ABSTRACT
This study evaluated the clinical survival rates of 170 Morse taper implants through clinical and mechanical parameters in different therapeutic approaches such as single crowns, fixed partial prostheses, and fixed full-arch prostheses. Patients referred to the Center on Education and Research on Dental Implants from May 2017 to July 2018 with the indication for dental implant therapy, aged >18 years, without periodontal disease, recent evidence of inflammatory activity or other oral disorders, current pregnancy, uncontrolled diabetes mellitus or heavy smoking habit were included in this study. After 12 weeks of healing since the implants were placed in the mandible and after 16 weeks following implants placed in the maxilla, patients returned to the Center for prosthetic rehabilitation. After implant therapy, all patients underwent periodical, clinical, and prosthetic examinations every 6 months. Prosthetic restorations involved 109 fixed reconstructions in function. Few prosthetic complications were reported (6.55%). Twenty implants were rehabilitated with cemented prostheses; from those, 1 crown suffered a loss in retention/decementation. Of the 148 implants rehabilitated with screwed-retained prostheses, 6.76% suffered prosthetic screw loosening. The cumulative implant survival rate was 98.2%. When peri-implant tissue health was evaluated, the keratinized mucosa band appeared related to peri-implant tissue stability. Thus, Morse taper implants represented a successful procedure for implant rehabilitation, with a high cumulative implant survival rate, low prevalence of biological and prosthetic complications, and good stability of peri-implant tissues over the assessed period.
Subject(s)
Dental Implants , Humans , Follow-Up Studies , Female , Middle Aged , Male , Adult , Dental Prosthesis, Implant-Supported , Dental Prosthesis Design , Dental Restoration Failure , Aged , Dental Implantation, Endosseous , CrownsABSTRACT
O objetivo deste trabalho foi relatar um caso clínico onde o planejamento reverso e o uso racional das cirurgias implantares e periodontais mostraram-se fundamentais no preparo para reabilitação da zona estética com coroas cerâmicas e metalocerâmicas. Uma paciente de 32 anos apresentava estética pobre, como ausências dentárias isoladas e perda de tecido mole/duro na região dos caninos superiores. O tratamento foi dividido em cinco etapas: 1) coroas provisórias e correção do plano oclusal e corredor bucal; 2) expansão da crista do rebordo e implantes conexão cone-morse/platform-switching (em dois estágios); 3) gengivoplastia; 4) reabertura e cirurgias gengivais (gengivectomia, enxerto ósseo/de tecido conjuntivo, divisão de papilas); e 5) condicionamento e colocação das coroas cerâmicas defi nitivas nos dentes (cimento resinoso) e metalocerâmicas (cimento fosfato de zinco) sobre os implantes. O desenvolvimento deste caso está baseado no uso da biomecânica de interface implante/pilar que confere os menores valores de reabsorção óssea ao longo do tempo, fornecendo restaurações definitivas com aspecto natural, e ainda apoiado por uma revisão sistemática demonstrando a eficácia do tecido conjuntivo subepitelial no aumento da largura queratinizada ao redor dos implantes. A finalização obtida é esteticamente aceitável e durável, muito desejável na região anterior da maxila.
The objective of this study was to report a case where the reverse planning and the rational use of implant and periodontal surgical protocols were fundamental to prepare the rehabilitation in the esthetic zone with all-ceramic and metalloceramic crowns. A 32 years-old patient had poor aesthetics, single-tooth defi cits, and soft/hard tissue losses in the region of the upper canines. After a concise planning, the treatment was divided into fi ve steps: 1) temporary crowns, correction of occlusal plane and buccal corridor; 2) ridge expansion, morse cone/platform-switching dental implants (two-stage procedure); 3) gingivoplasty; 4) implant exposure and gingival surgeries (gingivectomy, bone graft/connective tissue grafts, pedicle flaps); and 5) tissue conditioning and cementation of all-ceramic (resin cement) over teeth and metalloceramic (zinc phosphate cement) over the implant abutments. The development of this case is based on the use of a biomechanical implant interface/abutment which gives lower values of bone resorption over time, providing final restorations with a natural aspect, and still supported by a systematic review demonstrating the effectiveness of subepithelial connective tissue grafts to increase the width of the keratinized peri-implant mucosa. The outcome is esthetically acceptable and has long-term quality, a very desirable condition in the anterior maxilla.
Subject(s)
Humans , Female , Adult , Ceramics , Connective Tissue/surgery , Dental Implants , Gingivectomy , Lithium/chemistry , Transplantation, Autologous/methodsABSTRACT
The objective of this study was to evaluate the bacterial seal at the implant-abutment interface using two morse taper implant models, by means of an in vitro microbiological analysis. For that were used 15 implants with mini-abutments tightened by friction, no screws (Group 1); and 30 implants with screw-tightened abutments, of which 15 received 20 N.cm of closing torque (Group 2) and the other 15 received 30 N.cm (Group 3). Microbiological analysis was carried out using colonies of Escherichia coli transported directly from a culture dish to the prosthetic component. Friction implants (Group 1) were activated by tapping and a torque wrench was used for screw-tightened implants (Groups 2 and 3). Each abutment/implant set was immersed in test tubes containing 5 mL of brain-heart infusion broth and incubated at 37 °C for 14 days, observed daily for the presence of contamination. A statistically significant difference was observed regarding the number of contaminated implants. There was greater contamination in Group 2 implants (p<0.05), with no statistically significant difference between the other groups (Group 1 = 20% and Group 3 = 0%). It was concluded that there was no significant difference in in vitro bacterial sealing between implants with mini-abutments tightened by friction without screws and implants with screw-tightened abutments with 30 N.cm of closing torque. The difference in closing torque altered the in vitro sealing ability of the tested abutments, with a greater contamination for components that received a closing torque of 20 N.cm.
O objetivo deste estudo foi avaliar comparativamente, por meio de análise microbiológica in vitro, a capacidade de selamento bacteriano de dois modelos de implante de encaixe morse. Foram utilizados 15 implantes com travamento de seus respectivos mini-pilares por fricção, sem auxílio de parafuso (Grupo 1) e 30 implantes com travamento de seus respectivos mini-pilares sólidos reforçado pela presença de parafuso, sendo que 15 destes implantes receberam torque de inserção de 20 N.cm (Grupo 2) e o restante 30 N.cm (Grupo 3). A análise microbiológica foi realizada utilizando colônias de Escherichia coli transportadas diretamente da placa de cultivo para o componente protético. Os implantes friccionais (Grupo 1) foram ativados por meio do dispositivo bate conexão e para os aparafusados foi usada a chave de torque (Grupos 2 e 3). Cada conjunto de pilar/implante foi imerso em tubos de ensaio contendo 5 mL de caldo BHI (Brain-Heart Infusion) e incubados a 37 °C durante 14 dias com verificação diária de presença de contaminação. Foi observada diferença estatisticamente significante, com relação ao número de implantes contaminados. Para os implantes do Grupo 2, houve maior contaminação (60%, p<0,05), não sendo observada diferença significativa entre os outros grupos (Grupo 1 = 20% e Grupo 3 = 0%). Conclui-se neste estudo que não houve diferença estatística significante quanto ao selamento bacteriano in vitro entre os Grupos 1 e 3. A diferença de torque de inserção alterou a capacidade de selamento in vitro dos pilares testados, sendo observada uma maior contaminação para os componentes que receberam o torque de 20 N.cm.
