Effect of mismatching abutments on implants with wider platforms - an experimental study in dogs

Aim: To evaluate the effect of mismatching abutments on implants with a wider platform on the peri-implant hard tissue remodeling and the soft tissue dimensions.Material and methods: Mandibular premolars and first molars of six Labrador dogs were extracted bilaterally. After 3 months of healing, one tapered implant was installed on each side of the mandibular molar region with the implant shoulder placed at the level of the buccal alveolar bony crest. on the right side of the mandible, an abutment of reduced diameter in relation to the platform of the implant was used, creating a mismatch of 0.85 mm (test), whereas an abutment of the same diameter of the implant platform was affixed in the left side of the mandible (control). The flaps were sutured to allow a non-submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment.Results: All implants were completely osseo-integrated. Bone levels were superior at the test than at the control sites. However, statistically significant differences were found only at the buccal and proximal aspects. The soft tissue vertical dimension was higher at the control compared with the test sites. However, statistically significant differences were demonstrated only at the buccal aspects.Conclusions: A mismatch of 0.85 mm between the implant and the abutment yielded more coronal levels of bone-to-implant contact and a reduced height of the peri-implant soft tissue (biologic width), especially at the buccal aspect, if the implant shoulder was placed flush with the level of the buccal alveolar bony crest.

Establishment of the epithelial attachment and connective tissue adaptation to implants installed under the concept of "platform switching": a histologic study in minipigs

Aim: To validate the platform switching concept at oral implants with respect to the preservation of the alveolar crestal bone levels in an animal model. Material & methods: Five minipigs received three implants each with a 0.25mm implant/ abutment mismatch and were placed flush (T(0)), 1 mm below (T(1)) and 1 mm above (T(+1)) the alveolar bony crest, and as a control, one conventionally restored implant placed at the bone level. The implants were randomly inserted flapless into the mandible. Four months after implant insertion, the animals were sacrificed, and undecalcified block sections were obtained and used for histological analyses. Results: The mean values for peri- implant bone resorption were 1.09 +/- 0.59mm (Control), 0.51 (+/- 0.27 mm, T(0)), 0.50 (+/- 0.46 mm, T(1)) and 1.30 (+/- 0.21 mm, T (+1)), respectively. Statistically significant differences (P< 0.05) were found among the test (T(0), T(-1)) and the control sites. Control implants presented an average biologic width length of 3.20mm (+/- 0.33), with a connective tissue adaptation compartment of 1.29mm (+/- 0.53) and an epithelial attachment of 1.91 mm (+/- 0.71). T(0), T(1) and T(+1) implants presented with a mean biologic width of 1.97mm (+/- 1.20), 2.70 mm (+/- 1.36) and 2.84mm (+/- 0.90), respectively, with a connective tissue adaptation compartment of 1.21mm (+/- 0.97), 1.21 mm (+/- 0.65) and 1.50 mm (+/- 0.70) and an epithelial attachment of 0.84 mm (+/- 0.93), 1.66 mm (+/- 0.88) and 1.35 mm (+/- 0.44), respectively. Differences between the configurations were mainly associated with the length of the epithelial attachment. The epithelial attachment was significantly longer in the C sites than in T(0) (P = 0.014). However, no other differences between configurations were detected. Conclusion: If the implants are positioned at the level of the alveolar bony crest, the platform switching concept may have a minor impact on the length of the epithelial attachment (0.84 vs. 1.91 mm), while the connective tissue adaptation compartment remains relatively unaffected. Moreover, platform switching resulted in less resorption of the alveolar crest (0.58 mm).

Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog

AimTo evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri-implant tissue dimensions in a dog model.Material and methodsMandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough surface, were installed on each side of the mandible in the premolar region. on the right side of the mandible, implants with a tapered and enlarged platform were used, while standard cylindrical implants were installed in the left side of the mandible. Abutments with the diameter of the cylindrical implants were used resulting in a mismatch of 0.25 mm at the tapered implant sites. The flaps were sutured to allow a non-submerged healing. After 4 months, the animals were sacrificed and ground sections were obtained for histometric assessment.ResultsAll implants were completely osseointegrated. A minimal buccal bone resorption was observed for both implant configurations and surface topographies. Considering the animals as the statistical unit, no significant differences were found at the buccal aspect in relation to bone levels and soft tissue dimensions. The surface topographies did not influence the outcomes either.ConclusionsThe present study failed to show differences in peri-implant tissue dimensions when a mismatch of 0.25 mm from a tapered platform to an abutment was applied. The surface topographies influence a neither marginal bone resorption or peri-implant soft tissue dimension.To cite this article:Baffone GM, Botticelli D, Pantani F, Cardoso LC, Schweikert MT, Lang NP. Influence of various implant platform configurations on peri-implant tissue dimensions: an experimental study in dog.Clin. Oral Impl. Res. 22, 2011; 438-444.

A study of different calcification areas in newly formed bone 8 weeks after insertion of dental implants in rabbit tibias

In orofacial implantology there are many types of implants for the different systems. Among these is the implant surface type, e.g., a screw type, cylindrical and laminar. Furthermore, the implants are different in their dimensions, their metal composition, their surface condition, such as smooth, grit or layered surfaces and in their methods of application. Two different self-tapping implants, one smooth and the other grit-blasted, are screwed into the bone, and another one with a plasma of titanium coating, which is also in a screw form but with greater spaces between the screw threads are compared. The greatest amount of bone deposition in the bone/implant interface was encountered in the latter one, the smooth surfaced implant being in second place. All of these systems can alter the implant healing process and to demonstrate this, we injected bone markers in the rabbits over different periods of time so as to observe the different areas of bone deposition in the tibias where the implants had been inserted. The bone tracers used were Alizarin, Calcein and Xylenol-orange. The amount of deposition was calculated by using the method of surface morphometry.

Morphological, mechanical and rheological properties of nylon 6/acrylonitrile-butadiene-styrene blends compatibilized with MMA/MA copolymers

The morphological, mechanical and rheological properties of nylon 6/acrylonitrile-butadiene-styrene blends compatibilized with MMA-MA [poly(methyl methacrylate-comaleic anhydride)] copolymers were studied. A twin screw extruder was used for melt-blended the polymers and the injection moulding process was used to mold the samples. The main focus was on nylon 6/ ABS blends compatibilized with one MMA-MA copolymer. This copolymer has PMMA segments that appear to be miscible with the styrene-acrylonitrile (SAN) phase of ABS and the anhydride groups can react with amine end groups of the nylon 6 (Ny6) to form graft copolymers at the interface between Ny6 and ABS rich phases. Tensile and impact and morphological properties were enhanced by the incorporation of this copolymer. Transmission electron microscopy (TEM) observations revealed that the ABS domains are finely dispersed in nylon 6 matrix and led to the lowest ductile-brittle transition temperatures and highest impact properties. It can be concluded that the MMA-MA copolymer is an efficient alternative for the reactive compatibilization and can be used as a compatibilizer for nylon 6/ABS blends.© 2003 Kluwer Academic Publishers.

Microbiologic and radiographic analysis of ligature-induced peri-implantitis with different dental implant surfaces

Purpose: The goal of this study was to evaluate microbiota and radiographic peri-implant bone loss associated with ligature-induced peri-implantitis. Materials and Methods: Thirty-six dental implants with 4 different surfaces (9 commercially pure titanium, 9 titanium plasma-sprayed, 9 hydroxyapatite, and 9 acid-etched) were placed in the edentulous mandibles of 6 dogs. After 3 months with optimal plaque control, abutment connection was performed. On days 0, 20, 40, and 60 after placement of cotton ligatures, both microbiologic samples and periapical radiographs were obtained. The presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Campylobacter spp, Capnocytophaga spp, Fusobacterium spp, beta-hemolytic Streptococcus, and Candida spp were evaluated culturally. Results: P intermedia/nigrescens was detected in 13.89% of implants at baseline and 100% of implants at other periods. P gingivalis was not detected at baseline, but after 20 and 40 days it was detected in 33.34% of implants and at 60 days it was detected in 29.03% of dental implants. Fusobacterium spp was detected in all periods. Streptococci were detected in 16.67% of implants at baseline and in 83.34%, 72.22%, and 77.42% of implants at 20, 40, and 60 days, respectively. Campylobacter spp and Candida spp were detected in low proportions. The total viable count analysis showed no significant differences among surfaces (P = .831), although a significant difference was observed after ligature placement (P < .0014). However, there was no significant qualitative difference, in spite of the difference among the periods. The peri-implant bone loss was not significantly different between all the dental implant surfaces (P = .908). Discussion and Conclusions: These data suggest that with ligature-induced peri-implantitis, both time and periodontal pathogens affect all surfaces equally after 60 days.

Experimental peri-implant tissue breakdown around different dental implant surfaces: Clinical and radiographic evaluation in dogs

Purpose: Tissue reactions to 4 different implant surfaces were evaluated in regard to the development and progression of ligature-induced peri-implantitis. Materials and Methods: In 6 male mongrel dogs, a total of 36 dental implants with different surfaces (9 titanium plasma-sprayed, 9 hydroxyapatite-coated, 9 acid-etched, and 9 commercially pure titanium) were placed 3 months after mandibular premolar extraction. After 3 months with optimal plaque control, abutment connection was performed. Forty-five days later, cotton ligatures were placed around the implants to induce peri-implantitis. At baseline and 20, 40, and 60 days after placement, the presence of plaque, peri-implant mucosal redness, bleeding on probing, probing depth, clinical attachment loss, mobility, vertical bone loss, and horizontal bone loss were assessed. Results: The results did not show significant differences among the surfaces for any parameter during the study (P > .05). All surfaces were equally susceptible to ligature-induced peri-implantitis over time (P < .001). Correlation analysis revealed a statistically significant relationship between width of keratinized tissue and vertical bone loss (r 2 = 0.81; P = .014) and between mobility and vertical bone loss (r 2 = 0.66; P = .04), both for the titanium plasma-sprayed surface. Discussion and Conclusions: The present data suggest that all surfaces were equally susceptible to experimental peri-implantitis after a 60-day period.

Avaliação da formação do biofilme de Candida albicans sobre superfície de titânio revestida com hidroxiapatita por meio de microscopia eletrônica de varredura

In this study Candida albicans biofilm formation on the surface of commercially pure titanium (cp-Ti) coated with hydroxyapatite was observed by means of scanning electron microscope. The biofilm was formed after 45 days of incubation of the samples in liquid culture medium inoculated with fungus cells in a tube of polystyrene with screw cap and sterilized. After the biofilm removal with 10% EDTA solution was observed pitting on the surface of cp-Ti coated.

Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits

The purpose of this study was to compare by qualitative histology the efficacy of rigid internal fixation with titanium system and the Lacto Sorb® system in mandibular fractures in rabbits. Thirty male adult rabbits Oryctolagus cuniculus were used. Unilateral mandibular osteotomies were performed between the canine and first premolar. The animals were divided into two groups: for Group I - rigid internal fixation was performed with titanium system 1.5 mm (Synthes, Oberdorf, Switzerland), with two screws of 6 mm (bicortical) on each side of the osteotomy. For Group II-rigid internal fixation was performed with PLLA/PGA system 1.5 mm (Lacto Sorb®, WLorenz, Jacksonville, FL, USA). The histological analysis evaluated the presence of inflammatory reaction, degree of bone healing and degree of resorption of the Lacto Sorb® screws. The results of both fixation systems were similar, only with a small difference after 15 and 30 days. In Group I a faster bony healing was noted. But after 60 days, bony healing was similar in both groups. It is concluded that both PLLA/PGA and titanium plates and screws provide sufficient strength to permit mandibular bone healing. The resorption process of PLLA/PGA osteosynthesis material did not cause acute or chronic inflammatory reaction or foreign body reaction during the studied period. © 2004 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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).

In vitro evaluation of the precision of working casts for implant-supported restoration with multiple abutments

Objective: The purpose of this study was to compare the accuracy of two working cast fabrication techniques using strain-gauge analysis. Methods: Two working cast fabrication methods were evaluated. Based on a master model, 20 working casts were fabricated by means of an indirect impression technique using polyether after splinting the square transfer copings with acrylic resin. Specimens were assigned to 2 groups (n=10): Group A (GA): type IV dental stone was poured around the abutment analogs in the conventional way; Group B (GB), the dental stone was poured in two stages. Spacers were used over the abutment analogs (rubber tubes) and type IV dental stone was poured around the abutment analogs in the conventional way. After the stone had hardened completely, the spacers were removed and more stone was inserted in the spaces created. Six strain-gauges (Excel Ltd.), positioned in a cast bar, which was dimensionally accurate (perfect fit) to the master model, recorded the microstrains generated by each specimen. Data were analyzed statistically by the variance analysis (ANOVA) and Tukey's test (α= 5%). Results: The microstrain values (με) were (mean±SD): GA: 263.7±109.07με, and GB: 193.73±78.83με. Conclusion: There was no statistical difference between the two methods studied.

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.

Evaluation of a new intraoral paralleling device for creating guiding planes: A pilot study

Aim: The aim of the study was to assess the accuracy of a new intraoral paralleling device for creating proximal guiding planes for removable partial dental prostheses. Methods and Materials: Thirty gypsum casts were divided into two groups in which the proximal surfaces of selected teeth were prepared using either a surveying device (Group 1) or the new ParalAB paralleling device (Group 2). In each cast guiding planes were prepared on the distal surface of the maxillary left canine (A), on the mesial and distal surfaces of the maxillary left second molar (B and C), and on the distal surface of the maxillary right canine (D). Each prepared surface formed an angle related to the occlusal plane that was measured five times and averaged by one operator using a tridimensional coordinate machine. Results: The mean guiding plane angles (± standard deviation) for the prepared surfaces were A=91.82° (±0.48°, B=90.47° (±0.47°, C=90.21° (±0.76°, and D=90.50° (±0.73°) for the dental surveyor (Group 1) and A=92.18° (±0.87°), B=90.90° (±0.85°), C=90.07° (±0.92°), and D=90.66° (±0.76°) for the ParalAB paralleling device (Group 2). A two-way ANOVA, Tukey's, and Levène's tests (at p<0.05) revealed statistically significant differences among surfaces prepared by both groups and that one surface Conclusions: The ParalAB device was able to prepare parallel surfaces and despite significant difference between groups, the ParalAB presented a small deviation from absolute parallelism and can be considered a valid method to transfer guide plans in the fabrication of removable partial dentures. Clinical Significance: The preparation of suitable guiding planes on abutment teeth during the fabrication of removable partial dentures is dependent on the ability of the operator and requires considerable chair time. When multiple teeth are involved, achieving parallelism between abutment surfaces can be technically challenging, especially in posterior regions of the mouth. The ParalAB prototype intraoral paralleling device can aid the clinician during the preparation of accurate guiding planes with a minimum degree of occlusal divergence. © 2010 Seer Publishing LLC.

Influence of ridge type on mandibular distal extension removable partial denture.

The aim of this study was to use photoelastic models to analyze the distribution of stress caused by the incidence of loads on a mandibular distal extension removable partial denture, both on the abutment teeth and on differently shaped residual ridges: distal ascending, descending-ascending, horizontal and distal descending. The best type of retainer and location of the rest on the last abutment tooth were determined for the different types of ridge. Four models were made from photoelastic resin (PL-1 for the teeth and PL-2 for the alveolar ridge), one for each kind of ridge. For each model, 4 removable partial dentures (RPD) were made (16 RPD altogether): T-bar retainer and distal rest, T-bar retainer and mesial rest, circumferential retainer and distal rest, and circumferential retainer and mesial rest. The models were placed on a circular polariscope and a 100 N axial load (point load) was applied to premolars and molars of the RPD. The formation of photoelastic bands was photographed for qualitative analysis. Results showed that the horizontal ridge had better distribution of stress, while the distal descending ridge had greater concentration of stress. The circumferential retainer had greater areas of stress for all types of ridges except the horizontal ridge, where there was no influence related to retainer type. The distribution of stress was similar among the different types of ridges when the rest was mesial or distal to the last abutment tooth, except for the distal descending ridge, where there was greater concentration of stress when the rest was located distally to the last abutment tooth. Thus, it may be concluded that (1) the situation was least favorable for the distal descending ridge and most favorable for the horizontal ridge, (2) the T-bar retainer had more favorable stress distribution, except when the ridge was horizontal, in which case there was no influence in relation to the type of retainer, (3) the location of the rest showed similar behavior in all except the distal descending ridge.