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1.
Braz. dent. sci ; 25(2): 1-8, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1363026

ABSTRACT

Objetivo: O sucesso da terapia periodontal requer um relacionamento adequado entre o clínico geral e o periodontista. O objetivo deste estudo foi determinar, por meio de um questionário, o padrão de encaminhamento de pacientes por dentistas clínicos gerais a periodontistas em Yazd, Irã. Material e Métodos: Este estudo transversal descritivo foi realizado na forma de uma pesquisa incluindo 145 dentistas licenciados em Yazd. Foi elaborado um questionário composto por sete questões com subquestões. Resultados: 89% dos cirurgiões-dentistas encaminham o paciente ao periodontista. A recessão gengival foi o motivo mais frequente de encaminhamento (69,7%), enquanto o sangramento gengival foi o menos frequente (13,1%). Em termos de procedimentos cirúrgicos, os procedimentos mais frequentes para encaminhamentos foram terapias de periimplantite e aumento de rebordo. O encaminhamento realizado por dentistas do gênero feminino foi de 95,9% e pelo gênero masculino foi de 81,7%. O número de pacientes encaminhados por dentistas que atuavam simultaneamente em clínicas privadas e públicas foi maior do que aqueles que atuavam apenas em clínicas privadas ou públicas. O maior percentual de encaminhamento foi no grupo de cirurgiões-dentistas com menos de 5 anos de experiência, com ligeira diferença daqueles com mais de 10 anos de experiência. Apenas 26,1% dos entrevistados relataram ter participado de programas de reciclagem. Conclusão: É necessário que os dentistas gerais considerem os sinais primários da doença periodontal e encaminhem os pacientes mais graves em estágios iniciais para fornecer um resultado ideal a longo prazo para os pacientes.(AU)


Objective: The successful periodontal therapy needs a proper relationship between general dentist and periodontist. The aim of this study was to determine the referral pattern of patients to periodontists by general dentists in Yazd, Iran, by means of a questionnaire. Material and Methods: This descriptive cross-sectional study was carried out in the form of a survey among 145 licensed general dental practitioners in Yazd, Iran. A questionnaire comprising of seven questions with sub-questions was prepared. Results: 89% of dentists have referred patient to periodontist. Gingival recession was the most frequent reason for referring (69.7%) and the least was gingival bleeding (13.1%). The most frequent surgical procedure for what patients have been referred were peri-implantitis therapy and ridge augmentation. Referral status to periodontist for female dentists was 95.9% and for male dentists was 81.7%. The number of referred patients form the dentists who were practicing simultaneously at both private and public clinics was higher than those who were practicing only at private or public clinics. The most referral percentage was in the group of dentists with less than 5 years of experience with a slight difference from those with more than 10 years of experience. Only 26.1% of the respondents have participated in retraining programs. Conclusion: There is a need for general dentists to consider the primary signs of periodontal disease and necessity of referring the patients in early stages more serious, to provide an optimal long-term outcome for patients. (AU)


Subject(s)
Humans , Periodontal Diseases , Periodontal Index , Dentists , Peri-Implantitis , Alveolar Ridge Augmentation , Gingival Recession
2.
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
3.
Rev. odontol. UNESP (Online) ; 50: e20210015, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1289856

ABSTRACT

Abstract Introduction The investigation of peri-implant diseases risk indicators helps to prevent and target treatment techniques. Objective The aim of this cross-sectional study was to determine the occurrence of peri-implantitis and its potential risk indicator factors, besides to assess the long-term success and survival rates of dental implants after 8 to 10 years of function. Material and method For this, fifty individuals who had received their implant-supported rehabilitation between 2003 and 2005 were included. Data regarding demographics, medical and dental history were collected and a complete clinical examination was performed. Multivariate analysis was used to identify potential risk indicator factors related to the occurrence of peri-implantitis. Overall, 211 implants had been placed; 197 were in function, 9 were still submerged, and 5 had been lost. Result Success and survival rates were 81.5% and 97.6%, respectively. Peri-implant mucositis affected 77.1% of subjects and 52.3% of implants. Peri-implantitis was diagnosed in 14 individuals (29.2%) and 25 implants (12.7%). Subjects with osteoporosis (OR = 2.84) and generalized bleeding on probing (OR = 8.03) were significantly associated with higher odds of peri-implantitis. At the implant level, visible plaque (OR = 4.45) and deep probing depths (OR = 4.47) were significantly associated with peri-implantitis. Conclusion Through these results, our study suggests that osteoporosis and generalized periodontal/peri-implant mucosa inflammation increase the likelihood of peri-implantitis.


Resumo Introdução A investigação dos fatores indicadores de risco para as doenças peri-implantares auxilia na prevenção e direcionamento das técnicas de tratamento Objetivo O objetivo deste estudo transversal foi determinar a ocorrência de peri-implantite e seus potenciais fatores indicadores de risco, além de avaliar as taxas de sucesso e sobrevida em longo prazo dos implantes dentários após 8 a 10 anos de função Material e método Foram incluídos cinquenta indivíduos que receberam sua reabilitação implanto-suportada entre 2003 e 2005. Dados demográficos, história médica e odontológica foram coletados e um exame clínico completo foi realizado. A análise multivariada foi utilizada para identificar potenciais fatores indicadores de risco relacionados à ocorrência de peri-implantite. Ao todo, 211 implantes foram colocados; 197 estavam em função, 9 ainda estavam submersos e 5 haviam sido perdidos. Resultado As taxas de sucesso e sobrevivência foram de 81,5% e 97,6%, respectivamente. A mucosite peri-implantar afetou 77,1% dos indivíduos e 52,3% dos implantes. A peri-implantite foi diagnosticada em 14 indivíduos (29,2%) e 25 implantes (12,7%). Indivíduos com osteoporose (OR = 2,84) e sangramento generalizado à sondagem (OR = 8,03) foram significativamente associados a uma maior chance de peri-implantite. Ao nível do implante, a placa visível (OR = 4,45) e as maiores profundidades de sondagem (OR = 4,47) foram significativamente associadas à peri-implantite. Conclusão Por meio desses resultados, nosso estudo sugere que a osteoporose e a inflamação generalizada da mucosa periodontal / peri-implantar aumentam a probabilidade de peri-implantite.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Implants , Survival Rate , Risk Factors , Peri-Implantitis , Prevalence , Indicators (Statistics) , Disease Prevention
4.
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
5.
Rev. ADM ; 77(6): 321-328, nov.-dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1151475

ABSTRACT

La periimplantitis se define como la patología inflamatoria e irreversible que afecta al hueso periimplantario y le hace perder soporte y función al implante según la definición del European Workshop on Periodontology (EWOP). La prevalencia estimada de la periimplantitis es de 28 a 77%. Los diferentes protocolos de abordaje de la periimplantitis nos ofrecen diversas posibilidades: destoxificación de la superficie y regeneración, limpieza mecánica y resección del tejido inflamado, extracción del implante, entre otros. El principal problema de los tratamientos regenerativos es limpiar y desintoxicar correctamente la superficie del implante expuesto, ya que al tratarse de superficies generalmente muy rugosas, las bacterias del medio bucal las colonizan con mucha facilidad y es prácticamente imposible eliminar por completo el biofilm. El protocolo de tratamiento para la periimplantitis se basa en un algoritmo de tratamiento, en el que se retiran los implantes gravemente afectados por periimplantitis de forma atraumática, lo cual garantiza la conservación del lecho al 100% al no retirarse volumen óseo, y cuándo deben utilizarse las trefinas, pues las que se utilizan en el protocolo únicamente rompen la unión ósea de los primeros milímetros sin retirarlo. En el siguiente caso clínico mostramos el retratamiento de un caso de periimplantitis en el que se ha realizado una nueva rehabilitación implantosoportada (AU)


Periimplantitis is defined as the inflammatory and irreversible pathology that affects the peri-implantary bone and causes it to lose support and function to the implant as defined by the European Workshop on Periodontology (EWOP). The estimated prevalence of periimplantitis figures ranging from 28 to 77%. The different protocols for approaching periimplantitis offer different possibilities: detoxification of the surface and re-generation, mechanical cleaning and resection of inflamed tissue and extraction of the implant mainly. The main problem with regenerative treatments is to correctly clean and detoxify the surface of the exposed implant, since as these are generally highly rough surfaces, bacteria in the oral environment colonise them very easily and it is practically impossible to completely eliminate the biofilm. This treatment algorithm, in which implants severely affected by periimplantitis are removed atraumatically, guarantees the conservation of the bed at 100% since no bone volume is removed and trephines must be used, since those used in the protocol only break the bone union of the first few millimetres, without removing it. In the following clinical case, we show the re-treatment of a case of peri-implantitis where a new implant-supported rehabilitation has been performed (AU)


Subject(s)
Humans , Male , Aged , Osseointegration , Minimally Invasive Surgical Procedures/methods , Dental Implantation, Endosseous , Peri-Implantitis/therapy , Bone Regeneration , Algorithms , Clinical Protocols , Dental Prosthesis, Implant-Supported , Retreatment , Mouth Rehabilitation/methods
6.
Int. j. med. surg. sci. (Print) ; 7(4): 1-12, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1151807

ABSTRACT

Los implantes dentales son ampliamente usados para el reemplazo de piezas dentarias y se han convertido en el "gold standard" de las terapias protésicas en odontología. Dado el mayor uso de éstos, las investigaciones epidemiológicas recientes han demostrado elevadas tasas de prevalencia de enfermedad periimplantaria. En el presente estudio se presentan tres casos clínicos diagnosticados con periimplantitis. Todos los casos presentaron aumento de la profundidad al sondaje periimplantario en relación a controles anteriores, supuración, sangramiento al sondaje y pérdida ósea confirmada a través de tomografía computada cone beam. El tratamiento indicado para todos los casos fue una terapia conjunta entre un tratamiento mecánico mediante ultrasonido con la utilización de puntas plásticas (P.I EMS®, Suiza) y la terapia con láser. Para la laserterapia se utilizó un equipo de láser diodo de 940 nm (Biolase®, USA) con una potencia de 2 W en modo CW, utilizando una punta de 300 µm. El láser de diodo no daña la superficie de titanio y es capaz de descontaminar las superficies rugosas de los implantes. En este reporte, el uso de una terapia combinada mecánica y láser fue efectiva en todos los casos. En los controles clínicos, la mucosa periimplantaria no presentó signos de supuración ni sangramiento, y la profundidad al sondaje también se vió disminuída. El nivel óseo se controló a través de una tomografía computada cone beam y no se evidenciaron cambios significativos. En la actualidad, la evidencia clínica para el tratamiento periimplantario mediante la fototerapia todavía es limitada. Sin embargo, el láser ofrece un enfoque técnico novedoso que es completamente diferente de los instrumentos mecánicos y tiene varios efectos beneficiosos, por lo que puede desempeñar un papel importante, en la resolución de la peri-implantitis.


Dental implants are widely used for the replacement of teeth and have become the "gold standard" of prosthetic therapies in dentistry. Given the increased use of these, recent epidemiological investigations have shown high prevalence rates of peri-implant disease. In the present study, three clinical cases diagnosed with peri-implantitis are presented. All cases presented increased depth to peri-implant probing in relation to previous controls, suppuration, bleeding and bone loss confirmed by cone beam computed tomography. The treatment indicated for all cases was a joint therapy between a mechanical ultrasound treatment with the use of plastic tips (P.I EMS®, Switzerland) and laser therapy. For laser therapy, a 940 nm diode laser equipment was used (Biolase®, USA) with a power of 2W in continuous laser beam mode, using a 300 µm tip. The diode laser does not damage the titanium surface and is capable of decontaminating the rough surfaces of the implants. In this report, the use of a combined mechanical and laser therapy was effective in all cases. In clinical controls, the peri-implant mucosa did not show signs of suppuration or bleeding, and the depth on probing was decreased. The bone level was controlled through a cone beam computed tomography and no significant changes were evidenced. At present, the clinical evidence for peri-implant treatment using phototherapy is still limited. However, the laser offers a novel technical approach that is completely different from mechanical instruments and has several beneficial effects, so it can play an important role in the resolution of peri-implantitis.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Lasers, Semiconductor/therapeutic use , Peri-Implantitis/radiotherapy , Dental Implants
7.
Medisan ; 24(5) ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1135216

ABSTRACT

Se presenta una revisión sistemática de la bibliografía para esclarecer diferencias entre el conjunto de características microbiológicas de la periimplantitis y el de la periodontitis. De acuerdo a la declaración PRISMA, se realizaron búsquedas en bases de datos (PubMed, EBSCOhost, LILACS, Web Of Science y Clinical Key) y se seleccionaron artículos originales y revisiones sistemáticas donde se compararan o analizaran datos microbiológicos obtenidos de muestras de biopelículas subgingivales de pacientes con periodontitis y periimplantitis. El peso de la evidencia se evaluó por medio de las escalas de Newcastle-Ottawa y PRISMA. De los 335 artículos identificados, se incluyeron 12, de los cuales 9 fueron estudios observacionales y 3 revisiones sistemáticas. Se obtuvo que las características microbiológicas asociadas a la periimplantitis son similares a las de la periodontitis debido a que comparten un porcentaje de su microbiota, como es el caso de los agentes periodontopatógenos; sin embargo, se encontraron bacterias relacionadas únicamente al surco periimplantar. Finalmente, se destacó que en la periimplantitis figuran bacterias que en su mayoría son gramnegativas anaerobias, periodontopatógenas, oportunistas y no cultivables; es decir, que sus características microbiológicas resultan complejas y difieren de las específicas de la periodontitis.


A systematic literature review is presented to clarify differences between the group of microbiologic characteristics of peri-Implantitis and periodontitis. According to the PRISMA declaration, searches in databases were carried out (PubMed, EBSCOhost, LILACS, Web Of Science and Clinical Key) and original works and systematic reviews were selected where comparing or analyzing microbiologic data obtained from samples of subgingival biofilms of patients with periodontitis and peri-Implantitis. The weight of evidence was evaluated by means of the Newcastle-Ottawa and PRISMA scales. Of the 335 identified works, 12 were included, of which 9 were observational studies and 3 systematic reviews. It was obtained that the microbiologic characteristics associated with peri-Implantitis are similar to those of periodontitis because they share a percentage of their microbiota, as the case of the periodontopathogen agents; however, bacterias only related to the peri-implantar line were found. Finally, it is remarkable that in peri-Implantitis are bacterias that are mostly gramnegative anaerobias, periodontopathogens, opportunists and noncultivable; that is to say that their microbiologic characteristics are complex and differ from the specific characteristics of periodontitis.


Subject(s)
Periodontitis , Peri-Implantitis , Bacteria , Microbiota
9.
Braz. dent. j ; 31(4): 380-384, July-Aug. 2020. tab
Article in English | LILACS, BBO | ID: biblio-1132315

ABSTRACT

Abstract The purpose of this study was to compare biofilm formation on materials used for the fabrication of implant-supported dental prostheses. Twenty discs (D=15 mm, H=3 mm) were fabricated from one of the following restorative materials: yttria tetragonal zirconia polycrystal (Y-TZP); commercially pure titanium (CP-Ti); or heat-cured polymethyl methacrylate (PMMA). Specimens were polished following standard protocols. A non-contact profilometer (NPFLEX, Bruker, UK) was used to assess the surface roughness of each disk; results were reported as Ra (µm). Five strains of Gram-negative bacteria frequently associated with peri-implantitis, Aggregatibacter actinomycetemcomitans, Candida. albicans, Porphyromonas gingivalis, Prevotella intermedia, and Tannerella forsythia, were cultured on hand-polished discs fabricated from heat-cured PMMA, Y-TZP, or CP-Ti to compare biofilm formation on each type of material. The results were reported as colony-forming units per milliliter (CFU/mL). One-way ANOVA and post hoc tests were used to compare surface roughness and bacterial colonization on the respective materials. Statistical significance was set at a = 0.05. Discs fabricated from Y-TZP had a significantly higher Ra value (350 ± 30 µm) than either PMMA, or CP-Ti discs. Discs fabricated from either Y-TZP and CP-Ti may exhibit less colonization by bacteria associated with peri-mucositis and peri-implantitis. Y-TZP and CP-Ti are suggested materials for fabrication of implant-supported prostheses, considering biofilm formation.


Resumo O objetivo deste estudo foi comparar a formação de biofilme em materiais utilizados na confecção de próteses dentárias implantossuportadas. Vinte discos (D = 15 mm, H = 3 mm) foram confeccionados com um dos seguintes materiais restauradores: zircônia tetragonal policristalina estabilizada por ítrio (Y-TZP); titânio comercialmente puro (CP-Ti); ou polimetilmetacrilato (PMMA). As amostras foram polidas seguindo protocolos padrão. Um perfilômetro sem contato (NPFLEX, Bruker, UK) foi usado para avaliar a rugosidade da superfície de cada disco; os resultados foram relatados como Ra (µm). Cinco cepas de bactérias Gram-negativas freqüentemente associadas a peri-implantite, Aggregatibacter actinomycetemcomitans, Candida. albicans, Porphyromonas gingivalis, Prevotella intermedia e Tannerella forsythia, foram cultivadas em discos polidos à mão feitos de PMMA, Y-TZP ou CP-Ti para comparar a formação de biofilme em cada tipo de material. Os resultados foram relatados como unidades formadoras de colônias por mililitro (UFC/mL). Análise de variância a um fator e testes post hoc foram usados ​​para comparar a rugosidade da superfície e a colonização bacteriana nos respectivos materiais. A significância estatística foi estabelecida em a=0,05. Os discos feitos de Y-TZP tiveram um valor Ra significativamente mais alto (350 ± 30 µm) do que os discos de PMMA ou CP-Ti. Os discos fabricados com Y-TZP e CP-Ti podem apresentar menor colonização por bactérias associadas à perimucosite e peri-implantite. Considerando O Y-TZP e CP-Ti são materiais indicados para a confecção de próteses implantossuportadas, considerando a formação de biofilme


Subject(s)
Humans , Dental Implants , Peri-Implantitis , Surface Properties , Titanium , Biofilms
10.
Rev. cient. odontol ; 8(2): e023, mayo-ago. 2020. ilus
Article in Spanish | LIPECS, LILACS, LIPECS | ID: biblio-1119301

ABSTRACT

Los implantes dentales son un tipo más de tratamiento para la resolución de casos de edentulismo. Desde su inicio, en los años 70, han sido una alternativa creciente para rehabilitar pacientes, sobre todo en casos en los que las rehabilitaciones convencionales no eran posibles. Cada vez de forma más frecuente nos enfrentamos a retratamientos de implantes y casos con atrofias más complejas. En el siguiente caso, mostramos un retratamiento de implantes fracasados unido a una situación de atrofia extrema vertical y horizontal combinada. En casos de atrofia severa maxilar y mandibular, el uso de los implantes cortos puede acortar los tiempos de tratamiento y simplificar las técnicas quirúrgicas sin renunciar a la predictibilidad como en el caso mostrado. (AU)


Dental implants are an alternative treatment for extended the resolution of cases of edentulism. Since its inception in the year 70 have been a growing alternative to rehabilitate patients, especially in cases where conventional rehabilitations were not possible. Every time, in the dental office were more often we re-treatments of implants and cases with more complex atrophies. In the following case we show a re-treatment of failed implants attached to a situation of extreme atrophy combined vertical and horizontal. In cases of severe maxillary and mandibular atrophy, the use of short implants can shorten treatment times and simplify surgical techniques without sacrificing predictability as in the case shown. (AU)


Subject(s)
Humans , Female , Aged , Bone Diseases/therapy , Dental Implants , Retreatment , Peri-Implantitis/therapy
13.
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
17.
Braz. dent. j ; 31(1): 63-68, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089266

ABSTRACT

Abstract The present study evaluated polymorphisms in RANK, RANKL and OPG-encoding genes to assess whether they are associated with mucositis and peri-implantitis in a population from the Brazilian Amazon region. One hundred and fourteen patients with dental implants were included in the study. After clinical and radiographic examination, the sample was categorized into 4 groups, according to the peri-implant status: Healthy (n=71), Mucositis (n=30), Peri-implantitis (n=13) and Diseased (Mucositis + Peri-implantitis, n=43). Genomic DNA was extracted from buccal cells from saliva, and the genetic polymorphism in osteoprotegerin (OPG), Kappa nuclear factor activator receptor (RANKL) and nuclear kappa factor activator receptor (RANK) were genotyped by the real time PCR. Univariate and multivariate statistical analyses were performed to compare clinical variables among groups and to evaluate genotypes and alleles distributions and the established alpha was 5%. Age, peri-implant biotype, diabetes and presence of peri-implant biofilm were associated with mucositis (p<0.05) and peri-implantitis (p<0.05). Smoking, alcoholism, and periodontal biofilms were also associated with the presence of peri-implantitis (p<0.05). Univariate and multivariate analysis did not demonstrate an association of peri-implantitis or mucositis with any genetic polymorphism in RANK (rs3826620), RANKL (rs9594738) and OPG (rs2073618) (p>0.05). The studied genetic polymorphism in RANK, RANKL and OPG were not associated with mucositis and peri-implantitis in a Brazilian population from the Amazon region.


Resumo O presente estudo avaliou a associação da predisposição clínica e dos fatores genéticos com a presença de doenças peri-implantares. Cento e quatorze pacientes com implantes dentais instalados na Clínica de Especialização do Amazonas, Brazil, foram incluidos no estudo. Após exame clínico e radiográfico, a amostra foi categorizada em 4 grupos, de acordo com o Status peri-implantar: saúde (n=71), mucosite (n=30), peri-implantite (n=13) e doentes (mucosite + peri-implantite). DNA genômico foi extraído de células orais da saliva, e o polimorfismo genético em osteoprotegerina (OPG), ligante do receptor ativador do fator Kappa nuclear (RANKL) e receptor ativador do fator Kappa nuclear (RANK) foram genotipados por PCR em tempo real. O estudo se propôs a avaliar se os polimorfismos em RANK, RANKL e OPG estão envolvidos na patogênese da mucosite e da peri-implantite, e avaliar também a presença de fatores de risco moduladores da resposta em uma população brasileira. Idade, biotipo peri-implantar, diabetes e presença de biofilme peri-implantar foram associados a mucosite (p<0.05) e peri-implantite (p<0.05). Tabagismo, alcoolismo e biofilme periodontal também foram associados com a presença de peri-implantite (p<0.05). Análise univariada e multivariada não demonstraram associação de peri-implantite ou mucosite com os polimorfismos genéticos em RANK (rs3826620), RANKL (rs9594738) e OPG (rs2073618) (p>0.05). Os polimorfismos genéticos estudados não foram associados com mucosite e peri-implantite em uma população brasileira da região Amazônica.


Subject(s)
Humans , Dental Implants , RANK Ligand/genetics , Receptor Activator of Nuclear Factor-kappa B/genetics , Osteoprotegerin/genetics , Peri-Implantitis , Polymorphism, Genetic , Brazil , Mouth Mucosa
18.
Rev. odontol. UNESP (Online) ; 49: e20200075, 2020. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1251980

ABSTRACT

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


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


Subject(s)
In Vitro Techniques , Chlorhexidine , Decontamination , Dental Implantation , Chemical Phenomena , Peri-Implantitis , Oxygen , Titanium , Escherichia coli
19.
Periodontia ; 30(3): 87-93, 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1129297

ABSTRACT

The so-called "blunt" or flapless surgery is considered less traumatic or invasive. However, as there is a need for rupture of the epithelial tissue performed by surgical drills or other means, the term is conceptually incorrect and known as marketing. The objective of the present study is to discuss the technique in the so - called blunt surgeries considered by the Federal Council of Dentistry (CFO) as an irregular or misleading advertisement, even when preceded by tomographic planning and performed by means of surgical guides. Furthermore, the lack of bone limits this type of surgery, in which case conventional surgery with mucoperiosteal flap elevation is indicated. As a consensus, is there a significant increase in apical lesions in implants related to this technique? (AU)


A cirurgia denominada "sem corte" ou flapless é considerada menos traumática ou invasiva. Entretanto como há necessidade de ruptura do tecido epitelial realizada por brocas cirúrgicas ou outros meios, o termo é conceitualmente incorreto e sabidamente utilizado como marketing. O objetivo do presente trabalho é discutir a técnica nas cirurgias ditas sem corte, considerada pelo Conselho Federal de Odontologia - CFO, como propaganda irregular ou enganosa, mesmo quando precedidas por um planejamento tomográfico e realizadas por meio de guias cirúrgicos. Além do mais, a falta de osso limita esse tipo de cirurgia, sendo nesse caso indicada uma cirurgia convencional com elevação de retalho mucoperiosteo. Como consenso, estaria o aumento significativo de lesões apicais nos implantes relacionados com esta técnica? (AU)


Subject(s)
Humans , Male , Female , Adult , Surgery, Oral , Bone and Bones , Epithelium , Peri-Implantitis , Surgical Wound
20.
Article in English | WPRIM | ID: wpr-811434

ABSTRACT

PURPOSE: The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations.MATERIALS AND METHODS: A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany.RESULTS: An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option.CONCLUSION: Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.


Subject(s)
Cohort Studies , Crowns , Dental Implants , Dental Offices , Dentistry , Dentists , Dentures , Education , Germany , Humans , Peri-Implantitis , Prostheses and Implants
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