Impact of Replacing Conventional Complete Dentures with Implant-Supported Fixed Complete Dentures

The aim of this study was to assess the impact of replacing conventional mandibular complete dentures with implant-supported fixed complete dentures (ISFDs) on the oral health related quality of life (OHOOL) of edentulous patients and on the associated kinesiographic parameters. The patients had their complete dentures replaced by ISFDs and were assessed after 1, 2, 3, 6, and 12 months. An improvement of general OHQOL was observed 2 months after treatment with ISFDs. Kinesiographic recordings revealed significant mandibular vertical and horizontal opening increases and a greater vertical intrusion of the maxillary complete dentures during clenching after the treatment with ISFD.

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.

Repair Technique for Fractured Implant-Supported Metal-Ceramic Restorations: A Clinical Report

The fracture of porcelain structures have been related in either natural dentition or implant-supported restorations. Techniques using a composite resin or indirect methods can be used. This article presents a porcelain fracture on implant-supported metal-ceramic restoration. IPS Empress e.max laminate veneer restoration was used to repair the fracture. With this technique, it was possible to restore aesthetics and function, combined with low cost and patient satisfaction.

BIOMECHANICAL BEHAVIOR OF THE SYSTEM PROSTHESIS/DENTAL IMPLANT: ANALYSIS BY THE PHOTOELASTICITY METHOD

One of the main reasons for the failure in dental implant treatments is the overload, which can cause bone resorption and later, the osseointegration loss in the implant. Therefore, the aim of this study was to analyze the tension generated around dental implants in the rehabilitation of three mandible posterior teeth, varying the connection type, the disposal, and the quantity of implants. The photoelasticity method was used in order to accomplish it. Through photoelasticity, the quantity and localization of the tensions around the implants in the different studied groups were compared (three straight line implants, three offset placement implants, two implants with a mesial cantilever, and two implants with a pontic). The results showed that the tension quantity and disposition around the dental implants of the connection external hexagon and internal hexagon were similar in all groups. In the group where the cantilever was used, an increase of the tension around the implant, adjacent to the cantilever, was observed. From the results it is concluded that the type of connection used in this study did not influence the tension quantity and distribution around the implants; however, the prosthetic configuration with the cantilever use, led to an increase of the tension around the implant, adjacent to the cantilever.

Immediate and late analysis of dental pulp stem cells viability after indirect exposition to alternative in-office bleaching strategies

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

Immediate human pulp response to ethanol-wet bonding technique

To evaluate the short-term response of human pulps to ethanol-wet bonding technique. Methods Deep class V cavities were prepared on 17 sound premolars and divided into three groups. After acid-etching, the cavities from groups 1 (G1) and 2 (G2) were filled with 100% ethanol or distilled water, respectively, for 60 s before the application of Single Bond 2. In group 3 (G3, control), the cavity floor was lined with calcium hydroxide before etching and bonding. All cavities were restored with resin composite. Two teeth were used as intact control. The teeth were extracted 48 h after the clinical procedures. From each tooth serial sections were obtained and stained with haematoxylin and eosin (H/E) and Masson's trichrome. Bacteria microleakage was assessed using Brown & Brenn. All sections were blindly evaluated for five histological features. Results Mean remaining dentine thickness was 463 ± 65 μm (G1); 425 ± 184 μm (G2); and 348 ± 194 μm (G3). Similar pulp reactions followed ethanol- or water-wet bonding techniques. Slight inflammatory responses and disruption of the odontoblast layer related to the cavity floor were seen in all groups. Stained bacteria were not detected in any cavities. Normal pulp tissue was observed in G3 except for one case. Conclusions After 48 h, ethanol-wet bonding does not increase pulpal damage compared to water-wet bonding technique. Clinical significance Ethanol-wet bonding may increase resin-dentine bond durability. This study reported the in vivo response of human pulp tissue when 100% ethanol was applied previously to an etch-and-rinse simplified adhesive system.

Radical management of solid ameloblastoma of the mandible: report of a case with 5-year follow-up

Ameloblastoma is a true neoplasm of odontogenic epithelial origin. This pathology can be classified into 4 groups: unicystic, solid or multicystic, peripheral, and malignant. Solid ameloblastomas of the mandible are the most common of them, and represent a challenging group of tumours to treat; in addition the follicular histopathological subtype has a high likelihood of recurrence. Thus, the challenges in the management of this tumour are to provide complete excision in addition to reconstruct the bony defect, in order to provide the patient with reasonable cosmetic and functional outcome. With this in mind, this paper aimed to describe the management of a solid multilocular ameloblastoma of follicular subtype in a 39-year-old female. Case report The authors report a case of a solid multilocular ameloblastoma of follicular subtype in a 39-year-old female who was successfully treated by partial resection of the mandible with immediate reconstruction using an iliac crest, as a donor site. After 15 months, the patient was rehabilitated using titanium implant dentistry, and has been followed up for 5 years without signs or symptoms of recurrence. Conclusion Correct surgical planning is the key for successful management of solid ameloblastoma with multilocular features, which is best treated using radical resection with immediate reconstruction, which ensures complete tumour excision, prevents recurrence, and enables fast and safe dental rehabilitation. Biomedical prototypes should be used since they provide acceptable precision and are useful for surgical planning.

Frequência de ressonância e sondagem peri-implantar em implantes curtos sob carga imediata com prótese total fixa em cantiléver na arcada mandibular: acompanhamento de um ano

This paper presents a case report with the use of short dental implants and immediate prosthesis placement. After 13 months of follow-up, peri-implant probing values are near 1.87 mm and ISQ values around 78.56.

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.

Protese total fixa em função imediata confeccionada em resina composta indireta

Immediate functioning of osseointegrated implants has been widely employed in edentulous patients due to its safety and high predictability. However, viability and success of immediate-loaded implants is defined by factors such as number of implants, distribution and splinting, as well as reduction of oblique loads and excessive occlusal contacts. The indirect composite resin-modified glass enable building of a highly aesthetic prosthesis, combining satisfactory resistance and better force dissipation on occlusal loading. This article describes a resin composite, mandibular fixed prosthesis on osseointegrated implants in immediate function.

The influence of different implant surfaces on osseointegration in diabetes: a systematic review of the literature

AIM: The aim of this study was to evaluate, through a systematic review of the literature, the effects of different implant surface modifications on osseointegration in diabetic subjects. METHODS: A search was performed of the PubMed database, using a combination of the following keywords: “Implant surface” OR “Dental implants” AND “Diabetes” OR “Hyperglycemia”. Papers published in English between January 1960 and November 2013 were selected. All experimental models were considered in this search, but case reports and in vitro studies were excluded from this review. RESULTS: The initial search identified 182 articles. After reading the titles and abstracts, 39 articles were selected for full reading. Finally, 4 papers were selected after evaluation of all the papers, and these papers are discussed in this review. Due to the methodological heterogeneity of the selected studies, it was not possible to perform a meta-analysis of the data. CONCLUSION: It can be concluded that although the benefits of surface modifications present in individuals with diabetes have biological plausibility, there is little evidence of the benefits of these modifications.

Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications

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

Rehabilitacion oral sobre implantes instalados por medio de la tecnica sin colgajo (flapless) y carga inmediata

The oral rehabilitation with osseointegrated implants is a well-documented treatment with high rate of success. Nevertheless, demands related to treatment time and surgical technique began to appear. In this context, the procedure of immediate loading in which the dental prosthesis is placed right after implant surgery has become a constant practice. Although immediate loading has been an important advance, minimally invasive procedures, such as implant placement without raising a mucoperiosteal flap (flapless) are increasingly being performed. Association of immediate loading with the flapless technique improves acceptance by patients and professionals, because no suturing is required. Moreover, it reduces swelling, bleeding during and after surgery, postoperative pain, surgery time, discomfort and hematoma, as well as the need for postoperative medication. These characteristics ease the stages of rehabilitation soon after implant placement, cooperating with prosthodontist's work. Thus, the proposal of this study is to present a clinical case of oral rehabilitation with osseointegrated implants and fixed prosthesis in both arches, in which the flapless technique was applied, followed by immediate loading. It will discuss the diagnosis, prosthetic planning, surgical/prosthodontic procedures and follow-up for 20 months.

Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.