Implantes Platform Switching: longevidade e preservação óssea: revisão crítica da literatura

The concept of switching platform is the use of an implant by platform wider than the abutment. Recently, researches have shown that this type of dental implant design tends to offer a higher preservation of crestal bone when compared to the traditional pattern of bone loss. The present study aims to perform a critical review on the switching platform concept establishing possible advantages of the technique. A search was performed on Medline/Pubmed about the topic “dental implant” and “platform switching”, and after applying inclusion criteria 40 studies were selected. The literature on longevity present prospective studies that show less bone loss, studies in biomechanics exhibit better or similar stress distribution around the bone crest, however, is not yet defined the role of the biological width. Thus, studies of longevity, and randomized prospective studies are of a great relevance to be performed in order to confirm the benefits of this technique and to establish a protocol indication. It is possible, based on this literature review, to conclude that longitudinal and randomized studies show that the platform switching implants have longevity and less bone loss. Biomechanically, the technique is possible.

Implantes tipo plataforma modificada: revisión de literatura

The purpose of this revision was to explore the concept of Platform Switching in implantology and its acting in the clinical practice. The concept of platform switching will be considered together with a revision of pertinent literature, with the purpose of providing guidelines based on scientific evidences. The following databases were used: Pubmed, Library Cochrane and ISI in the last 17 years. The inclusion approaches were: clinical articles, laboratorials and of revision on the topic, in English language. 41 articles were selected, using the describers "platform switching dental implants", "platform shifting and dental implants", "expanded platform dental implant". In accordance with this revision, implant them platform switching they present a rate of more favorable bony remodeling that you implant them conventional. This fact seems to be resulting of a group of biological factors and mechanics. The concept of platform switching has important relevance in the aesthetic area.

Complicações na reabilitação bucal com implantes osseointegravéis

The oral rehabilitation now has a powerful ally: the dental implants. There is no denying the importance of the implant within the context of dental practice. Initially indicated for the rehabilitation of fully edentulous patients, now has gained growing space, with indications for partial edentulism, multiple unit, with high predictability of success in esthetic restorations, combined with the techniques of manipulation of soft tissues, and guided tissue regenerationearly prosthetic loading. But like any dental procedure, whether surgical or medical implantology is also subject to the occurrence of failures and complications. This paper aims to provide a review of the literature for discussion of these complications, their causes, their managements and proservation.

Reações alérgicas aos implantes osseointegráveis de titânio: uma revisão de literatura

Titanium dental implants have been common practice in the dental office, which can increases the number of allergic reactions to this material. Objectives: to alert dental surgeons and specialists of this possible phenomenon through a literature review. Material and methods: an electronic search at PubMed was performed with the keywords “dental implants”, “titanium”, and “allergy” from January 1990 to May 2013. Only articles published in the English language were included. Letters to editor were excluded. Results: from the 22 initially retrieved articles, only 7 were included, being 4 clinical case reports and 3 experimental studies. For clinical cases, the reactions included edema, erythema, exfoliative cheilitis, and eczema. Regarding experimental studies, skin rash and dermatitis were reported. A patch test was not used in two clinical reports. Only one study used histological analysis to attest the lack of allergic reactions. Conclusion: within the limits of the available literature, allergic reactions to titanium dental implants are extremely rare and seem to be related to the female gender. More controlled clinical studies are necessary to elucidate this question.

Implantes osseointegrados: evolução e sucesso

Introduction: The oral rehabilitation with dental implants is a very viable treatment modality for patients. Therefore the discovery of osseointegration, dentistry has reached the trigger with respect to treatment with a high predictability of success. For this various principles, since the surgical protocols, the choice of material and even the technique for the manufacture of implant-supported prosthesis influence a good prognosis for treatment. Objective: Therefore, it is proposed this study a literature review of the fundamentals of osseointegration, explaining the historical and technical parameters of implantology, focusing in what the literature currently is studying with more intensity, the acceleration of osseointegration. Conclusion:well conducted procedures promotes the best aimed success in implantology. Rough surfaces shows great are for implant-bone contact and better mechanical results. The bone quality is fundamental in results foresigh.

Osseointegração de implantes instalados sem estabilidade primária: o papel dos materiais à base de fibrina e fosfato de cálcio

When implants are installed immediately after tooth extraction may occur anchoring primary decreased, delay or failure of osseointegration process. This occurs because of the large interface between the surrounding walls of the socket and the surface of the implant. For reconstruction, replacement or filling of bone defects the solution can be obtained with the use of autogenous, heterogenous or allogeneic bone grafts. However, these grafts suffer certain drawbacks, particularly a high rate of donor site morbidity, limited amounts of available bone, and the additional operative time required for harvest. For these reasons, intensive efforts have been directed toward developing alternative substances for to either augment or substitute. In this paper, we will examine some of the commonly used materials : fibrin and calcium phosphate.

Tratamento de superfície de implantes dentários: SBF

Various surface treatments of dental implants have been developed in order to ensure anchorage to bone tissue, optimization of the determinants of electronic structure, crystallinity, composition and properties. Coating techniques have been proposed in order tocreate unionbiochemicalable to accelerate the early stages ofbone tissue, combining the positive properties of titanium and its alloys bioactivity of ceramic materials. This paper discusses protocol for handling the SBF coating of titanium alloys. The apatite phase nucleation occurs by immersing the substrate in synthetic solution simulating blood plasma (Simulated Body Fluid). The protocol allows manipulation of the SBF solution to establish guidelines regarding the usestreamlinedand organized to make practical application.

Protocolo radiográfico para a instalação de mini-implantes: descrição da técnica

In the last decade mini-screws have gained popularity in orthodontics field and a correct placement of mini-screws is a critical point to the success of the skeletal anchorage. A careful clinical and radiographic diagnostic before insertion mini-screw is an essential requirement to achieve the central point of the radicular septum. The correct application of these pre-surgical procedures should avoid possible iatrogenic damages in periodontal ligament, dental roots, nasomaxillary cavities, or even important vascular tissues. As of today, periapical radiographs is a regular pre surgical procedure during mini-screw insertion technique. Nevertheless, accurate execution of the radiographic parallax technique can offer to us useful and precise radiographic images, to decide the right local insertion of mini-screws in to the septum bone. The purpose of this paper is to describe the ¬application of new positioning circular guides in conjunction with a ¬parallax radiographic protocol before placement of orthodontic mini-screws.

Recuperação da harmonia dos dentes anteriores por meio de implantes e restaurações cerâmicas

Introdução: a ausência ou alterações da estrutura dentária, principalmente em áreas estéticas, compromete a aparência, as relações sociais, a autoestima e, consequentemente, a qualidade de vida do indivíduo. Atualmente, avanços tecnológicos e científicos na Odontologia têm possibilitado várias opções de tratamentos reabilitadores e restauradores que oferecem resultados cada vez mais seguros e confiáveis. Objetivo: relatar, por meio de um caso clínico, a recuperação da harmonia dos dentes anteriores com a utilização de laminados de cerâmica e prótese sobre implante associada a recursos para recuperar a estética gengival. Conclusão: o planejamento adequado, associado aos conhecimentos de uma Odontologia integrada, possibilita resultados extremamente satisfatórios, resgatando a função e a estética, tanto dentária quanto gengival, proporcionando um sorriso harmonioso e o bem-estar social do paciente.

Avaliação da biocompatibilidade de implantes de silicone gel em subcutâneo de ratos: estudo histomorfométrico

Objective: Histomorphometric study to evaluate the biological tissue compatibility of silicone implants suitable for plastic surgery. Methods: Thirty Wistar white rats received subcutaneous implants ande the revestiment of silicone gel Silimed, and randomized into six groups of five animals each, according to the type of implanted material and the time of sacrifice. Eight areas of 60.11 mm2 corresponding to the obtained surgical pieces were analyzed, counting mesenchymal cells, eosinophils, and foreign body giant cells, observing an acceptable biocompatibility in all implants, for subsequent statistical analysis by Tukey test. Results: Silicone gel showed inflammation slightly greater than for other groups, with tissue reactions varying from light to moderate, whose result was the formation of a fibrous capsule around the material, recognized by the organism as a foreign body. Conclusion: In general, it is possible to affirm that silicone gel had acceptable levels of biocompatibility, confirmed the rare presence of foreign body giant cells, and when of the rupture, formed a fibrous capsule around the material, separating the material of the organism.

Utilização de biomateriais poliméricos associados a implantes dentários: revisão de literatura

A remodelação óssea é um processo contínuo, que possibilita a substituição de osso envelhecido e danificado por tecido novo. A reparação ao redor de implantes osseointegráveis e enxertos ósseos em situações desfavoráveis depende do estabelecimento de um adequado contato entre tecido ósseo e implante por meio da estabilidade primária. Tendo em vista a importância da estabilidade primária do implante na biomecânica e conseqüente osseointegração, a associação de biomateriais reabsorvíveis ao sítio de instalação dos implantes se torna relevante. Destes biomateriais, destaca-se o copolímero de ácido polilático/ poliglicólico (PLA/PGA), que poderia contribuir com a estabilidade temporária dos implantes.

Reabilitação protética de mandíbula atrófica por meio de implantes curtos: relato de caso clínico com oito anos de acompanhamento

This case report shows how the prognosis of severe mandibular atrophy can be improved with the use of short dental implants. A Caucasian 54 years-old male patient received four dental implants in the anterior mandibular region. Four months later, the definitive prosthesis was delivered. At the 8-year follow-up period, no complaints or loss of integration were reported. Short dental implants with complete, fixed definitive prosthesis can be a successful treatment in the mandibular arch.

Implantes pós-exodônticos: relato de caso

With the search for treatments faster and aesthetic improvement of materials and surgical techniques, immediate implants have become a clinical reality increasingly practiced. Thus, based on literature the specific purpose of this study was to address critically the concepts of immediate implants, discussing issues related to dental extraction, milling technique, care of the periodontal tissues support and protection, prosthetic replacement, benefits, indications and contraindications. To this end, from Pubmed electronic crawler Medline, 54 articles published between 1990 and 2009, over 4 items classics, all in English were selected. The Studies have shown success rates for this technique Conventional techniques like two-stage surgery, many different techniques and planning are present among these techniques, and implants more immediate subject to failures.

Estudo retrospectivo de implantes osseointegrados instalados imediatamente após exodontias

Objectives: to evaluate implant survival immediately placed after tooth extraction considering different sites, prosthodontic modalities, and the need for biomaterials. Material and methods: dental records of 500 patients treated with dental implants between 2004 and 2011 were screened. Results: only 200 records (20%) corresponded to immediate implants. Reasons for tooth extraction included extensive caries, bone loss, and root fractures. From the 197 immediate dental implants, 86 were placed in the maxilla with a survival rate of 93.9% and 111 in the mandible (survival rate of 99.1%). The overall survival rate was 97.46%. Prosthodontic modalities identified were: Brånemark classic complete denture screwed prostheses (36%), overdentures (5.6%), fixed partial denture (31%), and single-tooth prostheses (27.4%). Also, it was observed that in 33% of cases there was a need for the use of grafts and/or biomaterials. Conclusion: it can be concluded that, when correctly indicated, immediate implants are an excellent choice. The anterior mandibular region, screwed and overdenture-type prostheses presented higher success rates when associated to immediate implant placement. The need for bone graft/biomaterial does not affect the clinical results.

Avaliação do índice de sucesso dos enxertos autógenos e dos implantes instalados em região de seio maxilar

Maxillary sinus lifting surgery is considered an excellent option for patient rehabilitation in cases of maxillary sinus pneumatization. This longitudinal study was performed in 41 patients to evaluate 51 maxillary sinus lifting procedures concomitant to autogenous bone grafted from mandibular ramus. Of the 107 implants installed, 28 were immediate fixations. Success index achieved regarding to bone graft was of 98.04%. The implants installed immediately or after bone grafting resulted in success rates of 92.86% and 94.59% respectively, with no statistically significant differences between them. Surgeries for bone grafting and immediate installation are considered a reliable treatment alternative provided that both anatomical structures and tissue physiology are kept in good conditions, with appropriate indication and techniques for good implant stability.