Cicatrizadores personalizados: relato de caso / Customized healing abutments: case report

Quando feita a instalação de um implante imediato pode se optar entre a instalação de uma coroa provisória clínica, um cicatrizador ou pode se optar pelo fechamento do implante para um tratamento em duas etapas cirúrgicas. O uso de cicatrizadores personalizados sela os implantes e leva a uma cicatrização individualizada, que favorece a confecção das coroas subsequentes. O presente trabalho objetiva relatar um caso clínico envolvendo um implante imediato e a instalação de um cicatrizador personalizado, demonstrando os resultados e a importância de conhecimento dessa técnica pelo cirurgião-dentista.

When installing an immediate implant, you can choose between installing a temporary clinical crown, healing abutments, or to close the implant for a two-step surgical treatment. The use of customized healing abutments seals the implants and leads to individualized healing, which favors the creation of subsequent crowns. The present study aims to report a clinical case involving an immediate implant and the installation of customized healing abutments, demonstrating the results and the importance of knowledge of this technique by the dentist.

Effects of flapless versus flap implant surgery on tissues surrounding implants in esthetic zone / 中华医学美学美容杂志

Objective To evaluate the effects of flapless versus flap implant surgery on the tissues surrounding the implants in the esthetic zone.Methods A controlled study was conducted in 20 patients with a single implant in the anterior esthetic zone,as compared with the flapless and traditional flap implant placement.6 and 12 months after the implant ation,the vertical reduction of labial and lingual bone were assessed by cone beam computed tomography (CBCT);6 and 12 months after the crowns restoration,the peri-implant soft tissues were examined by probing depth (PD),modification sulcus bleeding index (mSBI),papillary index (PPI) and evaluated by pink esthetic score (PES) standard.Results The vertical reduction of the flapless labial and lingual bone was lower than that of the flap,in which the change of labial bone was statistical differences at 6 months after implant surgery between groups (P ＜ 0.05).The differences of PES between two groups were not statistically significant,although PES increased over time in both groups,which the flapless group had a significantly change in PES from crown placement to 12 months (P＜0.05).Conclusions A flapless implant surgery in sufficient bone support may provide a better short-term esthetic result,whereas the longterm effects need further studies.

Mechanical and biological complication rates of the modified lateral-screw-retained implant prosthesis in the posterior region: an alternative to the conventional Implant prosthetic system

PURPOSE: The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS: Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS: Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION: Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

Screw loosening of different UCLA-type abutments after mechanical cycling

AIM: To evaluate the loss of applied torque (detorque) values in cast and pre-machined abutments for external hex abutment/implant interface of single implant-supported prostheses subjected to mechanical cycling. METHODS: Ten metal crowns were fabricated using two types of UCLA abutments: cast and pre-machined with metal base in NiCrTi alloy and tightened to regular external hex implants with a titanium alloy screw, with an insertion torque of 32 N.cm, measured with a digital torque gauge. Samples were embedded with autopolymerizing acrylic resin in a stainless steel cylindrical matrix, and positioned in an electromechanical machine. Dynamic oblique loading of 120 N was applied during 5 x 10(5) cycles. Then, each sample was removed from the resin and detorque values were measured using the same digital torque gauge. The difference of the initial (torque) and final (detorque) measurement was registered and the results were expressed as percentage of initial torque. The results of torque loss were expressed as percentage of the initial torque and subjected to statistical analysis by the Student's t-test (p<0.05) for comparisons between the test groups. RESULTS: Statistical analysis demonstrated that mechanical cycling reduced the torque of abutments without significant difference between cast or pre-machined UCLA abutments (p=0.908). CONCLUSIONS: Within the limitations of this in vitro study, it may be concluded that the mechanical cycling, corresponding to one-year use, reduced the torque of the samples regardless if cast or pre-machined UCLA abutments were used.

Outcome Evaluation of an Immediately Placed Maxillary Anterior Single-Tooth Implant Using Objective Esthetic Criteria: Case Report

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.

Implant with simultaneous bone grafting for replacement of maxillary anterior tooth - A case report.

Successful replacement of the lost teeth by means of tissue-integrated implants represents a major advance in dentistry. The bone quality and amount of bone available in anterior maxilla is often variable and commonly there is a deficiency of bone volume. Currently, however, implants are also being placed in sites with ridge defects of various dimensions. The various reconstruction techniques using bone graft, guided bone regeneration, orthognathic surgery or bone distraction provides the surgical specialist with a wide range of treatment options for placing implants in compromised ridges. Appropriate use of these methods will enable the successful treatment of almost any complicated case with bone deficient jaws. This case reports the step-by-step procedures in a case where the missing maxillary left central incisor was restored by placement of implant simultaneous with the use of bone grafting using Hydroxyapatite for the correction of minor dehiscence in the alveolar ridge.

Use of separate single-tooth implant restorations to replace two or more consecutive posterior teeth: a prospective cohort study for up to 1 year

PURPOSE: The aim of this study was to evaluate the periodontal and prosthodontic complications of multiple freestanding implants in the posterior jaws for up to 1 year of function. MATERIAL AND METHODS: Eight patients received 20 implants posterior to canines. Two or more implants were consecutively inserted to each patient. Single crowns were delivered onto the implants. Marginal bone loss, implant mobility, probing depth, and screw loosening were examined to evaluate the clinical success of such restorations for maximum 1 year of functional loading. RESULTS: All the implants performed well during the observation period. Neither periodontal nor prosthodontic complications were found except a slight porcelain chipping. While the marginal bone level was on average 0.09 mm lower around the implant after 6 months of loading, it was 0.15 mm higher after 1 year. CONCLUSION: Within the limits of this investigation, separate single-tooth implant restorations to replace consecutive missing teeth may clinically function well in the posterior jaw.

Rehabilitación diente único con implante en zonas estética anterior: reporte de un caso / Restauration with a single implant in the anterior esthetic zone: a case report

El conocimiento acerca de la rehabilitación de dientes con implantes ha ido aumentando de manera potencial; los resultados favorables de la oseointegración superan el 90%, pero los conceptos para designar una restauración como exitosa cada vez se tornan mas estrictos. La estética gingival peri-implantar es ahora quien rige los parámetros de éxito o fracaso y la diferencia estructural del periodonto al rededor de un diente y de un implante es quien determina factores como la posición tridimensional, el pronóstico y el resultado estético final. Este caso reporta la rehabilitación de un incisivo central superior (considerado actualmente como el mayor reto estético) de una paciente de 22 años de edad que asiste a la clínica CES de Sabaneta (Antioquia). La corona del diente fue restaurada en varias ocasiones desde la edad de 12 años, después de sufrir un accidente de tránsito. La paciente presenta un resto radicular fracturado con caries activa en su porción cervical. La revisión de literatura incluye todos los parámetros dentales, óseos y gingivales que se tuvieron en cuenta para la colocación del implante, y su posterior rehabilitación con el sistema Procera. El tratamiento realizado fue la extracción atraumática del resto radicular, la colocación inmediata del implante, y la restauración final con una corona libre de metal utilizando el sistema Procera.

The knowledge about the rehabilitation of teeth with implants has grown up in a potential way; the favorable outcomes of Osseo integration exceed 90%, but the concepts to designate a restoration as successful have become stricter. Peri-implant gingival esthetics parameters currently determine failure or success, and the structural differences of the periodontum surrounding the tooth and implant are determining factors of three-dimensional position ofthe restoration, prognosis and final esthetic result. This case reports the rehabilitation of a central incisor of a 22 year old patient who consulted CES University Dental Clinic. Past Dental History revealed she had been treated and had the restoration and been repeated on several occasions since the age of 12 after suffering dento-alveolar trauma in an automobile accident. Oral examination showed that the patient presented a fractured root with decay on its cervical third. Treatment included a traumatic extraction of the root, immediate placementof an implant and a final restoration with a Procera all ceramic crown.

Implante imediato unitário em função imediata: relato de caso / Immediate single tooth implant in immediate loading: case report

A possibilidade de reabilitação oral com implantes dentários mostrou um avanço significativo nos últimos quarenta anos. Da recomendação inicial para p tratamento de mandíbulas totalmente edêntulas com próteses fixas suportadas em implantes, houve uma evolução rápida e ascendente no sentido de aprimorar os implantes dentários, bem como de agilizar a resolução dos casos clínicos. Uma proposta já documentada com sucesso na literatura científica é a possibilidade de posicionamento de implantes unitários imediatamente pós-exodontia, o que representa um grande avanço na implantodontia. O objetivo deste trabalho é relatar um caso clínico no qual foi decidido seguir a abordagem de implante imediato com aplicação da filosofia de carga imediata, o que foi realizado no intuito de diminuir o número de intervenções cirúrgicas, bem como o tempo entre a instalação do implante e a restauração protética final. aumentando, assim, a satisfação estética e funcional do paciente.

A retrospective study on survival rate of the most posterior single tooth implant / 대한치주과학회지

PURPOSE: The purpose of this study was to assess the long term survival rates of the most posterior single tooth implant and to evaluate the influence of implant characteristics on implant survival. MATERIAL AND METHODS: This retrospective report presents findings on 37 patients with 43 implants replacing single molars. The inclusion criteria were having implants replacing a molar of the most posterior region and follow-up data over at least 6 months. Data were recorded regarding the incidence of complications and survival rates of these implants. RESULTS: The range of follow-up was from 9 to 66 months(mean: 40.2 months). The cumulative survival rate of total implants was 93.0% which reflects the loss of three implants: one had broken neck, one implant failed because of infection, one implant showed failed osseointegration. Abutment- screws loosening occurred in five implants(11.6%). CONCLUSION: Within the limits of this study, a single tooth-implant can serve as a good long-term and predictable treatment modality to replace the most posterior teeth with low complication and failure rates.

Anterior esthetic improvement through orthodontic extrusive remodeling and single-unit implantation in a fractured upper lateral incisor with alveolar bone loss: A case report / 대한치과보존학회지

The treatment of esthetic areas with single-tooth implants represents a new challenge for the clinician. In 1993, a modification of the forced eruption technique, called "orthodontic extrusive remodelling," was proposed as a way to augment both soft- and hard-tissue profiles at potential implant sites. This case report describes augmentation of the coronal soft and hard tissues around a fractured maxillary lateral incisor associated with alveolar bone loss, which was achieved by forced orthodontic extrusion before implant placement. Through these procedures we could reconstruct esthetics and function in a hopeless tooth diagnosed with subgingival root fracture by trauma.

Clinical study on success rate of single tooth implant

A Retrospective study on upper single tooth implants / 대한치주과학회지

The aim of this retrospective study was to compare the amount of marginal bone loss between upper anterior area and upper posterior area with 71 upper single-tooth restorations on 2 stage machined Branemark implants since Jan 1995. The second aim was to compare the bone defect group which had dehiscence and fenetration and the others in the upper anterior region. The results were as follows. 1. The most frequent reason of missing tooth in the upper anterior region was trauma by 61%. While upper posterior region showed various reasons such as congenital missing, advanced periodontitis, trauma. 2. Peri-implantitis with fistula occurred 1 of 41 implants in the upper anterior group in 1 year after loading and 2 of 32 implants in the upper posterior group failed before loading. The 1 year success rate of upper anterior group was 97.56 %, and 93.75 % for upper posterior group. 3. The mean marginal bone loss in the upper anterior group was 0.44 +/- 0.25 mm, while 0.57+/- 0.32 mm in the upper posterior group. There was stastically significant difference in the amount of mean marginal bone loss (P<0.05). 4. The mean marginal bone loss of bone defect group was 0.40+/- 0.10 mm at one year, and 0.48+/- 0.26 mm for the control group. No statistically significant difference of mean marginal bone loss was showen between bone defect group and the others at implantation. According to the results, the upper anterior region showed less marginal bone loss than the upper posterior region. In case of missing single upper tooth, careful consideration on recipient residual ridge to determine proper implant diameter and length, sufficient healing time, proper loading would lead to implant success. Single tooth implants in the maxilla seemed to be an alternative to fixed partial dentures without damage to adjacent teeth.