Aspectos relevantes em implantes imediatos pós-exodonticos em área estética / Relevant aspects in esthetic outcomes of immediate implant placement following extraction

O objetivo deste artigo é apresentar um protocolo de tratamento de implantes imediatos de excelente previsibilidade estética e biológica. O caso clínico em questão apresenta comprometimento do elemento 21, que após o exame clínico e complementar constatou a fratura radicular irreparável. O planejamento foi a exodontia da raiz fraturada e instalação de implante imediato com provisionalização imediata, associando biomaterial para preenchimento do gap e enxerto conjunto na vestibular. Para restauração final foram confeccionadas uma coroa zircocerâmica como restauração definitiva do elemento 21 e uma microlâmina em dissilicato de lítio (IPS e.max) no dente 11 para harmonizar contorno e proporção entre os incisivos. O resultado final obtido mostrou-se favorável no follow-up de 1 ano, tanto nos aspectos biológicos dos tecidos peri-implantares e quanto à estética final. Com isso, concluímos que o protocolo adotado mostrou excelente previsibilidade.

The aim of this paper is to present a treatment protocol for excellent aesthetic and biological predictability with immediate implant. In the reported clinical case, the element 21 was compromised with irreparable root fracture. The planning was the extraction of the fractured root and immediate implant placement with immediate temporization, associating biomaterial for gap filling and conjunctive tissue graft. for the final restoration were made a zirco-ceramic crown in the element 21, and a lithium disilicate veneer (IPS e.max) in tooth 11 to harmonize contour and ratio between the incisors. The final result was favorable along the 1 year follow-up for both biological aspects of peri-implant tissues and final aesthetic. Thus, it could be concluded that the adopted protocol showed great predictability.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants

PURPOSE: In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS: Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous(R); Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30degrees in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS: Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION: Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

In-vitro development of a temporal abutment screw to protect osseointegration in immediate loaded implants

PURPOSE: In this study, a temporal abutment fixation screw, designed to fracture in a controlled way upon application of an occlusal force sufficient to produce critical micromotion was developed. The purpose of the screw was to protect the osseointegration of immediate loaded single implants. MATERIALS AND METHODS: Seven different screw prototypes were examined by fixing titanium abutments to 112 Mozo-Grau external hexagon implants (MG Osseous(R); Mozo-Grau, S.A., Valladolid, Spain). Fracture strength was tested at 30degrees in two subgroups per screw: one under dynamic loading and the other without prior dynamic loading. Dynamic loading was performed in a single-axis chewing simulator using 150,000 load cycles at 50 N. After normal distribution of obtained data was verified by Kolmogorov-Smirnov test, fracture resistance between samples submitted and not submitted to dynamic loading was compared by the use of Student's t-test. Comparison of fracture resistance among different screw designs was performed by the use of one-way analysis of variance. Confidence interval was set at 95%. RESULTS: Fractures occurred in all screws, allowing easy retrieval. Screw Prototypes 2, 5 and 6 failed during dynamic loading and exhibited statistically significant differences from the other prototypes. CONCLUSION: Prototypes 2, 5 and 6 may offer a useful protective mechanism during occlusal overload in immediate loaded implants.

Loosening torque of Universal Abutment screws after cyclic loading: influence of tightening technique and screw coating

PURPOSE: The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS: Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at 106 cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS: The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION: The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.

Mini-implante dentário como alternativa terapêutica para resolução de agenesia de incisivo lateral com cirurgia flapless e provisionalização imediata: relato de caso com 84 meses de acompanhamento / Mini dental implant as an alternative therapy for lateral incisor agenesis with flapless surgery and immediate provisionalization a case report with 84 months of follow-up

O presente estudo apresenta um caso de paciente do gênero masculino, 18 anos de idade, com agenesia do elemento 12, que optou pela utilização de um mini-implante associado à técnica de cirurgia sem retalho e realização de provisionalização imediata. Foi realizado acompanhamento clínico semanal no primeiro mês pós-implantação, não tendo sido observada qualquer complicação, assim como nos controles mensais seguintes, demonstrando sucesso nos resultados estéticos e funcionais. Após seis meses, a reabilitação protética foi finalizada com uma coroa In-Ceram e reabilitação cosmética do sorriso. O presente caso ressalta a importância do correto planejamento protético-cirúrgico, a experiência do profissional e os acompanhamentos clínicos de longo prazo

This case report illustrates a 18 years-old male patient with agenesis of tooth 22 receiving a mini dental implant with flapless surgery and immediate provisionalization. Postoperative control was performed every week in the first month and monthly thereafter demonstrating esthetic and functional success. Six months later, an In-Ceram crown was delivered for cosmetic smile design. This case highlights the importance of adequate surgical and prosthetic procedures, professional experience, and long-term clinical follow-ups.

Ridge Augmentation Using Block Type of Autogenous Tooth Bone Graft Material in Severe Alveolar Bone Resorption of Single Tooth: Case Report

Masticatory function following implants replacing a second molar

PURPOSE: The aim of this study was to obtain objective and standardized information on masticatory function and patient satisfaction following second molar single implant therapy. METHODS: Twenty adult patients, who had restored second molar single implants more than 1 month before the study, were enrolled in this study. All patients received a chewing test using peanuts before and after insertion of the implant prosthesis, with a questionnaire and visual analogue scale (VAS) to evaluate the effect of second molar single implant therapy. RESULTS: This study obtained standardized information on the masticatory function objectively (e.g., P, R, X50) before (Pre-insertion) and after insertion (Post-insertion) of the implant prosthesis. Masticatory performance (P) after insertion of the implant prosthesis significantly increased from 67.8+/-9.9 to 84.3+/-8.5% (P<0.0001). With the implant prosthesis, the P value increased by 24%. The masticatory efficiency index (R) of Post-insertion is higher than that of Pre-insertion (P<0.0001). With the implant prosthesis, the R value increased by 29%. The median particle size (X50) of Post-insertion is lower than that of Pre-insertion (P<0.0001). More than 90% of the patients were satisfied with the second molar single implant therapy from a functional point of view. CONCLUSIONS: These findings indicate that a second molar single implant can increase masticatory function.