A Modified Technique for Induced Gingival Growth Around Compromised Teeth Prior to Implant Placement: A Report of Two Cases.

Regenerative and reconstructive periodontal plastic surgery are important options for treating marginal tissue recession and can be indicated for root coverage or periodontal procedures prior to implant placement. Among the available procedures, periodontal flaps with subepithelial connective tissue graft (CTG) is the most common treatment option to achieve proper tissue manipulation. The present study proposes a modification of a previous technique for inducing spontaneous gingival growth around teeth that will be extracted prior to implant placement, through successive reduction of the buccal root surface. This successive reduction of root surfaces is performed with diamond burs, and such reductions create space for the gingival tissue to grow coronally by reducing root convexity and, consequently, stimulating the healing process with the formation of granulation tissue that will then differentiate into keratinized tissue. The presented technique is suggested to improve the esthetic outcomes for cases involving tooth extraction, implant placement in the extraction socket, and immediate loading with interim restoration and CTG.

Influence of Implant Inclination and Prosthetic Abutment Type on the Biomechanics of Implant-Supported Fixed Partial Dentures.

Obtaining parallelism during implant placement is often difficult, leading to inclination of implants. The present study evaluated the stress distribution in 3-unit fixed partial dentures supported by 2 implants with different inclinations and prosthetic abutments. Universal castable long abutments (UCLAs) or tapered abutments were used considering 17° of implant angulation in different directions (mesial, distal, buccal, or lingual). To do so, 3-dimensional finite element models were built and exported to specific analysis software. Forces were applied to the functional cusps. Data were obtained with regard to the maximum principal and von Mises stresses (in MPa). No relevant differences were observed in the stress values in the cortical and cancellous bone nor in the prosthesis with UCLA or tapered abutments. However, a relevant stress reduction in the prosthetic screws of the tilted implant was observed when using UCLA abutments. According to the obtained results, it is possible to suggest that both UCLA or tapered abutments can be used for 3-unit fixed partial dentures when 1 of the implants is tilted. UCLA abutment might lead to less biomechanical problems related to screw loosening or fracture.

Reabilitação de dentes anteriores: a ciência aliada à arte / Rehabilitation of anterior teeth: science combined with art

Traumatismos dentários que resultam em fratura de dentes anteriores são comumente observados no dia a dia da prática clínica, e a reabilitação de tais elementos apresenta grande demanda estética. O presente relato de caso clínico descreveu os procedimentos e decisões clínicas realizadas para restaurar dois incisivos centrais superiores com histórico de trauma/fratura há mais de cinco anos, com coroas totalmente cerâmicas de dissilicato de lítio. A queixa principal do paciente (estética), bem como publicações científicas na área de materiais dentários e prótese dental, foi considerada na seleção do tipo de material restaurador e procedimentos realizados, de modo a proporcionar ao paciente a melhor opção restauradora no momento.

Dental trauma resulting in fracture of anterior teeth is commonly observed in daily clinical practice and the rehabilitation of such elements has great aesthetic demand. This case report describes the procedures and clinical decisions made to restore two central incisors with history of trauma/fracture with all-ceramic lithium dissilicate single-tooth crowns. The major complaint of the patient (aesthetics) as well as scientific publications of dental materials and dental prosthesis were considered in the selection of restorative material and procedures performed in order to give the patient the best treatment option.

Effect of vertical misfit and clip material on stress distribution of overdentures under masticatory loading.

Framework misfit is a common problem observed in overdentures, which might result in prosthetic and biological complications. The aim of this study was to evaluate the influence of vertical misfit and clip material on the stress distribution in an overdenture-retaining bar system under masticatory loading. A 3-D finite element model of a resorbed jaw was created, including two implants and a bar-clip retained overdenture. A pressure of 100 MPa was applied to the right mandibular first molar. Different vertical misfit levels (50, 100, and 200 µm) and clip materials (plastic or gold) were evaluated. Data were evaluated using von Mises stress and microstrain. Vertical misfit amplification caused an increase in the microstrain values in the peri-implant bone tissue next to the ill-fitted component and increased the stresses in the prosthetic screws. The clip material influenced the stress and microstrain distribution in the prosthetic components and bone tissue. The levels of vertical misfit seem to be closely linked with the stress values in the prosthetic screws, mainly to that of the ill-fitted component. The gold clip presented an increase in the stress compared to the plastic clip.

Comparison of the Accuracy of Different Transfer Impression Techniques for Osseointegrated Implants.

The aim of this study was to evaluate 3 transfer techniques used to obtain working casts of implant-supported prostheses through the marginal misfit and strain induced to metallic framework. Thirty working casts were obtained from a metallic master cast, each one containing 2 implant analogs simulating a clinical situation of 3-unit implant-supported fixed prostheses according to the following transfer impression techniques: group A, squared transfers splinted with dental floss and acrylic resin, sectioned, and re-splinted; group B, squared transfers splinted with dental floss and bis-acrylic resin; and group N, squared transfers not splinted. A metallic framework was made for marginal misfit and strain measurements from the metallic master cast. The misfit between the metallic framework and working casts was evaluated with an optical microscope following the single-screw test protocol. In the same conditions, the strain was evaluated using strain gauges placed on the metallic framework. The data were submitted to one-way analysis of variance followed by the Tukey test (α = 5%). For both marginal misfit and strain, there were statistically significant differences between groups A and N (P < .01) and groups B and N (P < .01), with greater values for group N. According to the Pearson test, there was a positive correlation between the misfit and strain variables (r = 0.5642). The results of this study showed that the impression techniques with splinted transfers promoted better accuracy than the nonsplinted technique, regardless of the splinting material used.