Influência de implantes pós-exodônticos com diferentes configurações sobre os tecidos peri-implantares: estudo experimental em cães

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do tipo de conexão protética, do platform-switching e do designe do implante no ambiente biomecânico de implantes imediatos com carga imediata

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Sequential healing of open extraction sockets. An experimental study in monkeys

AimTo describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made.Material and methodsThe third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180days was morphometrically studied.ResultsAfter 4days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20days, the amount of woven bone was sensibly increasing. At 30days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4days to 7.6% at 180days, of the whole length of the inner alveolar surface.ConclusionsModeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access.

Filling of extraction sockets of feline maxillary canine teeth with autogenous bone or bioactive glass

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

A digital evaluation of alveolar ridge preservation at implants placed immediately into extraction sockets: an experimental study in the dog

Objective: To compare with pristine sites bone resorption and soft tissue adaptation at implants placed immediately into extraction sockets (IPIES) in conjunction with deproteinized bovine bone mineral (DBBM) particles and a collagen membrane.Material and methods: The mesial root of the third premolar in the left side of the mandible was endodontically treated (Test). Flaps were elevated, the tooth hemi-sectioned, and the distal root removed to allow the immediate installation of an implant into the extraction socket in a lingual position. DBBM particles were placed into the defect and on the outer contour of the buccal bony ridge, concomitantly with the placement of a collagen membrane. A non-submerged healing was allowed. The premolar on the right side of the mandible was left in situ (control). Ground sections from the center of the implant as well as from the center of the distal root of the third premolar of the opposite side of the mandible were obtained. The histological image from the implant site was superimposed to that of the contralateral pristine distal alveolus, and dimensional variation evaluated for the hard tissue and the alveolar ridge.Results: After 3 months of healing, both histological and photographic evaluation revealed a reduction of hard and soft tissue dimensions.Conclusion: The contour augmentation performed with DBBM particles and a collagen membrane at the buccal aspects of implants placed IPIES was not able to maintain the tissue volume.

Considerações clínicas em implantes imediatos

The biological principles of osseointegration caused the rehabilitation treatment with osseointegrated implant become a safe, well alternative accepted by the dental community for the high success rate, allowing the preparation of functional and aesthetic prostheses in edentulous and partial patients. We passed the initial phase of functional vision for an aesthetic approach, too, depending on the demands of the patient and the quest for excellence by professionals. Over these last years, implant treatment has undergone many changes in surgical and prosthetic protocols. The less invasive surgical techniques and the development of restorative materials, especially ceramics allow the prosthetic rehabilitation of high functional quality and aesthetics. The installation of implants in sockets immediately after extraction of teeth involved by fracture, periodontal disease, endodontic lesions, is part of the arsenal of techniques for rehabilitating a number of advantages that we get to the outcome of multidisciplinary treatment. For this, we must consider several criteria in its planning as a fundamental unit, adjacent teeth, multiple losses, system, form and number of implants, type of retention of the prosthesis components, the patient expectation of the outcome perspective, gingival biotype, standard of ridge resorption, the smile line, etc. occlusal analysis. With the three-dimensional placement of the implant can immediately join the biological processes of repair of the socket, implant osseointegration, speeding treatment time. Much has been made by companies in the surface treatment of endosseous implants to be osseointegration shortened and restorative procedures started earlier, bringing benefits to the patient and professional. Among the main advantages we can emphasize the preservation of the structures adjacent to the teeth replaced, minor resorption of bone tissue involved... (Complete abstract click electronic access below)

Avaliação da integração de implantes de silicone com superfícies lisa, texturizada e de poliuretano em cavidades anoftálmicas evisceradas de coelhos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Reparação óssea em alvéolos de ratas ovarectomizadas após implante com biovidro: análise histomorfométrica e imunoistoquímica

Pós-graduação em Odontologia - FOA

Caracterização radiográfica ex vivo de biomateriais utilizados para regeneração óssea em mandíbulas de porcos

Introduction: The radiographic characteristics of a biomaterial, such as its density, may influence the evaluation of the results obtained following its clinical use. Objective: The aim of this study was to evaluate the radiographic density of biomaterials used as bone substitutes, inserted into dental sockets and bone defects in created in the jaws of pigs. The influence of a soft tissue simulator on the results was also evaluated. Material and method: Two and three-millimeter-deep bone defects were created in the pigs mandible and the right first molar extraction socket were used. Commercial samples of five biomaterials were tested: Hydroxyapatite, Lyophilized Bovine Bone, 45S5 bioglass (generic), PerioGlass and β-Tri-Calcium Phosphate, and compared to a positive (mandibular bone) and negative (empty alveolar bone defects) controls. Radiographic images were acquired with and without a 10 mm thick soft-tissue simulator. Result: The results for the extraction sockets showed no differences between the biomaterials and the negative control. For the bone defects, the depth of the defect density influenced the density, both in the negative control (p < 0.01) and biomaterials (p < 0.05) groups. The soft- tissue simulator did not alter the results. Conclusion: The type of the evaluated defect can interfere in the radiographic features presented by each biomaterial, while the simulation of soft tissues was not statistically significant.

Estudio histológico del processo de reparación alveolar después de la aplicación tópica de la solucioón anestésica prilocaína 3 % con felipressina o,o3 ui/ml

The aim of this study was to evaluate the local anesthetic solution, composed by Prilocaine 3% and felipressin 0,03 UI/ml, influence on the alveolar repair process in rats after dental extraction. This research was previously approved by the Ethic Committee in Research of the Masters Degree Program in Oral and Maxillofacial Surgery of the Marília University (UNIMAR), Marília, São Paulo, Brazil. It was an experimental, randomly controlled study, with bifactorial analysis (group control versus experimental group, in function of the postoperative times (2 X 4)). For the accomplishment of this study 32 rats were used (Rattus norvegicus, albinus, Wistar), males, adults, weighing between 280 and 320 grams. The animals were selected and divided into Group I (control) and Group II (Citocain 3%® - Prilocaine 3% with felipressin 0,03UI/ml) with 16 rats each; being four animals of the Group I and four of the Group II, destined to the euthanasia in the postoperative periods of 3rd, 7th, 15th and 24th days. The histological analysis with base in the developed methodology, allowed us to conclude that the anesthetic solution of Citocain 3%® applied with gauze compress on the surgical dental wound, produced tissue events that committed the basic biological principles, that are responsible for the regeneration of the gingival epithelium and the alveolar process repair in rats. The Group I presented better results in the alveolar repair when compared to the Group II.

Deproteinized Bovine Bone Mineral or Autologous Bone at Dehiscence Type Defects at Implants Installed Immediately into Extraction Sockets: An Experimental Study in Dogs

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

A combined approach for the treatment of resorbed fresh sockets allowing immediate implant restoration: a 2-year follow-up

Introduction: The demand for optimal esthetics has increased with the advance of the implant dentistry and with the desire for easier, safer and faster technique allowing predictable outcomes. Thus, the aim of this case report was to describe a combined approach for the treatment of a periodontally compromised tooth by means of atraumatic tooth extraction, immediate flapless implant placement, autogenous block and particulate bone graft followed by connective tissue graft and immediate provisionalization of the crown in the same operatory time. Case Report: A 27-year-old woman underwent the proposed surgical procedures for the treatment of her compromised maxillary right first premolar. The tooth was removed atraumatically with a periotome without incision. A dental implant was inserted 3 mm apical to the cement-enamel junction of the adjacent teeth enabling the ideal tridimensional implant position. An osteotomy was performed in the maxillary tuber for block bone graft harvesting that allowed the reconstruction of the alveolar buccal plate. Thereafter, an autogenous connective tissue graft was placed to increase both the horizontal and vertical dimensions of the alveolar socket reaching the patient functional and esthetic expectations. Conclusion: This treatment protocol was efficient to create a harmonious gingival architecture with sufficient width and thickness, maintaining the stability of the alveolar bone crest yielding excellent aesthetic results after 2-years of follow-up. We suggest that this approach can be considered a viable alternative for the treatment of periodontally compromised tooth in the maxillary esthetic area enhancing patient comfort and satisfaction.

Influência do desenho do implante na micromovimentação de implantes imediatos com carga imediata: análise multivariada em elementos finitos

The purpose of this paper was to evaluate the influence of different implant designs on the micromovements of immediately placed implants. CT-based finite element models comprising an upper central incisor socket and four commercially available internal connection implant designs (SIN SW®, 3i Certain®, Nobel ReplaceTM, and RN synOcta® ITI Standard) of comparable diameter and length were constructed. 50, 100 and 200N magnitude loads were applied over the implant. ANOVA at 95% level of significance was used to evaluate bone to implant relative displacement (micromovements). The implant design (68,80%) greatly influences the micromovement of immediately placed implants. However, the loading magnitude (68,80%) is the most important factor regarding the implant stability in this protocol.

Replantation as treatment for extrusive luxation

In the treatment of extrusive luxation cases, it is important that the repositioning of extruded tooth in the socket is done as soon as possible. If this does not occur, periapical clot becomes organized and makes replantation difficult reposition. In this article the patient referred to the Clinics for dental trauma sustaining extrusive luxation of the maxillary right central incisor. The patient reported having suffered a bicycle accident 12 days before, which caused traumatic tooth injuries. The repositioning was attempted without success and an alternative form of treatment was necessary to solve the case. Intentional tooth replantation, which is the deliberate extraction of the tooth and its replantation, was indicated. This technique allows clot removal and correct repositioning of the extruded tooth. Care should be taken as endodontic treatment is required for the prevention of subsequent infection-related resorption. Intracanal dressing with calcium hydroxide was used for 30 days before final root filling. Splint, systemic antibiotics and avoidance of further damage to the root surface is also important. After 49 months, showed clinical and radiographic characteristics of normality and demonstrates the availability of this technique to adversity in trauma.

Análise histométrica do processo de reparo do reimplante dentário submetidos à terapia com laser de baixa intensidade: estudo em ratos

Pós-graduação em Odontologia - FOA