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

Influence of diameter on mechanical behavior of morse taper narrow implants

Dental implants could give back function, esthetics and quality of life to patients. The correct choice of the implant, especially in borderline cases, is essential for a satisfactory result. Aim: Thus, the objective of this study was to evaluate the mechanical behavior of Morse taper implants with two different prosthetic interfaces. Methods: Twenty self-locking Morse taper implants, 2.9 mm in diameter (FAC), and 20 Morse taper implants, 3.5 mm in diameter (CM) were divided into two groups (n=10), and submitted to strength to failure test, optical microscopic evaluation of fracture, metallographic analysis of the alloy, finite element analysis (FEA) and strain gauge test. A Student's t test (α = 0.05) was made for a statistical analysis. Results: For the strength to failure test, a statistically difference was observed (p <0.001) between FAC (225.0 ± 19.8 N) and CM (397.3 ± 12.5 N). The optical microscopic evaluation demonstrated a fracture pattern that corroborated with FEA ́s results. The metallographic analysis determined that the implants of the FAC group have titanium-aluminum-vanadium alloy in their composition. In the strain gauge test, there was no statistical difference (p = 0.833) between CM (1064.8 ± 575.04 µS) and FAC (1002.2 ± 657.6 µS) groups. Conclusion: Based on the results obtained in this study, ultra-narrow implants (FAC) should ideally be restricted to areas with low masticatory effort

Elevación de seno maxilar sin injerto y colocación simultánea de implante dental / Graftless maxillary sinus lift with simultaneous dental implant placement

Introducción: La elevación de seno maxilar con implante dental simultáneo, sin el uso de substitutos óseos, ha retomado la teoría del potencial de neoformación ósea, que el coágulo de sangre alojado bajo la membrana de Schneider por sí solo presenta. Excluyendo así la necesidad de materiales exógenos. Objetivo: Exponer la efectividad de la elevación de seno maxilar con implante dental simultáneo, sin el uso de injerto, mediante la evaluación de la cantidad de ganancia ósea vertical. Presentación de casos: Caso 1: Paciente de 62 años, género femenino, que fue sometida a una elevación de seno maxilar sin injerto e implante dental simultáneo, con técnica de ventana lateral debido a altura ósea reducida de 5,24 mm. Luego del período de seguimiento tomográfico de 12 meses, después de la carga protésica, se logró una altura ósea vertical de 10,2 mm, lo que dio como resultado una ganancia ósea vertical de 4,96 mm. Caso 2: Paciente de 48 años, género femenino, que fue sometida a una elevación de seno maxilar sin injerto e implante dental simultáneo, con técnica transalveolar, mediante el uso de piezoeléctrico debido a una altura ósea reducida de 8,33 mm. Luego del período de seguimiento radiográfico de 4 meses, antes de la carga protésica, se logró una altura ósea vertical de 11,55 mm, lo que dio como resultado una ganancia ósea vertical de 3,19 mm. Conclusiones: Con base en estos 2 informes de casos, la elevación de seno maxilar e implante dental simultáneo sin injerto se asocian con la reducción de la morbilidad quirúrgica, menor probabilidad de procesos infecciosos y menor costo de la cirugía. Por lo tanto, puede considerarse una alternativa quirúrgica para la colocación de implantes en el maxilar posterior superior debido a deficiencias óseas verticales, independientemente de la técnica (lateral o transalveolar(AU)

Introduction: Maxillary sinus lift with simultaneous dental implantation without using bone substitutes, reapproaches the theory about the bone neoformation potential of the blood clot housed under the Schneider membrane, all by itself, thus excluding the need to use exogenous materials. Objective: Discuss the effectiveness of graftless maxillary sinus lift with simultaneous dental implant placement through an evaluation of the amount of vertical bone gain. Case presentation: Case 1: Female 62-year-old patient undergoing graftless maxillary sinus lift with simultaneous dental implantation by lateral window technique due to a reduced bone height of 5.24 mm. After a 12-month tomographic follow-up period subsequent to prosthetic loading, a 10.2 mm vertical bone height was achieved, resulting in 4.96 mm vertical bone gain. Case 2: Female 48-year-old patient undergoing graftless maxillary sinus lift with simultaneous dental implantation by transalveolar technique using a piezoelectric generator due to a reduced bone height of 8.33 mm. After a 4-month radiographic follow-up period, before prosthetic loading, an 11.55 mm vertical bone height was achieved, resulting in 3.19 mm vertical bone gain. Conclusions: According to these two case reports, graftless maxillary sinus lifting with simultaneous dental implantation is associated to reduced surgical morbidity, a lesser probability of infectious processes and lower surgical costs. It may therefore be considered to be a surgical alternative for implant placement in the posterior maxilla due to vertical bone deficiencies, regardless of the technique used (lateral or transalveolar(AU)

Implant-supported Dental Prosthesis and Orthognathic Surgery for Rehabilitation of Patients with Obstructive Sleep Apnea / Prótese Dentária Implanto-suportada e Cirurgia Ortognática para Reabilitação de Pacientes com Apneia Obstrutiva do Sono

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)

Cirurgia Guiada para Instalação de Implantes em Paciente Submetido à Radioterapia em Região de Cabeça e Pescoço / Guided Surgery for Implant Surgery in a Patient Undergoing Radiotherapy in Head and Neck Region / Cirugía Guiada para la Colocación de Implantes en Pacientes Sometidos a Radioterapia en la Región de la Cabeza y el Cuello

Introdução: O uso dos implantes osseointegrados para reabilitação de pacientes com dificuldade de adaptação de próteses convencionais mostra-se mais frequente a cada dia. Um grande grupo candidato à reabilitação com essa modalidade são os pacientes tratados para as neoplasias de cabeça e pescoço (CP). A irradiação na região de CP pode ser limitante para a instalação de implantes, porém a literatura apresenta evidências de técnicas e planejamentos favoráveis ao procedimento nesse grupo de pacientes. As técnicas menos traumáticas para intervenções na cavidade oral devem ser avaliadas, e os guias cirúrgicos para colocação de implantes podem ser aliados nesses procedimentos. Relato do caso: Paciente do sexo feminino, 64 anos, tratada com cirurgia, quimioterapia e radioterapia em cavidade oral para um carcinoma espinocelular (CEC) em língua e, em um segundo momento, diagnosticada e tratada com cirurgia para CEC em região de rebordo alveolar maxilar esquerdo por meio de hemipalatecmia, necessitava de reabilitação com implantes osseointegrados na região onde havia sido tratada com radiação primariamente. Realizou-se a cirurgia de colocação dos implantes com a tecnologia guiada para acarretar o mínimo trauma às estruturas bucais. Conclusão: O procedimento cirúrgico foi executado com sucesso. Atualmente, aguarda-se o período de osseointegração para a posterior reabilitação protética

Introduction: The use of osseointegrated implants for the rehabilitation of patients with difficulty fitting conventional prostheses is becoming more frequent every day. A great eligible group for rehabilitation with this modality are patients treated for head and neck cancer (HNC). Irradiation in the region of HN may be limiting for implants, but there are evidences in the literature of techniques and planning favorable to the procedure in this group of patients. Less traumatic techniques for interventions in the oral cavity should be evaluated, and surgical guides for implant placement may be allies in these procedures. Case report: A 64-year-old female patient, treated with surgery, chemotherapy and radiotherapy in the oral cavity for a squamous cell carcinoma (SCC) in the tongue and, in a second moment, diagnosed and treated with surgery for SCC in the region of the left maxillary alveolar ridge by means of hemipalatectomy, needed rehabilitation with osseointegrated implants in the region where she had been primarily treated with radiation. The implant placement surgery was then planned and performed using guided technology so that minimal trauma to the oral structures could occur. Conclusion: The surgical procedure was successfully performed, and the patient is now waiting for the osseointegration period for posterior prosthetic rehabilitation

Introducción: El uso de implantes osteointegrados para la rehabilitación de pacientes con dificultades de adaptación de las prótesis convencionales es cada vez más frecuente. Un gran grupo de candidatos a la rehabilitación con esta modalidad son los pacientes tratados por neoplasias de cabeza y cuello (CC). La irradiación en la región del CC puede ser limitante para la instalación del implante, sin embargo, la literatura presenta evidencias de técnicas y planificación favorables al procedimiento en este grupo de pacientes. Deben evaluarse técnicas menos traumáticas para las intervenciones en la cavidad oral, y las guías quirúrgicas para la colocación de implantes pueden ser un aliado en estos procedimientos. Caso clínico: Paciente de 64 años, mujer, tratada con cirugía, quimioterapia y radioterapia en la cavidad oral por un carcinoma de células escamosas (CCE) en la lengua y en un segundo momento diagnosticada y tratada con cirugía por CCE en la región de la cresta alveolar maxilar izquierda mediante hemipalatectomía, necesitó rehabilitación con implantes osteointegrados en la región donde había sido tratada principalmente con radiación. La cirugía de colocación de implantes se realizó con tecnología guiada para causar el menor traumatismo en las estructuras orales. Conclusión: La intervención quirúrgica se llevó a cabo con éxito. Actualmente se espera el periodo de osteointegración para la posterior rehabilitación protésica

Transcrestal sinus lift with simultaneous implant placement using osseodensification in posterior maxilla with residual bone height of 4-6 mm / Elevação de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador em região posterior de maxila com altura do remanescente ósseo de 4 a 6 mm

Objective: The aim of this study was to evaluate the transcrestal sinus lift using Osseodensification technique with simultaneous implant placement. Material and Methods: In this case series 7 patients who needed implant placement in the atrophic posterior maxilla were enrolled. In all the cases the residual bone height between the sinus floor and the alveolar crest was 4-6 mm. Transcrestal sinus lift was performed using Osseodensification with simultaneous implant placement. Cone-beam computed tomography (CBCT) were obtained immediately postoperative and 6 months after operation. Implant stability using Osstell® were assessed at the time of implant placement and implant exposure (6 months). Results: The results showed that the mean bone height gain was 5.33±0.83mm at 6 months postoperatively. Mean bone density value was 818.43±109.63 HU. Mean ISQ value was 80.00±3.11 at 6 months postoperatively. The duration of surgical procedure (minutes) ranged between 25-38 minutes with an average of 30.86±4.10 minutes. Conclusion: The crestal maxillary sinus floor elevation using Osseodensification technique with simultaneous implant placement provide superior results regarding bone density and implant stability and less duration of surgical procedure. (AU)

Objetivo: O objetivo deste estudo foi avaliar a elevação de seio maxilar via crista do rebordo com a técnica de Osseodensificação com instalação simultânea de implante. Material e Métodos: Nesta série de casos, participaram 7 pacientes que necessitavam de implantes em região posterior de maxila atrófica. Em todos os casos a altura de remanescente ósseo entre o soalho do seio e a crista alveolar estava entre 4 a 6 mm. A elevação de seio maxilar via crista do rebordo foi realizada com osseodensificação com instalação simultânea de implante. As Tomografias Computadorizadas Cone Beam (TCCB) foram obtidas imediatamente após a cirurgia e 6 meses depois. A estabilidade dos implantes utilizando Osstell® foi avaliada no momento da instalação do implante e no momento da reabertura (6 meses). Resultados: Os resultados mostraram que a média de ganho de altura óssea foi de 5.33±0.83mm após 6 meses da cirurgia. A média da densidade óssea foi de 818.43±109.63 HU. A média de ISQ foi de 80.00±3.11 após 6 meses da cirurgia. A duração do procedimento cirúrgico (minutos) foi entre 25 a 38 minutos com uma média de 30.86±4.10 minutos. Conclusão: A elevação do soalho de seio maxilar via crista do rebordo com instalação simultânea de implante utilizando osseodensificador promove resultados superiores em relação à densidade óssea, estabilidade do implante e menor duração do tempo cirúrgico (AU)

Impact of different scan strategies and implant angulation on impression accuracy of full arch multiple implant: an in vitro study / Impacto de diferentes estratégias de escaneamento e angulação dos implantes na acurácia da moldagem de implantes múltiplos em arco completo: um estudo in vitro

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)

Does the Use of Surface Electromyography Could Improve Quality of Life among Patients Rehabilitated by Mandibular Overdentures on Different Attachments?

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.

Influence of filling materials on the fracture resistance of resin composite used for sealing screw access hole / Influência dos materiais de preenchimento na resistência a fratura das resinas compostas utilizadas para selamento do orifício de acesso ao parafuso

Introduction: Screw-retained restorations have a screw access hole (SAH) sealed with resin composite aiming at safe-guarding the aesthetic features of the ceramic veneer. The loss or wear of the resin composite applied in sealing the SAH is among the most common complications in implant prosthodontics, as the fracture of ceramic veneer. Objective: Evaluate the influence of sealant materials on the fracture resistance of resin composite applied in sealing screw access hole in screwed (SAH) implants. Material and method: The samples were produced from UCLA abutments in metallic NiCr alloy with subsequent application of ceramic. After asperisation and conditioning ceramic surface, was applied silane and dentin adhesive, before sealing the conduits with resin composites Z100 and P60. Nine groups (n=10) were evaluated: sealing with Z-100 (ZNC) and P-60 (PNC) without obturation of SAH; sealing with Z100 (ZCP) and P-60 (PCP) with absorbent cotton; Z100 (ZPT) and P60 (PPT) with polytetrafluoroethylene; Z100 (ZGP) and P60 (PGP) with gutta-percha and a cemented ceramic crown (ICS). After the fracture resistance test, the data were analyzed using two-way ANOVA and Tukey HSD tests (p<.05). Result: The fracture mode was evaluated by scanning electron microscope. Irrespective of the filling material, the highest mean values of fracture resistance were observed in the sealing with P60 (p=.002). When combined with resins composed of a sealing material, the results obtained were: ZGP: 805.5N/ PGP: 929.5N

Introdução: As próteses parafusadas possuem orifício de acesso ao parafuso (SAH), os quais são selados com resina composta. Sua perda ou desgaste está entre as complicações mais comuns em próteses sobre implantes, associadas a fratura da lâmina cerâmica. Objetivo: Assim, é importante avaliar a influência dos materiais de selamento na resistência à fratura de resina composta aplicada ao SAH no selamento de prótese sobre implantes parafusadas. Material e método: As amostras foram produzidas utilizando pilares UCLA em liga metálica de NiCr com posterior aplicação de cerâmica. Após asperização e condicionamento da superfície cerâmica, foram aplicados silano e adesivo dentinário, antes da selagem dos condutos com as resinas compostas Z100 e P60. Foram avaliados nove grupos (n = 10): selamento com Z-100 (ZNC) e P-60 (PNC) sem selamento do SAH; selamento com Z100 (ZCP) e P-60 (PCP) com algodão absorvente; Z100 (ZPT) e P60 (PPT) com politetrafluoroetileno; Z100 (ZGP) e P60 (PGP) com guta-percha e coroa de cerâmica cimentada (ICS). Após o teste de resistência à fratura, os dados foram analisados usando ANOVA de dois fatores e testes Tukey HSD (p<0,05). O tipo de fratura foi avaliado por microscópio eletrônico de varredura. Resultado Independentemente do material obturador, os maiores valores médios de resistência à fratura foram observados no selamento com P60 (p=0,002). Quando combinados com resinas compostas por um material de selamento, os resultados obtidos foram: ZGP: 805,5N/ PGP: 929,5N

Acidente Vascular Cerebral por dissecção carotídea bilateral pós-procedimento odontológico: relato de caso / Stroke from bilateral carotid dissection after dental procedure: case report

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)

Tratamiento multidisciplinario en un niño afectado por un quiste dentígero / Multidisciplinaty treatment in a child with dentigerous cyst

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.

Integración de tres especialidades estomatológicas en el tratamiento protésico / Integration of three stomatological specialties in the prosthetic treatment

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.

One-piece Implant Placement as an Alternative and Acceptable Treatment for Missing Tooth Rehabilitation: A Case Report

ABSTRACT@#Currently dental implant treatment become popular. More clinicians are being presented with the opportunity to perform implant services in their own practice. The use of one-piece implant can be considered as treatment for the replacement of missing tooth in the areas of limited tooth-to-tooth spacing and would bring less trauma for the soft tissue. A 52-year-old female patient presented with difficulty in mastication due to the loss of teeth of 35 region with limitation mesio distal space. Radiology examination did not reveal any radiolucencies in 35 region. Radiograph revealed sufficient bone height from crestal to the floor of the mandible. A one-piece implant was placed in the 35 region. The present case used an endosteal implant, one stage surgery, and delayed loading. Restoration with porcelain fused to the metal crown had been delivered three months after the one-piece implant placement. The result of this treatment indicated that one-piece implant could be considered as an effective therapy choice for replacement of missing tooth in order to rehabilitate the masticatory function.

Patient Satisfaction and Pink Esthetics of PEEK Versus Zirconium Abutments in the Esthetic Zone (A Randomized Controlled Trial) / Satisfação do paciente e estética rosa dos pilares PEEK versus Zircônia na zona estética (um ensaio clínico randomizado)

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)

Reliability of Linear and Curvilinear Measurements on Cone-Beam Computed Tomography Images for the Evaluation of Implant Sites and Jaw Pathologies

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.

Evaluation of Masticatory Performance and Patient Satisfaction Before and After Posterior Implant Restoration

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.

Comparing Torque Loss in Standard Implants and Short Implants with Increased Vertical Cantilever Abutments: an In Vitro Study / Comparação da perda de torque em implantes padrão e implantes curtos com pilares cantilever verticais aumentados (in vitro)

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)

Applicability of cone beam computed tomography gray values for estimation of primary stability of dental implants / Aplicabilidade dos valores de cinza da tomografia computadorizada de feixe cônico na estimativa da estabilidade primária de implantes dentários

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)

Estudo comparativo da osseointegração de implantes manufaturados em Ti-cp ou Ti6Al4V com ou sem superfície modificada por ablação a laser: caracterização topográfica, análises biomecânica, histólogica e imunoistoquímica / Comparative study of osseointegration of implants manufactured in cp-Ti or Ti6Al4V with or without modified surface by laser beam: topographic characterization, biomechanical, histological and immunohistochemical analyzes

A proposição do trabalho foi avaliar o comportamento biológico e mecânico ao tecido ósseo periimplantar em implantes manufaturados em Ti-cp com superfícies usinada (CPMS) e modificada por LASER (CPLS) e implantes manufaturados em Ti6Al4V com superfícies usinada (ALLOYMS) e modificada por LASER (ALLOYLS). As superfícies foram analisadas por meio da microscopia eletrônica de varredura acoplado a espectroscopia por energia dispersiva de raios X (MEV-EDX) previamente a cirurgia experimental. Noventa e seis (2x4mm) implantes foram instalados em leitos cirúrgicos fresados nas tíbias direita e esquerda de 48 ratos Wistar machos, sendo um implante de cada material (metal) ou superfície instalado em cada tíbia. Análise biomecânica foi realizada por meio do torque de remoção dos implantes em todos os grupos nos períodos de 14, 21 e 42 dias pós-operatório e as tíbias foram seccionadas e processadas para análise histológica e imunoistoquímica. Posteriormente, foi realizada MEV-EDX dos implantes removidos por torque reverso em todos os períodos de análises. Os dados obtidos na análise biomecânica foram submetidos à análise estatística (p< 0,05). MEV-EDX antes da instalação dos implantes apresentou diferença entre as superfícies usinadas e modificadas por LASER, independente do metal do implante. O torque de remoção de ALLOYLS foi estatisticamente superior a CPLS, CPMS e ALLOYMS em 14 e 21 dias (p < 0,05), bem como CPLS foi estatisticamente superior a CPMS e ALLOYMS. Aos 42 dias CPLS e ALLOYLS apresentaram diferenças estatística quando comparados com CPMS e ALLOYMS (p< 0,05), porém não foi observada diferença entre CPLS e ALLOYLS (p = 0,07). O MEV-EDX dos implantes removidos por contra-torque evidenciou o recobrimento ósseo total das superfícies de CPLS e ALLOYLS, independe do período analisado e um aumento gradual de recobrimento ósseo nas superfícies de CPMS e ALLOYMS nos períodos de 14, 21 e 42 dias respectivamente, sendo que o CPLS aos 42 dias apresentou característica de tecido ósseo mais maturo. Na análise histológica qualitativa observa-se um tecido ósseo mais maturo, sugerindo aceleração do processo de reparo ósseo nos grupos CPLS e ALLOYLS. Para análise imunoistoquímica observou-se uma maior expressão de OPN (osteopontina) para os grupos ALLOYLS 14 e 21 dias pós-operatório, surgindo de maior ativação celular. Os implantes com modificação de superfície por ablação a LASER, independente do material manufaturado, proporcionaram importantes modificações físico-químicas na superfície, permitindo melhor embricamento mecânico com o tecido ósseo e aceleração do processo de osseointegração quando comparados com implantes com superfície usinada(AU)

This study aimed to evaluate the biological and mechanical behavior of peri-implant bone tissue in implants manufactured in cp-Ti with machined surfaces (CPMS) and modified by LASER (CPLS) and implants manufactured in Ti6Al4V with machined surfaces (ALLOYMS) and modified by LASER (ALLOYLS). The surfaces were analyzed using scanning electron microscopy coupled with X-ray dispersive energy spectroscopy (SEM-EDX) prior to experimental surgery. Ninety-six (2x4mm) implants were installed in surgical beds milled in the right and left tibias of 48 male Wistar rats, one implant of each material (metal) or surface installed in each tibia. Biomechanical analysis was performed using the implant removal torque in all groups in the periods of 14, 21 and 42 days postoperatively and the tibias were sectioned and processed for histological and immunohistochemical analysis. The data obtained in the biomechanical analysis were submitted to statistical analysis (p < 0.05). The SEM-EDX before the installation of the implants showed a difference between the surfaces machined and modified by LASER, regardless of the metal of the implant. The removal torque of ALLOYLS was statistically higher than CPLS, CPMS and ALLOYMS in 14 and 21 days (p < 0.05), as well as CPLS was statistically higher than CPMS and ALLOYMS. In 42 days CPLS and ALLOYLS showed statistical differences when compared to CPMS and ALLOYMS (p < 0.05), however no difference was observed between CPLS and ALLOYLS (p = 0.07). The SEM-EDX of the implants removed by removal torque showed the total bone coverage of the surfaces of CPLS and ALLOYLS, regardless of the analyzed period and a gradual increase in bone coverage on the surfaces of CPMS and ALLOYMS in the periods of 14, 21 and 42 days respectively, CPLS in 42 days showed a mature bone tissue. In the qualitative histological analysis, a mature bone can be observed, suggesting an acceleration of the repair process in the CPLS and ALLOYLS groups. For immunohistochemical analysis, a higher expression of OPN (osteopontin) was observed for the ALLOYLS groups in 14 and 21 days, arising from higher cellular activation. The implants with surface modification by LASER beam, regardless of the material manufactured, provided important physical-chemical modifications on the surface, allowing better mechanical resistance with bone tissue and acceleration of the osseointegration process when compared to implants with machined surfasse(AU)

Evaluación de la precisión de impresiones sobre implantes usando guía multifuncional en el sistema all-on-four / Accuracy of implant impression using a multifunctional guide in the All-on-Four treatment concept

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)