Survival of osseointegrated implants: a 10-year retrospective study.

Introduction: New techniques, surgical protocols, dental implant designs, and prosthetic rehabilitation have been used in dentistry, most of which have yielded good results in the literature. This retrospective survey assessed the clinical results of patients rehabilitated with dental implants between January 2011 and December 2021. Load protocols (immediate and conventional), types of connections of the installed implants, external hexagon (EH), and cone morse (MC) were evaluated. Material and methods: Two evaluators were selected and calibrated to perform the analyses. The inclusion criteria were records with complete and legible information of patients rehabilitated with dental implants who were followed for at least 1 year after rehabilita-tion. The medical records were divided into two groups, G1 (implants with conventional load) and G2 (implants with immediate load), and further subdivided according to implant type. Information about the rehabilitation failures was noted and descriptive statistics of the results were obtained. Results: Among the 432 evaluated medical records of patients rehabilitated with implants, the study included 319 records: 223 from women and 96 from men, aged 20-79 years. In total, data were available on 1,227 implants with dimensions of 10-13 mm and diameters of 3.75-4 mm. The G1 (n=1.188) survival rates were 94.95% for EH implants and 99.5% for MC implants. In G2 (n=39), the survival rates were 93.75% for EH implants and 91.3% for MC implants. The implant survival rates were relatively high among all groups evaluated; however, the discrepancy between the number of implants in the groups may compromise the comparison between them. Understanding and respecting the biomechanical and technical principles of each protocol was the main factor influencing the success of rehabilitation. Conclusion: The results of this study showed that, according to medical records, rehabilitation with dental implants showed excellent results regardless of the connection type (EH or MC) or loading protocol (conventional or immediate). The two loading protocols and two connection types had excellent results and scientific support. Therefore, the choice should be based on the clinical needs of each patient.

Antibiofilm effect of cleaning agents for ocular prostheses.

Introduction: This study aimed to evaluate the antibiofilm effect of different agents (neutral soap, 4% chlorhexidine, Efferdent effervescent tablets, 1% triclosan, and citronella essential oil) used for ocular prosthesis cleaning. Material and Methods: Biofilms of S. aureus and S. epidermidis were formed on 60 ocular prosthesis acrylic resin specimens. The specimens were cleaned with the studied agents with different techniques. Microorganism counting was performed. Data were submitted to ANOVA and HSD Tukey-Kramer (p<.01). Results: When compared to the control group, all cleaning protocols promoted a reduction in growth of microorganisms. The 4% chlorhexidine, effervescent tablets, and 1% triclosan cleaning agents eliminated biofilm in all groups. Conclusion: Therefore, immersion in 4% chlorhexidine, effervescent tablets, and 1% triclosan could be the best protocols indicated for ocular prosthesis cleaning due to their ability to eliminate biofilm.

Influence of Light-Curing Glaze and Chlorhexidine Gluconate in the Acrylic Resin Properties: An in situ Study.

This in-situ study aimed to evaluate the chromatic stability, microhardness, and surfacefree energy of chemically activated acrylic resin (CAAR) samples. Eighty CAAR samples were made and each volunteer (n = 20) received two palatal plates with two sides of groups (without and with glaze application). The samples were exposed to two conditions: the control condition (sucrose 30%) and the test condition (sucrose 30% and 0.12% chlorhexidine). The volunteers used the first palatal device (control condition) for seven days and the second palatal device (test condition) for another seven days, with a seven-day break between them. Then, the ΔΕ00, microhardness, and surface-free energy tests were performed. Analysis of Variance and the Tukey test were used (α = 0.05). The control group with glaze showed higher ΔΕ00 compared to the group without the glaze. The test group with glaze had less ΔΕ00 than their respective controls. In both periods, when the glaze was applied, higher microhardness values were found for all groups. Groups with glaze showed lower roughness and higher surface-free energy than groups without the glaze. The values obtained in this study were satisfactory, showing the clinical efficacy of glaze and the use of 0.12% CH for maintaining the physical and mechanical properties of CAAR.

Effect of photopolymerized glaze application on bacterial adhesion on ocular acrylic resin surfaces submitted to accelerated ageing.

Conditions of the acrylic resin (AR) surface, such as roughness, can promote a favourable environment for the adhesion of micro-organisms, even on the surface of ocular prostheses. This study evaluated the influence of photopolymerized glaze application on the roughness of ARs and adhesion of Staphylococcus aureus and Staphylococcus epidermidis on ocular AR surfaces submitted to accelerated ageing. Two hundred and eighty-eight samples of white colour (N1) and colourless ARs were distributed in eight groups (n = 9), based on surface treatments (glaze or ARs submitted to only a final polishing), accelerated ageing (before and after) and periods of microbial growth (24- and 48-h). The roughness average (Ra) and total height of roughness profile (Rt) values were greater for the groups with glaze and increased for all groups after ageing. The microbial adhesion among the groups with and without glaze did not present a statistically significant difference. The ageing did not statistically affect the adhesion of Staph. epidermidis, but affected the adhesion of Staph. aureus, which presented an increase after 24 h of growth on only N1 AR with glaze. These results demonstrate that the glaze did not contribute to adhesion of Staph. aureus and Staph. epidermidis, which are responsible for most ocular prosthetic infections. SIGNIFICANCE AND IMPACT OF THE STUDY: Some recent evidence suggested that the surface finish of ocular prostheses influences the accumulation of deposits that can affect the interaction with pathogenic bacteria, increasing the probability of infections. In addition, surface deterioration over time can increase the roughness and, consequently, biofilm formation. Thus, a better understanding of the influence of surface finish on bacterial adhesion becomes extremely important. In this study, we tested a glaze for surface polishing compared to mechanical polishing, before and after ageing. The results suggest that the glaze did not contribute to microbial adhesion and might be useful in preventing possible prosthetic infections.

Oral rehabilitation of patients after maxillectomy. A systematic review.

Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients' characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient.

Microbiological analysis of conjunctival secretion in anophthalmic cavity, contralateral eye and ocular prosthesis of patients with maxillofacial abnormalities.

The purpose of this study was to identify and analyse the micro-organisms present in the conjunctival secretion in anophthalmic cavities of wearers of ocular prostheses, as well as on the prostheses used by them, correlating them with the microbiota of the contralateral eye. Nine patients with maxillofacial abnormalities, wearers of an acrylic resin ocular prosthesis participated in the study. Collections of conjunctival secretions and biofilm were performed on the prosthesis, anophthalmic cavity and contralateral eye for the mycological and bacterial analyses. The data were submitted to statistical analysis, performing a Kendall correlation test to identify the correlation between the collection site and the identified micro-organism (P < 0·05). It was verified that the most prevalent micro-organisms were the Staphylococcus aureus and Staphylococcus epidermidis, independent of the collection site, and that negative cultures for fungi were encountered in 85·2% of collections, independent of the region. It was not possible to establish a correlation among the types of micro-organisms and the collection sites. SIGNIFICANCE AND IMPACT OF THE STUDY: Some evidence suggests that the surface roughness of ocular prostheses can influence interactions with micro-organisms, with greater prejudicial consequences, such as the establishment of biofilms, which could lead to infections. Thus, it becomes extremely important to identify the micro-organisms present on the acrylic surfaces of ocular prostheses, as well as the microbiota of the anophthalmic cavity and contralateral eye of wearers of the same, so that subsequent control measures promote the homeostatic maintenance of the ocular region.

Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for. The searches identified 30 eligible studies. A total of 3,049 implants were installed in a total of 1,435 patients with a mean age of 46.68 years and a minimum of 6 months of follow-up. The survival rate of delayed implants (98.38%) was significantly greater than immediate implants (95.21%) (p=.001). For the marginal bone loss (p=.32), implant stability quotients values (p=.44), and pocket probing depth (p=.94) there was no significant difference between the analysed groups. The immediate implants placed in fresh sockets should be performed with caution because of the significantly lower survival rates than delayed implants inserted in healed sockets.

Effects of platelet-rich plasma in association with bone grafts in maxillary sinus augmentation: a systematic review and meta-analysis.

This systematic review evaluated the effect on bone formation and implant survival of combining platelet-rich plasma (PRP) with bone grafts in maxillary augmentation. A comprehensive review of articles listed in the PubMed/MEDLINE, Embase, and Cochrane Library databases covering the period January 2000 to January 2015 was performed. The meta-analysis was based on bone formation for which the mean difference (MD, in millimetres) was calculated. Implant survival was assessed as a dichotomous outcome and evaluated using the risk ratio (RR) with 95% confidence interval (CI). The search identified 3303 references. After inclusion and exclusion criteria were applied, 17 studies were selected for qualitative analysis and 13 for quantitative analysis. A total of 369 patients (mean age 51.67 years) and 621 maxillary sinus augmentations were evaluated. After the data analysis, additional analyses were performed of the implant stability quotient, marginal bone loss, and alveolar bone height measured by MD. The results showed no significant difference in implant stability (P=0.32, MD 1.00, 95% CI -0.98 to 2.98), marginal bone loss (P=0.31, MD 0.06, 95% CI -0.05 to 0.16), alveolar bone height (P=0.10, MD -0.72, 95% CI -1.59 to 0.14), implant survival (P=0.22, RR 1.95, 95% CI 0.67-5.69), or bone formation (P=0.81, MD -0.63, 95% CI -5.91 to 4.65). In conclusion, the meta-analysis indicates no influence of PRP with bone graft on bone formation and implant survival in maxillary sinus augmentation.

Psychosocial impact on anophthalmic patients wearing ocular prosthesis.

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.

Influence of natural weathering on colour stability of materials used for facial prosthesis.

Colour stability of resin and silicone is an important factor for longevity of facial prostheses. The aim of this study was to evaluate the colour stability of resins and silicone for facial prostheses. Three brands of acrylic resin and one of facial silicone were evaluated considering pigment incorporation for the colourless materials. Ten samples of each material were fabricated and submitted to measurements of chromatic alteration initially and after 90 and 180 days of weathering natural through visual analysis and spectrophotometry. Data were evaluated by ANOVA and Tukey test (p < 0.05). Statistically significant colour alteration was observed among some materials regardless of the period. The materials did not present a statistical difference between 90 and 180 days except for the pigmented heat-polymerized resin. The colour difference between pigmented Silastic MDX4-4210 and colourless Silastic was statistically significant (p < 0.01) in both periods as well as between pigmented and colourless heat-polymerized resin, and between the resins Rapidaflex and Lentaflex. The visual method demonstrated colour alteration in all materials evaluated during the first 90 days of ageing. All materials exhibited colour alteration due to exposure to environment.

Effect of disinfection and accelerated ageing on dimensional stability and detail reproduction of a facial silicone with nanoparticles.

The aim of the present study was to evaluate the effect of disinfection and accelerated ageing on the dimensional stability and detail reproduction of a facial silicone with different types of nanoparticle. A total of 60 specimens were fabricated with Silastic MDX 4-4210 silicone and they were divided into three groups: colourless and pigmented with nanoparticles (make-up powder and ceramic powder). Half of the specimens of each group were disinfected with Efferdent tablets and half with neutral soap for 60 days. Afterwards, all specimens were subjected to accelerated ageing. Both dimensional stability and detail reproduction tests were performed after specimen fabrication (initial period), after chemical disinfection, and after accelerated ageing periods (252, 504 and 1008 hours). The dimensional stability test was conducted using AutoCAD software, while detail reproduction was analysed using a stereoscope magnifying glass. Dimensional stability values were statistically evaluated by analysis of variance (ANOVA) followed by Tukey's test (p < 0.01). Detail reproduction results were compared using a score. Chemical disinfection and also accelerated ageing affected the dimensional stability of the facial silicone with statistically significant results. The silicone's detail reproduction was not affected by these two factors regardless of nanoparticle type, disinfection and accelerated ageing.

Quality of life and stimulus perception in patients' rehabilitated with complete denture.

The objective of this study was to evaluate and correlate quality of life (QoL), and stimulus perception of complete denture users, before and after the insertion of new prostheses. We selected 60 patients using bimaxillary complete conventional dentures who needed to replace their prostheses. During anamnesis, we collected demographic data and applied the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) questionnaire and stimulus perception questionnaire (PERCEPTION). Before installation of new prostheses, the patients responded to OHIP-EDENT questionnaire, and on the day of installation, they responded to PERCEPTION questionnaire. At the patients' 3-month follow-up, we re-administered the OHIP-EDENT and PERCEPTION questionnaires. The Wilcoxon and MacNemar tests were used to compare patient responses between the time points analysed. Most of the OHIP-EDENT items showed a highly significant impact of the new prostheses on oral health (P ≤ 0·003). The PERCEPTION questionnaire data indicated that the patients experienced significant improvements (P < 0·05) in terms of their sensations with the new prostheses. Cross-lagged data analysis did not show any causality between the OHIP-EDENT and PERCEPTION questionnaires (ZPF test, P = 0·772). We concluded that the treatment was effective with respect to the patients' QoL and their adaptation to the new prostheses.