Efficacy of Gutta-Percha and Polytetrafluoroethylene Tape to Microbiologically Seal the Screw Access Channel of Different Prosthetic Implant Abutments.

PURPOSE: To evaluate in vitro, the efficacy of gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape to act as a seal against the penetration of Escherichia coli through prosthetic implant abutments (PIA) with external hexagon (EH) and morse taper (MT) connections. MATERIALS AND METHODS: 120 sets of implant analogs with their respective PIA were used. 60 sets from each system were divided into four groups (n = 15): I - GP sealing; II - PTFE tape sealing; III - no sealing (NS) and IV - negative control. Microbiological challenge was performed by placing bacterial colonies inside the titanium PIA before screwing them into their respective analogs. Each set was immersed in 5 mL of BHI and incubated for 14 days with daily checks for contamination, according to the nutrient medium turbidity. RESULTS: The type of seal used influenced microbial penetration at all evaluation times (p < 0.05). Compared to GP, PTFE led to an increase in turbidity and its effectiveness against microbial penetration was equivalent to group NS. When the sealing efficacy of each group was compared in terms of time, Cochran's Q test revealed that in the two groups sealed with PTFE, there was a progressive increase in the number of turbid nutrient media (p < 0.0001), while in the group sealed with GP, this was only observed in the MT system (p = 0.0310). CONCLUSIONS: Sealing the PIA channel with GP was a significantly superior approach to sealing it with PTFE tape. PTFE tape or NS led to a progressive increase in microbiological leakage over time in PIA channels, however, this only occurred with GP in the MT system.

Implantes em pacientes diabéticos - do pré-operatório ao controle a longo prazo / Implants in diabetic patients - the preoperative and a long-term control

A diabetes é uma das principais doenças crônicas degenerativas que acometem o homem. O número de pacientes com diabetes que tem procurado tratamentos odontológcos e, principalmente, reabilitações com implantes aumentou muito nos últimos anos. Esse fato deve-se a evolução do tratamento e dos métodos de controle, que permitem aos seus portadores terem uma vida próxima dos não portadores da doença. Este trabalho tem como objetivo relatar um protocolo e os parâmetros de sucesso para as reabilitações com implantes em pacientes diabéticos.

Diabetes mellitus is one of the main degenerative chronic illnesses affecting the general population and there are an increasing number of those patients searching for dental implants. Treatment has evolved and allowed the affected persons to have a quality of life similar to the non-affected ones and this fact also allowed the diabetic patients to be candidates implant rehabilitation. The aim of this work is to report a protocol and success parameters for diabetic patients.

Avaliação do sucesso de 20 casos de levantamentos de seio maxilar utilizando osso autógeno particulado e Gen-Ox inorgânico associados em partes iguais (1: 1) - controle de dois anos / Success evaluation of 20 cases of maxillary sinus lifting with filled with 1: 1 mixture of particulate, autogenous and Gen-Ox-anorganic bones - a two-year follow-up study

A técnica do levantamento de seio maxilar permite instalação de implantes em regiões maxilares posteriores deficientes. Os autores realizaram 20 casos, dez com 16 implantes instalados no mesmo estágio (grupo 1) e dez com 14 implantes instalados cinco meses após a enxertia (grupo 2). Foi usada uma combinação de osso autógeno particulado e Gen-Ox anorgânico (proporção de 1:1). Seis meses após a instalação dos implantes eles foram reabertos e as próteses metalocerâmicas implantossuportadas foram instaladas. Os pacientes foram submetidos a controles clínicos e radiográficos e após dois anos apresentaram um índice de sucesso de 100% no grupo 1 e 78,6% no grupo 2 com perda de três implantes. O índice de sucesso dos tratamentos independente de grupos foi de 90%.

Maxillary sinus lifting allows implant placement in maxillary posterior deficient areas. The authors performed 20 cases, ten with 16 implants installed in the same day of surgical procedure (group 1) and ten with 14 implants installed five months later (group 2). Six months after implant placement, implant-supported, metalloceramic prostheses were fabricated. Clinical and radiographic follow-ups were made. After two years, a success rate of 100% and 78.6% was verified in groups 1 and 2 (three implants lost), regardless of timing for implant placement. The overall success rate was 90%.

Implantes carregados imediatamente em maxila reconstruída com enxerto de ilíaco: 14 e 30 meses de avaliação / Immediately loaded implants in severely resorbed maxilla reconstructed with iliac bone grafts: an evaluation of 14 and 30 months

A atrofia da maxila é um dos maiores desafios da Implantodontia. A expectativa dos pacientes e a falta de colaboração em ficar sem as próteses dificultam os resultados e tornam restritas a indicação do tratamento. Baseados nestes fatos, os autores realizaram a reconstrução de maxilas atróficas através de enxerto de crista ilíaca com instalação dos implantes em carga imediata. Quatro pacientes portadores de atresia severa de maxila foram submetidos a reconstrução com osso de ilíaco. Após cinco meses os implantes foram instalados e quatro foram submetidos à carga imediata. Seis meses depois os demais implantes foram colocados em função e nova prótese foi confeccionada. Foram instalados 52 implantes, sendo 36 de maneira convencional e 16 em carga imediata. O índice de sucesso obtido foi de 89% nos implantes instalados de maneira convencional (perda de quatro implantes) e de 100% nos implantes instalados em carga imediata. Diante dos resultados obtidos, foi possível concluir que a técnica de reconstrução de maxila através da enxertia, cuja área doadora é a crista ilíaca, apresenta alta previsibilidade, além de se enquadrar nas expectativas do paciente. Os implantes colocados em carga imediata como proposto neste estudo facilitam a aceitação do paciente frente ao tratamento.

Jawbone atrophy is one of the largest challenges of the current implantology. The patients' expectation, along with the lack of cooperation in avoiding the use of their prostheses, hinders the results and treatment indication. Based on these facts the authors accomplished the reconstruction of atrophic jaws through iliac bone crest grafts with immediate loading implant placement. Four patients with severe atrophic maxillary or mandibular deficiencies underwent reconstructive procedures. After five months, the implants were installed and four were submitted to immediate loading. Six months later, the other implants were put into function and new prostheses made. Fifty-two implants were installed, being 36 in a conventional way and 16 immediate loaded. The success rate was 89% for conventional loaded implant (four implants were lost) and 100% in the immediate load protocol. It was possible to conclude that jawbone reconstruction with iliac bone crest graft presents high predictability and responds to patient's expectations. The implants immediately loaded in this treatment planning facilitate patient's acceptance.

Avaliação de 21 casos de enxertos autógenos em bloco na região posterior da mandíbula realizado com incisão em fundo de sulco / A study of 21 cases of bone augmentation in the posterior mandible

As reconstruções na região posterior da mandíbula são bastante complexas e exigem habilidade do cirurgião. O enxerto em bloco é uma boa opção de tratamento, pois é uma técnica fácil quando comparada com as demais alternativas, porém apresentam alto índice de exposição do enxerto. Os autores apresentam 21 casos que necessitavam de reconstrução óssea, sendo 15 para ganho em espessura e cinco para ganho em altura, tratados com enxerto em bloco utilizando incisão em fundo de sulco. Cinco meses depois os implantes foram instalados. Dos enxertos instalados dois apresentaram exposição do bloco, mas mesmo estes permitiram a instalação dos implantes planejados; apenas em um caso foi necessário o uso de regeneração tecidual guiada.

Clinical effectiveness of two microabrasion materials for the removal of enamel fluorosis stains.

This study evaluated the effectiveness of two microabrasion products for the removal of enamel fluorosis stains. Using a split-mouth study design, two operators used PREMA (PM) and Opalustre (OP) to remove fluorosis-like stains from 36 subjects (10-12 years old). Both products were rubbed onto the surface of the affected teeth for 30 seconds. This procedure was repeated five times during each clinical appointment. A maximum of three clinical appointments were scheduled. The subjects and/or their parents were questioned about their satisfaction with the treatment. Two blinded evaluators appraised both sides of the mouth using a visual scale system. The data were analyzed by Friedman repeated measures ANOVA and Wilcoxon test. The majority of the subjects (approximately 97%) reported satisfaction at the end of the treatment (p = 0.0001). A significant improvement in appearance was detected after the second clinical appointment when using PREMA and Opalustre (p < 0.002). After the first clinical appointment, OP showed a statistically higher mean rating for improvement in appearance (3.4 +/- 0.7) than PM (2.4 +/- 0.5) (p = 0.002).

One-year clinical evaluation of a flowable resin liner associated with a microhybrid resin in noncarious cervical lesions.

The aim of this study was to compare the clinical performance over 1 year of a microhybrid composite resin for class V restorations both lined and not lined with a flowable composite resin. Nineteen patients having at least two pairs of cervical noncarious lesions under occlusion were enrolled in this study. A total of 38 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250, and Single-Bond + Filtek Z250). Two calibrated operators placed all restorations according to the manufacturers' instructions. Two other independent examiners evaluated the restorations at baseline and after a 12-month period according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test and McNemar's test (P=0.05). One restoration was lost after 12 months for each group (retention rate 95% for each group). After 12 months, 18 restorations showed a trend towards dark yellowing (color match A2). The use of Filtek Flow as a liner under Filtek Z250 restorations did not improve the clinical performance of class V restorations after 6 and 12 months of evaluation.