RESUMO
The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as "high", "low" and "unclear" risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p <0.05), however statistically significant differences were found for PD between EH and IC implants (1-year follow-up) -0.53 [95%CI -0.82 to -0.24, p = 0.0004]. This present systematic review demonstrated that there are no significant differences between IC and EH implants for both ΔMBL and SR at 1, 3 e 5 years after functional loading, although better PD values were observed for implants pertaining to the IC connections. Considering the high heterogeneity, more well-delineated, randomized clinical trials should be conducted.
Assuntos
Perda do Osso Alveolar/etiologia , Dente Suporte/efeitos adversos , Projeto do Implante Dentário-Pivô/efeitos adversos , Implantes Dentários/efeitos adversos , Humanos , Valores de Referência , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
Abstract The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as "high", "low" and "unclear" risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p <0.05), however statistically significant differences were found for PD between EH and IC implants (1-year follow-up) -0.53 [95%CI -0.82 to -0.24, p = 0.0004]. This present systematic review demonstrated that there are no significant differences between IC and EH implants for both ΔMBL and SR at 1, 3 e 5 years after functional loading, although better PD values were observed for implants pertaining to the IC connections. Considering the high heterogeneity, more well-delineated, randomized clinical trials should be conducted.
Assuntos
Humanos , Implantes Dentários/efeitos adversos , Perda do Osso Alveolar/etiologia , Dente Suporte/efeitos adversos , Projeto do Implante Dentário-Pivô/efeitos adversos , Valores de Referência , Fatores de Tempo , Fatores de Risco , Medição de RiscoRESUMO
Two-piece implant systems are mainly used in oral implantology involving an osseointegrated implant connected to an abutment, which supports prosthetic structures. It is well documented that the presence of microgaps, biofilms and oral fluids at the implant-abutment connection can cause mechanical and biological complications. The aim of this review paper was to report the degradation at the implant-abutment connection by wear and corrosion processes taking place in the oral cavity. Most of the retrieved studies evaluated the wear and corrosion (tribocorrosion) of titanium-based materials used for implants and abutments in artificial saliva. Electrochemical and wear tests together with microscopic techniques were applied to validate the tribocorrosion behavior of the surfaces. A few studies inspected the wear on the inner surfaces of the implant connection as a result of fatigue or removal of abutments. The studies reported increased microgaps after fatigue tests. In addition, data suggest that micromovements occurring at the contacting surfaces can increase the wear of the inner surfaces of the connection. Biofilms and/or glycoproteins act as lubricants, although they can also amplify the corrosion of the surfaces. Consequently, loosening of the implant-abutment connection can take place during mastication. In addition, wear and corrosion debris such as ions and micro- and nanoparticles released into the surrounding tissues can stimulate peri-implant inflammation that can lead to pathologic bone resorption.
Assuntos
Projeto do Implante Dentário-Pivô/efeitos adversos , Implantes Dentários/efeitos adversos , Titânio , Corrosão , Dente Suporte/efeitos adversos , Implantação Dentária Endóssea/efeitos adversos , Implantação Dentária Endóssea/instrumentação , Falha de Restauração Dentária , HumanosRESUMO
The aim of this in vitro study was to evaluate bacterial leakage along the implant-abutment interface under unloaded conditions. Twelve premachined abutments with plastic sleeves and 12 dental implants were used in this study. Prior to tests of bacterial leakage, samples from the inner parts of the implants were collected with sterile microbrushes to serve as negative controls for contamination. After casting, the abutments were tightened to 32 Ncm on the implants. The assemblies were immersed in 2.0 mL of human saliva and incubated for 7 days. After this period, possible contamination of the internal parts of the implants was evaluated using the DNA Checkerboard method. Microorganisms were found in the internal surfaces of all the implants evaluated. Aggregatibacter actinomycetemcomitans and Capnocytophaga gingivalis were the most incident species. No microorganisms were found in the samples recovered from the implants before contamination testing (negative control). Bacterial species from human saliva may penetrate the implant-abutment interface under unloaded conditions.
Assuntos
Dente Suporte/microbiologia , Projeto do Implante Dentário-Pivô/efeitos adversos , Implantes Dentários/microbiologia , Infiltração Dentária/etiologia , Aggregatibacter actinomycetemcomitans/genética , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Capnocytophaga/genética , Capnocytophaga/isolamento & purificação , Contagem de Colônia Microbiana , DNA Bacteriano/análise , Dente Suporte/efeitos adversos , Implantes Dentários/efeitos adversos , Humanos , Hibridização de Ácido Nucleico , Saliva/microbiologiaRESUMO
PURPOSE: The purpose of this retrospective investigation was to evaluate the influence on the adjacent cervical bone of moving the implant-abutment microgap inward from the outer edge of an internal-hex implant platform (ie, a platform-switched configuration). MATERIALS AND METHODS: A convenience sample of 26 patients received 42 Frialit-2 (Dentsply-Friadent) implants for single tooth replacement and were divided into two groups. One group followed the original protocol (control group), and the other (study group) received narrower replaceable components. Follow-up time varied between 6 and 60 months (mean, 33.45 months). RESULTS: The control group showed noticeable bone remodeling (mean bone loss = 2.30 mm), and all the remodeled crests were apical to the implant platform. In contrast, all patients in the study (platform-switched) group showed stable levels (mean bone loss = 0.27) of the peri-implant crestal bone, coronal to the implant platform. CONCLUSION: The relocation of the implant-abutment microgap through platform switching with Frialit-2 System implants seems to be an effective means to minimize marginal bone loss in all circumstances employed.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Dente Suporte/efeitos adversos , Implantação Dentária Endóssea/instrumentação , Implantes Dentários/efeitos adversos , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante/instrumentação , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Processo Alveolar/diagnóstico por imagem , Remodelação Óssea , Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante/efeitos adversos , Seguimentos , Humanos , Pessoa de Meia-Idade , Radiografia , Estudos RetrospectivosRESUMO
Fracasos de los distintos momentos de la terapéutica implantaria. 1. Fracasos durante la técnica quirúrgica: Forma y calidad no adecuada de los maxilares; falta de precisión en las perforaciones. 2. Complicaciones durante el período de cicatrización: fístulas o abscesos, desatornillado de la tapa de cierre, hilo de sutura incluido en la mucosa, fibrointegración del implante. 3. Fracasos durante la conexión de los emergentes. Técnica quirúrgica inadecuada. Carga prematura. 4. Fracasos después de la colocación de la restauración: técnica quirúrgica inadecuada, tipo de fresas, velocidad de fresado, irrigación, intermitencia; sobrecarga, pérdida ósea marginal rápida, fractura del pilar o del implante. 5. Complicaciones después de la colocación de la restauración, mala conexión del pilar protésico. 6. Otras causas de fracasos: infección quirúrgica; criterio y/o diseño protético incorrecto; retiro de un implante; conclusión (AU)