ABSTRACT
BACKGROUND: Implant-bone block segment repositioning may be an option of treatment for patients with vertical alveolar bone atrophy. PURPOSE: To assess implant-bone block movement, gingival outcome and the subjective appreciation of patients after an alternative treatment of an implant-bone block segment repositioning in the maxillary esthetic region. MATERIALS AND METHODS: Patients who underwent implant-bone block segment relocation in areas of vertical alveolar bone atrophy in the anterior esthetic region were assessed. The outcome measures were implant failure, complications after initial loading, vertical bone augmentation, papilla index, width of the keratinized mucosa, and patient satisfaction. RESULTS: Twenty-five implants in nine consecutive patients were included in this study. During the follow-up period, only one implant failed. Vertical bone augmentation ranged from 3.0 to 8.4 mm (mean 4.9 mm). A significant improvement (P < .001) in the papilla index was observed, improving the esthetic outcome. Six patients (66.6%) had more than 2 mm of keratinized mucosa and all of the patients were satisfied with the treatment. CONCLUSIONS: The esthetics and functional gingival outcome of oral rehabilitation in areas with vertical alveolar bone atrophy can be successfully improved with the presented technique, which had a high overall implant survival rate within a short period.
Subject(s)
Alveolar Bone Loss/surgery , Dental Implantation, Endosseous/methods , Dental Implants , Osteotomy/methods , Adult , Esthetics, Dental , Female , Humans , Male , Maxilla/surgery , Middle Aged , Retrospective StudiesABSTRACT
Objetivo: avaliar pela análise microbiológica in vitro a capacidade de selamento bacteriano de dois modelos de implante conexão cone-morse e hexágono externo. Material e métodos: foram utilizados 28 implantes osseointegráveis (Colosso Emfils Itu/SP, Brasil) divididos em dois grupos (14 implantes cada), nos quais os componentes protéticos foram parafusados com um torque de 20 Ncm, em um ambiente controlado e após contaminação propositada da parte interna dos implantes por Escherichia coli. As colônias bacterianas foram transportadas por meio de hastes confeccionadas por fios ortodônticos, previamente esterilizadas, e então fixados seus respectivos pilares protéticos. Em seguida, um microbrush umedecido em solução salina a 0,9% estéril foi levemente friccionado na interface da superfície externa implante/conector protético. Cada conjunto implante/componente protético foi imerso em um tubo de ensaio contendo 5 ml de caldo BHI, permanecendo imerso no meio de cultura. As amostras foram monitoradas em relação ao crescimento bacteriano. Resultados: após 14 dias, verificou-se que não houve contaminação em nenhum dos tipos de conexões. Conclusão: a utilização desses implantes já evitaria a contaminação bacteriana nos primeiros dias após a carga imediata, determinando assim o aumento do índice de sucesso desse procedimento.
Objective: to evaluate by in vitro microbiological analysis the bacterial sealing ability of two implant models (Morse cone and external hexagon connections). Material and methods: Twentyeight dental implants (Colosso Emfi ls Itu/SP, Brazil) were divided into two groups (14 implants each) and the prosthetic components screwed with a 20 Ncm torque in a controlled environment and after deliberate contamination of the internal part of the implants by Escherichia coli. The bacterium strain was transported by orthodontic wire loops previously sterilized and then the prosthetic abutments were fastened. After, a microbrush moistened with a 0.9% saline sterile solution was lightly rubbed into the external implant/ prosthetic abutment surface. Each implant/prosthetic assembly was immersed in a test tube containing 5 ml of BHI broth remaining immersed in the culture medium. Samples were monitored for bacterial growth. Results: after 14 days, no contamination was observed in any of the implant connections. Conclusion: the use of these implants would already prevent bacterial contamination in the first days after immediate loading, thus increasing the success rate of this procedure.
Subject(s)
Humans , Environmental Pollution/prevention & control , Dental Implants , Escherichia coli , In Vitro Techniques , Microbiological Techniques/methodsABSTRACT
An alternative technique to reconstruct atrophic alveolar vertical bone after implant placement is presented. The technique consists of distraction osteogenesis or direct surgical repositioning of an implant-and-bone block segment after segmental osteotomies that can be used in esthetic or unesthetic cases. Initially, casts indicating the implant position are obtained and the future ideal prosthetic position is determined to guide the model surgery. After the model surgery, a new provisional prosthesis is fabricated, and an occlusal splint, which is used as a surgical guide and a device for distraction osteogenesis, is custom fabricated. Then, the surgery is performed. For mobilization of the implant-and-bone block segment, 2 vertical osteotomies are performed and then joined by a horizontal osteotomy. The implant-and-bone block segment is moved to the planned position. If a small movement is planned, then the implant-and-bone segment is stabilized; for larger movements, the implant-and-bone segment can be gradually moved to the final position by distraction osteogenesis. This technique has good predictability of the final position of the implant-and-bone segment and relatively fast esthetic rehabilitation. It can be considered for dental implants in regions of vertical bone atrophy.
Subject(s)
Alveolar Ridge Augmentation/methods , Dental Implantation/methods , Maxilla/surgery , Osteogenesis, Distraction/methods , HumansABSTRACT
Although pharmacologic treatments for central giant cell lesions have gained much emphasis, these treatment modalities do not always have successful outcomes, and surgical treatment may be necessary. The purpose of the present study was to report a case of aggressive central giant cell lesion initially treated by nonsurgical methods without satisfactory results, necessitating segmental mandibular resection for definitive treatment and oral rehabilitation. A 20-year-old woman was diagnosed with an aggressive central giant cell lesion in the mandible. The patient was first treated with intralesional corticosteroid injections. Subsequently, the lesion increased in size. Therefore, a second pharmacologic treatment was proposed with salmon calcitonin nasal spray, but no signs of a treatment response were noted. Because of the lack of response, surgical excision was performed, and a mandibular reconstruction plate was installed. At 12 months after surgical resection, the patient underwent mandibular reconstruction with bone grafts. After 6 months, 7 dental implants were installed, and fixed prostheses were made. After installation of the prostheses, the patient experienced persistent mandibular laterognathism, and a mandibular orthognathic surgery was performed to correct the laterognathia. The follow-up examination 4 years after orthognathic surgery showed no signs of recurrence and good facial symmetry.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Granuloma, Giant Cell/surgery , Mandibular Diseases/surgery , Orthognathic Surgical Procedures/methods , Combined Modality Therapy , Female , Granuloma, Giant Cell/drug therapy , Granuloma, Giant Cell/rehabilitation , Humans , Mandibular Diseases/drug therapy , Mandibular Diseases/rehabilitation , Mandibular Reconstruction/methods , Young AdultABSTRACT
Lesão de furca refere-se ao envolvimento patológico da região de bi ou trifurcação dos dentes posteriores, caracterizada pela perda de inserção periodontal no interior desta estrutura. O diagnóstico é obtido através da sondagem periodontal nos sentidos vertical e horizontal, podendo ser auxiliado pela imagem radiográfica da região. A presença de lesões de furca em paciente portador de doença periodontal, poderáinfluenciar o plano de tratamento e prognóstico do caso. Esse trabalho tem por objetivo apresentar dois casos clínicos de envolvimento de furca Grau III mesio-distal do primeiro molar superior, onde o tratamento indicado foi a amputação da raiz palatina, e discutir a literatura.
Subject(s)
Furcation Defects , Molar/surgery , Periodontal DiseasesABSTRACT
Com o advento dos implantes osseointegrados e sua aceitaçäo por parte da Odontologia,novas técnicas e novos materiais têm marcado muitos avanços na clínica protética. Inicialmente, as pesquisas realizadas por Bränemark foram direcionadas à fixaçäo de implantes osseointegrados para tratamento protético de pacientes desdentados totais, mas, diante dos índices de sucesso da técnica, desenvolveu-se a possibilidade de tratar pacientes parcialmente desdentados, abrindo-se um panorama mais amplo no campo da reabilitaçäo bucal. Neste trabalho, é apresentado um estudo das próteses sobre implantes osseointegrados, através da revisäo literária das publicaçöes dos últimos anos, no que se refere ao prognóstico desse método de tratamento em pacientes total ou parcialmente desdentados
