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1.
Rev. cuba. estomatol ; 58(3): e3073, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347440

ABSTRACT

Introducción: El posicionamiento de implantes dentales simultáneos a la elevación de seno maxilar en rebordes con reabsorción severa < 4mm es una técnica quirúrgica sensible que disminuye los tiempos operatorios. Sin embargo, es considerada cirujano-dependiente y en caso de no darse el manejo adecuado puede generar complicaciones. Objetivo: Evaluar, luego de 24 meses de carga funcional, la estabilidad de los tejidos periimplantares del implante dental que se posicionó simultáneo a la elevación de seno maxilar en un reborde alveolar con reabsorción ósea severa < 4mm. Presentación de caso: Paciente masculino de 62 años con reabsorción ósea severa en zona de primer molar superior derecho. Luego de analizar los medios diagnósticos y la evidencia científica; se logró posicionar un implante dental simultáneo a la elevación de seno maxilar técnica de ventana lateral; cuatro meses después se realizó la segunda fase quirúrgica y finalmente fue rehabilitado con una corona en zirconio. Tuvo un periodo de seguimiento de 24 meses. Conclusiones: Un buen diagnóstico, manejo quirúrgico adecuado, la colaboración del paciente y los controles periódicos, resultan en una técnica segura, que proporciona estabilidad de los tejidos periimplantares(AU)


Introduction: Dental implant placement simultaneous with maxillary sinus lifting on ridges with severe resorption < 4 mm is a sensitive surgical technique that shortens the duration of interventions. However, it is considered to be operator dependent, and may cause complications if not appropriately managed. Objective: After 24 months of functional load, evaluate the stability of the peri-implant tissue of a dental implant placed simultaneously with maxillary sinus lifting on an alveolar ridge with severe bone resorption. Case presentation: A case is presented of a male 62-year-old patient with severe bone resorption in the area of the first upper right molar. Analysis of the diagnostic means and scientific evidence involved led to placement of a dental implant simultaneous with maxillary sinus lifting (lateral window technique). The second surgical stage was performed four months later. A zirconium crown was finally placed, and a 24-month follow-up period was started. Conclusions: With a good diagnosis, appropriate surgical management, patient cooperation and periodic controls, it is a safe technique that ensures the stability of peri-implant tissue(AU)


Subject(s)
Humans , Male , Middle Aged , Bone Resorption/diagnosis , Dental Implants/adverse effects , Maxillary Sinus/surgery , Aftercare
2.
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
3.
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
4.
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
5.
Einstein (Säo Paulo) ; 19: eRC5638, 2021. graf
Article in English | LILACS | ID: biblio-1249744

ABSTRACT

ABSTRACT Peri-implant diseases, caused by bacteria from biofilm related to dental implants, are one of the main causes of late loss of implants. In this sense, peri-implant diseases are divided into peri-implant mucositis, when it affects only the soft tissues, and peri-implantitis, when there is a bone involvement, which can lead to the failure of dental implant therapy. Thus, biofilm removal is essential for peri-implant health, allowing long-term success in implant therapy. To improve the visualization of oral biofilm, which is usually transparent or colorless, disclosing agents have been routinely used. However, disclosing agents have allergenic potential and can cause staining extrinsically in restorative and prosthetic materials, leading to aesthetic impairment. Thus, the use of fluorescence has been studied as an alternative for visualization of oral biofilm. Therefore, this report describes the use of wide-field optical fluorescence for visualization of oral biofilm associated with implants and teeth, in a routine appointment and follow-up of a partially edentulous patient with peri-implant mucositis. In addition, this report showed wide-field optical fluorescence can be used in a clinical routine of care of patients with dental implants. In this sense, wide-field optical fluorescence allowed easy and immediate visualization of the mature oral biofilm for its adequate removal, evaluation of the quality of restoration to sealing of screw access-hole of implant and identification of cariogenic lesions, without risk of allergic reactions or staining of prostheses and restorations.


RESUMO Doenças peri-implantares, causadas por bactérias de biofilme relacionadas a implantes dentários, são uma das principais causas de perda tardia de implantes. Nesse sentido, as doenças peri-implantares são divididas em mucosite peri-implantar, quando afeta apenas tecidos moles, e peri-implantite, quando há comprometimento ósseo, o que pode levar ao fracasso da terapia com implantes dentários. Assim, a remoção do biofilme é essencial para a saúde peri-implantar, permitindo sucesso a longo prazo na terapia com implantes. A fim de melhorar a visualização do biofilme oral, que geralmente é transparente ou incolor, agentes reveladores têm sido rotineiramente utilizados. No entanto, esses agentes têm potencial alergênico e podem causar manchas extrinsecamente em materiais restauradores e protéticos, levando a prejuízo estético. Assim, o uso da fluorescência tem sido estudado como alternativa para visualização do biofilme oral. Este relato descreve o uso da fluorescência óptica de campo amplo para visualização do biofilme oral associado a implantes e dentes em uma consulta de acompanhamento de rotina de uma paciente parcialmente edêntula com mucosite peri-implantar. Além disso, este relato evidenciou que a fluorescência óptica de campo amplo pode ser utilizada dentro da rotina clínica de atendimento de pacientes com implantes dentários. Nesse sentido, a fluorescência óptica de campo amplo permitiu a visualização fácil e imediata do biofilme oral maduro para sua remoção adequada, a avaliação da qualidade da restauração do selamento do orifício de acesso do parafuso do implante e a identificação de lesões cariogênicas, sem risco de reações alérgicas ou manchamento de próteses e restaurações.


Subject(s)
Humans , Dental Implants/adverse effects , Mucositis , Peri-Implantitis/etiology , Peri-Implantitis/diagnostic imaging , Biofilms , Fluorescence
7.
Rev. cuba. estomatol ; 57(3): e2083, jul.-set. 2020. graf
Article in English | LILACS, CUMED | ID: biblio-1126528

ABSTRACT

ABSTRACT Introduction: The placement of dental implants is based on the creation of optimal conditions in the remnant bone. In some cases, it is indispensable to perform bone regeneration procedures and use barrier membranes to create such optimal conditions capable of favorably supporting the dental implant. Objective: Describe alternatives of barrier membranes in cases of guided bone regeneration. Case report: A female 53-year-old patient presents with a gingival fistula attached to tooth 14. Root fracture is diagnosed and extraction is conducted. Next, alveolar biomodification is performed to carry out guided bone regeneration and placement of a fibrin-rich plasma membrane. When healing is complete dental implants will be placed. Conclusions: The use of barrier membrane alternatives has shown to be effective in cases of guided bone regeneration(AU)


RESUMEN Introducción: Para la colocación de implantes dentales se deben establecer condiciones óptimas de hueso remanente, por lo cual existen casos en los que se hace indispensable realizar procesos de regeneración ósea y la utilización de membranas de barrera para generar esas condiciones óptimas que puedan soportar favorablemente el implante dental. Objetivo: Describir alternativas de membranas de barrera en casos de regeneración ósea guiada. Reporte de caso: Paciente femenino de 53 años de edad que acude a consulta por presentar fístula en encía adherida de órgano dentario 14, se diagnostica como fractura radicular y se procede a la extracción, posteriormente se realiza una biomodificación del alveolo para realizar regeneración ósea guiada y colocación de membrana de plasma rica en fibrina, se espera cicatrización para la colocación de implantes dentales. Conclusiones: El uso de alternativas de membranas de barrera muestra resultados efectivos en casos de regeneración ósea guiada(AU)


Subject(s)
Humans , Female , Middle Aged , Bone Regeneration/physiology , Dental Implants/adverse effects , Osseointegration/physiology
8.
Rev. cuba. estomatol ; 57(3): e3093, jul.-set. 2020. graf
Article in English | LILACS, CUMED | ID: biblio-1126527

ABSTRACT

ABSTRACT Background: The occurrence of a vestibular bone lamina dehiscence of a fresh alveolus becomes a challenge for rehabilitation treatment of dental implants. Objective: To evaluate prosthetic treatment and stability of periimplant soft tissues in an alveolus with advanced oral bone resorption immediately after extraction, by using single fixed prostheses on a dental implant. Case presentation: A 29-year-old female patient, without systemic disease, completely toothed, with a thick-scalloped gingival biotype, attended the clinic and her main reason for consultation was not being aesthetically satisfied with her right upper central incisor. Radiographic examination showed advanced oral bone loss, secondary to an infection of the root of the right upper central incisor. In a first surgical phase, the right central incisor was extracted using a traumatic technique with periotomes, and a dental implant was placed. A resorbable membrane was adapted to the vestibular defect and the particulate cortical bone allograft was then compacted into the site in order to fill the space between the collagen membrane and the dental implant. A screw-retained provisional restoration was performed using the extracted natural tooth. The emergence profile was established simply by adding fluid composite resin, until the desired contours were achieved. Radiological and clinical follow-up at six months showed favorable implant evolution. No mechanical or biological complications were observed during this observation period. The oral gingival margin was in a correct position. Conclusion: This technique allowed predictable aesthetic-functional outcomes and soft tissue stability in a thick-scalloped gingival biotype with a single fixed prosthesis.


RESUMEN Antecedentes: La presencia de una dehiscencia de la lámina ósea vestibular de un alveolo fresco se convierte en un desafío en el tratamiento de la rehabilitación con implantes dentales. Objetivo: Evaluar el tratamiento protésico y la estabilidad de los tejidos blandos periimplantarios en un alveolo con reabsorción ósea bucal avanzada inmediatamente posterior a una extracción, mediante el uso de prótesis fijas unitaria sobre implante dental. Presentación del caso: Una paciente de 29 años de edad, sin enfermedad sistémica, completamente dentada, con un biotipo gingival festoneado grueso, asiste a la clínica y su principal motivo de consulta fue no estar conforme estéticamente en su incisivo central superior derecho. El examen radiográfico mostró la presencia de una pérdida ósea bucal avanzada, secundaria a una infección de la raíz del incisivo central superior derecho. En una primera fase quirúrgica, se extrajo el incisivo central derecho utilizando una técnica atraumática usando periótomos y se colocó un implante dental. Se adaptó una membrana reabsorbible al defecto vestibular y después se compactó el aloinjerto de hueso cortical particulado en el sitio para llenar el espacio entre la membrana de colágeno y el implante dental. Se realizó una restauración provisional atornillada utilizando el diente natural extraído. El perfil de emergencia se estableció simplemente agregando resina compuesta fluida, hasta que se lograron los contornos deseados. El seguimiento radiológico y clínico a los 6 meses mostró una evolución favorable del implante. No se observaron complicaciones mecánicas ni biológicas durante este periodo de observación. El margen gingival bucal estaba en una posición correcta. Conclusión: Esta técnica permitió resultados estéticos-funcionales predecibles y estabilidad de los tejidos blandos en un biotipo gingival festoneado grueso con una única prótesis fija.


Subject(s)
Humans , Adult , Dental Implants/adverse effects , Allografts , Bone-Anchored Prosthesis/adverse effects , Esthetics, Dental
9.
Rev. Asoc. Odontol. Argent ; 108(2): 68-74, mayo-ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1121446

ABSTRACT

Objetivo: Presentar la respuesta clínica a largo plazo del tratamiento de un granuloma periférico de células gigantes en un implante oseointegrado en el maxilar inferior. Caso clínico: Un paciente de 60 años, de sexo masculino, sin antecedentes sistémicos, concurrió por una lesión con márgenes definidos, de color rojizo morado y consistencia blanda sobre los tejidos blandos en la cara vestibular de un implante colocado en zona de 46. Se realizó la escisión quirúrgica de la lesión, se procesó el tejido extirpado y se envió al laboratorio. El estudio anatomopatológico confirmó el diagnóstico de granuloma periférico de células gigantes. La lesión recidivó dos veces. En la tercera extirpación se realizó la implantoplastía de la superficie del implante. La cicatrización no presentó inconvenientes. Hasta el último control, a los 5 años, no volvió a haber recidiva. Conclusión: En este caso clínico, se logró mantener la salud periimplantaria durante 5 años luego de la eliminación de un granuloma periférico de células gigantes. No obstante, este tuvo que ser removido en tres oportunidades debido a la alta recidiva (AU)


Aim: To evaluate the long-term clinical response to the treatment of a peripheral giant cell granuloma in an osseointegrated implant in the lower jaw. Clinical case: A 60-year-old male patient, with no systemic medical problems, presented a soft tissue lesion located at the buccal aspect of an implant placed in the 46 area. The lesion had defined reddish-purple margins and soft consistency. Surgical excision of the lesion was performed, processed and sent to the laboratory. The histopathology confirmed the diagnosis of peripheral giant cell granuloma. The lesion recurred twice. During the third surgical removal an mplantoplasty of the implant surface was performed. The healing was uneventful and there was no recurrence until the last control at 5 years. Conclusion: In this clinical case, perimplantar gingival health was maintained for 5 years after the surgical removal of a giant cell peripheral granuloma. However, it had to be removed three times, demonstrating a high recurrence (AU)


Subject(s)
Humans , Male , Middle Aged , Granuloma, Giant Cell/surgery , Granuloma, Giant Cell/etiology , Dental Implants/adverse effects , Argentina , Recurrence , Schools, Dental , Wound Healing/physiology , Biopsy , Follow-Up Studies , Oral Surgical Procedures
11.
J. oral res. (Impresa) ; S1 Preecedings: 20-25, jul. 1, 2020. graf
Article in English | LILACS | ID: biblio-1145546

ABSTRACT

Peri-implantitis is one of the leading causes of implant failure and loss, and its early diagnosis is not currently feasible due to the low sensitivity of currents methods. In the current exploratory cross-sectional study, we explored the diagnostic potential of lymphocyte B and Th17-chemotactic cytokine levels in peri-implant crevicular fluid (PICF) in 54 patients with healthy, peri-mucositis, or peri-implantitis implants. Peri-implant crevicular fluid was collected, and the levels of the molecules under study were quantified by Luminex assay. The concentrations of CCL-20 MIP-3 alpha, BAFF/BLYS, RANKL and OPG concentration in PICF were analyzed in the context of patient and clinical variables (smoking status, history of periodontitis, periodontal diagnosis, implant survival, suppuration, bleeding on probing, periodontal probing depth, clinical attachment level, mean of implant probing depth, and plaque index). Patients with peri-implantitis, appear to have an overregulation of the RANKL/BAFF-BLyS axis. This phenomenon needs to be investigated in depth in further studies with a larger sample size.


La periimplantitis es una de las principales causas de falla y pérdida del implante, y su diagnóstico temprano no es factible debido a la baja sensibilidad de los métodos actuales. En este estudio transversal exploratorio, se estudió el potencial diagnóstico de los niveles de citocinas quimiotácticas de linfocitos B y Th17 en el líquido crevicular periimplantario (LCPI) en 54 pacientes con implantes sanos, peri-mucositis o periimplantitis. Se recogió líquido crevicular periimplantario y se cuantificaron los niveles de las moléculas estudiadas mediante Luminex assay. Las concentraciones de CCL-20 MIP-3 alfa, BAFF/BLYS, RANKL y la concentración de OPG en LCPI se analizaron en el contexto de las variables clínicas y del paciente (tabaquismo, antecedentes de periodontitis, diagnóstico periodontal, supervivencia del implante, supuración, sangrado al sondaje, profundidad de sondeo periodontal, nivel de inserción clínica, media de la profundidad de sondeo del implante e índice de placa). Los pacientes con periimplantitis parecen tener una sobrerregulación del eje RANKL/BAFF-BLyS. Este fenómeno debe investigarse en profundidad en futuros estudios con un tamaño de muestra mayor.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Implants/adverse effects , Peri-Implantitis/diagnosis , Biomarkers , Chile , Cross-Sectional Studies , Gingival Crevicular Fluid , Mucositis , RANK Ligand , Chemokine CCL20
12.
Rev. cuba. estomatol ; 57(2): e2946, abr.-jun. 2020. graf
Article in English | LILACS, CUMED | ID: biblio-1126513

ABSTRACT

ABSTRACT Introduction: The volumetric preservation of bone and soft tissue after a tooth extraction has special relevance in the esthetic zone when it will be rehabilitated by a dental implant. Objective: Describe the prosthodontics treatment in a socket with advanced buccal bone resorption, with a flapless technique for guided bone regeneration and with a dental implant and implant-supported single fixed prosthesis. Case presentation: A case is presented of a male 62-year-old partially dentate patient. Radiographic examination showed the presence of advanced buccal bone resorption in relation to the maxillary left lateral incisor. It was a result of the root displacement secondary to root fracture. In a first surgical phase the lateral incisor was extracted using an atraumatic periotome technique. Particulate cortical bone allograft was compacted into the site to fill the space that was previously occupied by the root of the tooth. Temporary restoration was performed using the extracted natural tooth, which was adhesively bonded to the adjacent teeth. Four months after grafting the extraction site showed an adequate height and width of the bone. In a second surgical phase, an implant was placed. Six months after implant placement, osseointegration was clinically confirmed and a provisional crown was screwed on the implant performed. The final restoration with a zirconium dioxide abutment and a full ceramic crown was obtained and cemented. Conclusions: Regeneration of the buccal plate was possible through the use of particulate cortical bone allograft and a resorbable collagen membrane adapted to the bone defect and placed in a position to recreate the buccal plate. This allowed the installation of an implant 4 months later, the procedure allowing esthetic and functional results using a single fixed prosthesis(AU)


RESUMEN Introducción: La preservación volumétrica de los huesos y tejidos blandos después de una extracción dental tiene especial relevancia en la zona estética cuando será rehabilitada por un implante dental. Objetivo: Describir el tratamiento de prótesis en una cavidad con reabsorción ósea bucal avanzada, con una técnica sin colgajo para la regeneración ósea guiada y con un implante dental y una prótesis fija única con soporte de implante. Presentación del caso: Paciente masculino de 62 años, edente parcial. El examen radiográfico mostró la presencia de reabsorción ósea bucal avanzada en relación con el incisivo lateral superior izquierdo. Fue el resultado del desplazamiento de la raíz secundario a la fractura de esta. En una primera fase quirúrgica, el incisivo lateral se extrajo utilizando una técnica de periotoma atraumático. El aloinjerto de hueso cortical particulado se compactó en el sitio para llenar el espacio que anteriormente ocupaba la raíz del diente. La restauración temporal se realizó utilizando el diente natural extraído, que se unió adhesivamente a los dientes adyacentes. Cuatro meses después del injerto, el sitio de extracción mostró una altura y anchura adecuadas del hueso. En una segunda fase quirúrgica, se colocó un implante. Seis meses después de la colocación del implante, se confirmó clínicamente la osteointegración y se realizó una corona provisional atornillada al implante. La restauración final con un pilar de dióxido de circonio y una corona de cerámica completa se obtuvo y se cementó. Conclusiones: La regeneración de la placa bucal fue posible mediante el uso de aloinjerto de hueso cortical particulado y una membrana de colágeno reabsorbible adaptada al defecto óseo y colocada en una posición para recrear la placa bucal. Esto permitió la instalación de un implante 4 meses después. El procedimiento permitió la estética y los resultados funcionales utilizando una única prótesis fija(AU)


Subject(s)
Humans , Male , Middle Aged , Dental Implants/adverse effects , Osseointegration/physiology , Guided Tissue Regeneration/methods , Allografts/transplantation
13.
Odovtos (En línea) ; 22(1): 61-70, ene.-abr. 2020. graf
Article in Spanish | LILACS, BBO | ID: biblio-1091506

ABSTRACT

RESUMEN La elevación de piso de seno maxilar ha sido sumamente documentada en implantología como una técnica segura y predecible en el procedimiento de ganancia vertical ósea, en el maxilar posterior atrófico. Sin embargo, conjuntamente se han reportado complicaciones en este procedimiento, las cuales podrían poner en peligro los resultados de la regeneración, y por consiguiente la colocación del implante. El propósito de esta revisión de literatura es exponer y analizar diferentes complicaciones que pueden presentarse en la elevación de piso de seno maxilar.


ABSTRACT Maxillary sinus floor elevation has been extensively documented as a safe and predictable procedure for gaining vertical bone height in the atrophic posterior maxilla. Even though, complications have been reported, which can potentially jeopardize the outcome of the regeneration and implant therapy. Therefore, the purpose of this literature review is to present, debate and analyze the different complications that can occur during a sinus floor elevation.


Subject(s)
Dental Implants/adverse effects , Sinus Floor Augmentation/adverse effects , Maxillary Sinus/surgery , Maxillary Nerve/injuries , Nasal Mucosa/injuries
14.
Rev. medica electron ; 42(2): 1713-1723, mar.-abr. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1127028

ABSTRACT

RESUMEN La implantología es una rama en constante evolución que cada vez presenta técnicas más rápidas, predecibles y mínimamente invasivas; hoy en día es una solución bastante completa para aquellas personas que por distintos motivos han perdido una o más piezas dentales y ha traído grandes avances en el área odontológica. Los avances científicos y tecnológicos, así como la mejora de la praxis quirúrgica, han logrado que la tasa de éxito de los implantes dentales sea superior al 95% después de un año de la colocación de los implantes dentales. Se conoce que el porcentaje de fracaso de estos procedimientos es relativamente bajo. Se realizó una revisión bibliográfica con el objetivo de actualizar información sobre la importancia de la implantología, sus causas y complicaciones (AU).


SUMMARY Implantology is a branch in constant evolution, presenting every time faster, more predictable and minimally invasive techniques; nowadays it is a very complete solution for those persons that, for any reason, have lost one or more teeth, and has meant great advances in odontology. Scientific and technological advances, and also the improvement of surgical praxis, have made the success rate of dental grafts higher than 95 % after a year of being made. It is known that failure percentage is relatively low. A bibliographic review was carried out with the aim of updating the importance of implantology, its causes and complications (AU).


Subject(s)
Humans , Dental Implants/adverse effects , Causality , Dentition, Permanent , Oral Surgical Procedures/methods , Methods , Dentistry/methods , Dentistry/standards
15.
Rev. cuba. estomatol ; 57(1): e2199, ene.-mar. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126481

ABSTRACT

RESUMEN Objetivo: Comparar los cambios dimensionales de los tejidos peri-implantarios en la zona estética, después de la segunda etapa quirúrgica de injertos de tejido conectivo autógeno comparados con una matriz de colágeno xenogénica, después de 3 meses de cicatrización. Métodos: En una serie de casos de seis pacientes con defectos del reborde alveolar, se realizó un procedimiento de aumento de volumen de tejidos blandos, asignando al azar dos modalidades de tratamiento: injerto de tejido conectivo subepitelial y matriz de colágeno dérmica acelular. Para evaluar los cambios dimensionales se tomaron impresiones antes del aumento y a los 90 días; estas fueron vaciadas para obtener modelos de yeso que fueron digitalizados; las dos imágenes fueron superpuestas; y tras la definición de tres puntos de interés, se calculó mediante un Software (D500 3D dental scanner - 3Shape, Copenhague, Dinamarca), los cambios dimensionales en milímetros. Se indagó por el dolor experimentado por los pacientes usando una escala visual análoga. Resultados: A los 90 días de realizada la cirugía, se observó un aumento en el grosor de los tejidos blandos peri-implantarios de 0,77 mm (rango 0,0-1,3) para el injerto de tejido conectivo, y 0,89 mm (rango 0,3-1,5) para la matriz dérmica acelular. No se encontraron diferencias estadísticamente significativas entre las dos modalidades de tratamiento, en ninguno de los tres puntos evaluados por paciente (p= 0,83; p= 0,83; p= 0,51). En cuanto al dolor experimentado entre el primer y séptimo días, no se encontraron diferencias estadísticamente significativas en la zona receptora intergrupo (p= 0,07; p= 0,12); intragrupo, injerto (p= 0,11) y matriz (p= 0,32); ni en la zona donante del grupo del injerto (p= 0,11). Conclusiones: El aumento en el grosor de los tejidos peri-implantarios fue similar después de 90 días en los dos grupos del estudio(AU)


ABSTRACT Objective: Compare the dimensional changes of peri-implant tissues from the esthetic zone after the second surgical stage of autogenous connective tissue grafting vs. a xenogenic collagen matrix after three months' healing. Methods: A case-series of six patients with alveolar ridge defects underwent a soft tissue volume augmentation procedure, randomly assigning two treatment modes: subepithelial connective tissue graft and acellular dermal collagen matrix. Impressions were taken before augmentation and at 90 days to evaluate the dimensional changes. These were then emptied to obtain plaster models which were then digitalized. The two images were superimposed, and upon definition of three points of interest, the dimensional changes were estimated in millimeters with the software D500 3D dental scanner (3Shape, Copenhagen, Denmark). Inquiries were made about the pain experienced by patients using a visual analogue scale. Results: Ninety days after surgery, increase in thickness of peri-implant soft tissues was 0.77 mm (range 0.0-1.3) for the connective tissue graft and 0.89 mm (range 0.3-1.5) for the acellular dermal matrix. No statistically significant differences were found between the two treatment modes at any of the three points evaluated per patient (p= 0.83, p= 0.83, p= 0.51). With respect to the pain experienced between the first and the seventh days, no statistically significant differences were found in the recipient zone intergroup (p= 0.07, p= 0.12), the graft intragroup (p= 0.11) and the matrix (p= 0.32), or in the donor zone of the graft group (p= 0.11). Conclusions: Increase in the thickness of peri-implant tissues after 90 days was similar in the two study groups(AU)


Subject(s)
Humans , Dental Implants/adverse effects , Tissue Transplantation/methods , Alveolar Ridge Augmentation/methods , Epidemiology, Descriptive , Observational Studies as Topic
16.
São José dos Campos; s.n; 2020. 75 p. il., tab., graf..
Thesis in Portuguese | LILACS, BBO | ID: biblio-1223539

ABSTRACT

O presente estudo teve como objetivo investigar a probabilidade de sobrevivência e distribuição de tensão de restaurações de cerâmica infiltrada por polímero sobre implantes. Setenta e cinco coroas suportadas por implantes foram divididas de acordo com a técnica de fabricação, usando uma base de titânio(Tibase): CME - Solução protética de duas peças composta por uma coroa cimentada no pilar híbrido (Tibase + mesoestrutura cerâmica); MC - Solução protética de peça única composta por uma coroa cimentada diretamente sobre o Tibase; e MP - Solução protética de peça única composta por uma coroa cimentada em um Tibase com orifício de acesso para parafuso. Todas as coroas foram fadigadas pelo teste stepwise (intervalo de carga de 50 N a cada 20.000 ciclos até 1200 N e 350.000 ciclos). As coroas falhadas foram inspecionadas sob microscopia eletrônica de varredura e a probabilidade de sobrevivência foi analisada usando os testes Log-Rank e Willcoxon. Uma geometria tridimensional de cada grupo foi modelada e analisada pelo método dos elementos finitos. Resultados de deformação total, tensão de von-Misses, tensão principal máxima e microdeformação foram solicitados sob carga axial de 900 N. Log-Rank (p = 0,17) e Willcoxon (p = 0,11) revelaram uma probabilidade de sobrevivência semelhante entre as técnicas de fabricação sob 300 e 900 N. Independentemente da sobrevivência semelhante entre CME e MC, MP mostrou resistência característica superior e menor variação de dados. Maior concentração de tensão foi observada no perfil de emergência da coroa independente do grupo. A fractografia possibilitou identificar que a direção de propagação de trinca ocorreu da cervical para oclusal. É possível concluir que a sobrevivência de uma restauração implanto-suportada com cerâmica vítrea infiltrada por polímero independe da técnica utilizada para sua confecção; e que a região do perfil de emergência da coroa protética sempre deve ser avaliada nas consultas periódicas devido a grande prodominância de falhas nessa área(au)


The present study aimed to investigate the survival probability and the stress distribution of a polymer infiltrate ceramic restorations cemented on a chairside titanium­base manufactured using different techniques. Seventy-five implant-supported crowns were divided according to the manufacturing technique using a chairside titanium­base: CME - Two-piece prosthetic solution composed by a crown cemented on the hybrid abutment; MC - One-piece prosthetic solution composed by a crown direct cemented on a titanium base; and MP - One-piece prosthetic solution composed by a crown cemented on a Tibase with screw access hole. All crowns were staircase fatigued (load step of 50 N in each 20,000 cycles until 1200 N and 350,000 cycles). The failed crowns were inspected under scanning electron microscopy. And the survival probability using Log-Rank and Willcoxon tests. One threedimensional geometry from each group were modeled and analyzed using the finite element method. Results in total deformation, von-Misses stress, maximum principal stress and microstrain were requested under 900 N axial load. Log-Rank (p = 0.17) and Willcoxon (p = 0.11) revealed similar survival probability between the techniques at 300 and 900 N. Regardless of the similar survival between CME and MC, MP showed superior characteristic strength and less data variation. Higher stress concentration was observed in the emergence profile of the crown regardless the group design. Fractography analysis allowed to identify that the crack propagation direction occurred from cervical to occlusal. It is possible to conclude that the survival of an implant-supported restoration with polymer infiltrated ceramic network is not influence by the technique used to make it; and that the emergence profile of the prosthetic crown must always be evaluated due to the great incidence of failures in this area(AU)


Subject(s)
Dental Materials/chemical synthesis , Dental Implants/adverse effects , Ceramics , Fatigue/complications
17.
Rev. cuba. estomatol ; 56(3): e2120, jul.-set. 2019. graf
Article in English | LILACS | ID: biblio-1093243

ABSTRACT

ABSTRACT Introduction: In implant therapy, adequate alveolar bone volume and favorable alveolar ridge architecture are important considerations to obtain positive functional and esthetic rehabilitation. Objective: Describe prosthodontic treatment in an extraction socket with advanced palatal bone resorption secondary to a root fracture through the use of an implant-supported single fixed prosthesis. Principal case data: 39-year-old male patient, without systemic disease, and completely dentate with no occlusal parafunction. Radiographic examination showed the presence of advanced palatal bone resorption, almost total loss of the palatal plate in all its extension secondary to a root fracture of the maxillary left lateral incisor and a large osteolytic area on the palatal aspect of the root. The procedure consisted in extraction of the maxillary left lateral incisor and eventual regeneration of the palatal plate using a resorbable collagen membrane, which was adapted to the bone defect. Then, particulate cortical bone allograft was compacted into the site. Four months after grafting the extraction site, an implant was placed. Six months after implant placement osseointegration was confirmed, and after several stages restoration with a zirconium dioxide abutment and a full ceramic crown was obtained and followed up for 2 years. Conclusions: Regeneration of the palatal plate was possible through the use of particulate cortical bone allograft and a resorbable collagen membrane adapted to the bone defect and placed in position to recreate the palatal plate. This allowed installation of an implant 4 months after the procedure. This technique allowed esthetic and functional results using a single fixed prosthesis(AU)


RESUMEN Introducción: Para la terapia con implantes, un volumen adecuado de hueso alveolar y una arquitectura favorable de la cresta alveolar son consideraciones importantes para obtener una rehabilitación funcional y estética positiva. Objetivo: Describir el tratamiento protésico en una cavidad de extracción con reabsorción ósea palatina avanzada secundaria a una fractura de la raíz, mediante el uso de una prótesis fija única con soporte de implante. Datos principales del caso: Paciente masculino de 39 años, sin enfermedad sistémica, completamente dentado sin parafunción oclusal. El examen radiográfico mostró la presencia de una reabsorción ósea palatina avanzada, una pérdida casi total de la placa palatina en toda su extensión secundaria a una fractura de la raíz del incisivo lateral superior izquierdo y una gran área osteolítica en el aspecto palatino de la raíz. El procedimiento consistió en la extracción del incisivo lateral superior izquierdo y la regeneración posterior de la placa palatina mediante una membrana de colágeno reabsorbible, que se adaptó al defecto óseo. Luego, el aloinjerto de hueso cortical particulado se compactó en el sitio. Cuatro meses después de injertar el sitio de extracción, se colocó un implante. Seis meses después de la colocación del implante, se confirmó la osteointegración y, después de varias etapas, se obtuvo una restauración con un pilar de dióxido de circonio y una corona de cerámica completa, la que fue seguida durante dos años. Conclusiones: La regeneración de la placa palatina fue posible mediante el uso de aloinjerto de hueso cortical particulado y una membrana de colágeno reabsorbible adaptada al defecto óseo y colocada en una posición para recrear la placa palatina. Esto permitió la instalación de un implante 4 meses después del procedimiento. Con esta técnica se obtuvieron resultados funcionales y estéticos utilizando una única prótesis fija(AU)


Subject(s)
Humans , Male , Adult , Dental Implants/adverse effects , Osseointegration/physiology , Tooth Socket/transplantation , Esthetics, Dental
18.
Braz. oral res. (Online) ; 33(supl.1): e070, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039321

ABSTRACT

Abstract The aim of this review is to summarize the evidence on associations between diabetes mellitus (DM) and complications around dental implants. Electronic database searches of MEDLINE, EMBASE, JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and the PROSPERO register were performed from 1990 up to and including May 2018, using MeSH terms and other keywords. Systematic reviews and meta-analyses investigating the associations of DM and implant complications (failure, survival, bone loss, peri-implant diseases, and post-surgery infection) were eligible. The quality of the included reviews was determined using the Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2). Twelve systematic reviews were included. Implant survival rates ranged from 83.5% to 100%, while implant failure rates varied from 0% to 14.3% for subjects with DM. The three meta-analyses performed for event "implant failure" reported no statistically significant differences between diabetic and non-diabetic subjects. An apparently increased risk of peri-implantitis is reported in patients with DM. According to the AMSTAR 2 classification, 50% of the reviews were classified as being of "critically low", 25% as of "low" and 25% as of "moderate" quality. Evidence indicates high levels of survival and low levels of failure of implants inserted in patients with DM. However, DM was assessed as a whole in the majority of studies and, the actual influence of hyperglycemia on implant survival/failure is still uncertain. DM/hyperglycemia seems to be associated with a high risk of peri-implantitis. However, this conclusion is based on a limited number of systematic reviews.


Subject(s)
Humans , Diabetes Complications/complications , Peri-Implantitis/etiology , Prosthesis Failure , Dental Implants/adverse effects , Risk Factors , Treatment Failure , Dental Restoration Failure
19.
Braz. oral res. (Online) ; 33(supl.1): e073, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039320

ABSTRACT

Abstract Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.


Subject(s)
Humans , Dental Implants/adverse effects , Alveolar Bone Loss/therapy , Bone-Implant Interface/pathology , Bone-Anchored Prosthesis/adverse effects , Gingival Recession/therapy , Reproducibility of Results , Alveolar Bone Loss/etiology , Alveolar Bone Loss/pathology , Treatment Outcome , Face/pathology , Gingival Recession/etiology , Gingival Recession/pathology
20.
Braz. oral res. (Online) ; 33(supl.1): e071, 2019. graf
Article in English | LILACS | ID: biblio-1039316

ABSTRACT

Abstract The aim of this illustrated review is to present the new strategies and developments to treatment and diagnosis of periimplant diseases. Periimplant disease is a subject of great concern for modern dentistry. The numbers of implant exhibiting biological complications grows as implant dentistry expands thought-out the world. Diagnosis and treatment of those diseases are still controversial and difficult. We present novel treatment for infection control and biological rationale of additional use of guided bone regeneration, with an illustrative explanation of the treatments presented with two cases.


Subject(s)
Humans , Photochemotherapy/methods , Peri-Implantitis/diagnosis , Peri-Implantitis/therapy , Bone Regeneration , Dental Implants/adverse effects , Reproducibility of Results , Treatment Outcome , Guided Tissue Regeneration, Periodontal/methods , Bone-Anchored Prosthesis/adverse effects
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