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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 9-15, set.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1283900

ABSTRACT

Este relato descreve o caso de uma paciente jovem que necessitou de reabilitação na região maxilar anterior devido a insatisfações estéticas. O artigo objetivou relatar a sequência clínica da reabilitação de um implante pré-existente na região do dente 21 com UCLA de zircônia personalizável e coroa de dissilicato de lítio associada a instalação de facetas de dissilicato de lítio dos dentes 15 ao 25 para harmonização do sorriso. Previamente ao tratamento reabilitador, foi realizado o planejamento do caso que incluiu a necessidade de gengivectomia e condicionamento do perfil de emergência na região peri-implantar. Após a cicatrização, foram confeccionados preparo minimamente invasivos de acordo com as informações do mock-up. UCLA personalizável de zircônia foi selecionada como componente protético, visando a estética do caso. Para a moldagem, utilizou-se transfer de moldeira aberta para cópia do perfil de emergência e posicionamento do implante na região do 21 e moldagem simultânea com silicone de adição. Após a prova, a cimentação das facetas de dissilicato de lítio foi realizada com cimento adesivo fotopolimerizável. Os resultados estéticos e funcionais foram satisfatórios. No presente caso clínico, conclui-se a importância da abordagem multidisciplinar para alcançar resultados satisfatórios. Ademais, a associação das facetas e a coroa de dissilicato de lítio implantossuportada com UCLA de zircônia personalizável proporcionou os resultados estéticos e funcionais da paciente(AU)


This report describes the case of a Young patient who needed rehabilitation in the anterior maxillary region due to esthetic involvement. The article aimed to report the clinical sequence of the rehabilitation of a pre-existing implant in the region of tooth 21 with UCLA of zirconia customizable and crown of lithium disilicate associated with the installation of veneers of lithium disilicate of teeth 15 to 25 for harmonizing the smile. Prior to the rehabilitation treatment, case planning was carried out, which included the need for gingivectomy and conditioning of the emergency profile in the peri-implant region. After healing, preparations minimally invasive were made according to the information of mock-up. UCLA of zirconia customizable was selected as a prosthetic component, aiming at the aesthetics of the case. For impression, open tray transfer was used to copy the emergency profile and position the implant in the region of 21 and simultaneous impression with addition silicone. After the test of veneers, the cementation of veneers of lithium disilicate was performed with adhesive cement light-curing. The esthetic and functional results were satisfactory. In the present clinical case, the importance of a multidisciplinary approach to achieve satisfactory results is concluded. In addition, the combination of veneers and crow implanted of lithium disilicate with customizable zirconia UCLA provided the patient's esthetic and functional results(AU)


Subject(s)
Humans , Female , Adult , Dental Implants , Dental Veneers , Esthetics, Dental , Ceramics , Dental Prosthesis Design , Gingivectomy
2.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 25-31, set.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1284114

ABSTRACT

Os pilares personalizados são usados em reabilitações protéticas sobre implantes quando há exigências de angulação, perfil de emergência e margem gengival, em que os pilares convencionais não conseguem reabilitar de forma correta os conceitos de forma, função e estética. Através de um relato de caso clínico, onde houve a reabilitação dos elementos 21 e 22, com o uso de implante e próteses, usando o pilar personalizado em zircônia sobre o implante do 22, confeccionado com a tecnologia CAD/CAM. Esse sistema de pilares personalizados oferecem o desenho mais próximo do ideal e o ajuste mais perfeito em relação ao implante e ao tecido gengival, além de considerar as vantagens e desvantagen em relação aos pilares convencionais pré-fabricados nas questões de tempo de tratamento, custos e resultado estético e biológico. Concluimos que a reabilitação com pilares personalizados CAD/CAM confere uma excelente alternativa reabilitadora, devolvendo função e estética aos pacientes, desde que haja conhecimento adequado por parte dos profissionais envolvidos(AU)


Custom abutments are used in prosthetic rehabilitation on implants when angulation, emergence profile and gingival margin are used, where abutments are not recovered in a correct way to rehabilitate the concepts of shape, functions and aesthetics. Through a clinical case, where the elements 21 and 22 were rehabilitated, with the use of implants and practices, using the personalized abutments in zirconia, made with CAD / CAM technology. This customized system and abutments offers the closest ideal design and the most perfect fit in relation to the implant and gingival tissue, in addition to considering advantages and disadvantages in relation to the prefabricated applied abutments in terms of treatment time, costs and results aesthetic and biological. Conclude that a rehabilitation with customized CAD / CAM abutments provides an excellent rehabilitation alternative, returning function and aesthetics to patients, as long as there is adequate knowledge for part of the professionals involved(AU)


Subject(s)
Humans , Female , Aged , Dental Implants , Computer-Aided Design , Biocompatible Materials , Dental Prosthesis, Implant-Supported , Esthetics, Dental
3.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 47-51, maio-ago. 2021.
Article in Portuguese | LILACS, BBO | ID: biblio-1283886

ABSTRACT

A Odontologia atual apresenta relevantes mudanças no processo de reabilitação oral. Com isso, a instalação de implantes osseointegrados, constituem uma importante ferramenta neste âmbito, pois permitem a devolução da função mastigatória, permitindo também que os pacientes tenham a estética recuperada. O presente trabalho tem como objetivo realizar uma revisão de literatura, sobre a importância de um planejamento prévio, chamado também de planejamento reverso, o mesmo aponta um maior sucesso no processo reabilitador, apresentando-se como uma técnica que busca facilitar e estudar a correta reabilitação do paciente, proporcionando uma melhor previsibilidade para o tratamento, a partir do momento em que se planeja a reabilitação oral protética antes mesmo de se pensar no processo cirúrgico de implantes osseointegrados. Conclui-se com esse trabalho que o sucesso do tratamento com implantes depende diretamente de um prévio plano de tratamento, independentemente da extensão da área edêntula, quando é realizado um planejamento reverso diminuiu-se a taxa de intercorrências, além de aumentar a taxa de sucesso no processo de reabilitação(AU)


Current Dentistry presents relevant changes in the oral rehabilitation process. As a result, the installation of osseointegrated implants is na important tool in this context, as it allows the return of lost teeth, also allowing patients to have their function and aesthetics recovered. For greater success of the rehabilitation process, reverse planning presents itself as a technique that seeks to facilitate the correct rehabilitation of the patient, allowing better predictability for the treatment from the moment that the prosthetic oral rehabilitation is planned before even thinking about the surgical process of osseointegrated implants. The success of treatment with implants depends directly on a properly planned treatment plan, regardless of the extent of the edentulous area. This paper aims to conduct a literature review on the importance of reverse planning in implantology(AU)


Subject(s)
Dental Prosthesis Design , Dental Implantation, Endosseous , Dental Implants , Dental Implantation, Endosseous/methods , Esthetics, Dental , Mouth Rehabilitation
4.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 35-41, maio-ago. 2021.
Article in Portuguese | LILACS, BBO | ID: biblio-1252912

ABSTRACT

O objetivo deste estudo é realizar uma revisão da literatura para identificar os principais fatores que levam às complicações em implantodontia. Os implantes osseointegráveis e sua aplicação na odontologia revolucionaram a reabilitação oral de pacientes sejam eles edêntulos totais ou parciais em busca de recuperação funcional e satisfação estética. A pesquisa científica em uma busca constante pela magnificação deste tratamento, possibilitaram o uso de reabilitações implantossuportadas como um método de tratamento previsível com um índice elevado de sucesso. No entanto, como qualquer modo de tratamento, complicações e falhas também podem ocorrer na implantodontia. Após a revisão de literatura pode-se concluir que as condições médicas do paciente, hábitos sociais e parafuncionais, inexatidão do planejamento cirúrgico e protético, conhecimento técnico e científico do cirurgião-dentista, a falta de relacionamento interdisciplinar e deficiente cooperação do paciente no pós-operatório, podem estar relacionadas às complicações no tratamento reabilitador com implantes dentários(AU)


The objective of this study is to carry out a complete literature review to elucidate and evaluate the factors that lead to complications in implantology. The osseointegrated implantsimplants and their application in dentistry have revolutionized the oral rehabilitation of patients who need this treatment, be they total or partial edentulous in search of functional recovery and aesthetic satisfaction. Scientific research and a constant search for the magnification of this treatment, allowed the use of implant-enhanced rehabilitation as a predictable treatment method with a high success rate. However, like any treatment mode, complications and failures can also occur in implantology. the patient's medical conditions, social and parafunctional habits, inaccuracy of surgical and prosthetic planning, technical and scientific knowledge of the dental surgeon, lack of interdisciplinary relationship and poor patient cooperation in the postoperative, may be related to complications in rehabilitating treatment with dental implants(AU)


Subject(s)
Dental Implants , Dental Implants/adverse effects , Dental Implantation, Endosseous , Tobacco Use Disorder , Dental Prosthesis, Implant-Supported , Diabetes Mellitus , Diphosphonates , Peri-Implantitis , Mouth Rehabilitation
5.
Medisan ; 25(4)2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1340217

ABSTRACT

Introducción: La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una tasa de éxito superior a 89 % en periodos de observación entre 10-15 años; no obstante, el número de implantes continúa incrementándose y, con ello, la prevalencia de enfermedades perimplantarias. Objetivo: Profundizar los conocimientos sobre la enfermedad perimplantaria y los tratamientos existentes. Desarrollo: Como resultado del avance en la rehabilitación, el uso de implantes dentales ha tomado un gran auge en los últimos años y, en particular, en la provincia de Santiago de Cuba; sin embargo, con el uso de esta técnica también se han incremento las complicaciones y los fracasos por múltiples razones. Conclusiones: La enfermedad perimplantaria representa un problema de salud con incidencia creciente, que requiere de un enfoque multidisciplinario, lo que depende de varios principios biológicos que es preciso respetar, tales como el diagnóstico, el plan terapéutico, la ejecución cuidadosa del proceder, el seguimiento posoperatorio y la carga apropiada del implante, que son factores importantes para lograr el resultado deseado.


Introduction: The use of dental implant as method to replace lost teeth has demonstrated to be a treatment with a success rate higher than 89 % in periods of observation between 10-15 years; nevertheless, the number of implants is still increasing and, with it, the prevalence of peri-implantar diseases. Objective: To deepen the knowledge on the peri-implantar disease and the existing treatments. Development: As a result of the advance in rehabilitation, the use of dental implants has taken a great boom in the last years and, in particular, in the province of Santiago de Cuba; however, with the use of this technique the complications and failures have also increased due to multiple reasons. Conclusions: The peri-implantar disease represents a health problem with growing incidence that requires a multidisciplinary approach, what depends on several biological principles that is necessary to respect, such as the diagnosis, the therapeutic plan, the careful implementation of the procedure, the postoperative follow up and the appropriate load of the implant that are important factors to achieve the result desired.


Subject(s)
Dental Implants/adverse effects , Dental Restoration Failure , Stomatitis
6.
Rev. cient. odontol ; 9(1): e048, ene.-mar. 2021. ilus, tab
Article in Spanish | LILACS, LIPECS | ID: biblio-1254400

ABSTRACT

En los últimos años, se ha incrementado el porcentaje de colocación de implantes dentales y, con ello, también la mayor presencia de eventos adversos, por lo que las complicaciones no son infrecuentes. La gran mayoría de recomendaciones para la reducción de complicaciones asociadas con la colocación de implantes dentales están analizadas desde el punto de vista de sus causas directas, juzgando la técnica o al individuo, pero no al sistema en conjunto, cuando este constituye la etiología real de las complicaciones. Recientemente, se ha empezado a considerar más importante la inclusión de los factores humanos y la conciencia de la situación en la comprensión de las complicaciones en implantología oral. Esto ha permitido analizar de manera global tanto al individuo como a su entorno, y aportar soluciones basadas en la prevención. Sin embargo, el conocimiento y la utilización de estos aspectos en implantología oral están aún en vías de popularización, por lo que el objetivo del presente artículo es difundir el enfoque de los factores humanos y la conciencia de la situación en la prevención de complicaciones y en la reducción de riesgos en los procedimientos de colocación de implantes dentales. (AU)


In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures. (AU)


Subject(s)
Humans , Dental Implants , Risk Assessment , Accident Prevention
7.
Braz. dent. j ; 32(1): 34-41, Jan.-Feb. 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1180717

ABSTRACT

Abstract The objective of this study was to compare the biomechanical behavior of peri-implant bone tissue and prosthetic components in two modalities of treatment for posterior region of the maxilla, using short implants or standard-length implants associated with bone graft in the maxillary sinus. Four 3D models of a crown supported by an implant fixed in the posterior maxilla were constructed. The type of implant: short implant (S) or standard-length implant with the presence of sinus graft (L) and type of crown retention: cemented (C) or screwed (S) were the study factors. The models were divided into SC- cemented crown on a short implant; SS- screwed crown on the short implant; LC- cemented crown on a standard-length implant after bone graft in the maxillary sinus and LS- crown screwed on a standard-length implant after bone graft in the maxillary sinus. An axial occlusal loading of 300 N was applied, divided into five points (60N each) corresponding to occlusal contact. The following analysis criteria were observed: Shear Stress, Maximum and Minimum Main Stress for bone tissue and von Mises Stress for the implant and prosthetic components. The use of standard-length implants reduced the shear stress in the cortical bone by 35.75% and the medullary bone by 51% when compared to short implants. The length of the implant did not affect the stress concentration in the crown, and the cement layer acted by reducing the stresses in the ceramic veneer and framework by 42%. Standard-implants associated with cemented crowns showed better biomechanical behavior.


Resumo O objetivo do estudo foi avaliar o comportamento biomecânico do tecido ósseo peri-implantar e dos componentes protéticos em duas modalidades de tratamento para região posterior da maxila, utilizando implantes curtos ou implantes de comprimento padrão associados a enxerto ósseo em seio maxilar. Foram construídos quatro modelos 3D de uma coroa suportada por um implante osseointegrado na região posterior da maxila. O tipo de implante: implante curto (S) ou implante de comprimento padrão com presença de enxerto sinusal (L) e tipo de retenção da restauração: cimentada (C) ou parafusada (S) foram os fatores de estudo. Foi aplicada uma força oclusal de 300N, dividida em cinco pontos (60 N cada) correspondentes ao contato oclusal de um primeiro molar superior. Foram observados os seguintes critérios de análise: tensão de cisalhamento, tensão principal máxima e mínima para o tecido ósseo e tensão de Von Mises para o implante e componentes protéticos. O uso de implantes de comprimento padrão reduziu a tensão de cisalhamento no osso cortical em 35,75% e no osso medular em 51% quando comparado aos implantes curtos. O comprimento do implante não afetou a concentração de tensão na restauração. A camada de cimento atuou reduzindo as tensões na cerâmica de cobertura e infraestrutura de cerâmica em 42%. Os implantes de tamanho padrão associados às coroas cimentadas apresentaram o melhor comportamento biomecânico.


Subject(s)
Dental Implants , Maxilla/surgery , Stress, Mechanical , Dental Prosthesis Design , Dental Prosthesis, Implant-Supported , Finite Element Analysis , Crowns , Dental Stress Analysis
8.
J. oral res. (Impresa) ; 10(1): 1-8, feb. 24, 2021. ilus, tab
Article in English | LILACS | ID: biblio-1282719

ABSTRACT

Purpose: This study was designed to evaluate the diagnostic value of digital Bitewing (BW) radiographs with and without horizontal tube shift in detecting Residual excess cement (REC) on the proximal and non-proximal surfaces of implant restorations. Material and Methods: Eight mandibular models were fabricated with two implants placed on each side in the premolar and first molar positions. Excess cement was applied to either proximal or non-proximal surfaces of the restorations intentionally during the process of crown cementation. BW radiographs with and without applying horizontal tube shift were acquired. Three maxillofacial radiologists were asked to determine the presence and location of REC in the radiographs. Sensitivity and specificity of the radiographic technique were assessed according to the restoration surface that contained REC. Results: Sensitivity of BW radiographs was 100% for the detection of REC on the proximal surfaces and 41-18, 80% on the non-proximal surfaces. Specificity of the technique was 85.71%-100% for the proximal surfaces and 75-94. 12% for the non-proximal areas. Specificity of the radiographic method was generally greater than its sensitivity for the non-proximal surfaces while in the proximal areas, the two variables had quite similar values. Conclusion: Digital BW radiography is generally more useful for detection of REC on the proximal surfaces. Higher specificity of this technique for the bucco-lingual surfaces suggests more reliability of the negative diagnoses in the non-proximal areas.


Objetivo: Evaluar el valor diagnóstico de las radiografías digitales bitewing (BW), con y sin desplazamiento horizontal del tubo, para detectar el exceso de cemento residual (ECR) en las superficies proximales y no proximales de las restauraciones con implantes. Material y Métodos: Se fabricaron ocho modelos mandibulares con dos implantes colocados a cada lado en las posiciones premolar y primer molar. El exceso de cemento se aplicó intencionalmente en las superficies proximales o no proximales de las restauraciones durante el proceso de cementación de la corona. Se adquirieron radiografías BW con y sin aplicación de desplazamiento horizontal del tubo. Se pidió a tres radiólogos maxilofaciales que determinaran la presencia y ubicación de ECR en las radiografías. La sensibilidad y la especificidad de la técnica radiográfica se evaluaron según la superficie de restauración que contenía ECR. Resultados: La sensibilidad de las radiografías de BW fue del 100% para la detección de ECR en las superficies proximales y del 41,18-80% en las superficies no proximales. La especificidad de la técnica fue 85-71, 100% para las superficies proximales y 75-94, 12% para las áreas no proximales. La especificidad del método radiográfico fue generalmente mayor que su sensibilidad para las superficies no proximales, mientras que en las áreas proximales, las dos variables tuvieron valores bastante similares. Conclusión: La radiografía digital BW es generalmente más útil para la detección de ECR en las superficies proximales. La mayor especificidad de esta técnica para las superficies buco-linguales sugiere una mayor confiabilidad de los diagnósticos negativos en las áreas no proximales.


Subject(s)
Humans , Radiographic Image Enhancement/methods , Radiography, Bitewing/methods , Dental Cements , In Vitro Techniques , Dental Implants , Crowns
9.
Article in English | WPRIM | ID: wpr-878445

ABSTRACT

OBJECTIVES@#This study aims to evaluate the short-term clinical outcomes and patient satisfaction of anterior and pterygoid implants in the rehabilitation of edentulous maxilla with posterior atrophy.@*METHODS@#Given a minimum follow-up of 1 year, 25 patients with fixed maxillary rehabilitation over anterior and pterygoid implants were enrolled in this retrospective study. The implant survival rates, peri-implant soft tissue status (including probing depth, modified sulcus bleeding index, and plaque index), marginal bone loss, and patient satisfaction were measured.@*RESULTS@#The survival rates for anterior and pterygoid implants at 1-year follow-up were 96.5% and 97.8%, respectively (@*CONCLUSIONS@#For the edentulous maxilla with posterior atrophy, full-arch fixed prostheses supported by anterior and pterygoid implants has an acceptable short-term clinical outcome and excellent patient satisfaction. It may be considered as a predictable and feasible method for maxillary rehabilitation.


Subject(s)
Atrophy/pathology , Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis, Implant-Supported , Follow-Up Studies , Humans , Jaw, Edentulous/surgery , Maxilla/surgery , Retrospective Studies , Treatment Outcome
10.
Article in English | WPRIM | ID: wpr-878444

ABSTRACT

OBJECTIVES@#This study investigated the effects of different implant surface properties on the biological behavior of Schwann cells.@*METHODS@#Schwann cells (SCs) were cultured on three types of implant surfaces including smooth polished (SMO), sand-blasted, large grit, acid-etched (SLA), and chemically-modified SLA (modSLA). At different time points, the morphology and adhesion of SCs on the implant surfaces were observed by scanning electron microscope. Cell proliferation activity was detected by MTT method. The expression levels of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were detected by enzyme-linked immunosorbent assay. Changes in the mRNA levels of NGF and BDNF were detected by real-time fluorescent quantitative polymerase chain reaction (PCR).@*RESULTS@#SCs adhered, stretched, and proliferated well on the three types of implant surfaces. On the 3rd, 5th, and 7th days, the OD values of the SMO group were higher than those of the SLA group and the modSLA group, and the difference was statistically significant (@*CONCLUSIONS@#Different implant surface properties have different effects on the biological behavior of SCs. Proliferation of SCs is significantly promoted by smooth surface, while secretion and gene expression of neurotrophic factors are significantly promoted by modSLA surface at early stage.


Subject(s)
Dental Implants , Schwann Cells , Surface Properties , Titanium
11.
Article in Chinese | WPRIM | ID: wpr-878437

ABSTRACT

When design an implant restoration for edentulous patients, many doctors ignore the sufficiency of the interarch distance (vertical distance) or horizontal distance of the patient to accommodate the superstructure and restoration before designing the implant plan. However, the connotation of measuring the interarch distance or horizontal distance has not been clarified in clinical practice. It is often based on visual estimation after operation, and the decision-making path of implant restoration is inverted, resulting in many mistakes regarding the restoration after implantation. The main reason is the lack of standardized paths and practical methods to use before surgery. This article recommended initially establishing a maxillo-mandibular relationship based on natural teeth, old dentures, or new ones and then using the height and horizontal distance or angle of the target restorative space, which was easier to grasp as the measured index. The minimum vertical distance (including the height of the gingival surface and the bone surface) and the horizontal distance (or the angle from the bone or gingival surface to the proposed occlusal plane) should be measured before operation. A decision tree of edentulous jaw restoration guided by the values of the repair space was established based on the measured values. This article clarified the measuring points and planes and thus provided a quantitative relationship basis for the design of implant restoration.


Subject(s)
Dental Implantation, Endosseous , Dental Implants , Dental Prosthesis, Implant-Supported , Humans , Jaw, Edentulous , Mandible , Mouth, Edentulous
12.
Article in Chinese | WPRIM | ID: wpr-878420

ABSTRACT

Oromaxillofacial hard tissue defects is still a difficult problem in clinical treatment. Regeneration of oromaxillofacial hard tissue based on tissue engineering technology has a good clinical application prospect. The functional modification of scaffolds is one of key factors that influence the outcome of tissue regeneration. The biomimetic design of biomaterials through simulating the natural structure and composition of oromaxillofacial hard tissue has gradually become a research hotspot due to its advantages of simplicity and efficiency. In this article, the biomimetic modification of biomaterials for oromaxillofacial hard tissue regeneration is reviewed, expecting to provide a new idea for the treatment of oromaxillofacial hard tissue defect.


Subject(s)
Biocompatible Materials , Biomimetics , Bone Regeneration , Dental Implants , Tissue Engineering , Tissue Scaffolds
14.
J. appl. oral sci ; 29: e20200568, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1143153

ABSTRACT

Abstract Objective The aim of this study is to evaluate the new bone and connective tissue formation and the biomaterial remaining after maxillary sinus bone augmentation using 5 different bone substitutes. The osteocalcin immunolabeling was performed to demonstrate their calcification and the possibility of receiving dental implants. Methodology 40 patients underwent maxillary sinus bone augmentation and were divided in 5 groups: Group 1 with 8 maxillary sinuses were grafted with autogenous bone graft (AB); Group 2 with 8 maxillary sinuses grafted with bioactive glass (BG); Group 3 with 8 maxillary sinuses grafted with bioactive glass added to autogenous bone graft (BG + AB) 1:1; Group 4 with 8 maxillary sinuses grafted with Bio-Oss (BO) and Group 5 with 8 maxillary sinuses grafted with Bio-Oss added to autogenous bone graft (BO + AB) 1:1. Results In group AB, 37.8% of bone was formed in the pristine bone region, 38.1% in the intermediate and 44.5% in the apical region. In group BG, 43.6% was formed in the pristine bone, 37% in the intermediate and 49.3% in the apical region. In group BG + AB 1:1, 39.0% was formed in the pristine bone region, 34.8% in the intermediate and 36.8% in apical region. In group BO, 33.4% was formed in the pristine bone, 32.5% in the intermediate and 34.3% in the apical region. In group BO + AB 1:1, 32.8% was formed in the pristine bone, 36.1% in intermediate and 27.8% in the apical regions. The immunolabeling for osteocalcin showed an intensive staining for all groups, which could demonstrate the calcification of the bone formed. Conclusion This study showed that the groups evaluated formed a suitable lamellar bone in the maxillary sinus reconstruction after six months of bone healing, thus being indicated to receive dental implants.


Subject(s)
Humans , Osteogenesis , Dental Implants , Bone Transplantation , Bone Substitutes , Sinus Floor Augmentation , Dental Implantation, Endosseous , Maxillary Sinus/surgery , Maxillary Sinus/diagnostic imaging
15.
J. appl. oral sci ; 29: e20200647, 2021. graf
Article in English | LILACS | ID: biblio-1286912

ABSTRACT

Abstract Objective To evaluate the effect of different protocols of low-level intensity laser therapy (LLLT) irradiation on the osseointegration of implants placed in grafted areas. Methodology 84 rats were randomly allocated into six groups: DBB: defect filled with deproteinized bovine bone; HA/TCP: defect filled with biphasic ceramic of hydroxyapatite/β-tricalcium phosphate ; DBB-LI: defect filled with DBB and treated with LLLT after implant placement; HA/TCP-LI: defect filled with HA/TCP and treated with LLLT after implant placement; DBB-LIB: defect filled with DBB and treated with LLLT after graft procedure and implant placement; and HA/TCP-LIB: defect filled HA/TCP and treated with LLLT after graft procedure and implant placement. The bone defects were made in the tibia and they were grafted. After 60 days, the implants were placed. The rats were subsequently subjected to euthanasia 15 and 45 days after implant placement. The pattern of osseointegration and bone repair in the grafted area was evaluated by biomechanical, microtomographic, and histometric analyses. Furthermore, the expression of bone biomarker proteins was assessed. Results The LLLT groups presented higher removal torque, mineralized tissue volume, and a greater degree of osseointegration, especially when LLLT was performed only after implant placement, and these findings were associated with higher expression of BMP2 and alkaline phosphatase. Conclusion LLLT performed on implants placed in grafted areas enhances the osseointegration process.


Subject(s)
Animals , Cattle , Rats , Dental Implants , Osseointegration , Low-Level Light Therapy , Tibia/surgery , Ceramics
16.
Rev. Fac. Odontol. (B.Aires) ; 36(83): 21-26, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342862

ABSTRACT

La pérdida de estructura dentaria por debajo del margen gingival y de la cresta ósea alveolar, ya sea por caries, fracturas traumáticas, desgaste, reabsorción radicular o perforaciones iatrogénicas, dificulta el tratamiento protésico y requiere un abordaje multidisciplinario para conseguir resultados óptimos y estables a largo plazo. Se presenta el caso de una paciente adulta que acude a consulta con la pieza 2.3, que no permite una adecuada restauración protésica sin invadir el espacio biológico. Dentro del abanico de posibilidades terapéuticas se selecciona la extrusión dentaria unitaria guiada, para poder exponer un remanente dentario adecuado supragingival, y conseguir un adecuado efecto ferrule para la posterior rehabilitación protésica. La técnica presentada es eficaz, simple, cómoda, higiénica y útil en pacientes que no desean realizarse tratamiento de ortodoncia en ambas arcadas (AU)


Subject(s)
Humans , Female , Adult , Dental Implants , Orthodontic Brackets , Orthodontic Extrusion/methods , Orthodontic Wires , Patient Care Planning , Argentina , Schools, Dental , Post and Core Technique , Crowns , Dental Caries/therapy
17.
São José dos Campos; s.n; 2021. 81 p. il., tab., graf..
Thesis in Portuguese | LILACS, BBO | ID: biblio-1255006

ABSTRACT

Embora existe um alto índice de sucesso implantes dentários, podem ocorrer perda da osseintegração após instalação das próteses sobre implante e as causas são as periimplantites e sobre cargas oclusais. Diferentes conexõessurgiram para o melhor desempenho estético, biomecânico e para evitar perdas ósseas perimplantares. Para analisar às deformações geradas ao redor dos implantes e suas conexões, as duas metodologias utilizadas neste estudo e que apresentam resultados numéricos,foram a análise de elementos finitos e a extensometria linear.Para o teste do FEA, foi utilizado o software Rhinoceros 4.0 para obter os desenhos em 3D dos dois modelos de implantes,com o mesmo comprimento e largura, um hexágono externo HE (Titaoss® TM cortical Intraoss®, SP, Brasil) com diâmetro de 3,75 mm e comprimento de 13 mm e o segundo sendo um implante conexão interna (CM) (Titaoss® Max Cone Morse, Intraoss®, SP, Brasil). Sobre os implantes foram modelados seus abutments respectivamente, Ucla anti- rotacional com plataforma de 4.1 mm e um Pilar Cone Morse CMN com transmucoso de 0,8 mm. Ambos abutments para próteses parafusadas e foram exportados para o software de análise (ANSYS 17.0, ANSYS Inc., Houston, TX, USA) em formato STEP.Para o teste de extensometria, foram obtidos blocos de poliuretano (Poliuretano F160 ISO Axson, Cercy, França) de forma retangular com dimensões internas de 95 x 45 x 30 mm e intalados implantes Titaoss® Max Cone Morse 3,75 X 13 mm e os implantes Titaoss® TM 3,75 X 13 mm (Intraoss- SP - Brasil), e os abutments e coroas metálicas de cromo-cobalto. Formado 4 grupos: a) CM no; b) HE no, c) CM po e d) He po; em cada grupo foram instalados 4 extensômetros tangenciando cada um dos implantes, segundo mapas colorimétricos da região de maior microdeformação óssea. Na aplicação de carga, foi utilizado o dispositivo de aplicação de carga-DAC(Nishioka - Proc. 08/53071-4), com carga axial de 30 kg aplicadas por um período de 10 segundos (Mericske-Stern et al.) na fosseta central (carga axial).Resultados:1) FEA- a) Tensão de von-Mises gerada no conjunto implante/parafuso mostrou maior concentraçao de tensao no parafuso protético de ambos os grupos independente da perda óssea; b) Tensão de von-Mises gerada na região mais estressada que mostrou a possível falha na região da cabeça do parafuso de ambos os grupos independente da perda óssea; c) Tensão de von-Mises gerada no implante em secçao longitudinal foi maior concentraçao de tensao na plataforma do hexagono externo, mas, com pouca diferença no restante do corpo do implante, e d) microdeformaçao gerada no interior do bloco de poliuretano .Não foi possível notar diferenças significativas entre as diferentes conexões. Para os implantes com perda óssea é possível notar maior deformaçao ápica. 2) Na extensometria foi realizada a média da deformação gerada de cada os quatro grupos, no qual não apresentou diferenças numéricas entre os grupos. Neste estudo podemos concluir que não há diferenças significativas na microdeformação entre o grupo dos implantes CM no e HE no, com uma maior deformação CM e HE quando há presença de perda óssea(AU)


Although there is a high success rate, dental implants may lose osseintegration after implantation of prostheses on implants and the causes are peri-implantitis and occlusal loads.Different connections have emerged for better aesthetic and biomechanical performance to prevent perimplant bone loss.To analyze the deformations generated around the implants and their connections, the two methodologies used in this study and which present numerical results were the analysis of finite elements and linear extensometry.The Rhinoceros 4.0 software was used to obtain the 3D drawings of the two implant models with the same length and width, an external hexagon HE (Titaoss® TM cortical Intraoss®, SP, Brazil) with a diameter of 3.75 mm and a length of 13 mm and the second being an internal connection (CM) implant (Titaoss® Max Cone Morse, Intraoss®, SP, Brazil). The abutments were modeled on the implants, respectively, Ucla anti-rotational with 4.1 mm platform and a Morse Cone Abutment CMN with 0.8 mm transmucous. Both abutments for screwed prostheses and were exported to the analysis software (ANSYS 17.0, ANSYS Inc., Houston, TX, USA) in STEP format.For the extensometry test, rectangular polyurethane blocks (Polyurethane F160 ISO Axson, Cercy, France) with internal dimensions of 95 x 45 x 30 mm and Titaoss® Max Cone Morse 3.75 X 13 mm implants and implants were obtained Titaoss® TM 3.75 X 13 mm (Intraoss-SP - Brazil), and the abutments and metallic crowns of chromium-cobalt. Forming 4 groups: a) CM no; b) HE no; c) CM po and d) He po, each group installed 4 strain gauges tangent to each of the implants, according to colorimetric maps of the region with the greatest bone microdeformation. In the load application, the DAC load application device (Nishioka- Proc. 08 / 53071-4) was used, with an axial load of 30 kg applied for a period of 10 seconds (Mericske-Stern et al.) In the pit central (axial load).Results: 1) FEA- a) von-Mises tension generated in the implant / screw set showed a higher concentration of tension in the prosthetic screw of both groups regardless of bone loss; b) von-Mises tension generated in the most stressed region, showing possible failure in the screw head region of both groups regardless of bone loss; c) VonMises stress generated in the implant in longitudinal section was higher stress concentration in the external hexagon platform but with little difference in the rest of the implant body, and d) microdeformation generated inside the polyurethane block, it was not possible to notice significant differences between the different connections. For implants with bone loss, it is possible to notice greater apical deformation. 2) In the extensometry, the average strain generated for each of the four groups was performed, in which there were no numerical differences between the groups. In this study we can conclude that there was no difference in microdeformation between the group of CM implants and HE no, with a greater CM and HE deformation when there is bone loss(AU)


Subject(s)
Bone Resorption/diagnostic imaging , Dental Implants/trends , Alveolar Bone Loss/complications
18.
Braz. dent. sci ; 24(3): 1-12, 2021. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1281002

ABSTRACT

Objective: The aim of this study was to compare the horizontal dimensional changes of split-bone block and cortico-cancellous block graft in horizontal ridge augmentation using Cone Beam Computed Tomography (CBCT). The quality of the regenerated bone in both groups was compared histologically and histomorphometrically. Material and methods: Twenty patients were randomly divided in two equal groups (n= 10): Split-bone block group which was harvested from the external oblique ridge or cortico-cancellous block graft group which was harvested from the mandibular symphysis. Pre-augmentation crestal ridge width was measured using bone caliper. CBCT scans were taken on the 2nd week and 4th month post-operatively to measure crestal and total horizontal ridge dimensions. A biopsy was collected from the regenerated ridge immediately before implant insertion on the 4thmonth post-operatively. Results: Pre-augmentation crestal bone widths of both groups were comparable (P= 0.870). On the 2nd week and 4th month post-operatively, split-bone block showed a significantly wider crestal (P= 0.028 and P= 0.001 respectively) and total horizontal ridge dimension (P= 0.025 and P= 0.002 respectively), and on the 4th month post-operatively, it showed significantly lesser resorption at crest (P= 0.040) and in total horizontal ridge dimension (P= 0.017) than cortico-cancellous block. Histologically, the regenerated bone quality was similar in both groups. Histomorphometric analysis showed a non-significant difference in percentage of mature (P= 0.365) and immature collagen (P= 0.531) between both groups. Conclusion: Split-bone block maintained a significantly wider ridge and experienced less resorption after 4 months than the cortico-cancellous block graft, with no difference in regenerated bone quality between both groups. (AU)


Objetivo: O objetivo deste estudo foi comparar as mudanças dimensionais horizontais do enxerto de bloco ósseo dividido e do enxerto de bloco córtico-esponjoso no aumento de rebordo horizontal por meio da Tomografia computadorizada de feixe cônico (TCFC). A qualidade do osso regenerado em ambos os grupos foi comparada histológica e histomorfometricamente. Material e Métodos:Vinte pacientes foram divididos aleatoriamente em dois grupos iguais (n=10): Grupo de blocos de osso dividido retirado da crista oblíqua externa ou Grupo de enxerto em bloco córtico-esponjoso retirado da sínfise mandibular. A largura da crista pré-aumentada foi medida usando calibrador ósseo. Os exames de TCFC foram realizados na segunda semana e quarto mês de pós operatório para medir as dimensões da crista e dimensões horizontais totais do rebordo. Uma biopsia foi coletada da crista regenerada imediatamente antes da inserção do implante no quarto mês pós-operatório. Resultados: As larguras do osso crestal pré-aumentado de ambos os grupos eram compatíveis (p = 0,870). Na segunda semana e quarto mês pós-operatórios, o bloco ósseo dividido mostrou uma crista significativamente mais larga (p = 0,28 e p = 0,001 respectivamente) e a dimensão da crista horizontal total (p = 0,025 e p = 0,002 respectivamente), e no quarto mês pós-operatório, apresentou reabsorção significativamente menor na crista (p = 0,040) e na dimensão da crista horizontal total (p = 0,017) em comparação ao bloco córtico-esponjoso. Histologicamente, a qualidade do osso regenerado foi semelhante em ambos os grupos. A análise histomorfométrica mostrou uma diferença não significativa na porcentagem de colágeno maduro (p = 0.365) e colágeno imaturo (p = 0,531) entre ambos os grupos. Conclusão: O bloco ósseo dividido manteve uma crista significativamente mais larga e apresentou menos reabsorção após 4 meses, em comparação ao enxerto em bloco córtico-esponjoso, sem diferença na qualidade do osso regenerado entre ambos os grupos. (AU)


Subject(s)
Humans , Dental Implants , Transplants , Cone-Beam Computed Tomography
19.
Braz. dent. sci ; 24(3): 1-7, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1281776

ABSTRACT

Objective: The aim of this study was to evaluate implant and prosthesis survival rates in full-arch rehabilitation supported by implants with platform-switched Morse taper connection submitted to immediate or delayed loading, after up to 5 years of follow-up. Material and Methods: Data was retrospectively collected from clinical records of patients who were treated by means of implant-supported full-arch rehabilitation. Survival rates of implants and prostheses were evaluated according to immediate or delayed loading. Results: The sample comprised 967 implants. Of those, 627 were submitted to immediate loading (IL) while 340 to delayed loading (DL). After a follow-up period of up to 5 years, the implant survival rate for IL was of 99.7% (622/627 implants) and 97.2% (333/340 implants) for DL. The overall implant survival rate was 98.8% (955/967 implants). Prosthesis survival rate was 100% (N = 178) for both groups. Significantly more implants in the DL group presented bone loss (p > 0.01), either greater or lower than 2 mm, during the follow-up period. Conclusion:Within their limits, the present results suggest that full-arch rehabilitation with platform-switched Morse taper connection implants can lead to surgical and prosthetic predictable outcomes. Moreover, immediate loading protocol seems to be a good option for the rehabilitation of fully edentulous patients, as it involves a shorter treatment time, which may lead to greater patient satisfaction. (AU)


Objetivo: O objetivo deste estudo foi avaliar as taxas de sobrevivência de implantes e próteses em reabilitações de arco completo suportadas por implantes de conexão cone Morse e platform switching submetidos à carga imediata ou tardia, após até 5 anos de acompanhamento. Material e Métodos: Os dados foram coletados retrospectivamente em prontuários clínicos de pacientes que foram tratados por meio de reabilitação de arco completo suportada por implantes. As taxas de sobrevivência de implantes e próteses foram avaliadas de acordo com a carga imediata ou tardia. Resultados: A amostra foi composta por 967 implantes. Destes, 627 foram submetidos à carga imediata (IL) e 340 à carga tardia (DL). Após um período de acompanhamento de até 5 anos, a taxa de sobrevivência de implantes para IL foi de 99,7% (622/627 implantes) e de 97,2% (333/340 implantes) para DL. A taxa de sobrevivência geral dos implantes foi de 98,8% (955/967 implantes). Taxa de sobrevivência da prótese de 100% (N = 178) foi encontrada para ambos os grupos. Significantemente mais implantes no grupo DL apresentaram perda óssea (p > 0,01), seja maior ou menor que 2 mm, durante o período de acompanhamento. Conclusão: Os presentes resultados sugerem, dentro de seus limites, que a reabilitação de arco completo com implantes de conexão cone Morse e platform switching pode obter resultados cirúrgicos e protéticos previsíveis. Além disso, o protocolo de carga imediata parece ser uma boa opção para a reabilitação de pacientes totalmente edêntulos, pois envolve um menor tempo de tratamento, o que pode levar a uma maior satisfação do paciente (AU)


Subject(s)
Humans , Rehabilitation , Dental Implants , Survival Rate , Retrospective Studies
20.
Dental press j. orthod. (Impr.) ; 26(1): e2119155, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1154069

ABSTRACT

ABSTRACT Introduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.


RESUMO Introdução: Mini-implantes (MIs) mais curtos são necessários para uma Ortodontia mais eficiente e efetiva. Objetivo: Avaliar a estabilidade, torque de inserção e de remoção e dor associada a MIs de 3mm instalados em humanos por um ortodontista principiante. Métodos: 82 MIs foram instalados na região vestibular da arcada superior de 26 adultos. Pares de mini-implantes adjacente receberam carga imediata de 100g. Após 1, 3, 5 e 8 semanas, os pacientes foram reavaliados para verificar a estabilidade e preencher um questionário sobre a dor e o desconforto relacionados aos MIs. Resultados: A taxa geral de falhas foi de 32,9%, sendo de 35,7% para os MIs anteriores e 30% para os MIs posteriores. Excluindo os 10 MIs que foram perdidos por trauma (12,2%), a taxa de falha nas regiões anterior e posterior foram de 30,1% e 15,2%, respectivamente e ocorreram no 420 dia ou antes. A taxa geral de falha primária foi de 23,6%. A taxa de falha foi significativamente maior (p=0,010) nos primeiros 41 MIs do que nos 41 últimos (46,3% vs. 19,5%). As experiências relacionadas à dor foram baixas (2,2% máximo), assim como ao desconforto (5,5% máximo) durante a primeira semana. Conclusão: MIs de 3mm instalados por um novato são mais propensos a falhas. Porém, as taxas de falha podem diminuir substancialmente com a instalação de mais MIs com o decorrer do tempo. A dor e o desconforto após a instalação desses dispositivos são mínimos e temporários.


Subject(s)
Humans , Adult , Bone Screws , Dental Implants , Orthodontic Anchorage Procedures , Dental Implants/adverse effects , Feasibility Studies , Dental Prosthesis, Implant-Supported , Torque , Dental Implantation, Endosseous , Maxilla/surgery
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