Histomorphometric evaluation of a threaded, sandblasted, acid-etched implant retrieved from a human lower jaw: A case report

The purpose of this study was to histomorphometrically evaluate the bone-to-implant contact and bone area around a titanium implant retrieved from a human lower jaw. A screw-shaped titanium implant (sandblasted and acid-etched surface) was removed from a 68-year-old male after having been in function for 40 months because of a fracture of the abutment screw. Following the implant removal, an undecalcified section was obtained. The histomorphometric analysis showed a rate of 75.40% of bone-to-implant contact and 89.30% of bone area filling within the limits of the implant threads. The surrounding bone healed in a well-organized pattern and could not be differentiated from the anginal alveolus. The histologic evidence showed a high degree of osseointegration in a threaded, sandblasted, and acid-etched implant retrieved from a human lower jaw after functional loading for 40 months. Copyright © 2005 by Lippincott Williams & Wilkins.

Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: A computed tomography evaluation

Introduction: The force delivered during rapid maxillary expansion (RME) produces areas of compression on the periodontal ligament of the supporting teeth. The resulting alveolar bone resorption can lead to unwanted tooth movement in the same direction. The purpose of this study was to evaluate periodontal changes by means of computed tomography after RME with tooth-tissue-borne and tooth-borne expanders. Methods: The sample comprised 8 girls, 11 to 14 years old, with Class I or II malocclusions with unilateral or bilateral posterior crossbites Four girls were treated with tooth-tissue-borne Haas-type expanders, and 4 were treated with tooth-borne Hyrax expanders. The appliances were activated up to the full 7-mm capacity of the expansion screw. Spiral CT scans were taken before expansion and after the 3-month retention period when the expander was removed. One-millimeter thick axial sections were exposed parallel to the palatal plane, comprising the dentoalveolar area and the base of the maxilla up to the inferior third of the nasal cavity. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal alveolar bone crest level by means of the computerized method. Results and Conclusions: RME reduced the buccal bone plate thickness of supporting teeth 0.6 to 0.9 mm and increased the lingual bone plate thickness 0.8 to 1.3 mm. The increase in lingual bone plate thickness of the maxillary posterior teeth was greater in the tooth-borne expansion group than in the tooth-tissue-borne group. RME induced bone dehiscences on the anchorage teeth's buccal aspect (7.1 ± 4.6 mm at the first premolars and 3.8 ± 4.4 mm at the mesiobuccal area of the first molars), especially in subjects with thinner buccal bone plates. The tooth-borne expander produced greater reduction of first premolar buccal alveolar bone crest level than did the tooth-tissue-borne expander. © 2006 American Association of Orthodontists.

Efeitos de parâmetros de extrusão nas propriedades físicas de produtos expandidos de inhame

Effect of extrusion parameters was studied on the expansion index, specific volume, water absorption index (WAI) and water solubility index (WSI) of expanded yam snacks. The central composite design was used to study the parameters effect. It was verified three levels of temperature in the barrel (100, 115 and 130°C), three levels of screw speed (163, 204 and 245 rpm) and three levels of flour moisture (12, 15 and 18%). The results showed that expansion properties (expansion index and specific volume) depend on flour moisture and extrusion temperature. The WSI was dependant of three parameters. Higher levels of temperature and screw speed increase the water solubility index (WSI). The studied parameters did not influence the water absorption index (WAI).

Compressive fatigue in titanium dental implants submitted to fluoride ions action

The aim of this study was to assess the influence of a fluoridated medium on the mechanical properties of an internal hexagon implant-abutment set, by means of compression, mechanical cycling and metallographic characterization by scanning electronic microscopy. Five years of regular use of oral hygiene with a sodium fluoride solution content of 1500 ppm were simulated, immersing the samples in this medium for 184 hours, with the solutions being changed every 12 hours. Data were analyzed at a 95% confidence level with Fisher's exact test. After the action of fluoride ions, a negative influence occurred in the mechanical cycling test performed in a servohydraulic machine (Material Test System-810) set to a frequency of 15 Hz with 100,000 cycles and programmed to 60% of the maximum resistance of static compression test. The sets tended to fracture by compression on the screw, characterized by mixed ruptures with predominance of fragile fracture, as observed by microscopy. An evidence of corrosion by pitting on sample surfaces was found after the fluoride ions action. It may be concluded that prolonged contact with fluoride ions is harmful to the mechanical properties of commercially pure titanium structures.

Oftalmomiíase externa causada por cochliomyia hominivorax

The purpose of this study was to report a case of external ophthalmomyiasis caused by Cochliomyia hominivorax in a 10 years-old child, which presented acute preseptal celulitis and had 17 worms removed from the lacrimal canaliculus and conjunctival cul de sac, bilaterally, with resolution. The authors discuss the diagnosis and treatment of this nosological entity.

Avaliação das dimensões transversas na maxila e mandíbula em pacientes na fase da dentição mista tratados com aparelho ortodôntico removível superior

Objeti vo: Avaliar os efeitos da expansão lenta na maxila e na mandíbula com o aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, nas regiões oclusal, gengival e alveolar de pacientes jovens com atresia maxilar. Método: A amostra compreendeu 18 indivíduos leucodermas (11 meninas e 7 meninos; idade média: 8 anos e 10 meses no início do tratamento) que apresentavam atresia da maxila, acompanhadas ou não de mordida cruzada posterior uni ou bilateral na fase de denti ção mista. Todos os pacientes foram tratados com aparelho ortodônti co removível superior com torno de expansão simétrico e mediano, sendo o tempo médio de tratamento de 15,4 meses (± 7,6). Para avaliar a infl uência do tratamento nas mensurações dos pontos demarcados nas regiões oclusal, gengival e alveolar, foram uti lizados os modelos de gesso dos arcos superior e inferior (36 pares) obti dos em dois tempos: T1: início do tratamento e T2: ao fi nal do tratamento. Para cada paciente em ambos os tempos, foram mensuradas as distâncias transversas na região oclusal entre caninos decíduos, 1o molares decíduos ou 1o pré-molares permanentes e entre 1o molares permanentes, superiores e inferiores. Para verifi car se a movimentação ocorreu por inclinação ou por movimento de corpo, foram uti lizadas também medidas nas regiões gengival e alveolar. Os dados foram avaliados estati sti camente pelo teste “t student para amostras pareadas (5%). Resultados: Observou-se que em T2, todas as distâncias mensuradas para as regiões oclusal, gengival e alveolar apresentaram valores estati sti camente superiores às mesmas medidas em T1 (p<0,05). Conclusão: O aparelho ortodônti co removível superior é efeti vo nos casos de expansão lenta da maxila, agindo também indiretamente nas dimensões transversas do arco inferior.

Effect of unilateral misfit on preload of retention screws of implant-supported prostheses submitted to mechanical cycling

Purpose: The aim of this study was to evaluate the effect of different levels of unilateral angular misfit on preload maintenance of retention screws of single implant-supported prostheses submitted to mechanical cycling. Materials and methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n=12). The crowns presented no misfit in Group A (control group) and unilateral misfits of 50μm, 100μm and 200μm in the groups B, C and D, respectively. The crowns were attached to external hexagon implants with a titanium retention screw with torque of 30N/cm. Oblique loading of 130N at 2Hz was applied on each replica, totalizing 5×104 and 1×106cycles. Detorque values were measured initially and after each cycling period. Data were evaluated by analysis of variance and Tukey's HSD test (p<0.05). Results: All groups presented reduced initial detorque values (p< 0.05) in comparison to the insertion torque (30. ± 0.5. N/cm) and Group A (25.18. N/cm) exhibited the lowest reduction. After mechanical cycling, all groups presented detorque values from 19.5. N/cm to 22.38. N/cm and the mechanical cycling did not statistically influence the detorque values regardless the misfit level of the replicas. Conclusion: The unilateral misfit influenced the preload maintenance only before mechanical cycling. The mechanical cycling did not influence the torque reduction. © 2010 Japan Prosthodontic Society.

Tomographic, Histological, and Immunohistochemical Evidences on the Use of N-Butyl-2-Cyanoacrilate for Onlay Graft Fixation in Rabbits

Background: The bone tissue responses to Cyanoacrylate have been described in the literature, but none used N-butyl-2-cyanoacrilate (NB-Cn) for bone graft fixation. Purpose: The aims of the study were: (a) to analyze the bone grafts volume maintenance fixed either with NB-Cn or titanium screw; (b) to assess the incorporation of onlay grafts on perforated recipient bed; and (c) the differences of expression level of tartrate-resistant acid phosphatase (TRAP) protein involved in bone resorption. Materials and Methods: Eighteen New Zealand White rabbits were submitted to calvaria onlay grafting on both sides of the mandible. On one side, the graft was fixed with NB-Cn, while on the other hand the bone graft was secured with an osteosynthesis screw. The computed tomography (CT) was performed just after surgery and at animals sacrifice, after 1 (n=9) and 6weeks (n=9), in order to estimate the bone grafts volume along the experiments. Histological sections of the grafted areas were prepared to evaluate the healing of bone grafts and to assess the expression of TRAP protein. Results: The CT scan showed better volume maintenance of bone grafts fixed with NB-Cn (p≤0.05) compared with those fixed with screws, in both experimental times (analysis of variance). The immunohistochemical evaluation showed that the TRAP expression in a 6-week period was significantly higher compared with the 1-week period, without showing significant difference between the groups (Wilcoxon and Mann-Whitney). Histological analysis revealed that the NB-Cn caused periosteum damage, but provided bone graft stabilization and incorporation similar to the control group. Conclusion: The perforation provided by screw insertion into the graft during fixation may have triggered early revascularization and remodeling to render increased volume loss compared with the experimental group. These results indicate that the NB-Cn possesses equivalent properties to titanium screw to be used as bone fixation material in osteosynthesis. © 2010 Wiley Periodicals, Inc.

Avaliação microbiológica da superfície dos implantes ortopédicos metálicos usados para fixar fraturas ósseas

In the majority of cases of bone fracture requiring surgery, orthopedic implants (screw-plate and screw) are used for osteosynthesis and the infections associated with such implants are due to the growth of microorganisms in biofilms. The objective of this study was to identify microorganisms recovered from osteosynthesis implants used to fix bone fractures, to assess the viability of the cells and the ability of staphylococci to adhere to a substrate and to determine their sensitivity/resistance to antimicrobials. After surgical removal, the metal parts of austenitic stainless steel (ASTM F138/F139 or ISO NBR 5832-1/9) were transported to the Laboratory of Clinical Microbiology, washed in buffer and subjected to ultrasonic bath at 40±2 kHz for 5 minutes. The sonicated fluid was used to seed solid culture media and cell viability was assessed under the microscope by with the aid of a fluorescent marker. The production of extracellular polysaccharide by Staphylococcus spp. was investigated by means of adhesion to a polystyrene plate. The profile of susceptibility to antimicrobials was determined by the disk diffusion assay. The most frequently isolated bacteria included coagulase-negative Staphylococcus resistant to erythromycin, clindamycin and oxacillin. Less frequent were Pseudomonas aeruginosa resistant to trimethoprim/sulfamethoxazole and ampicillin, Acinetobacter baumannii resistant to ceftazidime, Enterobacter cloacae resistant to cephalothin, cefoxitin, cefazolin, levofloxacin and ciprofloxacin, Bacillus spp. and Candida tropicalis. The observation of slides by fluorescence microscope showed clusters of living cells embedded in a transparent matrix. The test for adherence of coagulase-negative Staphylococcus to a polystyrene plate showed that these microorganisms produce extracellular polysaccharide. In conclusion, the metal parts were colonized by bacteria related to orthopedic implant infection, which were resistant to multiple antibiotics.

Reliability and failure modes of internal conical dental implant connections

Objective: Biological and mechanical implant-abutment connection complications and failures are still present in clinical practice, frequently compromising oral function. The purpose of this study was to evaluate the reliability and failure modes of anterior single-unit restorations in internal conical interface (ICI) implants using step-stress accelerated life testing (SSALT). Materials and methods: Forty-two ICI implants were distributed in two groups (n = 21 each): group AT-OsseoSpeed™ TX (Astra Tech, Waltham, MA, USA); group SV-Duocon System Line, Morse Taper (Signo Vinces Ltda., Campo Largo, PR, Brazil). The corresponding abutments were screwed to the implants and standardized maxillary central incisor metal crowns were cemented and subjected to SSALT in water. Use-level probability Weibull curves and reliability for a mission of 50,000 cycles at 200 N were calculated. Differences between groups were assessed by Kruskal-Wallis along with Bonferroni's post-hoc tests. Polarized-light and scanning electron microscopes were used for failure analyses. Results: The Beta (β) value derived from use level probability Weibull calculation was 1.62 (1.01-2.58) for group AT and 2.56 (1.76-3.74) for group SV, indicating that fatigue was an accelerating factor for failure of both groups. The reliability for group AT was 0.95 and for group SV was 0.88. Kruskal-Wallis along with Bonferroni's post-hoc tests showed no significant difference between the groups tested (P > 0.27). In all specimens of both groups, the chief failure mode was abutment fracture at the conical joint region and screw fracture at neck's region. Conclusions: Reliability was not different between investigated ICI connections supporting maxillary incisor crowns. Failure modes were similar. © 2012 John Wiley & Sons A/S.

Histological analysis of the osseointegration of Ti-30Ta dental implants after surface treatment

Metallic biomaterials are used to reinforce or to restore the form and function of hard tissues. Implants and prosthesis are used to replace shoulders, knees, hips and teeth. When these materials are inserted in bone several biological reactions happen. This process can be associated to surface properties (topography, roughness and surface energy). In this work, the influence of biomimetic surface treatment in the osseointegration of Ti-30Ta dental implants was evaluated. Ingots were obtained from titanium and tantalum by using an arc-melting furnace. They were submitted to heat treatment at 1,100°C for 1 h, cooled in water and cold worked by swaging. Then, screw-shaped implants (2.0 mm diameter by 2.5 mm length) were manufactured and they were implanted in a rat's femur. Animals were divided into two groups: untreated (control group) and treated (biomimetic surface treatment). They were sacrificed 30 days after implantation. For histological analysis, implants with surrounding tissue were removed and immersed in formaldehyde. Samples were embedded in polymethyl methacrylate and after polymerization, cut with a saw, polished and mounted on glass slides. The results obtained suggest that biomimetic surface treatment was able to promote an increase osseointegration on the surface of dental implants. © Springer-Verlag Berlin Heidelberg 2013.

In vitro biomechanical evaluation of sagittal split osteotomy fixation with a specifically designed miniplate

Recent studies have evaluated many methods of internal fixation for sagittal split ramus osteotomy (SSRO), aiming to increase stability of the bone segments while minimizing condylar displacement. The purpose of this study was to evaluate, through biomechanical testing, the stability of the fixation comparing a specially designed bone plate to other two commonly used methods. Thirty hemimandibles were separated into three equal groups. All specimens received SSRO. In Group I the osteotomies were fixed with three 15 mm bicortical positional screws in an inverted-L pattern with an insertion angle of 90°. In Group II, fixation was carried out with a four-hole straight plate and four 6 mm monocortical screws. In Group III, fixation was performed with an adjustable sagittal plate and eight 6 mm monocortical screws. Hemimandibles were submitted to vertical compressive loads, by a mechanical testing unit. Averages and standard deviations were submitted to analysis of variance using the Tukey test with a 5% level of significance. Bicortical screws presented the greatest values of loading resistance. The adjustable miniplate demonstrated 60% lower resistance compared to bicortical screws. Group II presented on average 40% less resistant to the axial loading. © 2012 International Association of Oral and Maxillofacial Surgeons.

Stress distribution in implant-supported prosthesis with external and internal implant-abutment connections

Objective. This study aimed to investigate the stress distribution in screwed implant-supported prostheses with different implant-abutment connections by using a photoelastic analysis. Materials and methods. Four photoelastic models were fabricated in PL-2 resin and divided according to the implant-abutment connection (external hexagon (EH) and Morse taper (MT) implants (3.75 × 11.5 mm)) and the number crowns (single and 3-unit piece). Models were positioned in a circular polariscope and 100-N axial and oblique (45) loading were applied in the occlusal surface of the crowns by using a universal testing machine. The stresses were photographically recorded and qualitatively analyzed using software (Adobe Photoshop). Results. Under axial loading, the MT implants exhibited a lower number of fringes for single-unit crowns than EH implants, whereas for a 3-unit piece the MT implants showed a higher number of fringes vs EH implants. The oblique loading increased the number of fringes for all groups. Conclusion. In conclusion, the MT implant-abutment connection reduced the amount of stress in single-unit crowns, for 3-unit piece crowns the amount of stress was lower using an external hexagon connection. The stress pattern was similar for all groups. Oblique loading promoted a higher stress concentration than axial loading. © Informa Healthcare.

Effect of the number of screws on the stability of locking mandibular reconstruction plates

Atrophic mandible fractures are frequently a challenge to stabilize. This study evaluated, through mechanical testing in vitro, the number of locking screws that is sufficient to withstand loading when applied with a locking reconstruction plate in the fixation of atrophic mandible fractures. Polyurethane mandibles with a simulated linear fracture at the midline were used as substratum. Results show that resistance of the fixation is poor when one and two screws are used on each side of the fracture. Three screws on each side of the fracture significantly increases the resistance to displacement. However, no additional strength is added to the construct when more than three screws per side are used. © 2013 International Association of Oral and Maxillofacial Surgeons.

Enzyme use in kibble diets formulated with wheat bran for dogs: Effects on processing and digestibility

Recently, there is an interest in technologies that favour the use of coproducts for animal nutrition. The effect of adding two enzyme mixtures in diets for dogs formulated with wheat bran (WB) was evaluated. Two foods with similar compositions were formulated: negative control (NC; without WB) and test diet (25% of WB). The test diet was divided into four treatments: without enzyme (positive control), enzyme mixture 1 (ENZ1; added before extrusion β-glucanase, xylanase, cellulase, glucoamylase, phytase); enzyme mixture 2 (ENZ2; added before extrusion the ENZ1 more α-amylase); enzyme mixture 2 added after the extrusion (ENZ2ex). ENZ1 and ENZ2 were used to evaluate the enzyme effect on extruder pre-conditioner (processing additive) and ENZ2ex to evaluate the effect of enzyme supplementation for the animal. Digestibility was measured through total collection of faeces and urine. The experiment followed a randomized block design with five treatments (diets) and six dogs per diet, totalling 30 dogs (7.0 ± 1.2 years old and 11.0 ± 2.2 kg of body weight). Data were submitted to analysis of variance and means compared by Tukey's test and orthogonal contrasts (p < 0.05). Reducing sugars showed an important reduction after extrusion, suggesting the formation of carbohydrate complexes. The apparent total tract digestibility (ATTD) of dry matter, organic matter, crude protein, acid-hydrolysed fat and energy was higher in NC than in diets with WB (p < 0.001), without effects of enzyme additions. WB diets resulted in higher faecal production and concentration of short-chain fatty acids (SCFA) and reduced pH and ammonia concentration (p < 0.01), with no effect of enzyme addition. The enzyme addition did not result in improved digestibility of a diet high in non-starch polysaccharides; however, only ATTD was measured and nutrient fermentation in the large intestine may have interfered with the results obtained. WB modified fermentation product formation in the colon of dogs. © 2013 Blackwell Verlag GmbH.