Influence of abutment angulation on implant failure in immediately placed and restored implants in the esthetic zone: a randomized clinical trial

Background: Tooth extraction socket in the aesthetic area is a major indication for immediate implant placement greatly improving patient satisfaction and preserving the alveolar ridge. However, the effect of non-axial force on the peri-implant bone with subsequent early implant failure remains unclear. Objective:Evaluate the prognosis of tilted implants immediately placed and restored with angled abutments in comparison to straight implants restored with straight abutments in the esthetic area (anterior or premolars) using computer-aided surgical guides. Material and methods: Badly decayed non-restorable teeth in the aesthetic zone (anterior or premolars) were extracted atraumatically. Immediately after guided implant insertion, the abutments were adjusted and placed according to the allocation group (0, 15, or 25-degree angle) then a temporary crown was performed out of occlusion in centric and eccentric relation. Early implant failure was assessed at three and six months. Results:There was no statistically significant difference between the two groups (P=0.305). Straight and angled abutment groups showed 6 (14.3%) and 8 (20%) failed cases, respectively. The post-hoc subgroup analysis showed no statistically significant difference between angle 15 and angle 25 degree groups where (P=0.686) or between Anterior and Premolar groups (P=0.853). Conclusion: There was no statistically significant difference in the failure rate when comparing angled to straight immediately placed & restored implants. This applies to both anterior and premolar implants

Nasal Wall Oriented Implants for All-on-4 Fix-Detachable Maxillary Reconstruction / Implantes nasales orientados a la pared para una reconstrucción maxilar desmontable fija All-on-4

Abstract Immediate loading of full-arch prostheses on dental implants in the upper arch is challenging, as the bone is of low quality and obtaining sufficient torque may be difficult. The purpose of this case report is to describe the rehabilitation of a full- arch by means of placement of four internal tapered connection tilted implants and immediate loading. A 65-year-old man sought dental care with a partially edentulous upper arch. The teeth presented mobility and were extracted. In a second step, two conventional-length implants were placed in the anterior region and two tilted and nasal wall-directed extra-long implants in the posterior region. The insertion torques of 60 N.cm allowed the installation of an immediate prosthesis (hybrid). The clinical case report suggests that the placement of tilted and extra-long implants in the paranasal bone and immediate loading may be a viable option for rehabilitation of the edentulous upper arch.

Resumen La carga inmediata de prótesis de arco completo en implantes dentales en el arco superior es un desafío, ya que el hueso es de baja calidad y puede ser difícil obtener un par suficiente. El propósito de este reporte de un caso es describir la rehabilitación de un arco completo mediante la colocación de cuatro implantes inclinados de conexión cónica interna y carga inmediata. Un hombre de 65 años buscó atención dental con un arco superior parcial sin dientes. Los dientes presentaron movilidad y fueron extraídos. En un segundo paso, se colocaron dos implantes de longitud convencional en la región anterior y dos implantes extralargos inclinados y dirigidos a la pared nasal en la región posterior. Los pares de inserción de 60 N.cm permitieron la instalación de una prótesis inmediata (híbrida). El informe del caso clínico sugiere que la colocación de implantes inclinados y extralargos en el hueso paranasal y la carga inmediata pueden ser una opción viable para la rehabilitación del arco superior desdentado.

A Narrative Review of Alveolar Bone Analysis and CBCT Classification related to Immediate Implant Placement in The Anterior Maxilla

@#Immediate implant placement into fresh extraction sockets has gained a lot of attention in implant dentistry. Besides proper risk assessment, the evaluation of tooth anatomy aids the clinicians to select the finest treatment protocol. Cone Beam Computed Tomography (CBCT) imaging was frequently used for alveolar bone analysis prior to tooth extraction in immediate implant placement. As an ideal position is required to prevent a buccally tilted implant or too palatal implant placement, various authors have proposed the treatment guidelines for immediate implant placement in the anterior maxilla. Although insightful, the previous classification was lacking anatomic variant and key anatomical features of alveolar bone and tooth angulation. Furthermore, there is no standardization method of measuring the specific degree of tooth angulation in CBCT scans that could possibly be used in clinical setting for appropriate treatment protocol. Thus, it is essential for the clinician to have adequate knowledge on the role of facial alveolar bone, palatal alveolar bone and tooth angulation related to immediate implant before selecting the appropriate treatment guidelines based on the classification reviewed. In this review, the previous quantitative measurements were categorized, and the previous classification was listed for the sake of familiarity by the dental practitioner with the major updates on implant placement strategy, patient selection and to reduce the rate of surgical complications.

Rehabilitation of atrophic posterior partial edentulous maxilla with TTPHIL ALL TILT® technique: 3 year follow-up case report / Reabilitação de maxila atrófica posterior parcialmente desdentada com técnica TTPHIL ALL TILT®: relato de caso de acompanhamento de 3 anos

Maxillary sinus pneumatisation pose a grave clinical challenge for implant fixed rehabilitation in posterior maxilla owing to diminished bone volume. This necessitates sinus lift and grafting which increase the duration and cost and possible surgical complications. Pterygoid implant has a greater short term osseointegration and is a proven treatment method for rehabilitation of highly resorbed posterior maxilla. To overcome the limitations of sinus grafting techniques, the current case report describes the use of flapless, tilted and pterygoid implant for restoration of partially edentulous atrophic maxilla eliminating grafting (AU).

A pneumatização do seio maxilar representa um grande desafio clínico para a reabilitação fixa por implante na região posterior da maxila devido ao volume ósseo diminuído. Isso requer elevação do seio e enxerto, fatores que aumentam a duração, o custo e as possíveis complicações cirúrgicas. O implante pterigóide tem uma osseointegração maior em curto prazo e é um método de tratamento comprovado para reabilitação de maxila posterior altamente reabsorvida. Para superar as limitações das técnicas de enxerto de seio, o relato de caso atual descreve o uso de implante sem retalho, inclinado e pterigóide para restauração de maxila atrófica parcialmente edêntula eliminando o enxerto.(AU)

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.

Effect of Different Immediate Implant Loading Protocols on Peri-implant Soft Tissue Health / Efeito de diferentes protocolos de implante com carga imediata no tecido mole peri-implantar

Objectives: This clinical study was conducted to evaluate the effect of immediate loading on peri-implant soft tissue health using three protocols: I) Immediate functional loading using polymer infiltrated ceramic (PIC) material (IFLV). II) Immediate functional loading using polymethyl methacrylate (PMMA) followed by delayed functional loading using PIC material (IFLP). III) Immediate non-functional loading using PMMA followed by delayed functional loading using PIC material (INFLP). Material & Methods: 30 Implants were placed in the upper premolar area and divided randomly according to the immediate loading protocol. In the control group (INFLP), CAD/CAM PMMA crowns were placed out of occlusion for 3 months, and then replaced by CAD/CAM VITA ENAMIC crowns in functional occlusion. For (IFLV) group, CAD/CAM VITA ENAMIC crowns were immediately loaded in functional occlusion; while in (IFLP) group, CAD/CAM PMMA crowns were placed in functional occlusion for 3 months, and then replaced by CAD/CAM VITA ENAMIC crowns. Modified pink esthetic score (MPES) and probing depth were used for evaluation of peri-implant soft tissue at base line and follow up periods. Results: INFLP showed higher MPES results compared to IFLV and IFLP. Moreover, the INFLP probing depth at 3 months showed higher results compared to the other groups. Conclusions: Immediate non-functional loading showed the best outcomes. However, peri-implant soft tissue health of the immediate functional loading using the PIC crown material was clinically acceptable (AU)

Objetivo: Este estudo clínico foi realizado para avaliar o efeito da carga imediata na saúde do tecido mole peri-implantar usando três protocolos: I) Carga imediata funcional usando material de cerâmica infiltrada com polímero (PIC) (IFLV). II) Carga imediata funcional usando polimetilmetacrilato(PMMA) seguida por carga funcional retardada usando material PIC (IFLP). III) Carga imediata não funcional usando PMMA seguida por carga funcional retardada usando material PIC (INFLP). Material e Métodos: 30 implantes foram colocados na área dos pré-molares superiores e divididos aleatoriamente de acordo com o protocolo de carga imediata. No grupo controle (INFLP), as coroas CAD / CAM PMMA foram colocadas sem oclusão por 3 meses, e então substituídas pelas coroas CAD / CAM VITA ENAMIC na oclusão funcional. Para o grupo (IFLV), as coroas CAD / CAM VITA ENAMIC foram carregadas imediatamente em oclusão funcional; enquanto no grupo (IFLP), as coroas CAD / CAM PMMA foram colocadas em oclusão funcional por 3 meses, e então substituídas por coroas CAD / CAM VITA ENAMIC. O escore da estética rosa modificado (PESM) e a profundidade de sondagem foram realizados para avaliação do tecido mole peri-implantar no início e nos períodos de acompanhamento. Resultados: INFLP apresentou resultados de PESM superiores em comparação com IFLV e IFLP. Além disso, a profundidade de sondagem INFLP em 3 meses apresentou resultados superiores em comparação com os outros grupos. Conclusões: A carga imediata não funcional apresentou os melhores resultados. No entanto, a integridade do tecido mole peri-implantar da carga imediata funcional usando o material da coroa PIC foi clinicamente aceitável. (AU)

Estabshment of mouse model of experimental peri-implantis and expression of TNF-α in gingival issue of model mice / 吉林大学学报(医学版)

Objective: To establish the experimental peri-implantitis mouse models, to investigate the expression of tumor necrosis factor-α (TNF-α) in the gingival tissue of the experimental peri-implantitis model mice, and to elucidate its pathogenic effect on peri-implantitis. Methods: Eighteen 4-week-old C57BL/6J male mice were divided into blank group, control group and model group (n=6); the right and upper first molars were removed, and the custom implants were immediately implanted. After 4 weeks of healing, the mice in model group were used to establish the peri-implantitis models with ligation method; the mice in blank group and control group didn't receive any treatment. The mice in blank group were killed on the 0th day of ligation (before the ligation treatment); the mice in control group were killed on the second week without ligation; the mice in model group were killed on the second week of ligation of the neck of the implant with 5-0 silk thread. The upper jaw bone and gingvival tissue samples of the mice in various groups were obtained, and the morphology of peri-implant gingival tissue were observed with surgical microscope. Micro-CT scanning was used to measure the bone height and bone density around the implants and RT-PCR method was performed to detect the expession level of TNF-α mRNA in the gingival tissue. Results: The morphological observation showed that the gingival tissue around the implants in model group appeared obvious redness, edema, softening and exudation, while there were no visible signs of inflammation in blank group and control group. Compared with control group, the proximal, distal, buccal and zygomatic bone heights and the alveolar bone dellsity around the implants of the mice in model group were significantly reduced (P 0.05), and the expression level of TNF-α mRNA in the gingival tissue of the mice in control group had no statistical difference (P> 0.05). Conclusion: An experimental mouse model of peri-implantitis is successfully established with ligationinducing method. TNF-α is highly expressed in the gingival tissue of the model mice, which may have a role in promoting the pathogenesis of peri-implantitis.

Calidad de vida en el adulto mayor con prótesis dental implanto retenida de carga inmediata / Quality of life in the elderly with immediate-retained implanted dental prosthesis

RESUMEN Fundamento: los pacientes adultos mayores desdentados totales con grandes atrofias óseas, tienen afectada la masticación, fonación, deglución, la psiquis y por tanto su calidad de vida. Para ellos existe una alternativa de tratamiento, la implantología bucal. Objetivo: describir los resultados del tratamiento de prótesis total implantosoportada con carga inmediata en la calidad de vida de pacientes adultos mayores. Métodos: investigación descriptiva de corte transversal realizada en la consulta de implantología de la Facultad de Estomatología de La Habana, sobre 41 pacientes a los que, después de dos meses de rehabilitados con prótesis total implantosoportada con carga inmediata, se le aplicó el cuestionario de calidad de vida relacionado con salud bucal (OHIP-14). Se consideró como no impacto o impacto negativo cuando no hubo mejoría e impacto o impacto positivo cuando hubo mejoría de la calidad de vida. Resultados: las dimensiones con mayor impacto negativo fueron: dolor físico (48,8 %), incapacidad física (51,2 %), malestar psicológico (73,2 %) y las de impacto positivo fueron: limitación funcional, incapacidad social, psicológica y la minusvalía, con 95,1 %; 92,7 % y 100 % respectivamente. Conclusiones: el tratamiento mediante prótesis dental total implantosoportada mejora la calidad de vida de pacientes adultos mayores.

ABSTRACT Foundation: Total older toothless adult patients with large bone atrophies; have affected chewing, phonation, swallowing, psyche and therefore their quality of life. For them there is an alternative treatment, oral implantology. Objective: to describe the results on the quality of life of elderly patients of the total implant-supported prosthesis treatment with immediate load. Methods: descriptive cross-sectional research conducted in the implantology office of the Havana Faculty of Dentistry, on 41 patients who, after two months of rehabilitation with implant-supported total prosthesis with immediate loading, the quality of life questionnaire was applied related to oral health (OHIP-14). It was considered as no impact or negative impact when there was no improvement and positive impact or impact when there was improvement of the quality of life. Results: the dimensions with the greatest negative impact were: physical pain (48.8%), physical disability (51.2%), psychological distress (73.2%) and positive impact were: functional limitation, social, psychological disability and the disability, with 95.1%; 92.7% and 100% respectively. Conclusions: the implant-supported total dental prosthesis treatment improves the quality of life of elderly patients.

Implantes zigomáticos de carga imediata: relato de caso / Immediate load zygomatic implants: case report

Introdução: atualmente, o relevante desafio enfrentado pela odontologia se constitui na redução do tempo de tratamento e na restrição dos procedimentos cirúrgicos, na perspectiva de se assegurar o máximo conforto às pessoas que buscam a reabilitação oral. Em se tratando de pacientes edêntulos totais, os eventos que devem ser desenvolvidos demandam de um planejamento correto tendo em consideração o tempo de execução. Face a esses pressupostos, a reabilitação oral busca reconstituir a mastigação, a estética, o suporte labial e a fonética. Objetivo: o caso clínico ora descrito visa demonstrar a instalação de 4 implantes zigomáticos seguindo-se da colocação da prótese definitiva em sistema de carga imediata. Metodologia: com base na literatura científica e tendo em vista a limitação das condições anatômicas e clínicas apresentadas pela paciente do sexo feminino, com 68 anos de idade e boa saúde, fez-se a opção pela instalação de 4 implantes zigomáticos associada à técnica de carga imediata. Resultado e conclusão: em compatibilidade com os dados da literatura, o êxito cirúrgico e a reabilitação oral alcançados, associados à satisfação manifestada pela paciente, são indicadores de elevada previsibilidade quanto à longevidade da sobrevida dos implantes zigomáticos instalados.

Introduction: currently, the relevant challenge faced by dentistry constitutes in reduce treatment time and restrict surgical procedures, in order to ensure maximum comfort to people seeking oral rehabilitation. In case of total patient treatment, the events to be displayed require correct planning, taking into account the execution time. Do to these assumptions, the oral rehabilitation seeks to reconstitutes chewing, aesthetics, lip and phonetic support. Objective: the clinical case aims to demonstrate the installation of 4 zygomatic implants following the placement of the definitive prosthesis in the immediate loading system. Methodology: based on scientific literature and in view of the limitation of the anatomical and clinical conditions applied by the 68-year-old female patient, she choose to install 4 zygomatic implants used in the immediate loading technique. Result and conclusion: in line with literature data, surgical and oral rehabilitation achieved, associated with patient satisfaction, are indicators of increased predictability regarding the longevity of survival of the zygomatic implants used.

Una Nueva Alternativa para la Creación de Papilas en Implantes de Carga inmediata: Reporte de Caso / A New Alternative for the Creation of Papillae in Immediate Loading Implants: Case Report

RESUMEN: El objetivo de este artículo es evaluar el éxito clínico de una nueva alternativa para crear papilas en implantes de carga inmediata, que se realizó en una paciente de sexo femenino de 26 años de edad. Se inició el tratamiento con la confección de una guía quirúrgica, previo a la manipulación de los tejidos para crear las papilas peri-implantarias. En la cirugía se realizan 2 incisiones semilunares, unidas por una incisión perpendicular, las que al suturarlas sobre ellas mismas permitió crear las papilas; se instala un implante con buena estabilidad primaria y se toma la impresión para la rehabilitación. A las 24 horas se instala una corona atornillada, mostrando la presencia de las papilas de forma inmediata. Se realiza controles hasta los 20 meses de función, evidenciando buena estabilidad de las papilas mesial y distal sin presentar ningún tipo de complicación.

ABSTRACT: The aim of this paper is to evaluate the clinical success of a new alternative to create papillae in immediate load implants, which was performed in a 26-yearold female patient. The treatment was started with the preparation of a surgical guide, prior to the manipulation of tissues to create the peri-implant papillae. In the surgery, two semilunar incisions are made, joined by a perpendicular incision, which when sutured on them allowed to create the papillae. An implant with good primary stability is installed and the impression is taken for rehabilitation. At 24 h a screwed crown is installed, showing the presence of the papillae immediately. Controls are performed up to 20 months of function, demonstrating good stability of the mesial and distal papillae without presenting any type of complication.

Bioceramic cement in the filling of bone defects in rats

Abstract Purpose To evaluate PBS®MCIMMO cement in the filling of bone defects. Methods Thirty-six adult male Wistar rats were divided into three groups of twelve individuals each (group 1, group 2 and group 3). In all groups, a bone failure in the femur was induced, 2.0 mm wide and 7.0 mm deep. In group 1, the PBS®MCIMMO cement was applied to the bone defect produced and a titanium implant (CONNECTION®) 1.5 mm thick and 6 mm long was installed. In group 2, only the PBS® CIMMO cement was installed. In group 3, only bone failure was performed. Kruskal Wallis tests were performed to compare the mean area among the three groups. Results In all comparisons, significance was observed for group 2 (p = 0.0014-0.0026). Conclusion The PBS®CIMMO cement induced bone neoformation, and integration between the newly formed bone, cement, and implant was observed.

Performance mastigatória e impacto da saúde oral na qualidade de vida em pacientes reabilitados com prótese fixa implantossuportada com carga imediata / Masticatory performance and impact of oral health on quality of life in patients rehabilitated with implant-supported fixed prosthesis with immediate loading

O impacto da saúde oral na qualidade de vida (OHRQoL) dos pacientes através da substituição de próteses totais convencionais (PTC) por próteses fixas implantossuportadas (PFIS) ainda não está totalmente claro, devido à grande heterogeneidade metodológica. O objetivo desse ensaio clínico controlado não randomizado foi comparar a OHRQoL e a performance mastigatória (PM) em pacientes reabilitados com PTC e com PFIS com carga imediata na mandíbula. A amostra foi composta por 40 indivíduos com idade média de 59,08 anos (± 7,04), predominantemente do sexo feminino (n=36), distribuídos em dois grupos: PTC e PFIS. Todos os pacientes foram reabilitados com PTC inicialmente, 23 permaneceram com suas PTC, e o restante (17 pacientes), após 3 meses de uso das PTC tiveram suas próteses convertidas em PFIS com barra distal com carga imediata, sendo 7 suportadas por 3 implantes e 10 suportada por 4 implantes. O OHRQoL foi mensurado através do questionário OHIP-Edent (versão brasileira) e a PM, através do método das tamises com o X50 calculado. Dados foram coletados antes (T0), e após 3 meses da instalação das PTC e da PFIS (T1). Para a análise dos dados, Teste t de Student para amostras pareadas foi aplicado para avaliar o mesmo grupo antes e após a intervenção clínica, sendo na comparação entre os grupos aplicado o Teste t para grupos independentes e o "d" de Cohen calculado para ambas comparações. Teste de correlação de Spearman foi empregado para avaliar a correlação entre as variáveis. Os resultados mostraram que ao comparar o grupo PTC em T0 e T1, não houve melhora na OHRQoL e nem redução do X50, indicando que a PM não melhorou. Já no grupo PFIS, houve melhora significativa na OHRQoL (p < 0,001) com tamanho do efeito "muito grande" (Cohen'd = 2,49) e melhora significativa na PM com tamanho do efeito "muito grande" (Cohen' d = 2,47). Considerando a comparação no tempo T1 de ambos os grupos, o grupo PFIS apresentou menor valor de OHRQoL e menor valor de X50, indicando maior impacto positivo na qualidade de vida e melhor PM, quando comparado ao grupo PTC (p < 0,001). Constatou-se correlação entre a PM e o OHIP-Edent de forma positiva apenas para o grupo PTC, no tempo T0, no domínio "desconforto psicológico", indicando que a medida que a PM piorava, o desconforto psicológico aumentava. Concluiu-se que a conversão da prótese total convencional em prótese fixa implantossuportada impacta positivamente na qualidade de vida e na performance mastigatória dos usuários com um tamanho de efeito "muito grande" (AU).

Oral health impact on the quality of life (OHRQoL) of patients through the replacement of conventional complete dentures (CCD) to implant suported dentures (ISD) is still not completely clear due to the great methodological heterogeneity. The objective of this nonrandomized controlled clinical trial was to compare OHRQoL and masticatory performance (PM) in rehabilitated patients with CCD and ISD under lower immediate loading. The sample consisted of 40 individuals, mean age of 59.08 years (± 7.04), predominantly female (n = 36), were divided into two groups: CCD and ISD. All patients were rehabilitated with CCD initially, 23 remained with their CCD, and 17 patients after 3 months of CCD use had their dentures converted into ISD under immediate loading, supported by 3 or 4 implants. The OHRQoL was measured by OHIPEdent questionnaire (Brazilian version) and the PM, using the sieve method with the calculated X50. Data were collected before (T0), and after 3 months of installation of CCD and ISD (T1). Student's t-test for paired samples was applied to evaluate the same group before and after the clinical intervention, in the comparison between the groups the t test was applied for independent groups and the "d" of Cohen calculated for both groups comparisons. Spearman's correlation test was used to evaluate the correlation between the variables. Comparing the CCD group at T0 and T1, there was no positive impact on the OHRQoL and no significant X50 reduction, which indicates that there was no improvement in the PM. For ISD, there was an improvement in the OHRQoL (p < 0.001) with a large size effect (Cohen'd = 2,49) and a significant improvement in the PM with a large size effect (Cohen'd= 2,47). Comparison in time T1 for both groups, ISD presented lower OHRQoL and lower value of X50, which indicates a higher positive impact on the quality of life and better PM when compared to CCD (p < 0.001). Correlation between PM and OHIP-Edent was found only positively for CCD at time T0, in the "psychological discomfort" domain, indicating that as the PM worsens, the psychological discomfort increases. It is concluded that the conversion of complete dentures into implanted suported denture has a positive impact on the quality of life and on masticatory performance (AU).

Quantitative three-dimensional methodology based on intraoral scan to assess the soft tissue contour alterations following single immediate implant and immediate provisionalization in maxillary central incisor: a 1-year prospective study / 中华口腔医学杂志

Objective@#To establish a quantitative three-dimensional method based on intraoral scan and apply it to evaluation of the facial soft tissue contour alterations following single immediate implant and immediate provisionalization (IIPP) in central incisor via intraoral scanning.@*Methods@#This study was a prospective clinical study. The trial was conducted at Department of Implantology, Peking University School and Hospital of Stomatology, from January 2016 to September 2017. Twenty-nine eligible consecutive patients (15 women, 14 men) with a mean age of (34.3±12.0) were included and received immediate replacement of the failure maxillary single central incisor. A screw-retained immediate restoration was delivered for each patient. At 6-month follow-up, impression was taken and a screw-retained permanent restoration was performed for each patient. The anterior maxillary region was scanned by an intraoral scanning system at pre-surgery and 1-year follow-up. The Standard Tessellation Language (STL) files were output to a dedicated software and superimposed. Mid-facial recession and gingival zenith symmetry at 1-year follow-up were measured in the digital models. Three-dimensional configurations of the contour change volume were calculated and reconstructed for visual analysis. Furthermore, the following parameters were used to analyze the reconstructed volume: mean contour change in thickness (△d), mesio-distal width (DW), coronal-apical height (DH), contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site.@*Results@#Twenty-seven out of twenty-nine enrolled patients were finally available for analysis. At 1-year follow-up, the mid-facial mucosa level at implant site was (0.23±0.39) mm apical to the gingival zenith of the contralateral tooth. In general, a contour collapse was found in every patient. △d, DW and DH of the collapsed volume were (0.62±0.22), (11.03±1.74) and (6.82±1.52) mm, respectively. Contour change at 0, 1, 2, 3, 4, 5 mm apical to the free gingival margin on the implant site were (0.54±0.48), (0.87±0.62), (1.03±0.46), (0.96±0.52), (0.90±0.52), (0.89±0.57) mm.@*Conclusions@#The described quantitative measurement based on intraoral scan can be an effective method for assessment of soft tissue contour changes. At 1 year following single IIPP treatment in maxillary incisor, free gingival margin is stable, with only mild recession. The mean level of the facial soft tissue contour collapse is 0.62 mm.

Energy Dispersive Spectroscopy (EDS) Analysis of Calcium and Phosphor Minerals Elements on Bone After Insertion Immediate Implant on Socket Filled with Extract Aloe vera

Objective: To examine the effect of aloe vera that containing bioactive materials on the levels of calcium (Ca) and phosphorus (P) minerals and their ratios around the immediate implanted in alveolar bone. Material and Methods: Research method by conducting experimental test on experimental animals: 9 male mongrel dogs are divided into 3 groups each 3 tails. In each animal was pulled the second premolar teeth on right side and left side, and immediately inserted titanium implant (3mm x 10mm diameter) after the socket filled with 10% aloevera extract on the right side and control on the left side. Analysis of calcium and phosphorus minerals content formed by examination of Energy Dispersive Spectroscopy (EDS) on Scanning Electron Microscope on implant and around bone tissue was done on days 14, 28 and 56. The result of statistical analysis using repeated ANOVA with independent t test. The level of significance was set at 5%. Results: There was a significant difference on calcium level between control and treatment groups on days 14, 28 and 56 (p<0.05). There was no significant difference on phosphorus level between control and treatment groups (p>0.05). The ratio of Ca / P in both control and treatment groups was also significantly different in every observation day (p<0.05). Conclusion: The addition of aloe vera extract that containing bioactive materials has an effect on increasing levels of mineral elements calcium and calciumphosphorus ratio after immediate implant insertion.

Carga imediata não funcional associada à RTI-3 / Non-functional immediate loading associated with ITR-3

Os implantes imediatos têm sido utilizados com bastante frequência como uma forma de tratamento para a substituição de dentes condenados. Entretanto, quando a área a ser tratada pertence à zona estética, muito cuidado deve ser tomado. Nessa região, quando o objetivo é alcançar um peri-implante com estética satisfatória, o profissional deve utilizar técnicas que, associadas ao implante imediato, evitem a formação de um defeito decorrente da remodelação pós-exodontia, ou ainda, utilizar procedimentos de melhoria tecidual nos casos em que os dentes condenados já apresentem defeitos de tecido ósseo e/ou mole ao seu redor. O objetivo deste trabalho é, através da apresentação de um caso clínico de reposição do elemento 41 condenado, com perda óssea severa e defeito mucogengival, demonstrar e discutir uma modalidade de tratamento que utiliza o implante imediato de carga imediata não funcional associado ao enxerto de tecido conjuntivo e preenchimento com osso mineral bovino particulado.

Immediate implants have been used frequently as a treatment choice for the replacement of compromised teeth. However, when the area to be treated belongs to the aesthetic zone, great care must be exercised. In this region, when the objective is to reach a peri-implant with a satisfactory esthetics, the professional must use techniques that, associated to the immediate implant, prevent the formation of a defect due to the bone remodeling after tooth loss or to use procedures of tissue improvement for cases where the compromised teeth already have defects of bone and/or soft tissue around them. The objective of this study is to present a clinical case of replacement at tooth 41 with severe bone loss and mucogingival defect to demonstrate and discuss a treatment modality that uses the immediate implant with non-functional immediate loading associated with the connective tissue graft and particulate, deproteinized bovine bone filling.

Comportamento dos tecidos peri-implantares quando utilizada carga imediata em implantes unitários na região anterior de maxila: uma revisão sistemática / Peri-implantation tissue behavior when used immediate loading in unit implants in the previous region of maxila: a systematic review

Objetivo: Avaliar o comportamento dos tecidos peri-implantares (moles e duros) após a carga imediata de implantes unitários em áreas estéticas de maxila. Material e Métodos: Uma busca eletrônica foi realizada nas bases de dados BVS e PubMed por dois avaliadores independentes. Quando não houve consenso entre os avaliadores, depois de ler o artigo completo, um terceiro revisor foi incluído. Foram acrescidos textos completos de ensaios clínicos dos últimos 15 anos que avaliaram os seguintes parâmetros: altura da crista óssea, altura da papila interdental e recessão gengival vestibular. Resultados: Um total de nove artigos foi selecionado. Os dados mostraram que o comportamento dos tecidos peri-implantares em implantes com carga imediata foi muito semelhante aos observados em implantes com carga tardia. Além disso, em maiores períodos de acompanhamento, foi verificado que as papilas podem migrar coronalmente ao longo do tempo e que os tecidos duros apresentaram perda óssea média a 1,0 mm, independentemente da utilização ou não de carga imediata. No que diz respeito à estética, em geral, os pacientes ficaram satisfeitos e as perdas notadas ao longo do tempo parecem não interferir da satisfação estética do paciente. Conclusões: A perda de papilas, recessão gengival vestibular e perda óssea podem ocorrer silenciosamente, sendo o tempo mais importante para sua ocorrência que a utilização de carga imediata ou não, o que torna a carga imediata uma alternativa viável e promissora em regiões estéticas sem comprometer o comportamento dos tecidos peri-implantares. (AU)

Objective: Evaluate the behavior of peri-implant tissues (soft and hard) after loading. Low implants in aesthetic maxilla units. Material and methods: Therefore an electronic search was performed in the VHL and PubMed databases by two independent evaluators. When there was no consensus among the reviewers, after reading the full article, a third reviewer was included. We included complete texts of clinical trials of the last 15 years, which ancestors the respective parameters: height of the bone crest, height of the interdental papilla and gingival vestibular recession. Results: A total of nine articles were selected. The data showed that the behavior of the peri-implant tissues in loaded implants. There were very important observations in late load implants. In addition, at longer follow-up periods, it was verified that as papillae may migrate coronally over time and with hard tissues they presented mean bone loss of 1.0 mm, regardless of whether or not the load was used. With regard to aesthetics, patients were generally satisfied and perceived losses over time without interference from the aesthetic satisfaction of the patient. Conclusions: Thus, a loss of papillae, vestibular gingival recession and bone loss can occur silently, being the most important time for its occurrence that the use of load, there is not, which makes a load of a viable and promising alternative in aesthetic regions without Compromise the behavior of peri-implant tissues. (AU)

Three-dimensional finite element analysis according to the insertion depth of an immediately loaded implant in the anterior maxilla / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. MATERIALS AND METHODS: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at 30°with respect to the central axis of the implant, then a finite element analysis was performed. RESULTS: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was 39.34 µm. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. CONCLUSION: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.

Retrospective study on marginal bone resorption around immediately loaded implants / 대한치과보철학회지

PURPOSE: Patients who treated implant immediate loading within a week after implant placement at Wonkwang University Dental Hospital Implant Center were evaluated marginal bone resorption. These retrospective analyses are intended to reinforce the clinical evidence for the implant immediate loading. MATERIALS AND METHODS: Medical history and radiographic data were investigated, which were the patients' who treated implant immediate loading and restoration with provisional prostheses between January 2005 and June 2016, at Wonkwang University Dental Hospital Implant Center. Total number of implants was 70, marginal bone resorption was measured according to implant length, diameter and connection type. To measure marginal bone resorption, periapical radiographs were taken when the implants were placed and after 6 month. Statistical analysis was done in Mann-whitney U test and Kruskal-wallis test with SPSS 22.0 software (P < .05). RESULTS: Mean marginal bone resorption around immediately loaded implants according to implant connection type was shown 1.24 ± 0.72 mm in internal hexagon connection type and 1.73 ± 1.27 mm in external hexagon connection type. There was no statically significant difference in marginal bone resorption with implant length and diameter. CONCLUSION: Implants with immediated loading in internal hexagon connection type showed less marginal bone resorption significantly than in external hexagon connection type.

Apuntes históricos sobre implantología oral y su impacto científico y sociocultural en los estudios estomatológicos / Historical notes on oral implantology and its socio-cultural and scientific impact in Dentistry studies

Fundamento: la pérdida dental y sus consecuencias han sido una plaga para la humanidad durante muchos siglos, se plantea que es la mutilación más frecuente en la especie humana. Objetivo: reseñar históricamente la implantología oral y su impacto científico y sociocultural como referente bibliográfico para los estudios estomatológicos. Métodos: se realizó una investigación documental en la Universidad de Ciencias Médicas de Villa Clara, durante el año 2016, cuyo objeto de estudio fue la historia de la implantología oral y su impacto científico y sociocultural. Para ello se utilizaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: el análisis documental. Resultados: los estudios realizados avalan la antigüedad de la implantología, la cual ha ido avanzando a medida que la técnica ha evolucionado. Toma un impulso considerable a partir de 1950, a nivel mundial, cuando destacados profesionales se dedican a su desarrollo. En Villa Clara comienza a realizarse desde 1997, con buenos resultados anatómico-funcionales. Desde el punto de vista de su impacto científico y sociocultural constituye una alternativa terapéutica avalada por numerosos estudios porque provoca un factor psicológico positivo, logros estéticos y funcionales y mayor durabilidad, lo cual proporciona al paciente una satisfacción desde el punto de vista emocional. Conclusiones: la implantología oral deviene en una técnica quirúrgica novedosa en los estudios estomatológicos, su práctica es abordada interdisciplinariamente por estomatólogos generales, cirujanos y prostodoncistas. Los contenidos de esta especialidad médica requieren su inserción en los diseños de los currículos de la carrera.

Background: dental loss and its consequences have been a plague for mankind for many centuries; it is argued that it is the most frequent mutilation in the human species. Objective: to review the history of oral implantology and its socio-cultural and scientific impact as a bibliographical reference for Dentistry studies. Methods: a documentary research was carried out at Villa Clara University of Medical Sciences, during the year 2016, whose object was the history of oral implantology and its social-scientific impact. For this purpose theoretical methods were used: analysis-synthesis, induction-deduction and historical-logical; And empirical: the documentary analysis. Results: the studies carried out confirm the antiquity of implantology, which has progressed as the technique has evolved. It takes a considerable impulse worldwide from 1950 on, when leading professionals are dedicated to its development. In Villa Clara these works have begun since 1997, with good anatomical-functional results. From the point of view of its socio-cultural and scientific impact, it is a therapeutic alternative supported by numerous scientific studies because it provokes a positive psychological factor, aesthetic and functional achievements and greater durability, which provides the patient with an emotional satisfaction. Conclusions: oral implantology becomes a novel surgical technique in Dentistry studies, its practice is approached interdisciplinarily by general dentists, surgeons and prosthodontists. The contents of this medical specialty require its insertion in the curricular design of the career.

Clinical and Radiographic Evaluation of Rehabilitated Implants with Overdenture with Two Ball Abutments in the Mandible and Submitted to Immediate Load: One Year of Observation / Evaluación Clínica y Radiográfica de Implantes Rehabilitados con Sobredentadura con dos Pilares de Bola en la Mandíbula y Sometidos a Carga Inmediata: Un Año de Observación

ABSTRACT: The purpose of this prospective clinical study was to evaluate the clinical and radiographic survival of two non-splinted implants immediately loaded with ball abutments for supporting mandibular overdentures. Thirty edentulous patients using full dentures (22 women and 8 men) with a mean age of 64 years were included in this study. Each patient received two inter-foraminal implants in the mandible, near the canine, with an insertion torque greater than 45 Ncm. Nonsplinted ball abutments were connected to the implants, and the overdenture was immediately loaded. The success of the implants was clinically and radiographically evaluated; along with the satisfaction level of the patients, after the first year of having placed the implants. One patient withdrew from the study. After 12 months the implants were loaded, the survival rate was of 98.27 %, one implant failed. The average bone loss was of 0.34 mm. No surgical complications were observed, minor prosthetic maintenance appointments were required. The satisfaction of the patients was of 89.3 %. The immediate loading of two non-splinted implants in the inter-foraminal area of the mandible retaining an overdenture by means of ball abutments is a predictable treatment, with a high success rate of survival and a favorable response of the peri-implant tissues. The patients showed good satisfaction with this treatment modality.

RESUMEN: El propósito de este estudio clínico prospectivo fue evaluar la supervivencia de manera clínica y radiográfica de dos implantes no ferulizados cargados inmediatamente con pilares tipo bola para soportar sobredentaduras mandibulares.Treinta pacientes desdentados totales usuarios de prótesis total (22 mujeres y 8 hombres) con una edad promedio de 64 años se incluyeron en este estudio. Cada paciente recibió dos implantes interforaminales en la mandíbula aproximadamente en posición de canino con un torque mayor a los 45 Ncm. Pilares no ferulizados tipo bola se conectaron a los implantes y se cargó inmediatamente la sobredentadura. El éxito de los implantes se evaluó clínica y radiográficamente; así como el nivel de satisfacción de los pacientes al año de haber sido colocados los implantes. Una paciente se retiró del estudio. Después de 12 meses de cargados los implantes la tasa de supervivencia fue del 98,27 %, un implante fracasó. El promedio de pérdida ósea fue de 0.34 mm. No se observaron complicaciones quirúrgicas, se requirieron citas de mantenimiento protésicas menores. La satisfacción de los pacientes fue del 89,3 %. La carga inmediata de dos implantes no ferulizados en el área interforaminal de la mandíbula reteniendo una sobredentadura a través de pilares en bola es un tratamiento predecible, con un alta tasa de éxito de supervivencia, y respuesta favorable de los tejidos periimplantares. Los pacientes muestran una buena satisfacción ante ésta modalidad de tratamiento.