Atrophic Maxilla Rehabilitation Through Dental Implants Using the V-4 Strategy Associated With Guided Surgery: A Case Report and Technique Description.

Atrophic maxilla rehabilitation through dental implants is always a challenging procedure. However, alternative approaches such as guided surgery and the installation of short implants are progressively supplanting more invasive bone regeneration procedures. A V-4 technique described in 2016 facilitates the installation of dental implants in patients with atrophic maxilla; however, its authors recommend incision, flap opening, and elevation of the anterior area of the maxillary sinuses. This case report describes a less invasive proposal for modifying the technique through the association of guided surgery, which improves implant placement accuracy, shortens surgical time, and reduces morbidity.

Guided Surgery in Esthetic Region.

The placement of dental implants and subsequent placement of immediate temporary dentures after extractions has become a treatment modality accepted by the scientific community. In addition to the functional factor, the surgical procedure in a single stage in the anterior region of the maxilla offers an esthetic appearance, and relieves the psychological concerns of patients. To guarantee the success and longevity of treatments performed, the fabrication of surgical guides is a helpful method in these situations. Guided surgery has gained attention because it restores esthetics with immediate restoration, provides the patient with comfort in addition to dispensing with the need for performing surgical flaps. This auxiliary method allows the position and design of the implant, as well as the perforation sequence to be programmed, thus optimizing the clinical results. In this study, the authors present a clinical case of a patient who was submitted to extraction and subsequent implant placement with immediate loading in the anterior region of the maxilla, performed in a satisfactory manner.

Implantes contíguos na área estética: relato de caso / Contíguous Implants in the anterior region: case report

Apesar do avanço no conhecimento científico biológico e com melhores instrumentos para o planejamento, a perda de dois elementos dentários contíguos na região maxilar anterior continua sendo um grande desafio estético quando utilizamos a terapia com implantes osseointegrados. Este artigo relata um caso clínico em que um paciente do sexo masculino, 27 anos, teve dois incisivos centrais substituídos por implantes osseointegrados após o trauma. A opção foi a instalação de um implante no local incisivo central esquerdo com uma coroa provisória imediata cimentada, e atrasar a implantação no sítio do incisivo direito por seis meses. Regeneração Tecidual Guiada (RTG) foi necessária para o site incisivo central direito. Osso bovino desproteinizado com colágeno a 10% (Bio-Oss Collagen®) foi usado em conjunto com uma membrana de colágéno natural (Geistlich Bio Gide®). Depois de seis meses, um implante foi instalado no sítio do incisivo direito e, após período igual de tempo, duas coroas de cerâmica com base CAD-CAM de zircônia foram cimentadas. A proservação de seis meses demonstra boa estabilidade dos tecidos (AU).

Better planning tools are available, but, even following biological scientific parameters, the substitution of two adjacent teeth in the maxillary anterior region remains a major challenge when using cosmetic dental implants therapy. This article reports a clinical case where a male patient, 27 years old, had two central incisors replaced by osseointegrated implants after trauma. The option was to perform the immediate installation of an implant at the left central incisor site with a cemented immediate provisional crown, and delay for six months the placement of the implant at the right incisor site. Guided tissue regeneration (GTR) was necessary for the right central incisor site. Deproteinized bovine grafting material with 10% collagen (Bio-Oss Collagen®) was used with a natural collagen membrane (BioGide®). Six months later an implant was installed at the right incisor site and, after the same period of time, after casting and scanning, two CAD-CAM zirconia based ceramic crowns were cemented. After six months the tissues showed good stability (AU).

Tridimensional analysis of maxillary sinus anatomy related to sinus lift procedure.

PURPOSE: To evaluate the angulation of the maxillary sinus walls at the apical sinus region. MATERIALS AND METHODS: Using preoperative computerized tomographies of 15 patients selected for sinus lift procedures, the angulation of the maxillary sinus floor was measured drawing straight lines tangential to the mesial and lateral walls. The measurements were taken from sagittal images at specific areas (i.e., second bicuspid, first molar, and second molar). RESULTS: The results showed that the second bicuspid sites have a sharper angulation than the second molar sites, and these second molar sites have a sharper angle than the first molar sites. CONCLUSION: The sharper angle observed in the second bicuspid area can influence the feasibility of schneiderian membrane evaluation when compared to the molar areas.

Carga imediata em implantes instalados em pacientes totalmente edêntulos. Relato de um caso de sobredentadura / Immediate loading in implants placed in totally adentulous patiens. An overdenture case report

A instalação de implantes com carga imediata em pacientes edêntulos é apresentada como uma alteração do protocolo original dos implantes osseointegrados que recomenda um período de reparo tecidual de três a seis meses. O objetivo deste artigo é apresentar um caso clínico onde a resolução terapêutica encontrada foi o emprego de implantes com cargas imediatas e uma prótese em sobredentadura. A racionalidade deste procedimento é discutida