Carga ortodôntica imediata em implantes osseointegrados: esse procedimento é seguro? / Immediate load ossointegrated dental implants: Is this procedure safe?

O objetivo deste estudo foi avaliar o sucesso de um implante osseointegrado, submetido a forças protéticas e ortodônticas imediatas, durante um período de acompanhamento de 63 meses. Um implante protético foi colocado em paciente com ausência do elemento 35, com intuito de servir de ancoragem para movimentação ortodôntica e para substituir o dente ausente. Um torque inicial mínimo de 40N/cm era necessário para permitir carga oclusal imediata. Imediatamente após a cirurgia, uma coroa provisória de resina acrílica foi confeccionada com um componente protético antirrotacional temporário torqueado a 20N/cm; um braquete ortodôntico foi colado na superfície vestibular com resina acrílica. Dois dias após a cimentação da coroa provisória, uma força de 2N (?204g) foi aplicada ao implante através do uso de um arco de aço inoxidável 0,018” contínuo. Avaliações clínica e radiográfica foram realizadas 6, 43 e 63 meses após o início da movimentação ortodôntica. Os resultados foram animadores, com ausência de sinais e sintomas negativos. Após seguir os critérios determinados, obteve-se sucesso na aplicação de carga imediata no implante endósseo. O sucesso em longo prazo desse caso deve estimular o desenvolvimento de estudos futuros antes que esse procedimento se torne uma rotina.

Long-term follow-up of dental single implants under immediate orthodontic load.

OBJECTIVE: To evaluate the success of osseointegrated implants under immediate prosthetic and orthodontic forces after a follow-up period of at least 2 years. MATERIALS AND METHODS: The sample included 20 titanium implants which were used as orthodontic and prosthetic anchorage of immediately loaded single-crowns on a total of 13 patients. A 40 N initial torque was considered the minimum for inclusion in the sample. All implants received screwed provisional crowns immediately after surgery. The implants were randomly divided into two groups: the control group (9 implants) and the immediate orthodontic loading group (11 implants). A healing period of 4 months was observed before orthodontic loads were applied to the control group implants. For the immediate orthodontic loading group, orthodontic forces were applied within 24 hours. The maximum orthodontic force applied in both groups was 200 g. After 6 months of orthodontic movement, clinical and radiographic evaluations were obtained. Implants were considered successful when favorable results were obtained in all evaluations. RESULTS: After a 2-year follow-up, the success rates were 90.9% and 88.9%, respectively, in the orthodontic loading group and the control group. Each group had one failure. CONCLUSION: Shortening the healing period for the application of orthodontic forces did not seem to affect the success of osseointegrated implants used as anchorage.

Changes in facial profile of young adults with normal occlusion: a longitudinal study.

AIM: To evaluate longitudinally the cephalometric changes in the facial profile of young adults. METHODS: The sample was composed of 27 individuals of both genders who presented with Class I and normal occlusion; the initial mean age was 21.2 years. After a mean period of 7.2 years, patients were re-evaluated. All measurements were carried out via digitalized lateral cephalometric radiographs. One calibrated operator identified the cephalometric landmarks. Software was used to take linear and angular values; the mean dimensions were used for data. The evaluated measurements were nasal depth, soft pogonion thickness, upper and lower lip thickness, upper and lower lip position in relation to the esthetic plane of Ricketts, facial convexity including the nose, and facial convexity excluding the nose. The paired t test was used to evaluate the changes. RESULTS: Data indicate that the nose depth increased by a mean of 1.07 mm. The soft pogonion thickness and the lower lip thickness increased a mean of 0.51 mm and 0.55 mm, respectively, and the facial convexity excluding the nose decreased 0.72 degrees. Only the facial convexity including the nose was different between the genders, with greater values for the male subjects. CONCLUSIONS: Facial profile changes throughout the third decade of life; in the present study, these changes were statistically significant for nose depth, observed in both sexes.

Changes in dental arch measurements of young adults with normal occlusion--a longitudinal study.

This study evaluates the longitudinal changes in occlusal dimensions in young adults. The sample was composed of 27 individuals (13 male and 14 female individuals) who presented dental Class I and normal occlusion, according to the inclusion protocol. All teeth were present except for the third molars. The mean age of the subjects was 21 years and two months initially and 28 years and four months at the end of the observation period. The measurements collected in both arches were overbite, overjet, intercanine and intermolar distances, irregularity index, and perimeter. All measurements were taken from study dental casts by a calibrated operator, using a digital caliper. The paired t-test was used to evaluate the changes, using the difference between the initial and final mean measurements. Data indicated that the overbite increased 0.39 mm, the incisor irregularity increased 0.38 mm in the upper arch and 0.54 mm in the lower arch, and the arch perimeter decreased 0.67 mm in the upper arch and 0.71 mm in the lower arch (P > .05). The other measurements did not show significant changes. No sexual dimorphism was observed. It could be concluded that occlusal dimensions change throughout adult life. In the sample studied, changes were statistically significant for overbite, incisors irregularity, and arch perimeter after a mean period of seven years and two months. These changes can be observed in both sexes.