Avaliação retrospectiva de 774 implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos: acompanhamento clínico de sete anos / Retrospective evaluation of 774 external and internal hexagonal tapered surface dental implants with Al2O3 surface treatment followed by three acid-etching protocols: a 7-year follow-up

Objetivo: analisar o sucesso do tratamento através de implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, com acompanhamento clínico de sete anos. Material e métodos: foi realizado um estudo retrospectivo aprovado pelo comitê de ética da Universidade de Guarulhos, entre os anos de 2009 e 2016, no qual foram selecionados 136 pacientes após os critérios de inclusão e exclusão, sendo instalados 774 implantes cônicos de hexágono externo e interno nos maxilares. Após o tempo de osseointegração, os implantes receberam as coroas protéticas finais. Resultados: a avaliação retrospectiva de 774 implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, com um acompanhamento clínico de sete anos, resultou em índices totais de sucesso na osseointegração de 98,39%, com uma perda óssea marginal de 1,08 mm após este período. Conclusão: a previsibilidade de sucesso no tratamento através dos implantes cônicos de hexágono externo e interno, de superfície jateada com Al2O3 seguido de três ataques ácidos, foi de 98,3%. A qualidade óssea é fundamental na previsibilidade do tratamento.

Objective: to analyze the treatment success of Al2O3 sandblasted, acid-etched, external and internal tapered connection dental implants after 7 years of follow-up. Material and methods: upon approval by the Ethics Committee of the University of Guarulhos, a retrospective study involving 136 patients receiving 774 dental implants in the jaws was performed. After the osseointegration period, definitive prosthetic restorations were delivered. Results: after 7 years of follow-up, the overall success rate was of 98.33% with a marginal bone loss of 1.08 mm. Conclusion: the treatment predictability of alumina sandblasted, external and internal tapered implants was significant. Bone quality is fundamental for treatment success.

Sinus Augmentation and Simultaneous Implant Placement Success: Pilot Study (2008-2011).

OBJECTIVE: 1) To describe implant success in the posterior maxillary when a sinus augmentation procedure was performed simultaneously with implant placement and then compare differences in success when sinus augmentation was delayed in patients attending the maxillofacial surgery clinic of the University of Puerto Rico, 2008 through 2011. 2) To determine sociodemographic characteristics, ASA classification, graft material, and final restoration and, using a questionnaire, determine as well patient satisfaction. METHODS: A retrospective cohort study was conducted (approved by IRB) with 172 patients, using medical records. A total of 102 implants were placed in grafted maxillary areas, 55 placed simultaneously and 47 delayed. Patients were contacted, invited to participate, and, upon agreement, instructed to sign an informed consent. RESULTS: A total of 45 implants were evaluated clinically (22 immediate and 23 delayed), all with 100% success (according to Buser and Weber criteria). In the sample group, 72.5% of the participants were women and 26.8% were men; their ages ranged from 42 to 87 years, with a mean age of 57 years. Patient participation was low (44%). The categories of appearance and esthetics and function were both rated at 86.2%; cost of restoration came in at 86.1%, and maintenance was rated at 71.2%. CONCLUSION: Implant placement with simultaneous sinus augmentation was successful, and no differences were found between implants that were placed immediately and those that were delayed, which is similar to what has been found by previous studies. Patients reported being satisfied with the final cost of the implant restoration.

Prevalence and Possible Risk Factors of Peri-implantitis: A Concept Review.

AIM: The purpose of this review is to estimate the prevalence of peri-implantitis, as well as to determine possible risk factors associated with its development in patients treated with oral implants. BACKGROUND: Although implant therapy has been identified as a successful and predictable treatment for partially and fully edentulous patients, complications and failures can occur. Peri-implantitis is considered a biologic complication that results in bone loss around implants and may lead to implant treatment failure. RESULTS: A great variation has been observed in the literature regarding the prevalence of peri-implantitis according to the diagnostic criteria used to define peri-implantitis. The prevalence ranges from 4.7 to 43% at implant level, and from 8.9 to > 56% at patient level. Many risk factors that may lead to the establishment and progression of peri-implantitis have been suggested. There is strong evidence that presence and history of periodontitis are potential risk factors for peri-implantitis. Cigarette smoking has not yet been conclusively established as a risk factor for peri-implantitis, although extra care should be taken with dental implant in smokers. Other risk factors, such as diabetes, genetic traits, implant surface roughness and presence of keratinized mucosa still require further investigation. CONCLUSION: Peri-implantitis is not an uncommon complication following implant therapy. A higher prevalence of peri-implantitis has been identified for patients with presence or history of periodontal disease and for smokers. Until now, a true risk factor for peri-implantitis has not been established. Supportive maintenance program is essential for the long-term success of treatments with oral implants. CLINICAL SIGNIFICANCE: The knowledge of the real impact of peri-implantitis on the outcome of treatments with oral implants as well as the identification of risk factors associated to this inflammatory condition are essential for the development of supportive maintenance programs and the establishment of prevention protocols.

Avaliação das taxas de sucesso e sobrevivência de 497 implantes há cinco anos ou mais em função – estudo retrospectivo com 139 pacientes / Success and survival rates of 497 implants with at least 5 years of function – a retrospective study with 139 patients

Objetivo: avaliar as taxas de sucesso e sobrevivência de implantes há cinco anos ou mais em função. Material e métodos: pacientes tratados com implantes de titânio (Implacil De Bortoli, São Paulo, Brasil) na Fundecto (USP), no período de 1998 a 2008 foram incluídos neste estudo. Os implantes foram classificados individualmente, de acordo com um rigoroso critério de sucesso. Também foram levados em consideração o formato e o tipo de plataforma dos implantes. Resultados: a taxa de sobrevivência dos implantes tipo hexágono externo (n=357) e interno (n=140) foi de 99,4% e 99,3%, respectivamente. Já com relação aos implantes cônicos (n=88) e cilíndricos (n=409), a taxa de sobrevivência foi de 100% e 99,3%, respectivamente. A taxa de sucesso para implantes tipo hexágono externo e interno foi de 90,8% e 93,6%, respectivamente. Implantes cônicos obtiveram 90,9%, enquanto que implantes cilíndricos apresentaram 91,7% de taxa de sucesso. Conclusão: de acordo com o presente estudo, a taxa geral de sobrevivência dos implantes foi de 99,4%, enquanto a taxa de sucesso foi de 91,5%.

Objective: to assess success and survival rates from implants in function for five or more years. Material and methods: patients treated with osseointegrated implants (Implacil De Bortoli, Sao Paulo, Brazil) at Fundecto (USP), from 1998 to 2008, were included in this study. Implants were individually classified using strict success criteria. For further analysis, data were obtained regarding implant’s platform and implant’s macro design. Results: survival rates for external (n=357) and internal hexagon implants (n=140) were 99,4% and 99,3%, respectively. Regarding tapered (n=88) and cylindrical implants (n=409), survival rates were 100% and 99,3%, respectively. Success rates for external and internal hexagon implants were 90,8% and 93,6%. Tapered implants had 90,9% and cylindrical implants presented 91,7% of success rates. Conclusion: according to this retrospective study, the overall survival rate was 99,4% and the overall success rate was 91,5%.

Stability of implants placed in augmented posterior mandible after alveolar osteotomy using resorbable nonceramic hydroxyapatite or intraoral autogenous bone: 12-month follow-up.

PURPOSE: This prospective, controlled split-mouth study evaluated the stability of dental implants placed in the augmented mandibular areas with alveolar segmental "sandwich" osteotomies using nonceramic hydroxyapatite (ncHA) or autogenous bone. MATERIAL AND METHODS: This study included 11 bilaterally partially edentulous mandibular patients in a split-mouth design. Alveolar augmentation osteotomies were performed bilaterally with interpositional ncHA graft (test group) or interpositional intraoral autogenous bone graft (control group). After 6 months of healing, four implants (two implants in each side) were placed in each patient. Forty-four implants were inserted and loaded after 6-month healing period. At 1-year follow-up, radiographic, prosthetic, and resonance frequency analysis parameters were assessed. Success criteria included absence of pain, sensitivity, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact (DIB) < 2 mm. RESULTS: After a 1-year loading period, the overall implant survival rate was 95.45%, with two implant losses (one of each group). Among the surviving implants (42 out of 44), two did not fulfill the success criteria; therefore, the implant success was 90.90%. DIB was 0.71 ± 0.70 and 0.84 ± 0.72 mm for ncHA and autogenous bone grafts, respectively (p > .05). Implant stability measurements were similar between the groups during the 12-month follow-up (p > .05). CONCLUSION: Within the limits of this study, the implants placed either in sites augmented with ncHA or autogenous bone seem to represent a safe and successful procedure, at least, after 12-month follow-up.

Estudos longitudinais e sucesso na implantodontia / Longitudinal studies and success rates in implant dentistry: a literature review

Atualmente, observamos maior procura pelos tratamentos através dos implantes osseointegráveis para a reabilitação dos dentes perdidos. Isto deve-se a uma crescente conscientização dos pacientes em relação ao sucesso e aos benefícios dos implantes. Com isso, torna-se fundamental a busca por técnicas, materiais e protocolos que forneçam maior segurança e previsibilidade aos tratamentos, bem como a necessidade da realização de mais estudos longitudinais. O primeiro estudo avaliando os implantes osseointegráveis foi publicado em 1981 e, desde então, inúmeros outros trabalhos foram realizados. Contudo, estudos longitudinais que realizaram um acompanhamento a longo prazo ainda são escassos. Desta forma, o objetivo do presente trabalho foi realizar, através de uma revisão da literatura, a busca de estudos longitudinais avaliando o desempenho clínico dos implantes, bem como os parâmetros e as escalas de sucesso utilizados por eles.

Nowadays, there is an increasing demand for dental implant treatment to replace lost teeth. This can be due to great patient awareness about the related success and benefits of this therapy. Thus, the use of well-established materials, techniques, and protocols for predictable outcomes, as well as new longitudinal studies, is mandatory. The first study on osseointegrated implants was published in 1981 and since then several papers were presented. However, long-term studies are scarce. In this way, the aim of this paper is to review longitudinal studies regarding the long-term performance of dental implants along with its scales and parameters used to define success levels.

Evaluación clínico-radiográfica del éxito y supervivencia de implantes dentales con tratamiento de superficie e implantes con superficie torneada / Clinical-radiographic success and survival with implants dental surface treatment and surface turned

El objetivo principal del estudio fue evaluar la influencia del tratamiento de superficie del implante en el éxito y supervivencia de estos. Se evaluaron 24 pacientes que presentaban un total de 74 implantes dentales oseointegrados, 19 con superficie torneada y 55 superficie RBM® (Lifecore® Biomedical, Chaska, Minn). Los resultados obtenidos fueron una tasa de supervivencia de 98.18% para los implantes de superficie RBM®, 100% para los de superficie lisa y para el total de implantes 98.65%. La tasa de éxito para los implantes de superficie lisa fue 63.16%, para los de superficie RBM® 70.91% y para el total de implantes 68.92%; sin encontrar diferencias estadísticamente significativas entre estas. La pérdida ósea fue 1.82mm para los implantes de superficie torneada y 1.34mm para los de superficie RBM®, encontrándose esta diferencia estadísticamente significativa. Los resultados obtenidos indican que los implantes con superficie RBM® a comparación de los implantes con superficie torneada, presentan ventajas con respecto a la pérdida ósea marginal. También se observó que la variable que mayor influencia ejerce sobre la pérdida ósea marginal y el éxito del implante es el momento de la carga.

The principal aim of our study was to evaluate the survival and success rate of implants with treated surface (RBM®) and machined surface implants. 24 patients treated with 74 dental implants were evaluated. 19 machined surface implants and 55 RBM® surface implants (Lifecore® Biomedical, Chaska, Minn). The results were a survival rate of 98.18 % for RBM® implants, 100% for machined or smooth surface and 98.65 % and for the whole of implants. The success rate for smooth implants was 63.16% for RBM® implants was 70.91% and for the whole of implants was 68.92%. These results were not significantly different. However, peri-implant bone loss was significantly different between smooth implants (1.82mm) and RBM® implants 1.34. The results indicate that implants RBM present advantages with regard to the marginal bone loss. Also was observed that the load time is the variable that major influence has on the marginal bone loss and the implant success.