Piezosurgery Applied to Implant Dentistry: Clinical and Biological Aspects

Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery.

A música em As Báquides, de Plauto: tradução e análise dos cantica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Processo de reparo ósseo diante de três tipos de superfície de titânio: análise histomorfométrica e por microscopia eletrônica de varredura associada ao EDS: estudo experimental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Analysis of implants with laser irradiated surface and silicate deposition

Objectives: the purpose of this study was to evaluate the surfaces of commercially pure titanium (cpTi) implants surface modified by laser beam (LS), by laser beam associated with sodium silicate deposition (SS) and compare them with surfaces modified by dual-acid etched (AS) and with machined surface (MS). Methods: thirty rabbits received two implants each (one for each tibia). After 30, 60 and 90 days postoperative, the implants were removed by reverse torque for biomechanical analysis and surfaces were analyzed by scanning electron microscopy (SEM) and X-ray energy dispersive spectroscopy (EDS). Results: the mean values of reverse torque at 30, 60 and 90 days postoperative were respectively 24.60, 43.60 e 60.40 N.cm to MS, 43.00, 68.20 e 63.80 N.cm to AS group, 59.80, 76.60 e 78.00 N.cm to LS group and 63.00, 75.40 e 76.60 N.cm to SS group. At 30 days, LS and SS groups showed statistically significant difference (p<0.05) compared to the other groups. At 60 days, LS and SS groups showed statistically significant difference (p<0.05) when compared to MS. Conclusions: it was concluded that SL and SS implants' biomechanical and topographical properties increased bone-implant interaction when compared to the AS and MS implants.

Estabilidade esquelética da multisegmentação maxilar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito da administração de alendronato, a longo prazo, sobre as propriedades mecânicas do tecido ósseo, sua reparação e mineralização ao redor de implantes osseointegráveis. Estudo em ratas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise histológica e histomorfométrica do processo de reparo de defeitos ósseos em ratos diabéticos preenchidos com osso autógeno e recobertos por membrana de matriz óssea homógena ou por membrana de politetrafluoretileno

Pós-graduação em Odontologia - FOA

Avaliação da sensibilidade insulínica, transdução do sinal insulínico e da densidade mineral óssea em ratas tratadas com fluoreto de sódio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aparelho Herbst x osteotomia sagital mandibular bilateral no tratamento do padrão II, classe II, divisão 1 em adultos: relato de casos

Two treatment options are available for adult patients with skeletal Class II malocclusion caused by mandibular deficiency: combined mandibular advancement surgery and orthodontic treatment or mandibular advancement appliance. This study aimed to analyze the effects of two therapeutic modalities of Class II malocclusion treatment with mandibular deficiency. Two distinct individuals with Class II malocclusion division 1 and mandibular deficiency were treated after growth spurt. The first individual used the Herbst appliance as a therapeutic option and the second individual was treated with bilateral sagittal osteotomy. The cephalometric, occlusion and face results were evaluated for both individuals. Correction of Class II malocclusion was observed on both Herbst and surgery patients resulting on a normal occlusal relationship with normal overjet and overbite. Therefore it was concluded that Herbst appliance can be used to treat borderline skeletal Class II in adult patients.

Osteotomia sagital da crista alveolar para instalação de implantes Bicon

This case report presents details of a new surgical technique for mandibular ridge sagittal osteotomy and expansion associated to immediate dental implants in atrophic ridges. The bone atrophies represents a challenge for the surgeons that intends to modify this situation. In the past, the only viable option was the onlay bone graft. However, the bone graft requests a second surgical site that certainly increases the postoperative morbidity, without mentioning the longer treatment time required. The sagittal osteotomy of the alveolar crest represents a faster option, because it eliminates the time requested for bone graft integration, providing rehabilitation of edentulous areas with thin alveolar crests that otherwise would need additi onal surgical procedures for a satisfactory result. The authors report a clinical case in which this technique was used with the installation of a Bicon dental implant in the same surgical time, showing all the steps for this single-tooth rehabilitation.

Lack of bone healing: an unusual complication following surgically assisted rapid palatal expansion

Bone defects at interdental osteotomy sites are as a complication of surgi-cally assisted rapid palatal expansion (SARPE). The replacement of osseoustissue by fibrous connective tissue impairs the spontaneous closure of adiastema between central incisors, and orthodontic tooth movementthrough the defect area may lead to root resorption. Treatment of such asituation requires an orthodontic-surgical approach. In this report, wedescribe the lack of bone healing at the midline osteotomy site after SARPE,which was treated by autogenous bone grafting as assessed by cone beamcomputed tomography. In addition, we discuss factors related to the aetiol-ogy and treatment of a bone defect after SARPE.

Bone apposition and surface treatment in dental implants: histomorphometric pilot evaluation in rabbits

The surface of dental implants is an important factor for osseointegration process and different methods of surface treatment have been described. Objective: To investigate the bone apposition in implant surface treated with sandblasting and acid-etching. Material and methods: Ten rabbits were selected and received one implant treated with method I in the left tibia and one implant treated with method II in the right tibia. Then, twenty implants were divided in two groups, according to methods of sandblasting and acid-etching (method I and method II). After 7, 14, 30, 45 and 60 days, tibias were retrieved and submitted to histotechnical procedures. The percentages of bone–implant contact (BIC) and bone area between threads (BABT) were determined throughout histomorphometric analysis and bone apposition was detected in implants of both groups. Results: In BABT measurements, an increase was observed after 45 and 60 days in the method II, compared to method I and no differences were found after 7, 14 and 30 days. In BIC measurements, an increase was detected with method II at 45 days when compared to method I. No differences between groups in BIC values were observed after 7, 14, 30 and 60 days. Conclusion: Our data demonstrated that implants treated with the method II presented increase in the contact between bone and implant after 45 days compared to method I. Moreover, with concern to bone area between threads, it was observed an increased in the method II after 45 and 60 days. However, both groups can be successfully used as a therapeutic strategy to rehabilitation of edentulous patients. Then, further experiments are needed to evaluate, in depth, the putative differential role of each surface treatment.

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.

In vitro biomechanical comparison of six different fixation methods following 5-mm sagittal split advancement osteotomies

The sagittal split ramus osteotomy (SSRO) is a surgical technique used widely to treat many congenital and acquired mandibular discrepancies. Stabilization of the osteotomy site and the potential for skeletal relapse after the procedure are still major problems. The aim of this study was to compare the mechanical stability of six methods of rigid fixation in SSRO using a biomechanical test model. Sixty polyurethane replicas of human hemimandibles were divided into six groups. In group I, the osteotomies were fixed with two four-hole titanium miniplates; in group II, with one four-hole miniplate; in group III, with one four-hole miniplate + a bicortical screw; in group IV, with a grid miniplate; in group V, with a four-hole locking miniplate; and in group VI, with a six-hole miniplate. A linear load in the premolar region was applied to the hemimandibles. The resistance forces (N) needed to displace the distal segment by 1, 3, and 5 mm were recorded and the data transmitted from the load cell to a computer. One-way analysis of variance with Tukey's post hoc test was performed to compare the means between groups. For the three displacement conditions, there was a strong tendency for the 2.0-mm plate + screw and the grid plate to have higher values.

Análise histomorfométrica do reparo ósseo em tíbias de ratos castrados submetidos ao efeito do alendronato sódico

This study used histomorphometric analysis to investigate the effect of sodium alendronate, used for the treatment of osteoporosis, on the repair of surgically-induced bone defects in the tibia of castrated rats. Methods: The castrated animals were given subcutaneous injections of sodium alendronate (0.7mg/Kg) diluted in saline once a week; the control animals were given the same dose of saline. At 16, 30 and 44 days after the first injection of sodium alendronate, the animals were sacrificed and the right tibias were removed and processed for histomorphometric analysis. The volumetric bone mineral density was estimated by a reticular grid (25 points) attached to a light microscope. The number of points on the bone tissue was counted in the histological sections, totaling 100 points/animal. Results: The results revealed that sodium alendronate stimulated bone formation in castrated rats in all occasions, mainly at 16 and 30 days. Conclusion: Sodium alendronate affects mineral homeostasis, promoting bone repair.