The Scalloped Surgical Guide as an Alternative to Flat Bone Reduction Guide in Full-Arch Implant Restoration.

The goal of this clinical report was to present an alternative to traditional flat bone reduction guides, using a custom-designed 3-dimensional (3D)-printed guide according to the future gingival margin of the planned dentition. A 61-year-old woman with concerns regarding her smile appearance was presented. The initial examination revealed excessive gingival show accompanied by excessive overjet. The dentition was in a failing situation. The proposed treatment plan, relying on the sufficient amount of bone and keratinized tissue, consisted of recontouring of the alveolar ridge and gingiva and placement of 6 implants and an FP-1 prosthesis after extraction of all remaining maxillary teeth. Digital smile design was completed, and a fully digitally guided surgery was planned. This consisted of using 3 surgical guides, starting with the fixation pin guide, continuing with the scalloped hard- and soft-tissue reduction guide, and finally the implant placement template. Following the surgery, the patient received a temporary restoration, and on the 4-month follow-up, a new polymethyl meta-acrylate temporary prosthesis was delivered. The patient's 7-month follow-up is presented in the article. The report of this triple-template guided surgery indicated that digital 3D planning is a considerably predictable tool to properly establish and evaluate future occlusal plane, smile line, and lip support. Scalloped guides seem to be an excellent alternative to conventional bone reduction guides since they require less bone removal and improve patient comfort during surgery.

Assessment of quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis

Aim: Tooth loss is very prevalent in Brazil, reflecting high demand for dental services, especially those related to oral rehabilitation. This study aimed to assess the quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis. Methods: Thirty-two patients were evaluated before and after rehabilitation with dental implants and fixed prosthesis using the OHIP-14 questionnaire and the Visual Analogue Scale (VAS) after 6 months follow-up. Results:OHIP-14 revealed a significant improvement after treatment in all seven parameters and in the global score (P < 0.001). VAS presented positive results related to patient satisfaction regarding oral rehabilitation, except for the hygiene of the fixed dentures. Conclusion: At the end of this study, OHIP-14 scores decreased by 50% in most of the questions raised, and VAS presented positive results, except for hygiene of the fixed dentures, presenting an improvement in the quality of life of total edentulous patients after rehabilitation with implants and fixed prosthesis

In-Block Lateralization as a New Technique for Mobilization of the Inferior Alveolar Nerve: A Technique Case Series.

The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 3 years to 5 years and 3 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces), and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN and safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.

A influência do eugenol na microdureza de duas resinas compostas comerciais / The influence of eugenol on the microhardness of two commercial composite resins

Objetivo: avaliar, in vitro, a dureza superficial e profunda de dois tipos diferentes de resina composta, quandoem contato com o cimento de óxido de zinco e eugenol (IRM®). Métodos: foram selecionadas as resinasCharisma® e Vittra® e confeccionados 80 corpos de prova, sendo 40 para cada marca de compósito, queforam divididos em oito grupos (n=10) conforme o contato (imediato, 7 dias, 14 dias) ou não (grupo controle)com o eugenol. Colocou-se num pote dappen uma porção de IRM e um espécime de resina pronto, que,após a presa do material restaurador temporário e a remoção do exemplar colocado, gerou o molde pararealização das amostras em contato com o eugenol, sendo armazenado em água em temperatura ambiente,para os subgrupos 7 e 14 dias. Em sequência, foi inserido um único incremento de resina composta e polimerizadopor 40 segundos, gerando os espécimes que foram armazenados em local seco para serem submetidosao teste de microdureza Vickers sob uma carga de 300 gramas, com tempo de penetração de 10 segundos.Os dados obtidos foram analisados pelo teste ANOVA, a um nível de significância de p<0,05. Resultados:somente o grupo da resina Charisma® que teve contato imediato com eugenol não atingiu 80% de durezaprofunda em relação à superficial. Entretanto, para todos os grupos analisados, tanto a dureza superficialquanto a profunda aumentaram após o contato com o eugenol em relação ao grupo controle. Conclusão: oeugenol não influenciou negativamente a dureza das resinas compostas.(AU)

Objective: to evaluate, in vitro, the superficial and deep hardness of two different types of composite resin when in contact with zinc oxide eugenol cement (IRM). Method: Charisma® and Vittra® resins were selected and 80 specimens were made, 40 for each composite brand that were divided into eight groups (n = 10) according to contact (immediate, 7 days, 14 days) or no (control group) with eugenol. A portion of IRM and a ready-made resin specimen were placed in a dappen pot, which after setting the temporary restorative material and removing the placed specimen, generated the template for making the samples in contact with eugenol, being stored in water in room temperature for subgroups 7 and 14 days. In sequence, a single increment of composite was inserted and polymerized resin for 40 seconds, generating specimens that were stored in a dry place to be submitted to the Vickers microhardness test under a load of 300 grams, with a penetration time of 10 seconds. The data obtained were analyzed by the ANOVA test, at a significance level of p <0.05. Results: only the Charisma® resin group that had immediate contact with eugenol did not reach 80% deep hardness in relation to superficial hardness. However, for all groups analyzed, both superficial and deep hardness increased after contact with eugenol compared to the control group. Conclusion: eugenol did not negatively influence the hardness of composite resins.(AU)

Assessment of Adhesion and Proliferation of Bone Marrow Mesenchymal Stem Cells in Polymer Matrices with rhGH.

PURPOSE: Biomaterials, as an alternative to autogenous bone and other biologic tissues, have been widely used in oral and maxillofacial surgery. In this context, a biomaterial that functions as a scaffold (osteoconductor), combined with a growth factor (osteoinductor), would be of great interest for clinical application. Biodegradable polymers used for slow drug release have been investigated, demonstrating good results and interesting potential. Growth hormone (GH) may be released by incorporating it into these polymers. This study aimed to evaluate cell adhesion and proliferation of a polymeric biomaterial for slow release of recombinant human GH (rhGH). MATERIALS AND METHODS: Poly(lactic-co-glycolic acid) (PLGA) and PLGA/polycaprolactone (PCL) (at a 70/30 ratio of PLGA to PCL) matrices were prepared by the solvent evaporation method, combined or not with GH. Biomaterials were tested for cell adhesion and proliferation by culture in mesenchymal stem cells derived from Wistar rat bone marrow, 4',6-diamidino-2-phenylindole (DAPI) staining, and subsequent cell counting, in addition to scanning electron microscopy. Cell adhesion and proliferation was assessed at 24 and 72 hours of biomaterial exposure to culture medium. RESULTS: All tested polymers exhibited cell adhesion and proliferation. However, PLGA-based biomaterials, especially when combined with GH, showed greater cell proliferation when the difference in growth from 24 to 72 hours was evaluated. GH appeared to modify the polymer surface, with increased roughness and microporosity. This feature was more evident in the PLGA + GH combination. CONCLUSION: The biomaterials tested showed pronounced cell adhesion in all test groups, and GH appeared to contribute to the increase in cell proliferation, especially when combined with PLGA as compared with pure PLGA. Further studies are required to clarify this potential for development of new biomaterials.

Morphological and histomorphometric evaluation of autogenous bone graft resorption in rabbits treated with alendronate sodium / Avaliação morfológica e histomorfométrica da reabsorção de enxertos ósseos autógenos em coelhos usuários de alendronato de sódio

Introduction: Different rates of resorption are mediated by osteoclasts that may be affected by bisphosphonates during bone graft repair. Bisphosphonates are drugs that act as inhibitors of bone resorption. Objective:The aim of the present study was to evaluate the rate of resorption of skullcap grafts in rabbits with and without the use of alendronate sodium. Material and method: Thirty two New Zealand rabbits were divided into two groups (control group and alendronate group) and divided again into four periods (7, 14, 30 and 60 days). The control group did not receive alendronate, while animals of the experimental group received 4 mg of alendronate sodium weekly after the surgery. An 8 mm diameter bone block was removed from the parietal bone and fixed by screws to the contralateral parietal bone. During the periods of 7, 14, 30 and 60 days, the animals had undergone euthanasia and samples were removed for further analysis. Morphological and histomorphometric tests were used to compare graft thicknesses and to evaluate the newly formed bone at the interface between the graft and receptor site. The Wilcoxon and Mann-Whitney tests were used for statistical analyses. Result: All grafts healed and integrated uneventfully and no statistically significant differences in resorption rates or bone deposition were detected after the final incorporation of the graft in both groups. Conclusion: Alendronate Sodium did not decrease the bone graft resorption rates, but there was a tendency for better results in the control group regarding the resorption and neoformation in autogenous calvarial bone grafts in rabbits.

Introdução: Durante o reparo de enxertos ósseos, diferentes taxas de reabsorção são mediadas pelos osteoclastos e podem ser afetadas pelos bisfosfonatos, que são drogas que agem como inibidores da reabsorção óssea. Objetivo: Avaliar a taxa de reabsorção dos enxertos ósseos de calota craniana de coelhos, com e sem o uso alendronato de sódio. Material e método: Trinta e dois coelhos Nova Zelândia foram divididos igualmente em 2 grupos (grupo controle e grupo alendronato de sódio) e subdivididos em 4 períodos (7, 14, 30 e 60 dias). O grupo controle não recebeu alendronato, enquanto os animais do grupo experimental receberam 4 mg de alendronato de sódio por semana, em dose única, após a cirurgia. Um bloco de osso de diâmetro de 8 mm foi retirado o osso parietal e fixado com parafuso no osso parietal contralateral. Após cirurgia, nos períodos de 7, 14, 30 e 60 dias, os animais foram eutanasiados e as peças removidas para análise. Análises morfológica e histomorfométrica foram utilizados para comparar a espessura do enxerto e para avaliar a interface de osso recém formado entre o enxerto ósseo e o sítio receptor. Os testes de Wilcoxon e Mann-Whitney foram utilizados para as análises estatísticas. Resultado: Todos os enxertos repararam e integraram sem intercorrências; não foram detectadas diferenças estatisticamente significativas nas taxas de reabsorção ou deposição óssea, após a incorporação final do enxerto em ambos os grupos. Conclusão: Alendronato de sódio parece não diminuir a taxa de reabsorção, porém houve uma tendência de resultados melhores no grupo controle tanto na reabsorção quanto na neoformação óssea em enxertos ósseos autógenos de calota craniana de coelhos.

Treatment of lip hemangioma using forced dehydration with induced photocoagulation via diode laser: report of three cases.

Several vascular lesions are related to the lip area. There is no universally accepted protocol for the treatment of hemangiomas and vascular malformations. In the oral cavity, high-power lasers represent an excellent therapeutic option for this type of lesion. Their coagulative properties allow for the performance of procedures without the risk of bleeding, which promotes a better healing pattern and a differentiated postoperative appearance. This study describes three cases of lip hemangioma treated with forced dehydration with induced photocoagulation (FDIP) via diode laser. All the reported cases were followed up until complete healing of the operated area had total remission of lesions, with no complications or adverse effects. The findings of the present study suggest that FDIP is effective and useful in the treatment of hemangiomas in the oral cavity. Laser treatment of these lesions prevents their recurrence and is well tolerated by patients.

Hormônio do crescimento humano e a perspectiva futura em Odontologia / Human growth hormone and the future perspective in Dentistry

Objetivo: este trabalho busca demonstrar, a partir de uma revisão da literatura, as possibilidades de utilização do hormônio de crescimento (GH) em tratamentos e procedimentos na área das ciências da saúde, e as perspectivas na Odontologia. Revisão de literatura: reconstruções ósseas são frequentes na rotina de cirurgias bucomaxilofaciais, indicadas em traumas de face, patologias, cirurgia ortognática e implantodontia. Biomateriais osteoindutores apresentam benefícios na realização de enxertos ósseos, devido à menor morbidade, à grande disponibilidade e à quantidade de materiais, além de maior aceitação pelo paciente. Os fatores de crescimento podem surgir como uma alternativa interessante na reconstrução de tecidos, destacando-se o GH, o qual é um regulador do crescimento e responsável pelo remodelamento ósseo, que tem um papel fundamental, exercendo efeito sobre os condrócitos, osteoclastos e osteoblastos. Atua, também, como um fator de crescimento produzido localmente, sendo secretado por diversos tipos de células. Na literatura, encontrou-se o uso de GH relacionado a reparo de fraturas ósseas, implantes dentários, regeneração óssea guiada, tratamento de nanismo de mulibrey, enxertos ósseos com biomateriais, reparo de feridas, preservação de alvéolo e em ATM. Considerações finais: os biomateriais estão presentes nas mais diversas reconstruções ósseas em Odontologia. Substitutos ósseos de diferentes origens são utilizados em grande volume na prática cirúrgica. O GH parece ser, em um futuro próximo, um importante contribuinte na evolução desse conceito. Dessa forma, pesquisas e testes de associação com outros biomateriais com características osteocondutoras, são de grande interesse para a área da Odontologia.

Superfície em Implantodontia: características dos principais implantes brasileiros / Surfaces in implantology: characteristics of the main brazilian implants

Atualmente, há consenso sobre a superioridade dos implantes com tratamento de superfície em relação aos usinados. Decorrentes disso, diferentes métodos de tratamento têm sido criados para potencializar as respostas teciduais. Objetivo / Realizar uma avaliação crítica do que algumas das empresas brasileiras informam aos profissionais, sobre as características do tratamento de superfície, métodos utilizados e tempo de espera recomendando, e se essas importantes questões apresentam embasamento científico. / Métodos / As empresas brasileiras Conexão, Kopp, Neodent, P-I Brånemark, S.I.N. e Titaniumfix receberam um questionário com perguntas sobre tratamento de superfície, tempo de espera recomendado e evidência científica a respeito dos seus produtos. / Resultados / Diferentes métodos de tratamento foram citados, sendo eles ataque ácido, jateamento seguido de ataque ácido e PIII (Plasma Immersion Ion Implantation). Segundo as informações recebidas, o tempo de espera recomendado variou de um a seis meses. / Conclusões / Apesar de algumas empresas realizarem trabalhos científicos com seus implantes, constata-se, com o presente estudo, carência de evidência científica norteando os protocolos de carga recomendados e falta de esclarecimentos precisos

The superiority of implants with a roughened surface over machined implants seems to be consensual today. Different surface treatment methods have been developed to improve potential tissue response. This study critically reviewed the information that some Brazilian companies provide to dentists about the characteristics of surface treatment and the methods used, as well as the recommended loading time, and analyzed whether these important data are based on scientific findings.

Ancoragem rígida com mini-implantes em Ortodontia: uma revisão dos principais conceitos / Rigid anchorage with mini-implants in Orthodontics: a review of the main concepts

O objetivo desse estudo foi realizar uma revisão dos principais conceitos de ancoragem rígida em Ortodontia, com uma abordagem mais detalhada sobre os mini-implantes. Foram discutidos: desenho, comprimento e diâmetro dos mesmos; técnica cirúrgica; principais sítios de instalação e suas indicações; tempo de espera e complicações. Acreditamos que a utilização dos mini-implantes pode contribuir de forma bastante significativa no tratamento ortodôntico, facilitando e acelerando o mesmo.

The aim of this work was to review the main concepts in rigid anchorage in Orthodontics, focusing in mini-implants. The mini-implants design, length and diameter, surgical technics, most common sites for mini-implants installation and its indications, time for activation and complications was discussed. The authors believe that using mini-implants could significantly contribute in orthodontic treatment, facilitating and accelerating the results.