Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors.

BACKGROUND: The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS: This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS: A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION: The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.

Efficacy of 0.12% Chlorhexidine Gluconate for Non-Surgical Treatment of Peri-Implant Mucositis.

BACKGROUND: Because peri-implant mucositis may progress to peri-implantitis, effective treatment resulting in resolution of inflammation could prevent peri-implantitis. Current treatment protocols for this condition are still unpredictable. The purpose of this study is to analyze efficacy of non-surgical treatment for patients with peri-implant mucositis during a 6-month follow-up period. METHODS: This controlled, randomized, double-masked clinical trial included 37 patients diagnosed with peri-implant mucositis, randomly assigned into test group (basic periodontal therapy + 0.12% chlorhexidine) with 61 implants; and control group (basic periodontal therapy + placebo) with 58 implants. Therapy consisted of adaptation of the full-mouth scaling and root planing protocol. Clinical parameters of visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), and bleeding on probing (BOP) were measured in implants and were evaluated at baseline and at 1, 3, and 6 months post-therapy. Data were analyzed using the split-plot analysis of variance and χ2 tests with a significance level of 5%. RESULTS: Intragroup analysis showed that VPI, GBI, PD, and BOP presented statistically significant improvements compared with baseline. No statistically significant differences were found between the test and control groups at any time. CONCLUSIONS: Both isolated mechanical therapy and its association with 0.12% chlorhexidine mouthwash reduced peri-implant mucositis. Therefore, 0.12% of chlorhexidine was not more effective than placebo.

Simplified versus traditional techniques for complete denture fabrication: a systematic review.

STATEMENT OF PROBLEM: A number of methods have been described for the fabrication of complete dentures. There are 2 common ways to make conventional complete dentures: a traditional method and a simplified method. PURPOSE: The purpose of this study was to conduct a systematic review to compare the efficiency of simplified and traditional methods for the fabrication of complete dentures. MATERIAL AND METHODS: The review was conducted by 3 independent reviewers and included articles published up to December 2013. Three electronic databases were searched: MEDLINE-PubMed, The Cochrane Library, and ISI Web of Science. A manual search also was performed to identify clinical trials of simplified versus traditional fabrication of complete dentures. RESULTS: Six articles were classified as randomized controlled clinical trials and were included in this review. The majority of the selected articles analyzed general satisfaction, denture stability, chewing ability and function, comfort, hygiene, esthetics, speech function, quality of life, cost, and fabrication time. CONCLUSIONS: Although the studies reviewed demonstrate some advantages of simplified over traditional prostheses, such as lower cost and clinical time, good chewing efficiency, and a positive effect on the quality of life, the reports related the use of different simplified methods for the fabrication of complete dentures. Additional randomized controlled trials that used similar simplified techniques for the fabrication of complete dentures should be performed with larger sample sizes and longer follow-up periods.

Technical complications with implant-supported dental prostheses.

Studies are needed to determine the prognosis of different forms of dental prosthetic rehabilitation and the main complications involved. The purpose of the present study was to evaluate technical complications involving implant-supported prostheses. A retrospective one time snap-shot study was carried out with a total of 509 implants in 153 patients. Prosthetic conditions were determined by clinical and radiographic examination. The least frequent technical complication involved fracture (0.2%), loss (0.4%) and loosening (3.3%) of the screw. The most frequent complications were loss of resin covering the screw (23.8%), loss of overdenture retention (18.6%) and fractures of the resin (12.4%). A high frequency of misfit between the prosthesis and abutment (25.4%) was found, which was significantly associated (P < 0.05) with other variables, especially cemented prostheses (P < 0.001). To minimize the frequency of complications, protocols must be established from diagnosis to the completion of treatment and follow up of implant-supported prostheses, especially in terms of adequate technical steps and careful radiographic evaluation of the components.

Evaluation of bioactive glass and platelet-rich plasma for bone healing in rabbit calvarial defects.

Bone regeneration is an important objective in clinical dental practice and has been used for different applications. The aim of this study was to evaluate the effectiveness of platelet-rich plasma (PRP) and bioactive glass (BG) for bone healing of surgical calvarial defects in rabbits. Two 8-mm defects were prepared in the parietal bones of ten animals, and the animals were randomly assigned to two groups. In each group, two subgroups were created with five defects each: BC - blood clot, BG, PRP and PRP + BG. Thus, four treatments were performed with five specimens each. The animals were sacrificed after 12 weeks and the specimens were analyzed radiographically, histologically and histomorphometrically. Data were subjected to ANOVA and Tukey's tests (α = 0.05). Outcomes demonstrated that the PRP group had higher bone density (%) values than the groups not treated with PRP (P < 0.05). Histometrically, both groups treated with PRP (PRP: 25.6 ± 9.9; PRP+BG: 25.8 ± 12.4) demonstrated higher percentages of new bone formation than the groups not treated with PRP (BG: 6.1 ± 4.3; BC: 7.8 ± 5.6) (P < 0.05). The results suggested that PRP improved bone repair and that bioactive glass alone, or in association with PRP, did not improve bone healing.

A nova inserção da periodontia nos currículos integrados de faculdades de odontologia brasileiras / Insertion of Periodontics in integrated curriculum at brazilian dental schools

A Periodontia tem sido incluída na base da estrutura de clínicas por complexidade crescente. Essa abordagem segue as Diretrizes Curriculares Nacionais propostas pelo Ministério da Educação e Cultura (MEC). De acordo com a evolução da Odontologia nos últimos anos e as mudanças ocorridas com relação às necessidades da população, este estudo propôs-se a investigar a inserção da Periodontia neste novo contexto e os parâmetros utilizados na avaliação periodontal e das estruturas peri-implantares. Um e-mail foi submetido para um professor de Periodontia de cada instituição de ensino brasileira. Neste havia um link que o professor deveria acessar, ler e concordar com o termo de consentimento para ter acesso ao questionário. As respostas enviadas por 30 faculdades brasileiras foram analisadas de forma descritiva. De acordo com as respostas dos questionários pôde-se verifcar que há uma tendência à renovação curricular pautada na integração clínica. Porém, uma readequação e/ou inclusão da avaliação de certos aspectos anatômicos relacionados ao periodonto, no que diz respeito à saúde e estética periodontal e peri-implantar, faz-se ainda necessária.

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin

In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37ºC for 48 h. The drug powder concentrations (nystatin 500,000U - G2; nystatin 1,000,000U - G3; miconazole 125 mg - G4; miconazole 250 mg - G5; ketoconazole 100 mg - G6; ketoconazole 200 mg - G7; chlorhexidine diacetate 5% - G8; and 10% chlorhexidine diacetate - G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Peel bond strength of resilient liner modified by the addition of antimicrobial agents to denture base acrylic resin.

UNLABELLED: In order to prolong the clinical longevity of resilient denture relining materials and reduce plaque accumulation, incorporation of antimicrobial agents into these materials has been proposed. However, this addition may affect their properties. OBJECTIVE: This study evaluated the effect of the addition of antimicrobial agents into one soft liner (Soft Confort, Dencril) on its peel bond strength to one denture base (QC 20, Dentsply). MATERIAL AND METHODS: Acrylic specimens (n=9) were made (75x10x3 mm) and stored in distilled water at 37 ºC for 48 h. The drug powder concentrations (nystatin 500,000 U--G2; nystatin 1,000,000 U--G3; miconazole 125 mg--G4; miconazole 250 mg--G5; ketoconazole 100 mg - G6; ketoconazole 200 mg--G7; chlorhexidine diacetate 5%--G8; and 10% chlorhexidine diacetate--G9) were blended with the soft liner powder before the addition of the soft liner liquid. A group (G1) without any drug incorporation was used as control. Specimens (n=9) (75x10x6 mm) were plasticized according to the manufacturers' instructions and stored in distilled water at 37 ºC for 24 h. Relined specimens were then submitted to a 180-degree peel test at a crosshead speed of 10 mm/min. Data (MPa) were analyzed by analysis of variance (α=0.05) and the failure modes were visually classified. RESULTS: No significant difference was found among experimental groups (p=0.148). Cohesive failure located within the resilient material was predominantly observed in all tested groups. CONCLUSIONS: Peel bond strength between the denture base and the modified soft liner was not affected by the addition of antimicrobial agents.

Root cementum modulates periodontal regeneration in Class III furcation defects treated by the guided tissue regeneration technique: a histometric study in dogs.

BACKGROUND: Because the possibility of root cementum preservation as an alternative approach for the treatment of periodontal disease has been demonstrated, this study aimed to histometrically evaluate the effect of root cementum on periodontal regeneration. METHODS: Bilateral Class III furcation defects were created in dogs, and each dog was randomly assigned to receive one of the following treatments: control (group A): scaling and root planing with the removal of root cementum; or test (group B): removal of soft microbial deposits by polishing the root surface with rubber cups and polishing paste, aiming at maximum cementum preservation. Guided tissue regeneration (GTR) was applied to both groups. RESULTS: Four months after treatment, a superior length of new cementum (3.59 +/- 1.67 mm versus 6.20 +/- 2.26 mm; P = 0.008) and new bone (1.86 +/- 1.76 mm versus 4.62 +/- 3.01 mm; P = 0.002) and less soft tissue along the root surface (2.77 +/- 0.79 mm versus 1.10 +/- 1.48 mm; P = 0.020) was observed for group B. Additionally, group B presented a larger area of new bone (P = 0.004) and a smaller area of soft tissue (P = 0.008). CONCLUSION: Within the limits of this study, root cementum may modulate the healing pattern obtained by guided tissue regeneration in Class III furcation defects.