivel óseo alrededor del implante y encía queratinizada alrededor del implante, fueron las variables estudiadas. Para el análisis de los datos, se utilizaron medidas de distribución de frecuencia, y análisis estadísticos. Resultados: predominó el sexo femenino, así como los pacientes con edades de 31 a 45 años; la osteointegración se observó en el 97,4 % de los implantes. Las zonas que más implantes recibieron fueron premaxila y maxilar posterior, específicamente en las primeras bicúspides. En la mayoría de los pacientes, la osteointegración con formación de hueso tuvo lugar a nivel del cuello del implante y en presencia de encía totalmente queratinizada, con asociación estadísticamente significativa entre ambas variables. Conclusión: el tratamiento rehabilitador con este tipo de implante, posibilita una exitosa osteointegración en la mayoría de los casos estudiados.

Background: osseointegration is critical to start prosthetic rehabilitation. Objective: to describe osseointegration of immediate transalveolar implants. Methods: a prospective case series study was conducted from January 2012 to December 2013. It included all patients (75 patients with 79 implants) who attended the Prosthodontics service. Age, sex, osseointegration, cause of tooth loss, region of the implant, specific tooth, bone level and keratinized gingiva around the implant, were the variables studied. Frequency distribution and statistical analysis were used for data analysis. Results: females and patients aged 31 to 45 years predominated. Osseointegration was observed in 97.4% of the implants. Nearly all implants were placed in the premaxilla and posterior maxilla, specifically in the first bicuspids. In most patients, osseointegration with bone formation occurred at the implant collar and in the presence of completely keratinized tissue, with a statistically significant association between the two variables. Conclusion: rehabilitation treatment with this type of implant led to successful osseointegration in most cases studied.

Effects of health management of stomatology on the marginal bone resorption of minimally invasive implant in the elderly / 中华健康管理学杂志

Objective To evaluate the effects of health management of stomatology on the marginal bone resorption of minimally invasive implant in the elderly.Method Tottally 54 implants were placed in 37 elderly patients of missing teeth in maxillary molar areas and the patients were randomly divided into health management group and control group.Patients in the group of health management were guided to master the proper techniques of oral hygiene practices before and after the implantation and periodontal maintenance were carried out carefully until 1 year after loading of restoration.In the control group, oral hygiene was applied. X-ray and CBCT examinations were made and implant marginal alveolar bone loss (MBL) was measured 3, 6, 9, 12 months after loading with Planmeca PROMAX3D software. Besides, 3, 6, 9, 12 months after loading, improved plaque index (iPLI), modified bleeding index (mBI) and probing depth (PD) were also recorded. SPSS 15.0 was applied to analyze the data. Result Differences in diastolic and systolic blood pressure and changes in heart rate in patients during the intraoperative period were (8.86 ± 0.31) mmHg(1 mmHg=0.133 kPa), (19.18 ± 0.22) mmHg, (20.19 ± 1.84) times/min, which were significantly lower than those of the control group values [(16.55±1.08) mmHg, (28.31±2.30) mmHg, (20.19±1.84) times/min] (P<0.05 or 0.01);at 12 months after the load around the implant in oral health management group, the values of MBL and mSBI were 2.6 (2, 4), 2.1 (2, 4), which were significantly better than control group [4.3(3, 7), 4.3(3, 7)] (P<0.01);simultaneously, there was significant difference in the values of MBL and PD between experimental group (1.42 ± 0.03, 0.77 ± 0.24) and control group (1.59 ± 0.04, 0.54 ± 0.17) (P<0.01). Conclusion Well-performed health management of peri-implant could reduce the MBL and keep healthy soft tissue environment around implants.

Qual a idade adequada para colocação de implante dentário osseointegrável? / What is the appropriate age for dental implant placement?

A ausência de um dente pode causar problemas funcionais, estéticos e emocionaisa um paciente. Há mais de três décadas, os implantes osseointegráveis têm sido utilizadoscomo método alternativo para reposição de dentes perdidos, uma vez que apresentam um bom desempenhoem longo prazo. Implantes dentários unitários são colocados em muitos pacientes jovens,porém, pequenas mudanças na posição da margem gengival podem comprometer o resultado estéticodessas reabilitações. Implantes geram retardo no desenvolvimento dentoalveolar vertical, porisso são comparados a dentes anquilosados por diversos autores, já que não irrompem juntamentecom os dentes adjacentes. Isso significa que, em pacientes que ainda possam crescer, as prótesesimplantossuportadas podem ficar em infraoclusão. Como diversos autores relatam crescimentoapós a adolescência, essa revisão de literatura teve como objetivo indicar o momento mais adequadopara a colocação de implantes osseointegráveis, considerando o crescimento craniofacialresidual...

The absence of a tooth may cause functional, esthetic and emotional problemsto a patient. For more than three decades, osseointegrated implants have been used as an alternativemethod to replace missing teeth, as they have shown good long-term results. Single toothimplants are placed in many young patients, but slight changes in position of the gingival marginmay compromise the esthetic outcomes of such rehabilitations. Implants retard vertical dentoalveolardevelopment, for this reason, they are compared to ankylosed teeth by many authors, as theydo not erupt together with adjacent teeth. In the case of patients that could still grow up, that meansthe implant-supported prostheses may result in infra-occlusion. Objective: Since a variety of authorsreport post-adolescent growth, this literature review aimed to indicate the most adequatemoment for osseointegrated implant placement, taking into account residual craniofacial growth...

Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis

PURPOSE: Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. METHODS: From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. RESULTS: Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001). CONCLUSIONS: Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.

Implantes de zircônia reforçada com ítria (Y-TZP): avaliação histomorfométrica / Y-TZP dental implants: histomorfometry analysis

O objetivo do trabalho foi avaliar in vivo a osseointegração de implantes produzidos em zircônia reforçada com ítria (Y-TZP) e compará-los com o implante de titânio usinado e com o de superfície jateada com brushita. Para tanto, nas tíbias de 20 coelhos machos (n=10) e fêmeas (n=10) foram implantadas em uma das tíbias o implante Y-TZP (GE-1, n=10 implantes) e na outra tíbia o titânio usinado (GC, n=5 implantes) ou jateado com brushita (GE-2, n=5 implantes). Os animais receberam marcadores ósseos fluorescentes, tetraciclina (14 e 21 dias), alizarina (28 e 35 dias) e calceína (42 e 49 dias) após a cirurgia de implantação. Ao final de 56 dias, a região dos implantes foi coletada e processada histologicamente para obtenção de cortes teciduais não desmineralizados. Nas imagens obtidas no microscópio confocal foi avaliado o percentual de área para cada marcador. Nos cortes corados pelo azul de toluidina foi avaliado morfologicamente a qualidade do tecido ósseo formado e a existência de interposição de tecido conjuntivo entre osso e implante, e morfometricamente determinado o percentual de contato osso-implante (BIC) e o percentual de tecido ósseo próximo à superfície do implante (BA). Os resultados mostraram que, não houve diferenças estatisticamente significantes entre machos e fêmeas quanto aos parâmetros avaliados. Com relação aos grupos, GE-1 e GC apresentaram cortical óssea remanescente íntegra e formação de um tecido ósseo maduro/lamelar na superfície dos implantes. No GE-2 ocorreu intensa reabsorção da cortical óssea pre-existente próxima ao implante e extensa formação óssea mais imatura em relação aos observados no GE-1 e GC. Essa intensa reabsorção e extensa formação óssea fez com que o percentual de área dos marcadores fluorescentes fosse em média 0,73 vezes maior no GE-2 em relação aos grupos GE-1 e GC. Com relação ao BIC não houve diferença entre os grupos, sendo em média de 47,8%, porém, o BA no grupo GC (66,2%) foi 0,33 vezes...

The aim of this work was evaluate in vivo the osseointegration of implants produced with yttria stabilized zirconia (Y-TZP) and compare it with machined titanium implant and sandblasted surface with brushita titanium. Therefore, on the tibia of 20 rabbits males (n=10) and female (n=10) were implanted in one of the tibias the implant Y-TZP (GE-1, n=10 implants) and on the other tibia the machined titanium (GC, n=5 implants) or sandblasted surface with brushita titanium (GE-2, n=5 implants). The animals received fluorescent bone markers, tetracycline (14th and 21th days), alizarin (28th and 35th days) and calcein (42th and 49th days). At the end of 56 days, the implants regions were collected and histomorphometrically processed to obtain tissue sections not demineralized. On images obtained from confocal microscopy was evaluated the percentage of area for each bone markers. On slides stained with toluidine blue was measured morphologically the quality of formed bone tissue and the existence of interposition of connective tissue between bone and implant, and was morphometrically determined the percentage of bone-implant contact (BIC) and the percentage of bone tissue next to the implant surface (BA). The results showed that there were no statistically significant differences between male and female regarding to evaluated parameters. Concerning to the groups, GE-1 and GC exhibited wholesome remaining cortical bone and formation of mature/lamellar bone tissue on implants surface. In GE-2 ocurred intense reabsorption of preexisting cortical bone next to the implant and extensive bone formation more immature than GE-1 and GC. This intense reabsorption and extensive bone formation made the GE-2 area percentage for fluorescent markers 0.73 times higher on average when compared to GE-1 and GC. About the BIC, there were no differences between the groups, with an average of 47.8%, however, the BA on GC group (66.2%) was 0.33 higher compared to GE-1...

O uso de implantes, enxerto ósseo e condicionamento do tecido gengival perimplantar na reabilitação estética de área anterior de maxila / The use of dental implants, bone graft and peri-implant gingival tissue modeling in the esthetic rehabilitation of the maxillary anterior area

A reabilitação protética implanto-suportada de espaços edêntulos na região anterior da maxila é um desafio para o cirurgião-dentista. Um adequado posicionamento dos implantes e sua relação harmoniosa com os tecidos duros e moles são fundamentais para uma alta demanda estética. Esse caso relata a correção de um severo defeito estético no qual foi necessário associar vários procedimentos, como a realização de enxerto ósseo prévio, a instalação de implantes osseointegráveis, a manipulação dos tecidos peri-implantares e a escolha de componentes protéticos estéticos, para se alcançar um resultado estético satisfatório.

Implant-supported prosthetic rehabilitation of anterior edentulous spaces is a challenge to the dentist performing the implant surgery. Proper positioning of the implant and its harmonious relationship with the hard and soft tissues are fundamental for a high aesthetic demand. This case report a correction of a serious esthetic defect in that was necessary associate some procedures, like a previous bone graft, installation of osseointegrated implants, soft tissue manipulation and the use of esthetic prosthetic components to reach a satisfactory result.

Clinical Evaluation of Simultaneous Implants Placement Following Augmentation of the Maxillary Sinus with Deproteinized Bovine Bone

Nivel de evidencia en implantes: verdades a medias en construcción / Level of evidence implants: half-truths under construction

A manera de cavilación se pretende hacer un llamado a la investigación y a la mesura que abra un espacio para el trabajo en equipo en el que se hace imprescindible la planeación y en donde el nivel de evidencia basado en estudios con diseños metodológicos adecuados hacen creíble y traducible la información que se ofrece sobre esta temática que sin duda es actual y polémica. Además de tratar en concreto lo que la evidencia muestra sobre las uniones diente-implante y que aun se considera un tópico controvertible, se profundiza en la limitación de estudios con buenos diseños metodológicos que permitan llegar a conclusiones importantes en esta área biomédica. Igualmente, el considerable desconocimiento en la mayoría de protocolos de carga inmediata y temprana con implantes orales vistos en diferentes situaciones de edentulismo no es contemplado por algunos programas de escuelas odontológicas y casas comerciales que los avalan y popularizan basándose en investigaciones muy lejanas a las adecuadas y con un buen nivel de evidencia

As a reflection this article intends to make a call for the research and for the restraint, while opening a space for teamwork in which planning is prevalent and where the level of evidence-based studies with adequate methodological designs make credible and translate the information on this subject that is current and certainly controversial. It deals specifically what the evidence shows about tooth-implant unions that are still considered a controversial topic, also, describes the limitation of studies with good methodological designs that will lead to important conclusions in this biomedical area. Similarly, considerable unawareness in most protocols for immediate and progressive implants loading in different edentulism situations is not pondered by some dental schools programs and commercial corporations that consider them very popular and based on research far from adequate with a good level of evidence