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1.
Article in English | LILACS | ID: biblio-1369047

ABSTRACT

ABSTRACT: Among the treatment options for Obstructive Sleep Apnea (OSA) we have surgery to correct dentofacial deformities. OSA patients are routinely and predictably submitted to surgical treatment for dentofacial deformities. Frequently, orthognathic surgery and osseointegrated implants may be necessary to enable fixed rehabilitation. Patients submitted to orthognathic surgery have a transient decrease in blood supply after maxillary and mandibular osteotomy procedures, which can impair the results in these cases. This case report aimed to present and discuss the conflicting situation of an OSA patient in need of orthognathic surgery and dental implants. The treatment consisted of: (1) extraction of all teeth; (2) complete rehabilitation of the upper and lower jaw with dental implants and prosthesis without compensation; (3) bimaxillary orthognathic surgery to re-establish the maxillomandibular relationship and increase the upper airway volume. This rehabilitation sequence was a safe alternative for a case of Class II OSA, and rapidly achieved a final restoration with enhanced esthetics, functionality, biomechanics, maintenance of oral hygiene, and patient satisfaction. (AU)


RESUMO: Entre as opções de tratamento da Apneia Obstrutiva do Sono (AOS) temos a cirurgia para correção das deformidades dentofaciais. Freqüentemente, a combinação de cirurgia ortognática e implantes osseointegráveis pode ser necessária para permitir a reabilitação dental. Pacientes submetidos à cirurgia ortognática apresentam diminuição transitória do suprimento sanguíneo após procedimentos de osteotomia maxilar e mandibular, o que pode prejudicar os resultados nestes casos. Este relato de caso teve como objetivo apresentar e discutir a situação de um paciente com AOS que necessita de cirurgia ortognática e implantes dentários. O tratamento consistiu em: (1) extração de todos os dentes; (2) reabilitação completa da mandíbula superior e inferior com implantes dentários e próteses sem compensação; (3) cirurgia ortognática bimaxilar para restabelecer a relação maxilomandibular e aumentar o volume das vias aéreas superiores. Essa sequência de reabilitação foi uma alternativa segura para um caso de AOS Classe II, e rapidamente alcançou uma reabilitação com estética, funcionalidade, biomecânica aprimorada, manutenção da higiene oral e satisfação do paciente. (AU)


Subject(s)
Humans , Female , Adult , Sleep Apnea, Obstructive/rehabilitation , Dental Implantation , Orthognathic Surgical Procedures/rehabilitation
2.
Braz. dent. sci ; 25(1): 1-8, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1352731

ABSTRACT

Objective: to evaluate the impact of three different scan strategies and implant angulation on impression accuracy of an intraoral scanner for full-arch multiple implant scan. Material and Method: A maxillary edentulous model with six implant analogs served as a reference model. The four anterior analogs were positioned parallel to each other, the distal right and the distal left was placed with an angulation of 15o and 20o, respectively. Thirty impression were performed using an intraoral scanner (CEREC Primescan). The master cast was digitalized with an industrial reference scanner (ATOS Core 80). All scans were converted to standard tessellation language (STL), superimposed on the reference scan with a 3d inspection software (GOM Inspect Professional 2019) and then analyzed. Results: All linear distances presented equivalence [p<0.01] to those found on the reference scan for all scan strategies. All scan strategies presented a tendency of negative means for linear distances except for d4 in strategy C. All angular distances did not present equivalence [p=0.05] to those found on the reference scan. Significant 3D deviations [p<0.05] were found between strategy B (0.02 ± 0.01) and C (0.05 ± 0.04) for d1. In all others linear and angular distances no statistically significant difference was found between strategies A, B and C. Conclusions: There was no statistically significant difference between strategies A, B and C except for d1 in strategy B and C; Implant angulation did not affect the accuracy of the CEREC Primescan IOS (AU)


Objetivo: avaliar o impacto de três diferentes estratégias de escaneamento e angulação do implante na acurácia da moldagem de um scanner intraoral na moldagem de múltiplos implantes em arco completo. Material e Métodos: Um modelo edêntulo de maxila contendo seis análogos de implante serviu como modelo de referência. Os quatro análogos anteriores foram posicionados paralelos entre si, o distal direito e o distal esquerdo foram posicionados com angulação de 15o e 20o, respectivamente. Trinta moldagens foram realizadas usando um scanner intraoral (CEREC Primescan). O modelo mestre foi digitalizado com um scanner de referência industrial (ATOS Core 80). Todas as escaneamentos foram convertidas para a linguagem de mosaico padrão (STL), sobrepostas ao escaneamento de referência com um software de inspeção 3D (GOM Inspect Professional 2019) e, em seguida, analisadas. Resultados: Todas as distâncias lineares apresentaram equivalência [p <0,01] àquelas encontradas na escaneamento de referência para todas as estratégias. Todas as estratégias de escaneamento apresentaram tendência de médias negativas para distâncias lineares, exceto para d4 na estratégia C. Todas as distâncias angulares não apresentaram equivalência [p = 0,05] às encontradas no escaneamento de referência. Desvios 3D significativos [p <0,05] foram encontrados entre a estratégia B (0,02 ± 0,01) e C (0,05 ± 0,04) para d1. Em todas as outras distâncias lineares e angulares, nenhuma diferença estatisticamente significativa foi encontrada entre as estratégias A, B e C. Conclusões: Não houve diferença estatisticamente significante entre as estratégias A, B e C, exceto para d1 na estratégia B e C; A angulação do implante não afetou a precisão do CEREC Primescan. (AU)


Subject(s)
Dental Implantation , Precision Medicine , Models, Anatomic
3.
Pesqui. bras. odontopediatria clín. integr ; 22: e210131, 2022. tab, graf
Article in English | LILACS, BBO | ID: biblio-1365225

ABSTRACT

Abstract Objective: To analyze and compare changes of quality of life parameter among dental patients rehabilitated by the implant-supported overdentures with different attachment systems. Material and Methods: Forty-eight patients were recruited as a study cohort. The implant placement procedure was based on the results obtained by CBCT scanning and individualized surgical templates manufactured for correct implant placement. Each individual received two k3Pro Implants (Sure Type with 4.0 or 4.5 mm in diameter) at the intraforaminal area due to standard protocol of implantation provided by the manufacturer under local anesthesia. All patients were distributed between two groups based on the fact of using either Locator- or ball-attachments. Rank correlation was measured using Spearman correlation coefficient, while linear correlation was evaluated by Pearson correlation coefficient. Results: No statistically meaningful differences were noted regarding patients' distribution among groups considering age (p>0.05) and gender (p>0.05). Provided patient-level analysis demonstrated that increase of conventional full denture service time was positively correlated with escalation of OHIP-EDENT scores. The most prominent inter-correspondences were noted specifically between longevity of denture service and elevation of scores within "Functional limitation" (r=0.61; p<0.05), "Physical pain" (r=0.51; p<0.05) and "Physical disability" (r=0.57; p<0.05) subdomains. No statistically argumented regressions were noted between increase tendency of OHIP-EDENT scores and gender (p>0.05) or age (p>0.05) parameters. Conclusion: Significant improvements of quality of life measured with OHIP-EDENT were noted for both types of attachments compared to the pre-treatment situation independently of additionally provided surface electromyography-based alignment.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Quality of Life , Dental Prosthesis, Implant-Supported/instrumentation , Electromyography/instrumentation , Masticatory Muscles , Ukraine , Surveys and Questionnaires , Regression Analysis , Cohort Studies , Statistics, Nonparametric , Occlusal Adjustment , Adaptation , Dental Implantation , Denture, Complete , Denture, Overlay
4.
Article in Portuguese | LILACS | ID: biblio-1353484

ABSTRACT

RESUMO: Introdução: A dissecção da artéria carótida (DAC) tem como uma das principais repercussões o Acidente Vascular Cerebral isquêmico (AVCi) em indivíduos jovens previamente saudáveis. É comum que nas DAC traumáticas, como em acidentes automobilísticos, o paciente seja submetido à investigação mais complexa com exames de imagem. Estes permitem um diagnóstico precoce e, portanto, um tratamento, reduzindo as chances de sequelas. Todavia, cau-sas não traumáticas com desfecho de DAC já foram relatadas, como as causas odontológicas. Objetivo: Contribuir para valorização diagnóstica da DAC não traumática e profilaxia de AVC subsequente. Métodos: Relatamos um caso de dissecção não aneurismática das artérias carótidas internas (ACI) pós-procedimento odontológico com desfecho de AVC bilateral em paciente de 52 anos. Resultados: Devido à forte associação de DAC a fatores traumáticos, em um primeiro contato com a paciente não foram levantadas suspeitas da ocorrência de DAC nem de AVC (ausência de déficit focal). Porém, tardiamente, foi identificada oclusão da ACI à esquerda e estenose na ACI direita, resultando em dois AVCs e incapacidade funcional severa na alta. Conclusão: O diagnóstico da DAC é um desafio, em especial por tratar-se de uma lesão de etiologia multifatorial. No entanto, seu reconhecimento precoce afetará diretamente o desfecho do paciente. Portanto, na presença de eventuais sintomas de alerta, faz-se necessário um meticuloso ques-tionamento sobre as últimas atividades do indivíduo. Este estudo alerta para a adoção de condutas profiláticas na ocorrência de fatores causais como hiperextensão cervical prolongada ou movimentos súbitos da cervical. (AU)


ABSTRACT: Introduction: Carotid artery dissection (CAD) has the ischemic stroke as one of the main repercussions in pre-viously healthy young individuals. It is common that in traumatic CAD, as in automobile accidents, the patient is subjected to a more complex investigation with imaging exams. These, allow an early diagnosis and, therefore, a treatment, reducing the chances of sequelae. However, non-traumatic causes with CAD outcomes have already been reported, such as dental causes. Objective: To contribute to the diagnostic valuation of non-traumatic CAD and subsequent stroke prophylaxis. Methods: We report a case of non-aneurysmatic dissection of the internal carotid arteries (ICA) after a dental procedure with evolution to bilateral stroke outcome in a 52-year-old patient. Results: Due to the strong association of CAD with traumatic factors, in a first contact with the patient there was no suspicion of CAD or stroke (absence of focal deficit). However, late, ICA occlusion on the left and stenosis on the right ICA were identified, resulting in two strokes and severe functional disability at discharge. Conclusion:The diagnosis of CAD is a challenge, especially since it is a multifactorial lesion. However, its early recognition will directly affect the patient's outcome. Therefore, in the presence of any warning symptoms, meticulous questioning about the individual's latest activities is necessary. This study alerts to the adoption of prophylactic conducts in the occurrence of causal factors such as prolonged cervical hyperextension or sudden movements of the cervical. (AU)


Subject(s)
Humans , Female , Middle Aged , Carotid Artery, Internal, Dissection , Stroke , Dental Implantation , Ischemic Stroke
5.
Medisan ; 25(4)2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1340215

ABSTRACT

Se presenta el caso clínico de un paciente que a los 7 años de edad fue remitido a la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba por presentar un quiste dentígero y displasia fibrosa monostótica. Desde entonces, y durante casi 10 años, el paciente ha sido atendido por un equipo multidisciplinario odontopediátrico, que ha seguido su evolución y ha aplicado diferentes protocolos diagnósticos y terapéuticos; estos últimos han incluido intervenciones quirúrgicas, rehabilitaciones protésicas, quimioterapia, entre otros. Por la complejidad del caso y la poca frecuencia con que aparecen asociadas ambas entidades clínicas en la infancia, se decidió comunicar este artículo al gremio odontológico nacional y extranjero.


The case report of a seven years old child who was referred to Mártires del Moncada Provincial Teaching Stomatological Clinic in Santiago de Cuba, who had a dentigerous cyst and monostotic fibrous displasia is presented. Since then, and almost during 10 years, the patient has been assisted by a multidisciplinary odontopediatric team, which has followed his clinical course and has applied different diagnostic and therapeutic protocols, including surgical procedures, prosthetic rehabilitations, chemotherapy, among others. Due to the case complexity and the frequency with which both clinical entities are associated in childhood, it was decided to publish this work for the national anf foreing odontological community.


Subject(s)
Dentigerous Cyst/diagnosis , Fibrous Dysplasia, Monostotic/diagnostic imaging , Mouth Rehabilitation , Dentigerous Cyst/surgery , Dentigerous Cyst/therapy , Dental Implantation
6.
Medisan ; 25(1)ene.-feb. 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1154856

ABSTRACT

Los implantes dentales son una opción de restauración estética, funcional y armónica, cuya tasa de éxito es superior a 95 %. Se presenta el caso clínico de una paciente de 24 años de edad, atendida en la consulta de Ortodoncia de la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, quien fue remitida desde el Servicio de Prótesis Estomatológica, con el fin de lograr el espacio adecuado para colocarle un implante, pues desde los 12 años de edad aproximadamente había perdido un diente a causa de caries. La restauración protésica mediante el implante dental proporcionó un excelente resultado.


Dental implants are an option of cosmetic, functional and harmonic repairs whose rate of success is higher than 95 %. The case report of a 24 years patient is presented. She was assisted in the Orthodontics Service of Mártires del Moncada Teaching Provincial Stomatological Clinic in Santiago de Cuba and was referred from the Stomatological Prosthesis Service, with the purpose of achieving the appropriate space to place an implant, because she had lost a tooth due to dental decay since she was approximately 12 years. The prosthetic repair by means of dental implant provided an excellent result.


Subject(s)
Osseointegration , Dental Implantation/methods , Orthodontics , Prostheses and Implants , Dentistry
7.
Article in English | LILACS, BBO | ID: biblio-1154999

ABSTRACT

ABSTRACT Objective: To evaluate the intra-examiner and inter-examiner reliability of linear and curvilinear measurements for the complete assessment of implant sites and jaw pathologies using Cone-Beam Computed Tomography (CBCT). Material and Methods: Fifty cone-beam computed tomographic images of patients were retrieved from the archives of Dentomaxillofacial Radiology. CBCT images taken for implant planning and evaluation of intrabony jaw pathologies (benign cyst/tumor) were included. Two expert oral and maxillofacial radiologists analyzed the images independently and made the measurements. The images for implant planning were analyzed for width, the height of the edentulous site, and the qualitative analysis of bone in the region. Jaw pathologies were assessed for linear dimensions and curvilinear measurements. Results: The inter-observer measurement error for implant site analysis ranged from 0.12 to 0.42 mm with almost perfect agreement (ICC: 0.94 to 1). The inter-observer measurement error for jaw pathology was 0.09 to 0.25 mm (ICC: 0.98-1). Curvilinear measurements showed perfect agreement between the observers. The intraobserver reliability for the various parameters used for the assessment of the implant site and jaw pathologies indicated almost perfect agreement. Conclusion: Reliability between the radiologists is high for various measurements on CBCT images taken for implant planning and jaw pathologies.


Subject(s)
Humans , Pathology, Oral , Diagnostic Imaging/instrumentation , Radiographic Image Interpretation, Computer-Assisted/instrumentation , Dental Implantation/instrumentation , Cone-Beam Computed Tomography , Mandible/diagnostic imaging , Retrospective Studies , Observational Studies as Topic/methods , Dimensional Measurement Accuracy , Radiologists , India/epidemiology , Jaw , Mandible/pathology
8.
Article in English | LILACS, BBO | ID: biblio-1180859

ABSTRACT

ABSTRACT Objective: To evaluate the improvement in masticatory performances two weeks after posterior implant restoration. Material and Methods: Nine patients with missing first and second molars were included in the study. Masticatory performances were evaluated using subjective and objective methods utilizing color-changeable chewing gum and the visual analog scale (VAS) assessment. The subjects were asked to chew the color-changeable chewing gums before and two weeks after the posterior implant restoration. Their expectations regarding aesthetics and function were verified on the VAS before implant placement. Additionally, the VAS was used for the posttreatment completion rating two weeks after the implant restoration. Results: Significant differences in masticatory performance were noted at baseline (before implant posterior restoration) and two weeks after implant restoration (p<0.05). The posttreatment aesthetic and functional expectations ratings significantly exceeded the expectations (p<0.05). Conclusion: Masticatory performances were improved two weeks after implant restoration. In addition, the significant posttreatment ratings of the patients exceeded their initial expectations. In particular, patients with poor masticatory functions demonstrated significant improvements and satisfaction following implant restoration compared to those with good mastication. These findings indicate that a posterior implant restoration can increase the masticatory performance.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Chewing Gum/microbiology , Patient Satisfaction , Dental Implantation/instrumentation , Molar/anatomy & histology , Statistics, Nonparametric , Visual Analog Scale , Indonesia/epidemiology , Mastication
9.
Braz. dent. sci ; 24(3): 1-16, 2021. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1281922

ABSTRACT

Objective: This study was performed to evaluate the use of PEEK abutments versus zirconium abutments with lithium disilicate superstructure on the esthetic acceptance and peri-implant clinical parameters. Zirconium abutments were found to have high surface roughness even after polishing. This causes a remarkable collapse of the soft tissue papilla that is a primary factor in the Pink Esthetic Score(PES), resulting in failed esthetic restoration in the anterior esthetic zone. Material and Methods:Twenty patients who needed a single implant restoration in the esthetic zone were included in this study. Eighteen patients completed screening, baseline, three-month, six-month, and twelve-month follow-up visits. At the screening visit, the patients were randomly allocated into two groups: Zirconia abutments (A) Group, and PEEK abutments (B) Group, both of which were restored with IPS e.max CAD superstructure. Patients Satisfaction was assessed by visual analogue scale (VAS). Pink esthetics score (PES), modified plaque index (mPI) and modified gingval index (mGI) were also assessed. Results: All implants were successfully osseo-integrated with a 100% survival rate over one year. Patient satisfaction was significantly higher for the PEEK group than the zirconium group. The pink esthetic score showed no statistical significance between both groups. The modified plaque index was significantly lower for the PEEK group than the zirconium group. The modified gingival index showed no statistical difference between both groups. Conclusion: PEEK revealed to be a versatile material to replace zirconium for implant abutments, due to its lower plaque affinity and higher patient satisfaction (AU)


Objetivo: Este estudo foi realizado para avaliar o uso de pilares PEEK versus pilares de zircônia com estrutura de dissilicato de lítio quanto a aceitação estética e parâmetros clínicos peri-implantares. Os pilares de zircônia apresentam alta rugosidade superficial, mesmo após o polimento. Isso causa um colapso notável da papila do tecido mole, que é um fator primário no índice estético rosa (Pink Esthetic Score - PES), resultando em falha na restauração estética na zona estética anterior. Materiais e Métodos:Vinte pacientes que precisavam de um implante unitário na zona estética foram incluídos neste estudo. Dezoito pacientes completaram a triagem, a consulta inicial e as visitas de acompanhamento de três, seis e doze meses. Durante a triagem, os pacientes foram aleatoriamente divididos em dois grupos: Grupo Pilares de Zircônia (A) e Grupo de Pilares PEEK (B), ambos foram restaurados com IPS e.max CAD. A satisfação dos pacientes foi avaliada pela escala visual analógica (VAS). O PES, o índice de placa modificado (mPI) e o índice gengival modificado (mGI) também foram avaliados. Resultados: Todos os implantes foram osseointegrados com sucesso, com uma taxa de sobrevivência de 100% ao longo de um ano. A satisfação do paciente foi significativamente maior para o grupo PEEK quando comparado com o grupo de pilares de zircônia. O índice da estética rosa não apresentou significância estatística entre os dois grupos. O índice de placa modificado foi significativamente menor para o grupo PEEK quando comparado com o grupo de pilares de zircônia. Conclusão: O PEEK revelou-se um material versátil para substituir a zircônia em pilares de implante, devido a sua menor afinidade de placa e maior satisfação do paciente. (AU)


Subject(s)
Humans , Dental Abutments , Patient Satisfaction , Dental Implantation , Dental Implantation, Endosseous
10.
Braz. dent. sci ; 24(1): 1-8, 2021. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1145466

ABSTRACT

Objectives: With regard to the prevalence of abutment screw loosening (SL) and bone height reduction, particularly in the posterior regions of the jaws, as well as the contradictory issue of applying short implants instead of surgeries, along with all preparations associated with longer implants, the present study aimed to compare the amount of torque loss in short implants with increased vertical cantilever abutments and standard ones. Material and Methods: In this experimental study, a total number of 20 implants (MegaGen Implant Co., Ltd, South Korea) with 4.5 mm diameter including 10 short implants (7 mm) and 10 standard ones (10 mm) were utilized. Using a surveyor, fixtures were perpendicularly mounted in 13×34 mm resin for short implants and 19×34 mm resin for standard ones. The abutments of the same height but different cuff heights (2.5 mm for the standard implants and 5.5 mm for the short ones) were then tightened with 30 N.cm, via a digital torque meter. To compensate the settling effect, the abutment screw was re-tightened with 30 N.cm after 10 min. Upon applying 500,000 cycles at 75 N.cm and 1 Hz along the longitudinal axis on each sample, blind reverse torque value (RTV) was measured with a digital torque meter. The data were finally analyzed using Student's t-test. Results:Both groups experienced torque loss, but there was no statistically significant difference between the case and control groups in terms of abutment SL (p = 0451). Conclusion: Short implants seem to be a good mechanical alternative in emergencies with respect to torque loss and abutment SL. (AU)


Objetivos: Considerando a prevalência de afrouxamento de parafuso dos pilares, redução da altura óssea especialmente nas regiões posteriores, a questão contraditória da aplicação de implantes curtos em vez de cirurgias e todos os preparos associados a implantes mais longos, este estudo buscou comparar implantes curtos com pilares cantilever verticais aumentados e implantes padrão na quantidade de perda de torque. Material e métodos: Neste estudo experimental, foram utilizados 20 implantes (Megagen, Coreia do Sul) com diâmetro de 4,5 mm, incluindo 10 implantes curtos (7 mm) e 10 implantes padrão (10 mm). A fixação foi realizada perpendicularmente em uma resina 13 × 34 mm para implantes curtos e uma resina 19 × 34 mm para implantes padrão, usando um topógrafo. Os pilares da mesma altura, mas com diferentes comprimentos de manguito (2,5 mm para os implantes padrão e 5,5 mm para os implantes curtos) foram apertados com 30 N, utilizando um torquímetro digital. Para compensar o efeito de sedimentação, o parafuso do pilar foi reapertado com 30 N após 10 min. Depois de aplicar 500.000 ciclos a 75 N e 1 Hz ao longo do eixo longitudinal em cada amostra, o valor de torque reverso cego foi medido com um medidor de torque digital. Os dados foram analisados pelo teste t de Student. Resultados: Todos os grupos tiveram perda de torque, mas não houve diferença estatisticamente significativa entre os grupos caso e controle em termos de afrouxamento do parafuso do pilar (p = 0451). Conclusão: Os implantes curtos parecem ser uma boa alternativa mecânica em emergências em termos de perda de torque e afrouxamento do parafuso do pilar. (AU)


Subject(s)
Bone Screws , Torque , Dental Implantation
11.
Braz. dent. sci ; 24(1): 1-8, 2021. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1145561

ABSTRACT

Objetivo: Avaliar a relação entre a densidade óssea medida em imagens de tomografia computadorizada (TC) e tomografia computadorizada de feixe cônico (TCFC) e relacionar com a estabilidade primária de implantes dentários. Material e métodos: Foram utilizadas neste estudo 20 cabeças femorais bovinas frescas, preparadas pela remoção de partes moles, secção do osso e colocação de marcadores para localização e angulação dos implantes. A densidade óssea da área peri-implantar foi determinada no pré-operatório em imagens TC e TCFC das amostras de osso peparado, representadas por unidades Hounsfield (HUs) e valores de cinza (GVs), respectivamente. Em seguida, 60 implantes em três tamanhos (diâmetro = 4 mm, comprimento = 8, 10 e 12 mm) foram inseridos nos ossos e o torque máximo de inserção (TI) foi registrado. O dispositivo Osstell também foi usado para determinar o quociente de estabilidade do implante (ISQ) para cada implante. A análise estatística foi realizada nos dados (α = 0,05). Resultados: Os valores médios ± DP de GV,HU e ISQ foram 1592,75 ± 231,82, 675,26 ± 115,38 e 61,90 ± 10,14, respectivamente. Além disso, o limite de TI mais frequente foi 30-35 Ncm (41,4%). Relações significativas foram observadas entre HU e IT, GV e IT, HU e ISQ, GV e ISQ, e IT e ISQ em todos os tamanhos de implante. Os GV e HU também se correlacionaram significativamente. Conclusão: Os valores da densidade óssea em imagens de TCFC e TC mostram-se positivamente associados para estabilidade primária de implantes dentários. Portanto, os GVs obtidos no Sistema de TCFC (Sirona's Galileos) poderiam ser usados para a seleção pré-operatória de sítios edêntulos que permitam uma melhor estabilidade do implante ou locais que requerem procedimentos adicionais para aumentar a taxa de sucesso dos implantes dentários. (AU)


Objective: To evaluate the relationship between bone density measured by computed tomography (CT) and cone beam computed tomography (CBCT) (Sirona's Galileos scanner) with primary stability of dental implants. Material and methods: 20 fresh bovine femoral heads were prepared by removal of soft tissue, sectioning of the bone, and placement of markers for location and angulation of implants. Bone density of peri-implant areas was determined preoperatively by CT and CBCT scanning of the prepared bone samples represented by Hounsfield units (HUs) and gray values (GVs), respectively. Then, 60 implants in three sizes (diameter = 4 mm, length = 8, 10, and 12 mm) were inserted into the bones and maximum insertion torque (IT) was recorded. Osstell device was also used for determining the implant stability quotient (ISQ) for each implant. Statistical analysis was performed on the data (α = 0.05). Results: Mean ± SD values of GV,HU, and ISQ were 1592.75 ± 231.82, 675.26 ± 115.38 and 61.90 ± 10.14, respectively. Moreover, the most frequent IT limit was 30-35 Ncm (41.4%). Significant relationships were observed between HU and IT, GV and IT, HU and ISQ, GV and ISQ, and IT and ISQ in all implant sizes. Moreover, GV and HU also significantly correlated to each other. Conclusion: Bone density values in CBCT and CT scans are positively associated to primary stability of dental implants. Therefore, GVs obtained from Galileos CBCT scanner can be used for preoperative selection of edentulous sites which allow for better implant stability or locations which require further procedures for enhancing the success rate of dental implants (AU)


Subject(s)
Animals , Cattle , Tomography, X-Ray Computed , Dental Implantation , Cone-Beam Computed Tomography
12.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(3): 472-484, dez 5, 2020. fig
Article in Portuguese | LILACS | ID: biblio-1358017

ABSTRACT

Introdução: o aprimoramento do processo de osseointegração faz com que os investimentos em pesquisa e o desenvolvimento de novos materiais e tratamentos de superfície sejam despendidos para promover a relação entre osso e implante. Uma das condições para o sucesso é a ausência de micromovimentos ou estabilidade primária da peça implantada, fato esse que leva alguns cirurgiões a aplicar torques excessivos sobre o implante, podendo resultar em danos ao tratamento aplicado à superfície externa do mesmo. Objetivo: o presente trabalho investigou possíveis níveis de deformação do preparo de superfície conforme diferentes valores de torque foram aplicados à dois sistemas de implantes para avaliar os possíveis danos causados. Metodologia: foram instalados 5 implantes do sistema Dérig e 5 implantes do sistema Straumann em um bloco de poliuretano, para posterior remoção com contra-torque e avaliação da superfície sob o Microscópio Eletrônico de Varredura (MEV). Resultados: nos resultados obtidos, no grupo de implantes Dérig não foi possível constatar evidências que comprovem que a elevação dos valores de torque aplicados aos implantes até 95 Ncm danifiquem ou alterem a estrutura do preparo de superfície externa dos implantes, contudo, no grupo Straumann, verificamos danos e alterações no preparo de superfície com torque progressivo a partir de 50 Ncm. Conclusão: possíveis alterações e danos ao preparo de superfície de implantes que apresentem rugosidade de superfície aumentada por jateamento podem ocorrer em torques acima de 50 Ncm empregados com o objetivo de aumentar sua estabilidade primária.


Introduction: improving the osseointegration process means that investments in research and development of new materials and surface treatments are expended to promote the relationship between bone and implant. One of the conditions for success is the absence of micromovements or primary stability of the implanted part. This fact causes some surgeons to apply excessive torque to the implant, which may result in damage to the treatment applied to the external surface of the implant. Objective: The present work investigated possible surface preparation deformation levels as different torque values were applied to two implant systems to evaluate the possible damage caused. Methodology: ive Dérig system implants and five Straumann system implants were installed in a polyurethane block for subsequent counter-torque removal and surface evaluation under the Scanning Electron Microscope (SEM). Results: Iin the obtained results, in the Dérig implant group it was not possible to verify evidences that the increase of the torque values applied to the implants up to 95 Ncm could damage or alter the structure of the external surface preparation of the implants, however, in the Straumann group we verified damage and changes in surface preparation with progressive torque from 50 Ncm. Conclusion: possible alterations and damages to the surface preparation of implants that present increased surface roughness by blasting can occur in torques above 50 Ncm employed in order to increase their primary stability.


Subject(s)
Torque , Dental Implantation , Tooth Wear , Polyurethanes , Bone and Bones
13.
Rev. cuba. estomatol ; 57(4): e3016, Oct.-Dec. 2020. graf
Article in English | LILACS, CUMED | ID: biblio-1144446

ABSTRACT

ABSTRACT Introduction: The passivity of prosthetic components is one of the most important prerequisites in oral implant rehabilitation for maintenance of osseointegration. Objective: Thus, the present study analyzed in vitro the accuracy of different molding techniques in prosthetic rehabilitation on angled implants installed in an anatomical model of a metallic edentulous maxilla. Methods: Laboratory experiment study. A reference metal model of an edentulous maxilla was used. A metal framework was used for the misadaptation assessment. Three groups (n= 10) were compared and impressions were made with vinyl-polysiloxane and casts were obtained with type IV stone: (1) Impression with a metallic open-tray without splinted transfers; (2) Impression with a metallic open-tray and metal splinted transfers; (3) Impression with a multifunctional guide and metal splinted transfers. Misadaptation was assessed with the aid of a stereomicroscope and measuring software. Data were submitted to ANOVA with Welch correction and the Games-Howell post-hoc test with the significance set at 5 percent. Results: Misadaptation (µm) was 110,23 ± 30,94, 37,53 ± 3,92, and 37,69 ± 2,79 for the the groups. Statistically significant differences between impression with a metallic open-tray with and without splinted transfers were observed (p < 0,001). No significant differences between the other types of impression. Conclusions: Impression with a metallic open-tray without splinted transfers and with a multifunctional guide splinted with metal transfers were the most precise methods resulting in higher accuracy in transferred implants(AU)


RESUMEN Introducción: La pasividad de los componentes protésicos es uno de los prerrequisitos más importantes para el mantenimiento de la osteointegración en la rehabilitación oral sobre implantes. Objetivo: Evaluar in vitro la precisión de diferentes técnicas de impresión en rehabilitación sobre implantes inclinados instalados en un modelo anatómico de un maxilar metálico desdentado. Métodos: Estudio de laboratorio de tipo experimental. Se utilizó un modelo metálico de referencia de un maxilar desdentado. Fue utilizada una barra metálica para la evaluación de la desadaptación. Se compararon tres grupos (n = 10), se realizaron impresiones con polivinilsiloxano y se obtuvieron modelos con yeso piedra tipo IV: (1) impresión con una cubeta metálica abierta sin unión de los transferentes; (2) impresión con una cubeta metálica abierta y unión de los transferentes con cilindros metálicos; (3) impresión con una guía multifuncional y unión de los transferentes con cilindros metálicos. La desadaptación se evaluó con la ayuda de un microscopio estereoscópico y un software de medición. Los datos se enviaron a ANOVA con la corrección de Welch y la prueba post-hoc de Games-Howell con la significación establecida en 5 por ciento. Resultados: La desadaptación (µm) fue de 110,23 ± 30,94; 37,53 ± 3,92 y 37,69 ± 2,79 para los grupos, respectivamente. Se observaron diferencias estadísticamente significativas entre la impresión con cubeta abierta metálica con y sin unión de los transferentes (p <0,001). No hubo diferencias significativas entre los otros tipos de impresiones. Conclusiones: La impresión con cubeta abierta metálica sin unión de los transferentes y con una guía multifuncional con unión de los transferentes con cilindros metálicos fueron los métodos más precisos que dieron como resultado una mayor precisión en la transferencia de la posición de los implantes(AU)


Subject(s)
Humans , Dental Implantation/methods , Dental Impression Materials/adverse effects , Dental Materials/therapeutic use
14.
Medicentro (Villa Clara) ; 24(3): 662-666, jul.-set. 2020.
Article in Spanish | LILACS | ID: biblio-1125022

ABSTRACT

RESUMEN La estomatitis subprótesis es una de las lesiones más frecuentes encontradas en la consulta de Estomatología. Es una enfermedad comúnmente asintomática, cuya génesis es multifactorial, y tiene una alta prevalencia en pacientes portadores de prótesis removibles. Predecir su aparición resultaría muy oportuno pues permitiría alcanzar beneficios económicos y para la salud del individuo. Por ello, es importante desarrollar un modelo predictivo del riesgo a padecer estomatitis subprótesis. Se realizó este estudio en los pacientes que acudieron a la consulta de prótesis de la Clínica Estomatológica «Victoria de Santa Clara¼. Dicha investigación se caracterizó por la obtención de un modelo predictivo de la enfermedad. Los principales factores predictivos de la enfermedad fueron: la higiene bucal deficiente y la mala calidad de las prótesis. Se confeccionó una ecuación logística y se obtuvo un modelo predictivo con el propósito de conocer los pacientes con más probabilidades de padecer dicha enfermedad.


ABSTRACT Subprosthesis stomatitis is one of the most frequent lesions found in a dental consultation. It is a commonly asymptomatic disease, whose origin is multifactorial, and has a high prevalence in patients with removable prostheses. Predicting its appearance would be very timely as it would allow reaching economic benefits and benefits for individual's health. Therefore, it is important to develop a predictive model of the risk of suffering from subprosthesis stomatitis. This study was carried out on patients who came to the prosthesis consultation at "Victoria de Santa Clara" Dental Clinic. It was characterized by the elaboration of a predictive model of the disease. Poor oral hygiene and poor quality of the prosthesis were the main predictive factors of the disease. A logistic equation was made and a predictive model was obtained in order to know the patients with more probabilities of suffering from this disease.


Subject(s)
Risk Factors , Dental Implantation , Gingivitis, Necrotizing Ulcerative
15.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(1): 17-24, jun 17, 2020. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1358652

ABSTRACT

Introdução: a cirurgia guiada é uma técnica de planejamento virtual para instalação de implantes dentários que possibilita maior precisão e confiabilidade para o cirurgião, possibilitando menor morbidade ao paciente. Entretanto existem erros e distorções durante o processo, que podem resultar em desvios no posicionamento dos implantes. Objetivo: aferir a fidedignidade da tomografia computadorizada de feixe cônico para uso em cirurgia guiada, comparando as medidas reais dos corpos de prova com as obtidas pela tomografia de feixe cônico para identificar distorções e quantificá-las. Metodologia: Foram utilizados três corpos de prova posicionados para tomada tomográfica. 180 medidas foram realizadas com paquímetro digital, e então, submetidos à tomografia computadorizada de feixe-cônico. Após a obtenção das imagens, os pontos foram medidos na tomografia e os valores obtidos no corpo de prova e os da tomografia foram comparados e analisados. Resultados: em 80% das medidas, a tomografia foi superestimada e em 18,33%, mostrou-se menor. Em uma medida (1,67%), as médias dos corpos de prova e da tomografia impressa foram iguais. Na região anterior, a diferença das aferições da tomografia impressa e do corpo de prova foi de 0,45mm, na região posterior foi de 0,34mm, em média. Conclusão: a tomografia computadorizada de feixe cônico é uma ferramenta confiável desde que sejam observadas as margens de erro que apresenta. A aquisição de imagens é apenas uma das etapas da cirurgia guiada, a qual apresenta erros cumulativos que podem comprometer o resultado final se não forem observados e contornados pela experiência do cirurgião.


Introduction: guided surgery is a technique of virtual planning of placement of dental implants that allows greater precision and reliability for the surgeon, allowing less patient morbidity. However, there are errors and distortions during the process, which can result in deviations in implant placement. Objective: to assess the reliability of concomitant computed tomography for use in guided surgery by comparing the actual measurements of the specimens with those obtained by conical beam tomography to identify distortions and quantify them. Methodology: three specimens positioned for tomography were used. 180 measurements were performed with a digital caliper, and then, submitted to computed tomography of beams. After obtaining the images, the points were measured on the tomography and the values obtained in the test specimen and those of the tomography were compared and analyzed. Results: in 80% of the measurements, the tomography was overestimated and in 18.33%, it was lower. In one measurement (1.67%), the means of the test specimens and the printed tomography were the same. In the anterior region, the difference between the measurements of the printed tomography and the test specimen was 0.45mm, in the posterior region it was 0.34mm, on average. Conclusion: conebeam computed tomography is a reliable tool as long as the margins of error are observed. The acquisition of images is only one of the stages of guided surgery, which presents cumulative errors that can compromise the final result if not observed and circumvented by the experience of the surgeon.


Subject(s)
Tomography, X-Ray Computed , Surgery, Computer-Assisted , Dental Implantation , Cone-Beam Computed Tomography
16.
Medisan ; 24(3)mayo.-jun. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1125118

ABSTRACT

Introducción: La pérdida dentaria tiene consecuencias en la apariencia y en la función fisiológica general del adulto mayor, lo cual constituye un problema aún no resuelto en la República Bolivariana de Venezuela. Objetivo: Describir la morbilidad en adultos mayores con pérdida de dientes permanentes. Método: Se realizó un estudio descriptivo, observacional y de corte transversal en la Clínica Simón Bolívar del municipio de Diego Ibarra, perteneciente al estado venezolano de Carabobo, desde enero hasta junio del 2016. El universo estuvo constituido por 100 adultos mayores de 60 años y más, ambos sexos y desdentados parciales o totales. Las variables analizadas fueron edad, sexo, higiene bucal, número de dientes permanentes perdidos, así como el tipo de aparatología protésica requerida. Se emplearon las frecuencias relativa y absoluta como medidas de resumen. Resultados: Se encontró que 73,0 % de los ancianos perdieron sus dientes por caries dental, siendo las féminas y el grupo de 60-64 años de edad el más afectado. Asimismo, predominaron la higiene bucal deficiente y la necesidad de prótesis parcial. Conclusiones: Existió una elevada morbilidad en los adultos mayores con pérdida dentaria, lo cual afectó su funcionalidad, estética y autoestima, que de no ser corregida pudiera provocar consecuencias importantes en la cavidad bucal y en el resto del cuerpo, sin olvidar la prevención o detección precoz de cualquier otra enfermedad bucal que la genere.


Introduction: Dental loss has consequences in the elderly general physiologic function and appearance, that constitutes an unsolved problem in the Bolivian Republic of Venezuela. Objective: To describe the morbidity in elderly with loss of permanent teeth. Method: A descriptive, observational and cross-sectional study was carried out in Simón Bolívar Clinic from Diego Ibarra municipality, belonging to Carabobo in Venezuela, from January to June, 2016. The universe was constituted by 100 elderly of 60 years and more from both sexes and partially or totally toothless. The analyzed variables were age, sex, oral hygiene, number of lost permanent teeth, as well as the type of prosthesis required. The relative and absolute frequencies were used as summary measures. Results: It was found that 73.0 % of the elderly lost their teeth due to dental decay, being women and the 60-64 age group the most affected one. Also, the poor oral hygiene and the necessity of partial prosthesis prevailed. Conclusions: A high morbidity existed in elderly with dental loss, which affected their functionality, aesthetics and self-esteem that could cause important consequences in the oral cavity and in the rest of the body if it is not corrected, without forgetting the prevention or early detection of any other oral disease that generates it.


Subject(s)
Periodontal Diseases , Aged , Mouth, Edentulous , Dental Caries , Dental Implantation , Venezuela , Jaw, Edentulous, Partially
17.
Rev. cient. odontol ; 8(1): e013, ene.-abr. 2020. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1095515

ABSTRACT

La osteomielitis focal esclerosante es un cuadro de poca frecuencia ante el cual no existen demasiadas opciones terapéuticas, al margen del tratamiento de conductos del diente afectado. En caso de no encontrarse el diente vital, los tratamientos se reducen y, respecto del hueso afectado, no existen evidencias científicas sobre la colocación de implantes. Presentamos un caso clínico en el que se maneja este cuadro eliminando el hueso y regenerándolo con PRGF-Endoret®, para colocar posteriormente un implante dental. (AU)


Focal sclerosing osteomyelitis is a rare condition with few therapeutic options other than root canal treatment of the affected tooth. If the tooth is not vital, the treatments are reduced, and there is little scientific evidence of the benefits of the placement of implants in the affected bone. We present a clinical case in which this condition is managed by removing the affected bone, regenerating it with PRGF-Endoret® and subsequently placing a dental implant in the treated area. (AU)


Subject(s)
Humans , Female , Adult , Osteomyelitis , Dental Implantation
19.
Rev. odontol. UNESP (Online) ; 49: e20200075, 2020. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1251980

ABSTRACT

Introdução: Tratamentos têm sido propostos para a peri-implantite com o objetivo de descontaminar a superfície dos implantes, removendo microrganismos que podem estar associados à doença. Objetivo: O objetivo deste estudo foi avaliar a ação in vitro de diferentes métodos de aplicação de digluconato de clorexidina (CLX) na descontaminação de discos de titânio (Ti) com microtopografia e seu efeito físico-químico sobre a superfície. Material e método: Vinte discos de Ti foram expostos a inóculo de Escherichia coli por 24 horas. Foram distribuídos em quatro grupos de descontaminação (n=5): 1 - um minuto de exposição à solução de CLX 0,12%; 2 - dois minutos de exposição à solução de CLX 0,12%; 3 - esfregaço durante um minuto com gel de CLX 1%; 4 - esfregaço durante um minuto com gel de CLX 2%. O produto de cada disco foi diluído e plaqueado individualmente. Após 24 horas, realizou-se contagem das unidades de colônias formadas (UFC). Resultado: O grupo com o menor número de crescimento de UFC foi o grupo 4 (0,20±0,37), com apenas UFC em uma das amostras. Seguido do grupo 2 (0,40±0,73), grupo 1 (18,60±33,96). O grupo 3 apresentou as maiores quantidades de UFC (36,07±41,39). Em todas as amostras, foi possível observar uma diminuição estatisticamente significante da concentração superficial de Ti, assim como um aumento de oxigênio. Conclusão: Pode-se concluir que o uso de CLX gel a 2% em superfícies de Ti com microtopografia contaminadas com E. coli propicia a eliminação das UFC e que sua aplicação resulta em diminuição do percentual de Ti e aumento do teor de O.


Introduction: Treatments have been proposed for peri-implantitis aiming to decontaminate the implants` surface removing microorganisms associated with the disease. Objective: The objective of this study was to evaluate the in vitro action of application of chlorhexidine digluconate (CLX) in the decontamination of titanium (Ti) discs with microtopography and its chemical-physical effect on the surface. Material and method: Twenty Ti discs were exposed to the Escherichia coli inoculum for 24 hours. Distributed equally in 4 decontamination groups (n = 5): 1- one minute of exposure to the 0.12% CLX solution; 2- two minutes of exposure to the 0.12% CLX solution; 3- smear for 1 minute with 1% CLX gel; and 4- smearing for 1 minute with 2% CLX gel. The product was diluted and plated individually. After 24 hours, colony units formed (CFU) were counted. Result: The group with the lowest number of CFU growth was group 4 (0.20 ± 0.37) with only one CFU in one of the samples. Followed by group 2 (0.40 ± 0.73), group 1 (18.60 ± 33.96), and group 3, which presented the highest amounts of CFU (36.07 ± 41.39). In all samples it was possible to observe a statistically significant decrease in the surface concentration of Ti, as well as an increase in oxygen. Conclusion: It can be concluded that the use of 2% CLX gel on Ti surfaces with microtopography contaminated with E.coli allows the elimination of CFU, and that its application results in a decrease in the percentage of Ti and an increase in the content of O.


Subject(s)
In Vitro Techniques , Chlorhexidine , Decontamination , Dental Implantation , Chemical Phenomena , Peri-Implantitis , Oxygen , Titanium , Escherichia coli
20.
Rev. odontol. UNESP (Online) ; 49: e20200033, 2020. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1139420

ABSTRACT

Resumo Introdução A interface implante-pilar protético e a formação dos seus microgaps são aspectos relevantes na transferência das cargas e na resposta biológica, estando ligadas ao sucesso da reabilitação. Objetivo Avaliar microgaps na interface entre a conexão interna do implante do tipo Cone Morse e a superfície do componente protético por meio da microscopia eletrônica de varredura (MEV). Material e método Foram utilizados 20 implantes dentários de tamanho 3,75 × 11,0mm do tipo Cone Morse com seus respectivos pilares protéticos da Singular® (Singular Implants, RN, Brasil). Os munhões retos foram acoplados aos implantes com torque de 32N/cm2 e o conjunto resultante foi emergido em base de Resina Epóxi ES260, para permitir secção longitudinal da amostra. As amostras foram analisadas e os microgaps mensurados no MEV (JEOL JCM-5700, MA, USA), e posteriormente os dados foram analisados. Resultado A média e o desvio padrão dos maiores microgaps foram observados na parte apical do implante nos lados direito e esquerdo, sendo 1,44±2,68 e 1,16±1,49 μm, respectivamente. Os menores microgaps foram na parte superior do implante nos lados direito e esquerdo, sendo 0,60±0,73 e 0,66±0,67 μm, respectivamente. Contudo, no teste de Kruskal-Wallis, não houve diferença estatisticamente significativa entre as regiões dos implantes, tanto para o lado esquerdo (p=0,692) como para o direito (p=0,865). No teste de Mann-Whitney, não houve diferenças estatisticamente significativas entre os lados para as diferentes regiões dos implantes. Conclusão Mesmo com a presença de microgaps na interface implante-pilar protético, estes apresentam tamanho inferior ao que causaria problemas biológicos e mecânicos. As amostras analisadas quanto à sua compatibilidade de encaixe foram satisfatórias.


Abstract Introduction The implant-prosthetic abutment interface and the formation of its microgaps are relevant aspects in load transfer and biological response and are linked to the success of the rehabilitation. Objective To evaluate microgaps at the internal connection interface of the Cone Morse implant and the prosthetic component surface by means of scanning electron microscopy (SEM). Material and method Twenty 3.75 x 11.0 mm Cone Morse dental implants with their respective Singular® prosthetic abutments were used (Singular Implants, RN, Brazil). The straight trunnions were attached to the implants with a 32N/cm2 torque and the ES260 Epoxy Resin-based set emerged to allow longitudinal sectioning of the sample. The samples were analyzed and the microgaps measured in SEM (JEOL JCM-5700, MA, USA), and later the data were analyzed. Result The mean and standard deviation of the largest microgaps were observed in the apical part of the right and left side 1.44±2.68 and 1.16±1.49 μm, respectively. The smallest microgaps were on the upper implant right and left sides 0.60±0.73 and 0.66±0.67 μm, respectively. However, in the Kruskal-Wallis test there was no statistically significant difference between the implant regions, both for the left side (p=0.692) and right side (p=0.865). The Mann-Whitney test, there were no statistically significant differences between the sides for the different regions of the implants. Conclusion Even with the presence of microgaps in the implant-post interface, it presents a smaller size than the one presenting biological and mechanical problems. The samples analyzed for their fitting compatibility were satisfactory.


Subject(s)
Microscopy, Electron, Scanning , Statistics, Nonparametric , Dental Implantation
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