Influence of Implant Connection Type on the Biomechanical Environment of Immediately Placed Implants - CT-Based Nonlinear, Three-Dimensional Finite Element Analysis

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

PDGF-B gene therapy accelerates bone engineering and oral implant osseointegration

Platelet-derived growth factor-BB (PDGF-BB) stimulates repair of healing-impaired chronic wounds such as diabetic ulcers and periodontal lesions. However, limitations in predictability of tissue regeneration occur due, in part, to transient growth factor bioavailability in vivo. Here, we report that gene delivery of PDGF-B stimulates repair of oral implant extraction socket defects. Alveolar ridge defects were created in rats and were treated at the time of titanium implant installation with a collagen matrix containing an adenoviral (Ad) vector encoding PDGF-B (5.5 x 10(8) or 5.5 x 10(9) pfu ml (1)), Ad encoding luciferase (Ad-Luc; 5.5 x 10(9) pfu ml (1); control) or recombinant human PDGF-BB protein (rhPDGF-BB, 0.3 mg ml (1)). Bone repair and osseointegration were measured through backscattered scanning electron microscopy, histomorphometry, microcomputed tomography and biomechanical assessments. Furthermore, a panel of local and systemic safety assessments was performed. Results indicated that bone repair was accelerated by Ad-PDGF-B and rhPDGF-BB delivery compared with Ad-Luc, with the high dose of Ad-PDGF-B more effective than the low dose. No significant dissemination of the vector construct or alteration of systemic parameters was noted. In summary, gene delivery of Ad-PDGF-B shows regenerative and safety capabilities for bone tissue engineering and osseointegration in alveolar bone defects comparable with rhPDGF-BB protein delivery in vivo. Gene Therapy (2010) 17, 95-104; doi: 10.1038/gt.2009.117; published online 10 September 2009

Wax Teeth and Metallic Superstructure Trials at the Same Session: Simplified Technique for Implant-Supported Prosthesis

This clinical report describes a method to reduce the number of clinical sessions for the rehabilitation of implant-supported fixed dentures through a simplified and versatile procedure indicated mainly for immediate loading. According to this method, the immediate implant-supported fixed dentures for edentulous patients can be safely fabricated within 2 days. In this technique, the teeth in the wax are prepared on a base of light-polymerized resin, and both wax teeth and metallic superstructure trials are accomplished at the same session.

Effect of Platelet-Rich Plasma on Peri-Implant Bone Repair: A Histologic Study in Dogs

The present study evaluated the effect of platelet-rich plasma (PRP) on pen-implant bone healing. A total of 9 mongrel dogs received 36 dental implants with sandblasted acid-etched surface in lower jaws in a split-mouth design: in the PRP group (n = 18 implants) the implants were placed in association with PRP, and in the control group (n = 18 implants) the implants were placed without PRP. Biopsies were obtained and prepared for histologic and histometric analysis after 15, 30, and 55 days of healing. The biopsies retrieved at 15 days showed delicate bone trabeculae formed by immature bone with presence of numerous osteoblasts for both groups. At 30 days the trabeculae presented reversal lines and evident lamellar disposition, where some thread spaces were filled by bone and dense connective tissue. At 55 days, bone healing was not altered in the control group, and histologic aspects were variable for the group treated with PRP. There was no significant difference between the groups for bone-to-implant contact (P > .05). PRP did not enhance bone formation around sandblasted acid-etched implants.

The Effect of Splint Material Rigidity in Implant Impression Techniques

Purpose This in vitro study compared the dimensional accuracy of two impression techniques Duralay splinted impression copings (D) and metal splinted impression copings (M) for implant supported pros theses Materials and Methods A master cast with four parallel implant abutment analogs and a passive framework were fabricated Vinyl polysiloxane impression material was used for all impressions with a metal stock tray Two groups (D and M) were tested (n = 5) The measurement method employed was just one titanium screw tightened to the framework Each group s measurements were analyzed using software that received the images of a video camera coupled to a stereomicroscope at X100 magnification The results were analyzed statistically (t test) Results The mean values of abutment/framework interface gaps were master cast = 32 mu m (SD 2), group D = 165 mu m (SD 60), and group M = 69 mu m (SD 36) There was a statistically significant difference between the D and M groups (P <= 001) Conclusion Under the limitations of this study, it could be suggested that a more accurate working cast can be fabricated using metal splinted impression copings INT J ORAL MAXILLOFAC IMPLANTS 2010 25 1153-1158

THE SERVICE LIFE of IMPLANT-RETAINED OVERDENTURE ATTACHMENT SYSTEMS

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

Accuracy of Impression Techniques for an Implant-Supported Prosthesis

Purpose: This in vitro study compared the dimensional accuracy of a stone index and of two impression techniques (squared impression copings and modified squared impression copings) for implant-supported prostheses. Materials and Methods: A master cast with four parallel implant-abutment analogs and a passive framework were fabricated. Vinyl polysiloxane impression material was used for all impressions with a metal stock tray. Three groups of impressions were tested (n = 5): index (1), squared (S), and modified squared (MS). The measurement method employed was just one titanium screw tightened to the framework. The measurements (60 gap values) were analyzed using software that received the images from a video camera coupled to a stereomicroscope at x 100 magnification. The results were evaluated statistically (analysis of variance, Holm-Sidak method, alpha = .05). Results: The mean abutment/framework interface gaps were: master cast = 31.63 mu m; group I = 45.25 mu m; group S = 96.14 mu m; group MS = 51.20 mu m. No significant difference was detected among the index and modified squared techniques (P = .05). Conclusion: Under the limitations of this study, the techniques modified squared and index generated more accurate casts than the squared technique. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:715-721

Comparison of impression techniques and materials for implant-supported prosthesis

Purpose: To investigate, in vitro, the dimensional accuracy of two impression techniques (squared impression copings and squared impression copings sandblasted and coated with impression adhesive) made of vinyl polysiloxane and polyether impression materials. Materials and Methods: A master cast (control group) with four parallel implant abutment analogs, a passive framework, and a custom aluminum tray was fabricated. Four groups (n = 5 each group) were tested: squared Impregum (SI), squared Express (SE), sandblasted adhesive squared Impregum (ASI), and sandblasted adhesive squared Express (ASE). The measurement method employed was just one titanium screw tightened to the framework. A stereomicroscope was used to evaluate the fit of the framework by measuring the size of the gap between the abutment and the framework. The results were analyzed statistically. Results: The mean values for the abutment/framework interface gaps were: master cast, 31.63 mu m (SD 2.16); SI, 38.03 mu m (SD 9.29); ASI, 46.80 mu m (SD 8.47); SE, 151.21 mu m (SD 22.79); and ASE, 136.59 mu m (SD 29.80). No significant difference was detected between the SI or ASI techniques and the master cast. No significant difference was detected between the SE and ASE techniques. Conclusion: Within the limitations of this study, it can be concluded that Impregum Soft medium consistency was the best impression material and the impression technique did not influence the accuracy of the stone casts. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:771-776

Comparison of the Accuracy of Plastic and Metal Stock Trays for Implant Impressions

Purpose: This in vitro study evaluated the dimensional accuracy of two impression techniques (tapered and splinted) with two stock trays (plastic and metal) for implant-supported prostheses. Materials and Methods: A master cast with four parallel abutment analogs and a passive framework were fabricated. Polyvinyl siloxane impression material was used for all impressions with two metal stock trays and two plastic stock trays (closed and open trays). Four groups (tapered plastic, splinted plastic, tapered metal, and splinted metal) and a control group (master cast) were tested (n = 5 for each group). After the framework was seated on each of the casts, one abutment screw was tightened, and the marginal gap between the abutment and framework on the other side was measured with a stereomicroscope. The measurements were analyzed with the Kruskal-Wallis one-way analysis of variance on ranks test followed by the Dunn method. Results: The mean values (+/- standard deviations) for the abutment/framework interface gaps were: master cast, 32 +/- 2 mu m; tapered metal, 44 +/- 10 mu m; splinted metal, 69 +/- 28 mu m; tapered plastic, 164 +/- 58 mu m; splinted plastic, 128 +/- 47 mu m. No significant difference was detected between the master cast, tapered metal, and splinted metal groups or between the tapered and splinted plastic groups. Conclusions: In this study, the rigidity of the metal stock tray ensured better results than the plastic stock tray for implant impressions with a high-viscosity impression material (putty). Statistically similar results were obtained using tapered impression copings and splinted squared impression copings. The tapered impression copings technique and splinted squared impression copings technique with a metal stock tray produced precise casts with no statistically significant difference in interface gaps compared to the master cast. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:544-550.

Accuracy of impression and pouring techniques for an implant-supported prosthesis

Purpose: The purpose of this in vitro study was to compare the dimensional accuracy of a stone index and of 3 impression techniques (tapered impression copings, squared impression copings, and squared impression copings splinted with acrylic resin) associated with 3 pouring techniques (conventional, pouring using latex tubes fitted onto analogs, and pouring after joining the analogs with acrylic resin) for implant-supported prostheses. Materials and Methods: A mandibular brass cast with 4 stainless steel implant-abutment analogs, a framework, and 2 aluminum custom trays were fabricated. Polyether impression material was used for all impressions. Ten groups were formed (a control group and 9 test groups formed by combining each pouring technique and impression technique). Five casts were made per group for a total of 50 casts and 200 gap values (1 gap value for each implant-abutment analog). Results: The mean gap value with the index technique was 27.07 mu m. With the conventional pouring technique, the mean gap values were 116.97 mu m for the tapered group, 5784 mu m for the squared group, and 73.17 mu m for the squared splinted group. With pouring using latex tubes, the mean gap values were 65.69 mu m for the tapered group, 38.03 mu m for the squared group, and 82.47 mu m for the squared splinted group. With pouring after joining the analogs with acrylic resin, the mean gap values were 141.12 jum for the tapered group, 74.19 mu m for the squared group, and 104.67 mu m for the squared splinted group. No significant difference was detected among Index, squarellatex techniques, and master cast (P > .05). Conclusions: The most accurate impression technique utilized squared copings. The most accurate pouring technique for making the impression with tapered or squared copings utilized latex tubes. The pouring did not influence the accuracy of the stone casts when using splinted squared impression copings. Either the index technique or the use of squared coping combined with the latex-tube pouring technique are preferred methods for making implant-supported fixed restorations with dimensional accuracy.

Genetic association study between Interleukin 10 gene and dental implant loss

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

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals.Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants.Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations.Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Ensino Fundamental de 9 anos: estamos preparados para implantá-lo?

A revisão da história do desenvolvimento da educação brasileira ao longo do séc. XX permite-nos observar que grande parte das alternativas implantadas com o intuito de resolver os problemas de democratização, acesso e permanência do aluno em uma escola de qualidade foram suplantadas por políticas de caráter econômico e financeiro que acabavam preterindo os aspectos pedagógicos. Com base nesta constatação, entendemos que a atual proposição de ampliação do Ensino Fundamental de 8 para 9 anos representa uma nova oportunidade para a revisão deste procedimento histórico no âmbito da sociedade brasileira. Tendo em vista que o prazo proposto para adequação de todas as escolas à lei é 2010, realizou-se uma investigação junto a 2 (dois) Núcleos Regionais de Ensino, 8 (oito) Secretarias Municipais de Educação e 12 (doze) escolas vinculadas a estes órgãos, localizadas em diferentes cidades e regiões do estado do Paraná-Brasil, com o objetivo de investigar como a referida proposta chegou às escolas, bem como de que forma as mesmas estão se preparando para este processo. Para tanto, foram realizadas entrevistas junto a representantes dos núcleos e secretarias e também, junto aos diretores e professores das escolas. Pode-se constatar que muito pouco se sabe acerca da proposta de Implantação do Ensino Fundamental de 9 anos e que pairam muitas dúvidas e preocupações sobre se a proposta não consiste somente em mais uma mudança política e estrutural, se não significa, apenas, uma antecipação da alfabetização que poderá prejudicar as crianças. Assim sendo, parece ficar evidente a precocidade da implantação de forma ampla e generalizada, antes que sejam garantidas as condições de preparação das respectivas escolas e professores.

A Strain Gauge Analysis of Microstrain Induced by Various Splinting Methods and Acrylic Resin Types for Implant Impressions

Purpose: The aim of this study was to investigate the level of microstrain that is exerted during polymerization of acrylic resins used for splinting during implant impressions. Material and Methods: Two acrylic resins (GC Pattern Resin, Duralay II) and square transfer coping splinting methods were evaluated by means of strain gauge analysis. Two implants were embedded in a polyurethane block, and the abutments were positioned. Sixty specimens were prepared using two square transfer Copings that were rigidly connected to each other using the acrylic resins. The specimens were randomly divided into three groups of 20 each for the splinting methods: Method 1 was a one-piece method; in method 2, the splint was separated and reconnected after 17 minutes; and in method 3, the splint was separated and reconnected after 24 hours. In each group, half the specimens were splinted with GC Pattern Resin and the other half were splinted with Duralay II. Three microstrain measurements were performed by four strain gauges placed on the upper surface of the polyurethane blocks at 5 hours after resin polymerization for all groups. The data were analyzed statistically. Results: Both resin type and splinting method significantly affected microstrain. interaction terms were also significant. Method 1 in combination with Duralay II produced significantly higher microstrain (1,962.1 mu epsilon) than the other methods with this material (method 2: 241.1 mu epsilon; method 3: 181.5 mu epsilon). No significant difference was found between splinting methods in combination with GC Pattern Resin (method 1: 173.8 mu epsilon; method 2: 112.6 mu epsilon; method 3: 105.4 mu epsilon). Conclusions: Because of the high microstrain generated, Duralay II should not be used for one-piece acrylic resin splinting, and separation and reconnection are suggested. For GC Pattern Resin, variations in splinting methods did not significantly affect the microstrain created. Int J Oral Maxillofac Implants 2012;27:341-345

Machined and plastic copings in three-element prostheses with different types of implant-abutment joints: a strain gauge comparative analysis

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