Implant removal by means of an expansion of the alveolar bony crest: Report of a clinical technique

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

Alveolar bony crest preservation at implants installed immediately after tooth extraction: An experimental study in the dog

Aim: To evaluate the influence of deproteinized bovine bone mineral in conjunction with a collagen membrane, at implants installed into sockets in a lingual position immediately after tooth extraction, and presenting initial horizontal residual buccal defects <2 mm. Material and methods: The pulp tissue of the mesial roots of 4P4 was removed in six Labrador dogs, and the root canals were filled with gutta-percha and cement. Flaps were elevated, and the buccal and lingual alveolar bony plates were exposed. The premolars were hemi-sectioned, and the distal roots were removed. Implants were installed in a lingual position and with the margin flush with the buccal bony crest. After installation, defects resulted at about 1.7 mm in width at the buccal aspects, both at the test and control sites. Only in the left site (test), deproteinized bovine bone mineral (DBBM) particles were placed into the defect concomitantly with the placement of a collagen membrane. A non-submerged healing was allowed. Results: After 3 months of healing, one implant was found not integrated and was excluded from the analysis together with the contralateral control implant. All remaining implants were integrated into mature bone. The bony crest was located at the same level of the implant shoulder, both at the test and control sites. At the buccal aspect, the most coronal bone-to-implant contact was located at a similar distance from the implant margin at the test (1.7 ± 1.0 mm) and control (1.6 ± 0.8 mm) sites, respectively. Only small residual DBBM particles were found at the test sites. Conclusion: The placement of an implant in a lingual position into a socket immediately after tooth extraction may favor a low exposure of the buccal implant surface. The use of DBBM particles, concomitantly with a collagen membrane, did not additionally improve the outcome obtained at the control sites. © 2011 John Wiley & Sons A/S.

Arterial hypertension perpetuates alveolar bone loss

Few studies have focused on the impact of hypertension on the progression of periodontitis (PD). The purpose of this study was to evaluate whether hypertension affects PD by enhancing bone loss even after the stimulus for PD induction is removed. Ligature-induced PD was created on the first mandibular molars of spontaneously hypertensive rats (SHR) and normotensive rats (Wistar Kyoto-WKY). The animals were assigned to non-ligated controls (C) and PD groups: WKY-C, WKY-PD, SHR-C, and SHR-PD. After 10 days, five animals of each group were killed and the ligatures of the other animals were removed. On the 21st day (11 days without PD induced), the remaining animals were killed. The jaws were defleshed and the amount of bone loss was measured. After 10 days, the PD groups showed more bone loss than its controls (P < .05); SHR-PD = 0.72 ± 0.05 mm, SHR-C = 0.39 ± 0.04 mm, WKY-PD = 0.75 ± 0.04 mm, and WKY-C = 0.56 ± 0.04 mm. The cumulative bone loss on day 21 (0.94 ± 0.13 mm) was significantly worse than on day 10 only in SHR-PD group (P < .05). The final bone loss differences between PD and C groups accounted for 102% (SHR) and 26% (WKY) increase in comparison with the initial control levels. Hypertension is associated with progressive alveolar bone loss even when the stimulus for PD induction is removed and it may be speculated that host condition perpetuates alveolar bone loss. © 2013 Informa Healthcare USA, Inc.

Incomplete mandibular fracture after lateralization of the inferior alveolar nerve for implant placement

PURPOSE: The present case describes an inferior alveolar nerve lateralization for implant placement that caused mandible fracture a few days after surgery. CLINICAL REPORT: In this case, a 56-year-old female patient who had a severely atrophied jaw and showing bone height less than 7 mm from the bone crest and the mandibular canal was submitted to surgery lateralization of the inferior alveolar conducted with piezzo. Even with all postoperative care, the patient suffered an incomplete fracture of the mandible a few days after lateralization of the inferior alveolar nerve for implant placement. The patient was treated with soft diet and medications for pain and antibiotics, besides removing the implant associated with the fracture. CONCLUSION: It is suggested that this procedure may be conducted in 2 operative periods: firstly, the lateralization of the inferior alveolar; and secondly, after a period of 3 months, the implant placement in a situation of more bone stability. Copyright © 2013 by Mutaz B. Habal, MD.

Influence of presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. an experimental study in dogs

Objective: To investigate the influence of the presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. Material and methods: In six beagle dogs, the mandibular premolars and first molars were extracted bilaterally. In the right side of the mandible (test), flaps were elevated, and the buccal as well as part of the lingual masticatory mucosa was removed. The flap was released coronally to allow a primary wound closure. In the left side, the wounds were left unsutured with the keratinized mucosa remaining (control). After 3 months of healing, a complete absence of keratinized mucosa was found at the test sites. Two recipient sites were prepared at each side of the mandible, one in the premolar and one in the molar region. A buccal bony ridge width of approximately 1 and 2 mm was obtained at the premolar and molar region, respectively. Implants were installed with the shoulder flush with the buccal alveolar bony crest, and abutments were connected to allow a nonsubmerged healing. At least 2 mm of keratinized mucosa was surrounding the control sites, while at the test sites, the implants were bordered by alveolar mucosa. After 3 months, the animals were euthanized and ground sections obtained. Results: A higher vertical bony crest resorption was observed at the test compared with the control sites both at the premolar and molar regions, the differences being statistically significant. The top of the peri-implant mucosa was located more coronally at the control compared with the test sites. The horizontal resorption measured 1 mm below the implant shoulder was similar at the test and control sites. Only limited differences were found between premolar and molar sites, with the exclusion of the horizontal resorption that was higher at the test compared with the control sites. Conclusions: A higher alveolar buccal bony crest resorption and a more apical soft tissue marginal position should be expected, when implants are surrounded with thin alveolar mucosa at the time of installation, independently of the thickness of the buccal bony crest. © 2013 John Wiley & Sons A/S.

Orthodontic force increases interleukin-1β and tumor necrosis factor-α expression and alveolar bone loss in periodontitis

Background: The present study aims to evaluate the effects of orthodontic movement (OM) on the periodontal tissues of rats with ligature-induced periodontal disease. Methods: Eighty-eight rats were divided into four groups: 1) negative control (sham operated); 2) periodontal disease; 3) OM; and 4) periodontal disease followed by OM (OMP). Rats were sacrificed 3 hours or 1, 3, or 7 days after OM commencement. Bone volume fraction (BVF) and bone mineral density (BMD) were assessed in hemimaxillae by microcomputed tomography analysis. Expression of the proinflammatory cytokines interleukin (IL)-1β and tumor necrosis factor (TNF)-α were evaluated in gingival samples by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay, and in the furcation region by immunohistochemistry analysis (IHC). Results: The OMP group had lower BVF and BMD levels compared to the other groups at day 7 (P <0.05). Maximum messenger ribonucleic acid expression of both cytokines was observed in the OMP group at day 1 (P <0.05). In the same period, all proteins were expressed in high levels for all test groups compared to the control group. The number of cells positive for IL-1β and TNF-α by IHC was highest in the OMP group at day 1, with progressive reduction thereafter. Conclusion: The results suggest that OM acts synergistically with periodontal disease in periodontal breakdown through upregulation of proinflammatory cytokines.

The influence of topic and systemic administration of copaiba oil on the alveolar wound healing after tooth extraction in rats

The Copaiba oil has been used as an auxiliary treatment of inflammations, skin disorders and stomach ulcers, however, in dentistry, this alternative medicine has not been investigated yet. The purpose of this study was to evaluate the influence of topic and systemic administration of copaiba oil on the alveolar wound healing after tooth extraction. Twenty-eight wistar male rats had their lower first molar teeth extracted. Subsequently, they were divided in four groups, according to the treatment performed: (a) alveolar socket irrigation with copaiba oil; (b) alveolar socket irrigation with physiological serum; (c) daily gavage with copaiba oil or (d) daily gavage with physiological serum. After the sacrifice, the mandibles were removed and processed in order to obtain decalcified histological sections. The results demonstrated high level of epithelial migration, small number of inflammatory cells and vascular enhancement in the animals which received systemic administration of copaiba oil. The rats treated with topic administration of copaiba oil presented ulcerations and large number of inflammatory cells. An increased bone neoformation was observed in both groups treated with copaiba oil when compared with placebo group. It could be concluded that topic or systemic administration of copaiba oil leads to a better alveolar bone healing, however the topic application on connective tissue should be carefully considered, regarding the whole socket wound healing. © Medicina Oral S. L. C.I.F. B 96689336 - eISSN: 1989-5488.

Efeitos do citrato de sufentanil, administrado em infusão contínua, na concentração alveolar mínima (CAM) de isofluorano em felinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da dinâmica do processo de reparo alveolar utilizando fluorocromos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise histomorfométrica e imunoistoquímica do processo de reparo alveolar de ratas ovariectomizadas com dieta pobre em cálcio e submetidas à terapia com raloxifeno ou com alendronato

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Expressão das proteínas osteoprotegerina, RANK e RANKL durante o processo de reparo alveolar em ratos: estudo imunoistoquímico

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

Efeitos do cloridrato de remifentanil, administrado em infusão contínua, na concentração alveolar mínima(CAM) de isofluorano em felinos

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

Co-localização de OPG e RANKL durante o processo de reparo alveolar em ratas ovariectomizadas tratadas com estrógeno ou com raloxifeno

Pós-graduação em Odontologia - FOA

Estudo em suínos sobre osteotomia com brocas de alta e baixa rotação e refrigeração líquida: análise radiográfica digital densitométrica em tecido ósseo alveolar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ação do estrógeno na expressão de proteínas relacionadas ao metabolismo ósseo durante regeneração alveolar em ratas

Pós-graduação em Odontologia - FOA