Successful Management of Ludwig's Angina due to Dental Implant Displacement: A Rare Case Report.

Dental implant surgery is a common procedure in oral and maxillofacial surgery practices. Extensive training, skill, and experience allow this procedure to be performed with an atraumatic approach, but like any surgical technique, it is subject to accidents and complications. This is an unusual clinical case of an accidental displacement of an implant into the submandibular space that progressed to Ludwig's angina, and it has not yet been described in the literature. This case report describes a clinical case of dental implant displaced into the submandibular space after healing cap removal. After seven days, it progressed to Ludwig's angina. The removal was performed through extraoral access in the submandibular area by using hemostatic forceps and radioscopic technique. After implant removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical planning to achieve an appropriate treatment plan, which is essential for a favorable prognosis. Therefore, prevention and management of displaced objects requires proper planning and surgical technique.

Influence of implants with different sizes and configurations installed immediately into extraction sockets on peri-implant hard and soft tissues: an experimental study in dogs.

AIM: To study the influence on the healing of soft and hard peri-implant tissues when implants of different sizes and configurations were installed into sockets immediately after tooth extraction. MATERIAL AND METHODS: Transmucosal cylindrical implants, 3.3 mm in diameter in the control sites, and conical 5 mm in diameter in the test sites, were installed into the distal socket of the fourth mandibular premolars in dogs immediately after tooth extraction. After 4 months, the hard and soft tissue healing was evaluated histologically. RESULTS: All implants were integrated in mineralized mature bone. Both at the test and control sites, the alveolar crest underwent resorption. The buccal bony surface at the implant test sites (conical; 3.8 mm) was more resorbed compared with the control sites (cylindrical; 1.6 mm). The soft tissue dimensions were similar in both groups. However, in relation to the implant shoulder, the peri-implant mucosa was located more apically at the test compared with the control sites. CONCLUSION: The present study confirmed that the distance between the implant surface and the outer contour of the buccal alveolar bony crest influenced the degree of resorption of the buccal bone plate. Consequently, in relation to the implant shoulder, the peri-implant mucosa will be established at a more apical level, if the distance between the implant surface and the outer contour of the alveolar crest is small.

Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog.

AIM: To evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri-implant tissue dimensions in a dog model. MATERIAL AND METHODS: Mandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough surface, were installed on each side of the mandible in the premolar region. On the right side of the mandible, implants with a tapered and enlarged platform were used, while standard cylindrical implants were installed in the left side of the mandible. Abutments with the diameter of the cylindrical implants were used resulting in a mismatch of 0.25 mm at the tapered implant sites. The flaps were sutured to allow a non-submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment. RESULTS: All implants were completely osseointegrated. A minimal buccal bone resorption was observed for both implant configurations and surface topographies. Considering the animals as the statistical unit, no significant differences were found at the buccal aspect in relation to bone levels and soft tissue dimensions. The surface topographies did not influence the outcomes either. CONCLUSIONS: The present study failed to show differences in peri-implant tissue dimensions when a mismatch of 0.25 mm from a tapered platform to an abutment was applied. The surface topographies influence a neither marginal bone resorption or peri-implant soft tissue dimension.

Analysis in vitro of direct bonding system with cyanoacrylate ester and orthodontic wires.

The aim of this study was to evaluate the tensile strength of orthodontic wires bonded onto the enamel with cyanoacrylate ester. To obtain the specimens, 120 human premolars (extracted for orthodontic or periodontal reasons) were included in acrylic blocks of rapid polymerization with three teeth each. Four groups were formed with ten specimens each. In the specimens, a dental splint model was made with cyanoacrylate ester and round stainless steel wire. In groups I, II and III, cyanoacrylate ester was used with round steel wires, with variation in diameter: 0.014 inches; 0.016 inches and 0.018 inches, respectively. In group IV, round steel wire 0.018 inches was used with photo polymerizing resin composite with previous acid etching. The adhesive force of the materials was measured in two points under the action of the tensiometer (ETM-USA). The number of loose wires was counted along with those that remained fixed according to the different levels of force applied because of the direction of the tensile force (vertical or horizontal) and the diameter of the wire used. The data obtained were first submitted to a descriptive analysis and then submitted to a statistical analysis (Friedman's Test and Dunn's Test of Multiple Comparison - Epi-info 3.2). Within the limitations of the experimental conditions presented, the cyanoacrylate ester or 'Super Bonder' maintained bonded to enamel and steel wires (0.016 and 0.018 inches) during the tensile strength tests under different levels of applied forces.