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OBJECTIVES: The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. MATERIALS AND METHODS: Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. RESULTS: Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) CONCLUSIONS: ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. CLINICAL RELEVANCE: Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.
Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Perda do Osso Alveolar/diagnóstico por imagem , Implantes Dentários/efeitos adversos , Prótese Dentária Fixada por Implante , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Análise Multivariada , Peri-Implantite/diagnóstico por imagem , Estudos RetrospectivosRESUMO
Agenesis of lateral incisors, besides the functional issues, represents a great esthetic drawback. The selection of an appropriate treatment is a complex decision, which should consider the stability of the clinical outcomes over time. The aim of the present study was a histological and clinical comparison of two-stage split crest technique (SCT), with bone chips alone or mixed with porcine bone in patients affected by unilateral and bilateral agenesis of the upper lateral incisors. Eleven patients were enrolled, and randomly assigned to receive a treatment with autologous bone chips (group 1) or autologous bone chips mixed 1:1 to porcine-derived xenogenic bone (group 2). After a 2-month healing period, implants were placed and biopsies harvested for histomorphometrical evaluation. Clinical assessment, according to ICOI PISA health scale, and radiographic marginal bone loss evaluation at 12- and 24-month follow-ups were conducted. The histomorphometry showed significantly greater new bone formation (p > 0.0229) in group 2. At 12- and 24-month follow-ups, all the evaluated implants, regardless of the group they were allocated, could be categorized as "success" in the ICOI Pisa Health Scale for Dental Implants, and did not show significant difference in crestal bone loss. To the best of our knowledge, these are the first histological and clinical outcomes indicating that the use of bone chips mixed 1:1 to porcine bone in SCT could be a promising technique for the rehabilitation of patients with agenesis of the upper lateral incisors, although studies with a larger number of patients and implants, and a longer follow up are needed.
Assuntos
Incisivo , Perda do Osso Alveolar , Implantação Dentária Endóssea , Implantes Dentários , Seguimentos , Humanos , Projetos PilotoRESUMO
Abstract Agenesis of lateral incisors, besides the functional issues, represents a great esthetic drawback. The selection of an appropriate treatment is a complex decision, which should consider the stability of the clinical outcomes over time. The aim of the present study was a histological and clinical comparison of two-stage split crest technique (SCT), with bone chips alone or mixed with porcine bone in patients affected by unilateral and bilateral agenesis of the upper lateral incisors. Eleven patients were enrolled, and randomly assigned to receive a treatment with autologous bone chips (group 1) or autologous bone chips mixed 1:1 to porcine-derived xenogenic bone (group 2). After a 2-month healing period, implants were placed and biopsies harvested for histomorphometrical evaluation. Clinical assessment, according to ICOI PISA health scale, and radiographic marginal bone loss evaluation at 12- and 24-month follow-ups were conducted. The histomorphometry showed significantly greater new bone formation (p > 0.0229) in group 2. At 12- and 24-month follow-ups, all the evaluated implants, regardless of the group they were allocated, could be categorized as "success" in the ICOI Pisa Health Scale for Dental Implants, and did not show significant difference in crestal bone loss. To the best of our knowledge, these are the first histological and clinical outcomes indicating that the use of bone chips mixed 1:1 to porcine bone in SCT could be a promising technique for the rehabilitation of patients with agenesis of the upper lateral incisors, although studies with a larger number of patients and implants, and a longer follow up are needed.
Assuntos
Humanos , Incisivo , Implantes Dentários , Projetos Piloto , Seguimentos , Perda do Osso Alveolar , Implantação Dentária EndósseaRESUMO
The aim of this in vitro study was to evaluate the effect of air polishing on the implant abutment surface using different abrasive powders: sodium bicarbonate and amino acid glycine. Fifteen grade III machined surface titanium disks with 8-mm diameter and 2-mm thickness were divided in 3 groups of 5 samples each and subjected to air polishing for 20 seconds with an Ultrajet Flex air-abrasive device and a distinct prophylaxis protocol: air and water (G1); air, water, and sodium bicarbonate (G2); and air, water; and amino acid glycine (G3). After the air polishing, the average roughness (Ra) of the samples was measured using an optical profilometer, and the obtained data were statistically analyzed. We found that G1 and G3 had similar Ra, while Ra values for G2 were significantly higher. This study demonstrated that air-polishing powders containing glycine had less of an effect on the roughness of the surface of titanium disks compared with sodium bicarbonate powders. Future in vivo studies will be conducted to investigate the clinical relevance of the present results.
Assuntos
Dente Suporte , Implantes Dentários , Polimento Dentário , Bicarbonato de Sódio , Teste de Materiais , Pós , Propriedades de Superfície , TitânioRESUMO
OBJECTIVES: Osteocytes have emerged as key regulators of skeletal and mineral homeostasis. The number of these cells could be influenced by the presence of osteoporosis and osteopenia. Hence, the aim this study was to evaluate the osteocyte density in patients with osteopenia, and in patients with osteoporosis treated with bisphosphonates. MATERIALS AND METHODS: Thirty-nine patients were selected for this study and divided into three groups: (A) nine healthy patients (control), (B) 15 patients with osteopenia, and (C) 15 patients with osteoporosis. During the surgical insertion of dental implants in the lower jaw, bone samples were retrieved and processed for histological analysis of osteocyte density, measured as number of osteocytes/bone tissue area (µm(2) ). RESULTS: Patients with osteopenia showed statistically higher values of osteocyte density than patients with osteoporosis (P < 0.05) No significant differences were detected between osteopenia and osteoporosis subjects vs. healthy patients (P > 0.05). CONCLUSIONS: Bone metabolism diseases (osteoporosis and osteopenia) do not seem to influence the osteocyte density; this could be due to the administration of bisphosphonates in patients with osteoporosis. This information could play a fundamental role in the diagnosis and treatment of patients in a postmenopausal stage.
Assuntos
Alendronato/farmacologia , Conservadores da Densidade Óssea/farmacologia , Doenças Ósseas Metabólicas/tratamento farmacológico , Implantação Dentária Endóssea , Implantes Dentários , Difosfonatos/farmacologia , Arcada Edêntula/cirurgia , Mandíbula/citologia , Mandíbula/cirurgia , Osteócitos/citologia , Osteoporose/tratamento farmacológico , Absorciometria de Fóton , Densidade Óssea , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/diagnóstico por imagem , Feminino , Humanos , Arcada Edêntula/diagnóstico por imagem , Arcada Edêntula/patologia , Mandíbula/diagnóstico por imagem , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Estudos ProspectivosRESUMO
The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.
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PURPOSE: In vivo bone response was assessed by removal torque, hystological and histometrical analysis on a recently developed biomedical Ti-15Mo alloy, after surface modification by laser beam irradiation, installed in the tibia of rabbits. MATERIALS AND METHODS: A total of 32 wide cylindrical Ti-15Mo dental implants were obtained (10mm × 3.75mm). The implants were divided into two groups: 1) control samples (Machined surface - MS) and 2) implants with their surface modified by Laser beam-irradiation (Test samples - LS). Six implants of each surface were used for removal torque test and 10 of each surface for histological and histometrical analysis. The implants were placed in the tibial metaphyses of rabbits. RESULTS: Average removal torque was 51.5Ncm to MS and >90Ncm to LS. Bone-to-implant-contact percentage was significantly higher for LS implants both in the cortical and marrow regions. CONCLUSIONS: The present study demonstrated that laser treated Ti-15Mo alloys are promising materials for biomedical application.