Evaluation of low intensity laser's action on silicone mammary implant pseudocapsules in rats

OBJETIVO: Avaliar o efeito do laser de baixa intensidade sobre a contração da pseudocápsula que ocorre ao redor de implantes de silicone. MÉTODOS: 60 ratos machos divididos em dois grupos receberam implante de silicone. Grupo I: implante no subcutâneo da região dorsal, sem tratamento após a cirurgia; Grupo II: animais receberam sete sessões de irradiação com laser de baixa intensidade após o implante. Trinta, 60 e 180 dias após a cirurgia, foi feita a tonometria dos implantes, em seguida, os animais foram sacrificados, removendo-se o material de estudo que foi preparado para exame histológico, avaliando-se morfometricamente a espessura da pseudocápsula e a reação inflamatória. A análise estatistica pela técnica da Análise de Variância e Teste de Tukey (P<0.0 5). RESULTADOS: Pressões significativamente menores foram encontradas nos animais do grupo Grupo II. O estudo histológico não mostrou diferença significativa entre os grupos, destacando-se apenas maior quantidade de vasos intumescidos no Grupo II. A espessura da pseudocápsula foi menor no Grupo II. CONCLUSÃO: O laser de baixa intensidade altera o processo de reparação tecidual ao redor dos implantes, sugerindo que o mesmo possa ser útil para a modelação das contraturas que se estabelecem ao redor dos implantes de silicone.

Autologous implant of bone marrow mononuclear cells as treatment of induced equine tendinitis

Superficial digital flexor tendonitis is an important cause of lameness in horses and its incidence ranges from 13% to 30%, depending on the horse's activity. This injury can occur in yearlings and compromise its carriers by reinjury or even impossibility to return to athletic life. In spite of the long period required for tendon repair, the scar tissue presents lack of elasticity and stiffness. As current treatment strategies produce only marginal results, there has been great interest in research of therapies that influence the quality or the speed of tendon repair. Stem cell therapy has shown promising results in degenerative diseases and cases of deficient healing processes. This study aims to evaluate the influence of autologous mesenchymal bone marrow stem cells in tendon healing, comparing treated and non-treated tendons. Superficial digital flexor tendonitis lesions were induced by collagenase infiltration in both forelimbs of 6 horses, followed by autologous implant in one of the forelimbs of each animal. The horses were evaluated using clinical, ultrasonographic, histopathologic, and immunohistochemical parameters. Tendon biopsies were performed at Day 48. Results found in the treatment group, such as high inflammatory cells infiltration, extracellular matrix synthesis, reduced amount of necrosis areas, small increase in cellular proliferation (KI-67/MIB-1), and low immunoreactivity to transforming growth factor P I, suggested the acceleration of tendon repair in this group. Further studies should be conducted in order to verify the influence of this treatment on later phases of tendon repair. Overall, after analysis of the results, we can conclude that cellular therapy with the mononuclear fraction of bone marrow has accelerated tendon repair at 48 days after treatment.

Planning for Immediate Loading of Implant-Supported Prostheses: Literature Review

The aim of this study was to present the factors that influence planning for immediate loading of implants through a literature review for treatment success. Research was conducted in the PubMed database including the key words immediate implant loading, implant-supported prostheses, and implant planning for studies published from 2000 to 2011. Forty-eight articles were used in this review to describe the indications and counterindications, presurgical planning, and technologies available for planning of this treatment alternative.

Influence of Cusp Inclination on Stress Distribution in Implant-Supported Prostheses. A Three-Dimensional Finite Element Analysis

Purpose: The aim of this study was to assess the influence of cusp inclination on stress distribution in implant-supported prostheses by 3D finite element method.Materials and Methods: Three-dimensional models were created to simulate a mandibular bone section with an implant (3.75 mm diameter x 10 mm length) and crown by means of a 3D scanner and 3D CAD software. A screw-retained single crown was simulated using three cusp inclinations (10 degrees, 20 degrees, 30 degrees). The 3D models (model 10d, model 20d, and model 30d) were transferred to the finite element program NeiNastran 9.0 to generate a mesh and perform the stress analysis. An oblique load of 200 N was applied on the internal vestibular face of the metal ceramic crown.Results: The results were visualized by means of von Mises stress maps. Maximum stress concentration was located at the point of application. The implant showed higher stress values in model 30d (160.68 MPa). Cortical bone showed higher stress values in model 10d (28.23 MPa).Conclusion: Stresses on the implant and implant/abutment interface increased with increasing cusp inclination, and stresses on the cortical bone decreased with increasing cusp inclination.

Implant-retained thumb prosthesis with anti-rotational attachment for a geriatric patient

This report presents the use of a dental implant with an anti-rotational attachment for the retention of a thumb prosthesis. A retention system was manufactured with an attachment (UCLA) screwed into the implant with a two-bar system that was cast in metallic silver palladium. A substructure made from heat-cured acrylic resin was joined to the retention system by clips to join the thumb to the finger (bar clip) in the cast with implant rejoinder. The silicone material, Silastic-MDX 44210, was used to achieve function and aesthetics. Following osseointegration, no skin problems were observed. Whilst the implant-retained digital prosthesis presented some motor limitations, it allowed the patient to return to entertainment and achieve social conviviality.

Influence of the Connector and Implant Design on the Implant-Tooth-Connected Prostheses

Purpose:The purpose of this study was to evaluate stress transfer patterns between implant-tooth-connected prostheses comparing rigid and semirigid connectors and internal and external hexagon implants.Materials and Methods:Two models were made of photoelastic resin PL-2, with an internal hexagon implant of 4.00 x 13 mm and another with an external hexagon implant of 4.00 x 13 mm. Three denture designs were fabricated for each implant model, incorporating one type of connection in each one to connect implants and teeth: 1) welded rigid connection; 2) semirigid connection; and 3) rigid connection with occlusal screw. The models were placed in the polariscope, and 100-N axial forces were applied on fixed points on the occlusal surface of the dentures.Results:There was a trend toward less intensity in the stresses on the semirigid connection and solid rigid connection in the model with the external hexagon; among the three types of connections in the model with the internal hexagon implant, the semirigid connection was the most unfavorable one; in the tooth-implant association, it is preferable to use the external hexagon implant.Conclusions:The internal hexagon implant establishes a greater depth of hexagon retention and an increase in the level of denture stability in comparison with the implant with the external hexagon. However, this greater stability of the internal hexagon generated greater stresses in the abutment structures. Therefore, when this association is necessary, it is preferable to use the external hexagon implant.

Photoelastic Stress Analysis in Screwed and Cemented Implant-Supported Dentures With External Hexagon Implants

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

Compromised Primary Implant Stability

The aim of this study was to evaluate implants installed with compromised primary stability associated or not with polylactide and polyglycolide copolymer (PLA/PGA). Two 0.4-mm overdrilled defects (3 mm in diameter and 6 mm long) were produced in the right tibia of 25 rabbits. Half of the defects were left untreated, and the other half was filled with PLA/PGA. Implants of 2.6 mm in diameter and 6 mm long were placed into all defects. Animals were killed at 5, 15, 40, and 60 postoperative days, and biomechanical analysis (torque-reverse), histomorphometry, and immunohistochemistry (osteoprotegerin, receptor activator of NFJB ligand [RANKL], osteocalcin, and collagen-1 [ COL- I] staining) were performed. All the implants achieved osseointegration. There were no statistically significant differences in the torque-reverse and in linear contact extension between bone tissue and implant surface and no statistically significant difference in osteoprotegerin, RANKL, osteocalcin, and collagen-1 expression between the studied groups in all studied periods (P > 0.05). We can conclude that osseointegration can occur in compromised primary implant stability situations, and the addition of PLA/PGA did not improve the osseointegration process in this experimental model.

Evaluation of immediate bone-cell viability and of drill wear after implant osteotomies: Immunohistochemistry and scanning electron microscopy analysis

Purpose: This study sought to evaluate the effect of repeated implant drilling on the immediate bone-cell viability, and to evaluate drill wear by scanning electron microscopy.Materials and Methods: The tibiae of 10 rabbits were used, divided into 5 groups (G): G1 corresponded to new drills, and G2, G3, G4, and G5 corresponded to drills used 10, 20, 30, and 40 times, respectively. The animals received 10 sequential osteotomies in each tibia. The animals were euthanized immediately after the osteotomies by perfusion with 4% formaldehyde. Samples then underwent immunohistochemistry processing for ordinal qualitative analysis of osteoprotegerin (OPG), the RANK ligant (RANKL; a tumor-related necrosis factor receptor family), and osteocalcin protein immunolabels, as detected by the immunoperoxidase method and revealed with 3,3-diaminobenzidine. Drill wear and plastic deformation were analyzed by scanning electron microscopy (SEM).Results: The proteins were expressed in osteocytes of the superior bone cortical during the 40 drillings. However, in G4 and G5, a discrete increase in the expression of RANKL was observed, when compared with OPG; this increase was statistically significant in G5 (P = .016). The SEM analysis revealed major plastic deformation and drill wear in G4 and G5.Conclusion: Based on the present methodology, it may be concluded that cell viability is preserved if a less traumatic surgical protocol is used. However, the repeated use of drills alters the protein balance as of the thirtieth perforation. (C) 2008 American Association of Oral and Maxillofacial Surgeons.

Influence of Implant Angulation With Different Crowns on Stress Distribution

The aim of this study was to perform a photoelastic analysis of stress distribution on straight and angulated implants with different crowns (screwed and cemented). Three models were made of photoelastic resin PL-2: model 1: external hexagon implant 3.75 x 10.00 mm at 0 degrees; model 2: external hexagon implant 3.75 x 10.00 mm at 17 degrees; model 3: external hexagon implant 3.75 x 10.00 mm at 30 degrees. Axial and oblique (45 degrees) load (100 N) was applied with a universal testing machine. The photoelastic fringes on the models were recorded with a digital camera and visualized in a graphic software for qualitative analysis. The axial loading generated the same pattern of stress distribution. The highest stresses were concentrated between medium and apical thirds. The oblique loading generated a similar pattern of stress distribution in the models with similar implant angulation; the highest stress was located on the cervical region opposite to implant angulation and on the apical third. It was concluded that the higher the implant angulation, the higher the stress value, independent of crown type. The screwed prostheses exhibited the highest stress concentration. The oblique load generated higher stress value and concentration than the axial load.

Anterior Tooth Rehabilitation With Frozen Homogenous Bone Graft and Immediately Loaded Titanium Implant Using Computer-Guided Surgery

Computed tomographic scanning is a precise, noinvasive surveying technique that enables the professionals to improve the precision of implant placement by building a prototype that allows the confection of surgical guides. The authors present a clinical case of anterior tooth rehabilitation with frozen homogenous bone graft and immediately loaded titanium implant using computer-guided surgery. A multislice computed tomography was realized, and a prototype was built. All the procedures were previously realized in the prototype before started in the patient. This technique allows a better surgical planning, makes the procedures more accurate, and reduces surgery time.

Resolution of a titanium implant fracture after a recurrent trauma

Post-traumatic complications occasionally lead to tooth loss as well as the need for future implants. However, rehabilitation with endosseous osseointegrated implants does not protect the patient from the risk of suffering a new trauma. Implant fracture and the damage of the hexagon are post-traumatic complications that guide the clinician to preparing a more intricate treatment plan. The authors present a clinical case of a recurrent trauma of maxillary implant fracture. The treatment plan was to remove the implants followed by autogenous bone grafting to correct the defect. Two titanium implants were replaced, followed by connective tissue graft after allowing complete the healing process of the bone graft to occur. In the postoperative period of 6 months, satisfactory results have been shown as regards soft and hard tissues wound healing.

Inferior Alveolar Nerve Lateralization and Implant Placement in Atrophic Posterior Mandible

The aims of this article were to describe the surgical technique of the inferior alveolar nerve lateralization followed by implant installation by means of a clinical report and also to discuss the importance of an adequate surgical and prosthetic planning for atrophic posterior mandible rehabilitation.