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ABSTRACT This clinical report describes the implant rehabilitation for the treatment of pathological roots resorption due to inadequate orthodontic movement in prosthetic space reduced by means of load and immediate implants, computer-guided surgery and use of the own tooth crown in a 21-year-old-patient. The atraumatic exodontics of the right and left upper lateral incisors was performed, and then immediate placement of osseointegrated implants using the computer guided surgery technique. The crown teeth itself was used in the immediate aesthetic and functional rehabilitation. Completion of the treatment resulted in a functional and aesthetic successful outcome and a 27 months follow-up presented uneventful. The procedures included in this complex rehabilitation treatment in the esthetic zone were appropriate and essential for the maintenance of the soft and hard tissues contour and thickness ensuring the excellence in rehabilitation.

RESUMO Este relato de caso clínico descreve a reabilitação com implantes para o tratamento da reabsorção radicular patológica devido à movimentação ortodôntica inadequada em espaço protético reduzido, por meio implante imediato e carga imediata, pela técnica da cirurgia guiada por computador e uso da própria coroa dentária, em paciente de 21 anos. A exodontia atraumática dos incisivos laterais superiores direito e esquerdo foi realizada, em seguida realizou-se a instalação imediata dos implantes osseointegráveis, utilizando a técnica de cirurgia guiada por computador. Os próprios dentes da coroa foram usados na reabilitação estética e funcional imediata. A conclusão do tratamento resultou em sucesso funcional e estético com acompanhamento de 27 meses sem intercorrências. Os procedimentos incluídos neste complexo tratamento de reabilitação na zona estética foram adequados e essenciais para a manutenção do contorno e espessura dos tecidos moles e duros garantindo a excelência na reabilitação.

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PURPOSE: To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. METHODS: Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. RESULTS: The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively. CONCLUSION: Subcutaneous injection of nicotine following implant insertion didn't have effect on osseointegration, independently from the implant surface.

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Purpose: To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. Methods: Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. Results: The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively.Conclusion: Subcutaneous injection of nicotine following implant insertion didnt have effect on osseointegration, independently from the implant surface.(AU)

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Abstract Purpose: To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. Methods: Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. Results: The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively. Conclusion: Subcutaneous injection of nicotine following implant insertion didn't have effect on osseointegration, independently from the implant surface.

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ABSTRACT: Ameloblastoma is a rare tumor that affects the maxillomandibular region. Surgical resection is often indicated, and oral rehabilitation becomes a challenge. This study aims to report on the mandibular rehabilitation with implant supported prosthesis using immediate loading with subsequent resection. A patient with a confirmed diagnosis of multicystic ameloblastoma in the left jaw underwent a partial resection of the mandible and a reconstruction with a titanium plate. After 2 years of follow-up with clinical examinations and imaging testing and with no signs of recurrence, the patient underwent the technique of immediate load implants, rehabilitating the mandible with an implant supported fixed prosthesis and the maxilla with a conventional complete denture. During the seven years of follow-up with the patient, there was no sign of recurrence of ameloblastoma. The rehabilitation with oral implants under immediate loading demonstrated to be successful, and the cemented cylinder technique used in this study coupled with passivity showed a favorable prognosis for the longevity of implants.

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PURPOSE: This study aimed to describe the clinical case of implant placement in the nasopalatine canal as an aid for atrophic maxilla rehabilitation. CASE REPORT: The surgical procedure was carried out in 2 stages, the first part consisted of a surgery to lift the maxillary sinus membrane associated with the xenogeneic bone placement and the second part consisted of the surgery for the implants placement, both under local anesthesia. A number of seven osseointegrated implants were placed in the maxilla, one was anchored in the nasopalatine canal region after having its neurovascular content emptied by means of the use of drill threads of the implant system. After 5 months, the implant reopening was carried out, followed by the molding, manufacturing and placement of the protocol-type prosthesis. The case has a 4-year follow-up without any painful symptomatology. CONCLUSION: The implant placed in the nasopalatine canal region is a viable option to assist in the rehabilitation with implant-supported prostheses in atrophic maxilla.

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Introdução: estudos mostram que condições socioeconômicas podem interferir no nível de conhecimento dos pais sobre higiene bucal dos filhos, influenciando diretamente no índice de cárie. Objetivo: Avaliar o nível sócioeconômico e o conhecimento de uma amostra de 127 pais/responsáveis e correlacioná-lo com o índice de cárie diagnosticado em seus filhos com idades variando entre 3 e 5 anos. Método: foi aplicado um questionário composto por questões fechadas, abordando condições socioeconômicas e conhecimento dos pais/responsáveis sobre saúde e higienização bucal na primeira infância. Um único examinador calibrado realizou o levantamento epidemiológico nos filhos dos pais participantes. Os dados foram analisados por estatística descritiva e pelo teste de correlação linear de Pearson a um nível de significância de 5%. Resultados e Discussão: 60% dos pais possuíam renda de 3 a 5 salários mínimos, 70% com ensino médio completo e 73% das crianças com ceo-d=0. Ao avaliar a correlação entre o conhecimento dos pais/responsáveis e demais variáveis, observou-se diferença estatisticamente significante com o nível econômico/renda (p=0,006) e também com o grau de escolaridade dos pais (p=0,001). Houve diferença estatisticamente significante entre a correlação de índice de ceo-d e o conhecimento sobre saúde bucal (p=0,02). Não foi constatada correlação estatisticamente significante entre o índice ceo-d e a renda familiar (p=0,95), nem com o grau de escolaridade dos pais (p=0,06). Conclusão: concluiu-se que houve correlação negativa entre o índice de ceo-d das crianças e o conhecimento dos pais/responsáveis sobre saúde bucal, e correlação positiva entre o conhecimento dos pais/responsáveis e o nível sócioeconômico.(AU)

Introduction: studies show that socioeconomic conditions may interfere with parents' knowledge about oral hygiene of children, and then influencing caries index. Objective: to evaluate the socioeconomic level and knowledge of a sample of 127 parents/guardians and correlate it with caries index diagnosed in their children, ranging 3 to 5 years. Method: a questionnaire composed of closed questions was applied, addressing socioeconomic conditions and knowledge of parents/guardians about health and oral hygiene in early childhood. A single calibrated examiner performed the epidemiological survey on children of the participating parents. Data were analyzed by descriptive statistics and Pearson's linear correlation test at a significance level of 5%. Results and Discussion: 60% of the parents had income of 3 to 5 minimum wages, 70% with complete secondary education and 73% of the children with ceo-d = 0. When assessing the correlation between parents/guardians' knowledge and other variables, a statistically significant difference was observed with economic/income level (p = 0.006) and also with the parents' educational level (p = 0.001). There was a statistically significant difference between the correlation of ceo-d index and knowledge about oral health (p = 0.02). No statistically significant correlation was found between the ceo-d index and the family income (p = 0.95), nor with the parents' educational level (p = 0.06).Conclusion: it was concluded that there was a negative correlation between the children's ceo-d index and the knowledge of the parents/guardians about oral health, and a positive correlation between the knowledge of the parents/guardians and the socio-economic level.(AU)

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This study aimed to histometrically evaluate the presence of gingival recession in the mesial surface of the teeth of rats experimentally subjected to primary occlusal trauma. This evaluation verified the distance from the cement-enamel junction (CEJ) to the free marginal gingiva (FMG) and to the height of the alveolar bone crest (CEJ-crest bone distance). There were 10 animals, randomly divided into 2 groups: occlusal trauma (OT) (n = 5) - creation of an occlusal interference by fixing an orthodontic wire segment on the mandibular first molar occlusal face, which was randomly chosen, and a Control Group (CG) (n = 5) - five animals with no exposure to the OT variable were euthanised after 14 days to obtain the initial parameters. The inter-group evaluation showed there was no significant difference between OT × CG when the CEJ-FGM distance (P = 0.192) was evaluated after 14 days, but there was a significant difference between the two groups as regards the CEJ-alveolar crest bone distance (P = 0.0142). Thus, it can be concluded that the OT induction model, after 14 days of experiment, promoted bone resorption. This was observed by the increase in the CEJ-alveolar crest bone distance. It also did not promote gingival recession, which was evaluated by the CEJ-FGM distance.

El objetivo de este estudio fue evaluar histométricamente en ratas la presencia de recesión gingival en la superficie mesial de los dientes sometidos experimentalmente a trauma oclusal primario a partir de la evaluación de la distancia desde la unión esmalte cemento (CEJ) a la encía marginal libre y la altura de la cresta ósea restante (distancia de la CEJ-cresta ósea) Con este fin, 10 animales fueron divididos al azar en 2 grupos: trauma oclusal (TO) (n = 5) - creación de una interferencia oclusal mediante la fijación de un segmento de alambre de ortodoncia en la superficie oclusal del primer molar elegido al azar; y un grupo control (CO) (n = 5) -5 animales sin la introducción de la variable TO fueron sometidos a eutanasia después de 14 días para obtener los parámetros iniciales. La evaluación intergrupo no mostró diferencias significativas entre los grupos TO × CO al evaluar después de 14 días la distancia de la CEJ-encía marginal libre (p = 0,192) pero mostró una diferencia significativa entre los grupos TO × CO en cuanto a distancia de la CEJ-cresta ósea alveolar (p = 0,0142). Por lo tanto, se concluye que el modelo de inducción del TO después de 14 días del experimento promueve reabsorción ósea siendo observado por el aumento en la distancia de la CEJ-cresta ósea alveolar y no promueve la recesión gingival evaluada a partir de la distancia de la CEJ-encía marginal.

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PURPOSE: To evaluate a modified experimental model for medication-related osteonecrosis of the jaw (MRONJ) through the upper right central incisor extraction followed by intravenous bisphosphonate administration. METHODS: Forty five rats underwent the upper right central incisor tooth extraction were divided in 2 groups: Group I - experimental group, 30 rats received an intravenous administration protocol of zoledronic acid 35µg/kg into the tail vein every two weeks, totalizing four administrations, during eight weeks of administration, previously the extraction, and Group II - control group, 15 rats didn't received any medication before extraction. The groups were subdivided in postoperative periods: 14/28/42 days. Clinical analysis and microtomography were performed to verify the presence of osteonecrosis. In addition, descritive histological analysis of hematoxylin-eosin stained sections was performed to evaluate the presence of osteonecrosis or necrotic foci. RESULTS: Twelve (40%) rats, from experimental group, showed clinical signs of MRONJ (p=0.005), however, all samples showed imaginologic findings like osteolysis and loss of integrity of the cellular walls (p≤0.001). Microscopic evaluation revealed osteonecrosis areas with microbial colonies and inflammatory infiltrate (p≤0.001). In the control group, all animals presented the chronology of a normal wound healing. CONCLUSIONS: The presence of medication-related osteonecrosis of the jaw after maxillary central incisor extraction in rats. This new experimental model may be considered an option for the study of MRONJ.

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Na reabilitação implantossuportada em pacientes com edentulismo maxilar com atrofia óssea, em decorrência da reabsorção e pneumatização do seio maxilar, frequentemente, tem sido utilizada a técnica de elevação do assoalho do seio maxilar, que pode resultar em complicações, incluindo a perfuração da membrana de Schneider. Assim, o objetivo deste estudo foi relatar a técnica alternativa para o tratamento de uma extensa perfuração da membrana sinusal durante uma cirurgia de elevação do assoalho do seio maxilar. Paciente do sexo feminino, com 55 anos de idade. Durante a cirurgia de elevação da membrana sinusal, ocorreu perfuração de aproximadamente 2 cm de extensão. O tratamento proposto foi a técnica alternativa com utilização de membrana de colágeno, para reparar a membrana de Schneider e possibilitar a inserção e manutenção do substituto ósseo. No caso exposto, a membrana de colágeno reabsorvível demonstrou ser um método eficaz para o tratamento de uma extensa perfuração da membrana sinusal.

Generally, the sinus lifting technique has been used for patients with extensive atrophic areas in the maxillary arch due to the pneumatization process, but complications can be found, including the Schneider membrane perforation. Thus, the aim of this article is to present a clinical alternative to treat a large perforation of the sinus membrane during the surgical process. A 55 years-old female patient demonstrated a 2 cm width tearing during the operation. The proposed treatment was the use of a collagen membrane to repair the surgical field and to provide access for the bone substitute. The combined procedure is an efficient method in this kind of maxillary sinus complication.

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