ABSTRACT
Introdução: Quando a altura do osso alveolar residual é insuficiente na região posterior da maxila, a elevação do assoalho do seio maxilar visando a viabilizar a instalação de implantes dentários é um procedimento indicado. O enxerto autógeno (EA) de regiões intra ou extraorais é considerado o padrão ouro para esse procedimento. Novas opções de substitutos ósseos vêm surgindo, como o Straumann(r) BoneCeramic (BC) - 60% constituído de hidroxiapatita e 40% de ß tricálcio fosfato, 100% sintético -, sendo o material utilizado no presente trabalho. Objetivo: Avaliar e comparar histologicamente o comportamento deste substituto ósseo com o enxerto ósseo autógeno. Material e método: Dez pacientes saudáveis e parcialmente desdentados na região posterior da maxila foram submetidos à elevação do assoalho do seio maxilar previamente à instalação de implantes dentários osseointegráveis, sendo, destes, cinco com EA e cinco com BC. Após seis meses do tempo de integração do enxerto ósseo, as amostras foram coletadas por uma trefina e coradas em hematoxilina e eosina para microscopia. Resultado: Todos os implantes osseointegráveis apresentaram boa estabilidade primária. A análise histológica demonstrou tecido ósseo neoformado viável em quatro das cinco amostras do BC, além de um íntimo contato do tecido ósseo mineralizado recém-formado com as partículas do BC. Em uma amostra do BC, não foi observada formação de osso viável. O tecido ósseo formado a partir do EA e do BC apresentou uma característica histológica similar. Conclusão: O BC se mostrou um material adequado para a elevação do assoalho do seio maxilar previamente à instalação ...
Introduction: Sinus lift to permit insertion of implants when alveolar residual bone height is insufficient may be considered an effective procedure. The use of autogenous bone from intraoral or extraoral sources is considered as the gold standard for this procedure. New options of bone substitutes have been emphasizing, such as Straumann(r) BoneCeramic (BC), consisting of 60% of hydroxyapatite and 40% of calcium phosphate, 100% synthetic material that was used in this work. Objective: This investigation was designed to evaluate and compare the behavior of a fully synthetic biphasic calcium phosphate (BCP) 60% hydroxyapatite and 40% of ß-tricalcium phosphate (Straumann(r) Bone-Ceramic) to the autogenous bone graft (ABG) in maxillary sinus floor elevation procedure prior to installation dental implants. Material and method: Ten healthy patients who were partially edentulous in the posterior maxilla were included in this study and submitted to a unilateral maxillary sinus floor elevation procedure, with grafting using either ABG (control group; 5 patients) or BCP (test group; 5 patients). After 6 months of healing implant sites were created and biopsies taken for histological analyses. Result: A primary stability was achieved with all dental implants after the biopsies. Histological investigation showed a viable new bone tissue formed in 4 of 5 BCP specimens. Also, showed close contact between new bone and BCP particles, in 4 of 5 specimens. In 1 of 5 BCP specimens no viable bone tissue was found. Both ABG and BCP produced similar amounts of newly formed bone, with similar histologic appearance. Conclusion: The results indicate that BCP is a suitable material for sinus augmentation for the placement of dental implants. .
Subject(s)
Materials Testing , Bone Transplantation , Dental Implantation , Sinus Floor Augmentation , HydroxyapatitesABSTRACT
Temporomandibular joint (TMJ) ankylosis (TMJA) is an anatomic and functional alteration of the TMJ surfaces, caused by the fusion of these surfaces by either bone or fibrous tissue. Several techniques are used for the treatment of TMJA. The following case report describes a 5-year-old boy who was diagnosed with TMJA. The treatment of choice is reconstruction of the condyle by sliding the posterior border of the mandibular ramus. Temporomandibular joint ankylosis treatment with vertical ramus osteotomy and mandibular posterior border repositioning offers minimizing the reduction in height or shortening of the mandibular posterior border. The postoperative period requires a multidisciplinary approach with an aggressive physiotherapy.
