Relation between bruxism and dental implants

OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review. METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medline databases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled trials, in vitro studies, literature and systematic reviews, with or without meta-analysis, of the last 20 years that addressed the theme. Articles without abstracts, animal studies, articles in languages other than English and articles from journals unrelated to the dental field were excluded. RESULTS: after analysis according to inclusion and exclusion criteria, 28 articles were selected from a total of 54. It is known from the array of scientific articles which have assessed, either through retrospective, prospective or experimental studies, that the biomechanical and biological impact of bruxism on implant-supported prostheses is small, and that the literature has contributed little to exemplify the prosthetic limits of safety for the specialist from a clinical point of view. CONCLUSION: Although there is still no general consensus on this matter, most of the literature review articles do provide clinical guidelines that contribute to implant supported prostheses longevity and stability in patients with bruxism.

The influence of the alveolar ridge shape on the stress distribution in a free-end saddle removable partial denture supported by implant

The alveolar ridge shape plays an important role in predicting the demand on the support tooth and alveolar bone in the removable partial denture (RPD) treatment. However, these data are unclear when the RPD is associated with implants. This study evaluated the influence of the alveolar ridge shape on the stress distribution of a free-end saddle RPD partially supported by implant using 2-dimensioanl finite element analysis (FEA). Four mathematical models (M) of a mandibular hemiarch simulating various alveolar ridge shapes (1-distal desceding, 2- concave, 3-horizontal and 4-distal ascending) were built. Tooth 33 was placed as the abutment. Two RPDs, one supported by tooth and fibromucosa (MB) and other one supported by tooth and implant (MC) were simulated. MA was the control (no RPD). The load (50N) were applied simultaneously on each cusp. Appropriate boundary conditions were assigned on the border of alveolar bone. Ansys 10.0 software was used to calculate the stress fields and the von Mises equivalent stress criteria (σvM) was applied to analyze the results. The distal ascending shape showed the highest σvM for cortical and medullar bone. The alveolar ridge shape had little effect on changing the σvM based on the same prosthesis, mainly around the abutment tooth.

Prevalência de cárie dentária em gestantes atendidas no Sistema Único de Saúde em município paulista

The purpose of this study was to evaluate the dental caries prevalence and the use and needs of dental prosthetic in pregnant women attending in the National Health System in northwestern city of São Paulo state. The sample involved women, between 3 and 9 months of gestation, who were taking prenatal care in Health Units. Those who consented (n = 119) were examined and interviewed by calibrated dentists. We used the DMF-T index and indicators of the use and needs of dental prosthetic. The average age of the pregnant women was 24.7 years, the majority brown (48.7%) with complete high school (60.5%). The average DMFT was 11.7 and 25.2% and 46.2% of them require upper and lower prosthesis, respectively. The oral health indices showed a high DMT-F and great need for dental prostheses. The results show the need for actions directed, with the aim of to improve the specialized attention to the health of mothers and their babies.

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.

Confocal laser scanning microscopy investigation of bond interfaces involved in fiber glass post cementation

Objective: This confocal microscopy study evaluated the cement/dentin and cement/post interfaces along theroot canalwallswhenfiberglasspostswerebonded to dentin using different types of cements. Material & Methods: Thirty endodontically treated premolars were divided into 3 groups according to the adhesive materials used in the bonding procedure: Prime & Bond 2.1/Self Cure + Enforce, RelyX Unicem and RelyX Luting. Rhodamine B dye was incorporated in the luting materials for the cementation of the fiber glass posts (Exacto, Angelus) to dentin. Three transversal slices (apical, middle and coronal) were examined under confocal laser scanning microscopy. Statistical analysis was performed using the Kappa, Kruskal-Wallis and Dunnet tests, in a significance level of 5%. Results: The Prime & Bond 2.1/Self Cure + Enforce presented a uniform formation of tags in the dentin but gaps in the cement/dentin interface. The RelyX Unicem and RelyX Luting presented an adhesive interface with a fewer amount of gaps, but showed shorter tag formation than the Enforce system. All cements presented the same pattern of bubbles inside the cements. The RelyX Luting presented a greater amount of cracks inside the cement in comparison with the other cements in the coronal third, while no difference was observed between RelyX Unicem and Enforce. The RelyX Luting showed the lowest quantity of cement penetration into the post. Conclusion: In general, the quality of bonding interfaces of fiber posts luted to root canals was affected by both location and type of cement.

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.

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.

O impacto das próteses implantossuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Efeito da umidade no esmalte dental na interação de dois sistemas de colagem ortodôntica

Objetivo: a proposta desse estudo foi avaliar, por meio de microscopia eletrônica de varredura (MEV), a interface adesiva após a descolagem de acessórios ortodônticos, fixados em dentes bovinos com emprego de adesivo hidrofílico e hidrofóbico, em condições distintas de umidade do substrato dentário. Métodos: foram utilizados 20 incisivos inferiores, divididos em quatro grupos (n = 5): Grupo I , empregou-se o sistema de colagem contendo o primer hidrofílico Transbond MIP e a pasta adesiva Transbond XT, aplicados em substrato úmido; Grupo II, empregou-se o sistema de colagem primer hidrofóbico Transbond XT e pasta adesiva em substrato úmido; Grupos III e IV, os braquetes foram colados com os mesmos sistemas de união dos Grupos I e II, porém com esmalte dentário seco. Removidos os acessórios, avaliou-se em MEV, em diferentes magnificações, a interface adesiva e a interação dos sistemas adesivos com o esmalte dentário. As imagens foram avaliadas qualitativamente, observando-se o embricamento mecânico para o adesivo hidrófilo em quaisquer condições de substrato. Resultados: a falta de umidade no esmalte condicionado permitiu uma melhor interação entre os materiais de ligação e a estrutura adamantina. O adesivo hidrofóbico apresentou o pior resultado de interação micromecânica quando aplicado a uma estrutura dentária úmida; já o sistema hidrofílico mostrou-se versátil, obtendo resultados aceitáveis em condições de umidade e excelente interação na ausência de contaminação. Conclusão: os autores afirmam que a melhor condição do esmalte dentário para a aplicação de primers é com a ausência de umidade.

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.

Resistência de união e estabilidade de um sistema adesivo universal à dentina erodida/abrasionada após desproteinização

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Biocompatibilidade de primers e adesivo utilizados na confecção de próteses maxilofaciais implantorretidas: análise in vitro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Restaurações cerâmicas minimamente invasivas executadas por cirurgiões dentistas com diferentes níveis de experiência profissional: estudo clínico cego, longitudinal e prospectivo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo clínico retrospectivo de restaurações cerâmicas do tipo laminado sobre dentes com ou sem preparo dentário: 1 a 5 anos de acompanhamento

Pós-graduação em Odontologia - FOA

Análise do comportamento da cor de restaurações cerâmicas sem metal avaliadas por diferentes métodos: estudo clínico prospectivo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)