Planejamento reverso em implantodontia: relato de caso clínico

The oral rehabilitation has achieved great prominence in the dental implant, especially in the cases of reposition of units dental elements, so it is possible to replace each missing element to implant into your space where the tooth was loss. The reverse planning is fundamental to an appropriate rehabilitation, because promote the elimination of problems that might compromise the aesthetics and function of future dental implants. The objective of this study was to report the treatment plan for a patient in need of oral rehabilitation with implant dental prosthesis, using indications and techniques based on the literature, emphasizing the importance of reverse planning. We conducted an osseointegrated implant surgery using the principles of a connect procedure, thus allowing their successfully installing increasing the predictability of treatment. It is concluded that the success of rehabilitation treatment is directly related to the initial planning, a correct clinical approach and an integrated multidisciplinary team.

Visão contemporânea do uso de implantes de conexão interna tipo cone morse

The Morse Taper implant system, developed from its introduction in engineering, has become increasingly effective for use in dentistry. However, other systems, main external hexagon type, have been used more frequently today. Current studies have been reported the positive features of the Morse taper system and even emphasized as ideal within the systems used in implantology. Unfortunately, some professional duty by not knowing this system, or even prefer hexagon type system by decreased cost of components, have refused to use it. Thus, this study was aimed to perform a brief review of the Morse taper system, emphasizing its main points of interest in dentistry, in an attempt to familiarize the professionals to at least learn more about this system that has the prospect to become the leading system implants used in dentistry in the coming years. It is concluded that this system of dental implants is favorable showing predictability and success.

Implantes dentais curtos: alternativa conservadora na reabilitação bucal

The short dental implants represent an option of previsible treatment, its main indication lives in the possibility of avoiding techniques surgical invasive. The literature in the display that the geometry of the implants is of vital importance, combined with wide diameters and surface treatment, mainly when the bone quality is unfavorable. The mechanical resistance can be enlarged, increasing the number of implants and being used the spliting among them. A rigorous protocol prosthodontist should be following with intention of to avoid oblique loads and to control habits parafuncionais. We aimed at to discuss, through a wide bibliographical revision the short dental implants, their characteristics and indications, giving emphasis to the aspects biomechanic of the same ones. Material and Method: The bases given: Pubmed, ISI and Dentistry Oral Science from 1990 to 2009, were consulted to identify researches related to the length of the dental implants, with emphasis to the considered short and the biomechanics related to the same ones. They were located 568 articles, being selected 69 that gathered the inclusion criteria. Result: Among these 69 selected, 26 articles agreed the evidence level. Conclusion: Inside of the limits of appraised data, it can be concluded that the short implants represent a good treatment alternative, especially for cases with reduced bone bed. However a rigorous indication protocol and use should be followed for warranty of the success of the treatment.

Implantes curtos do tipo cone-Morse: proporção coroa-implante

The purpose of this study was to analyze the biomechanical interactions in bone tissue between short implants and implant-supported crowns with different heights. Two models were made using the programs InVesalius 3.0, Rhinoceros 4.0 and Solidworks 2010. The models were established from a bone block with the short implant (3.75 x 8.5 mm) with geometry Morse taper connection (MT). The height of the crown (cemented) was set at 10.0 mm and 15.00 mm. The models were processed by programs and 10 NEiNastran Femap 10.0. The force applied was 200N (vertical) and 100N (oblique). The results were plotted on maps Voltage Maximum Principal. Statistical analysis was performed using ANOVA. The results showed that the increase in crown height, increased stress concentration in the crown of 15 mm under oblique loading (p <0.001), the oblique loading has significantly expanded the area of stress concentration (p <0.001). Conclusion:the increase of the crown increased the stress concentration, being statistically significant for short implants Morse taper. The mesial and distal region had the highest concentration of stresses under oblique loading. The oblique loading was more harmful when compared with axial loading, being statistically significant.

Influência do aumento do comprimento de implantes dentários

The use of implants of greater length may be more favorable for the predictability of dental implants. This statement is relevant, since the cause of failures in dental implants are more related to biomechanical complications. The aim of this study was to evaluate the influence of increase of the length around the entire body of the implant. Six models were created with the presence of only one hexagonal implant (Master Screw connection, Implant Systems, São Paulo, Brazil) of 3.75 mm x 7.0 mm (Model A), 3.75 mm x 8.5 mm (Model B ), 3.75 mm x 10.0 mm (Model C) 3.75 mm x 11.5 mm (Model D) 3.75 mm x 13.0 mm (Model E) 3.75 mm x 15.0 mm (Model F) using the method of photoelasticity. The results were visualized through a qualitative analysis of stresses (number and intensity photoelastic fringes). The model A showed a pattern of less favorable stress distribution, the oblique loading was the most detrimental to the related structures. Conclusion: The increased length allowed for a better distribution of stresses. The oblique loading was more detrimental when compared to axial loading.

Reabilitação Oral: prótese livre de metal, Removível e implantes. Um caso de 12 anos de acompanhamento

The literature has suggested that the association of removable partial dentures with dental implants can improve the quality of life of patients. Thus, the purpose of this study was to present a case report. This case report describes the development of a removable partial denture associated with dental implants bilaterally been monitored for 12 years, and the efficacy of the proposed treatment. The radiographic controls demonstrated no changes on bone tissue. The maxillary arch was rehabilitated with metal-free crowns. The patient was fully satisfied with this technique providing stability, esthetics, and proper function. It was concluded that the technique of using removable partial dentures associated with dental implants is viable and show the advantages of improved function, aesthetics and cost reductions in rehabilitation treatment.

Análise Biomecânica em implantes com diferentes tipos de conexão: estudo pelo MEF-3D

The aim of this study was to evaluate the biomechanical behavior of different implant connection types, by means of three-dimensional finite element analysis. 3 Three-dimensional models were created with a graphic modeling software: SolidWorks 2006 and Rhinoceros 4.0, and InVesalius (CTI, São Paulo, Brasil), the bone was obtained by computerized tomography of a sagittal section of the molar region. The model was composed by bone block with an implant (4 x 10 mm) (Conexão Sistemas de Prótese, São Paulo), with different implant connections: external hex, internal hex and Morse-taper with the corresponding prosthetic component Ucla or Morse-taper abutment. The Three-dimensional models were transferred to finite element software Femap 10.0 (Siemens PLM Software Inc., CA, USA), to generate a mesh, boundary conditions and loading. An axial (200N) and oblique load (100N) was applied on the occlusal surface of the crowns. Analyses were performed using the finite element software NEiNastran 9.0 (Noran Engineering, Inc., USA) and transferred to the Femap 10.0 to obtain the results; after the results were visualized using von Mises stress maps and Maximum stress principal. The results showed the stress distribution was similar between models, with a little superiority of Morse-taper connection. It was concluded that: the three connection types were biomechanical viable; The Morse-taper connection presented the better internal stress distribution; there was not significant biomechanical differences on the bone.

A oclusão nas próteses totais implantossuportadas mediatas e imediatas

Rehabilitation of edentulous patients has been a challenge for professionals since the primary concepts and fundaments of occlusal rehabilitation. However, this philosophy has been improved by implant-supported fixed dentures that represent a predictable clinical modality on modern dentistry. Nevertheless, considering that the traditional protocol requires a long period for bone healing and definitive rehabilitation, immediate loading of implants has been advantageous for functional and esthetic rehabilitation of patients in a reduced period. The aim of this study is to discuss the biomechanical and functional fundaments of occlusion for implant-supported fixed dentures with mediate and immediate loading to provide clinical evidences for longevity of this treat ment modality based on the current literature. According to this, some prerequisites as proper bone quality, excellent primary stability, sufficient number of implants, rigid splinting, and control and mastering of biomechanical fundamentals of static and dynamic occlusion are mandatory for treatment predictability and longevity.

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.

Influência do material oclusal na distribuição de tensões em próteses implantossuportadas unitárias

Objective: the aim of this study was to evaluate the influence of occlusal veneering material in single fixed implant-supported crowns through the 3-D finite element method. Material and methods: Four models were fabricated using the Rhinoceros 4.0, SolidWorks, and InVesalius softwares. Each model represented a block of mandibular bone with an external hexagon implant of 5 mm x 10 mm and different veneering materials including NiCr (1), porcelain (2), composite resin (3), and acrylic resin (4). An axial load of 200 N and an oblique load of 100 N were applied. Results: model (2) with porcelain veneering presented a lower stress concentration for the NiCr framework, followed by the composite resin and acrylic resin. The stress distribution to the implant and bone tissue was similar for all models. Conclusions: there is no difference of stress distribution to the implant and supporting structures by varying the veneering material of a single implant-supported prosthesis.

Influência da angulação do implante e tipo de intermediário na distribuição das tensões

The aim of this study was to evaluate the influence of implant angulation and abutment type (UCLA and Estheticone) on stress distribution in screw-retained implant-supported prostheses through photoelasticity. Three models were fabricated with photoelastic resin PL-2 (Vishay, Micro-Measurements Group, Inc Raleigh, N.C., USA) containing one external hexagon implant with 3.75x10mm (Master screw, Conexão Sistemas de Prótese Ltda., Arujá, São Paulo) with 0°, 17° and 30° degrees and a screw-retained prostheses with UCLA and Estheticone abutments. The assembly was positioned in a circular polariscope; axial and oblique (45° degrees) loads of 100N were applied in fixed points on the occlusal crown surfaces by a universal testing machine. The stress generated was photographed and analyzed qualitatively with appropriate software (Adobe Photoshop®). The results demonstrated the same number of fringes for both abutment types for each angulation, with fringes increasing in the same way. A higher number of fringes were closer in the oblique loading mode. It was concluded that there was no significant difference in stress distribution in prostheses with UCLA and Estheticone abutments. Higher stress concentrations were observed with increased implant angulation. Stress concentration and intensity were higher in the oblique load than in axial load application.

Influência do material oclusal na distribuição de tensões em próteses implantossuportadas unitárias

Objective: the aim of this study was to evaluate the influence of occlusal veneering material in single fixed implant-supported crowns through the 3-D finite element method. Material and methods: Four models were fabricated using the Rhinoceros 4.0, SolidWorks, and InVesalius softwares. Each model represented a block of mandibular bone with an external hexagon implant of 5 mm x 10 mm and different veneering materials including NiCr (1), porcelain (2), composite resin (3), and acrylic resin (4). An axial load of 200 N and an oblique load of 100 N were applied. Results: model (2) with porcelain veneering presented a lower stress concentration for the NiCr framework, followed by the composite resin and acrylic resin. The stress distribution to the implant and bone tissue was similar for all models. Conclusions: there is no difference of stress distribution to the implant and supporting structures by varying the veneering material of a single implant-supported prosthesis.

Sistemas de retenção intrarradicular: considerações teóricas e comportamento biomecânico

The aim of this study was to review the current scientific literature to discuss the biomechanical behavior and characteristics inherent to both cast post and core and the prefabricated posts used in the practice of restoring endodontically treated teeth. To identify studies of this review, it was performed a detailed and advanced search strategy to the databases PubMed and Medline. It was used as descriptors: endodontically treated teeth, post, core, fiber post and metal post. Inclusion criteria were: clinical trials, randomized controlled trials, in vitro studies, literature reviews and systematic reviews with or without meta-analysis of the last 10 years that addressed the theme. Exclusion criteria were: articles without abstracts, animal studies, articles whose language was not English and articles from journals that do not belong to the Dentistry field. Of a total of 35 articles, after an analysis according to inclusion and exclusion criteria, 23 articles were selected. Most of the current scientific literature indicates that the prefabricated fiber reinforced and ceramic posts should be appointed for endodontically treated teeth that have a minimum height of 2mm ferrule. As for the cast metal cores, along with pre-fabricated metal represent a good prosthetic option, when weakened teeth have to be restored for any reason. Despite the large number of studies, there is still a lack of longterm prospective studies that evaluate the effectiveness of these posts in the treatment of endodontically treated teeth.

Influencia del nivel de inserción ósea del diente soporte en el desplazamiento de PPR de extremidad libre mandibular asociada al implante oseointegrado

The rehabilitation with mandibular distal extension removable partial dentures (DERPD) is complex and the use of implants has been improving the functioning of this approach. The insertion bony level around of the last support tooth is an aggravating factor, since it can harm the longevity of the treatment. Thus, the aim of this research was to evaluate the displacement tendency of a mandibular DERPD associated to an implant, with different insertion bony levels and different connections between the RPD and the support tooth, by finite element analysis. Eight models were made: MA - DERPD, incisal rest, no bony loss; MB - DERPD, distal plate, no bony loss; MC - DERPD, incisal rest, no bony loss, with implant and ERA system; MD - DERPD, distal plate, no bony loss, with implant and ERA system; ME - DERPD, incisal rest, bony loss; MF - DERPD, distal plate, bony loss; MG - DERPD, incisal rest, bony loss, with implant and ERA system; MH - DERPD, distal plate, bony loss, with implant and ERA system. Loads of 50 N in each peak were applied. Displacement maps were obtained and showed that implant favors this association and the bony loss harms the prognostic of the prosthesis. It is concluded that: the introduction of the implant with ERA system reduced the displacement tendency of the tooth and supporting structures; introduction of distal plate reduced the movement tendency of the support tooth; the decrease of the periodontal support didn't influence significantly the displacement tendency of the models with distal plate distal, but it influenced the models with distal incisal rest.

Fios ortodônticos superelásticos e sua aplicabilidade na clínica ortodôntica: revisão da literatura

During clinical routine, the orthodontist uses several materials, which include metallic alloys in the form of metallic wires. However, it is necessary that the professional has some knowledge of the properties of those wires. Different types of wires are commercially available: stainless steel wires, chrome-cobalt wires, nickel-titanium wires and beta-titanium wires. Among the nickel-titanium wires, there are three subdivisions: a conventional alloy and two superelastic alloys. The superelasticity, associated to the effect of form memory, is a property used in orthodontics to initiate the dental movement in the first phase of the orthodontic treatment. This property is considered to be biologically compatible with the effective dental movement. These wires are available at the market in different transformation temperatures, and they offer the best adaptation in the groove of the bracket, simplicity and a faster treatment. However, they present little formability, and they don’t accept solder. They are also more onerous than other wires. Moreover, the low rigidity of these wires doesn’t allow them to be used for the retraction of the anterior teeth or closing of spaces. Therefore, the coherent use of superelastic orthodontic wires is recommended, accompanied by a detailed diagnosis and planning, so the result will be an efficient orthodontic correction, accomplished in a shorter period of time.