Adesivo tecidual de fibrina e sua aplicação na implantodontia

The purpose of this literature review was to evaluate the use of fibrin tissue adhesive in implant dentistry. Materials and Methods: A literature search of Medline-PubMed for articles published, describing the use of fibrin tissue adhesive in implant dentistry was performed and articles were critically reviewed. Results: The literature review reveals clinical trials and experimental studies with regard to the use of fibrin tissue adhesive in implant dentistry. This material consists of 2 components: highly purified, freeze-dried human fibrinogen with factor XIII and a starter solution containing human thrombin. Clotting factor XIII is admitted for reinforcement of the fibrin network. The components are reconstituted before use and when mixed form a clot by mimicking the terminal phase of the physiological clotting cascade. Several studies showed that fibrin tissue adhesive is fully absorbed by macrophages within 2 weeks of application. Adhesive fibrin tissue may be used for to prevent bone loss, to create contour in the periimplant soft tissue and osseous tissue, to sculpt emergence profile for prosthetic components and to mimic tissue architecture. In the last years fibrin tissue adhesive also find use as material for the controlled delivery of drugs and biologics. Conclusions: The fibrin tissue adhesive presents good properties such as biocompatibility, hemostatic properties and ability to break down like the physiologic clot. This material, alone or associated with other materials, can be used with the implants immediately after extraction. In this condition it brings the necessary anchoring and efficient maintenance of osseous/mucosal contour, which it is important for the clinical success.

Impacto do controle glicêmico sobre as complicações associadas ao diabetes mellitus na osseointegração

The increased prevalence of diabetic individuals has become a public health problem. Diabetes Mellitus is a metabolic disorder characterized by an increase in plasma glucose levels. It impairs the physiological equilibrium in utilization of carbohydrate by tissues. The persistent hyperglycemia can produce deleterious effects on bone formation due the microvascular complication. The present paper reviews the bibliography linking the impact of glycemic control at complications associated at diabetes mellitus on osseointegration. In experimental models of diabetes it was observed a reduced level of bone-implant contact. This failure can be reduced by means of hyperglycemia control. Also, several studies point the beneficial effect of coated implant on osseointegration process. It is necessary to take special care into account for the placement of implants in diabetic patient and improve the percentages of implant survival. A rigorous control of plasma glycaemia, together with other measures, like as absence of chronic complications, good oral hygiene and regular medical follow-up has been related to rising the percentages of successful in diabetic patients.

Aspectos legais e éticos na implantodontia

There are few studies that evaluate the legal aspects, consent forms and ethical considerations facing implantology. This paper reviews and discusses the most important criteria in relation to the care of patients needing dental implants. Used the following databases: Medline (Pubmed), Dentistry Oral Science , Scielo, Athenas (Dissertation / Thesis), Digital Library of UNICAMP (Dissertation / Thesis), Digital Library of USP (Dissertation / Thesis) over the past 15 years . The inclusion and exclusion criteria were clinical articles, resulting from expert opinion on the subject of review and longitudinal follow-up who have studied or reported on the ethical aspects in implant dentistry; were excluded studies whose language was not English or Portuguese. Of a total of 52 articles and theses, after an analysis according to inclusion and exclusion criteria, 26 were selected. The literature shows that the safe practice of implantology is indispensable for the success of therapy. Respect the ethical, legal and make it explicit relationship with the patient (informed consent, information) are an important factor in the success of rehabilitative treatment. Since this treatment is long term, professional dental implant requires all documentation and clarity in time to offer treatment to the patient and professional expectations are met.

Reabilitação protética com associação entre prótese parcial removível e implante dentário: relato de caso

Removable partial denture improve functional and aesthetic failures caused by partial loss of teeth, however specific characteristics of each patients can determine the success of treatment, especially with regard to the support of the prosthesis, which may depend on teeth, the combination of teehe and mucosa and currently associated with the dental implants. The aim of this study is report a case in which there was the need of the association, to enable better aesthetics and self-esteem to the patients. After implant placement and fabrication of prosthetic patient reported satisfaction with the rehabilitation treatment, improving their quality of life.

Planejamento reverso em implantodontia: relato de caso clínico

The oral rehabilitation has achieved great prominence in the dental implant, especially in the cases of reposition of units dental elements, so it is possible to replace each missing element to implant into your space where the tooth was loss. The reverse planning is fundamental to an appropriate rehabilitation, because promote the elimination of problems that might compromise the aesthetics and function of future dental implants. The objective of this study was to report the treatment plan for a patient in need of oral rehabilitation with implant dental prosthesis, using indications and techniques based on the literature, emphasizing the importance of reverse planning. We conducted an osseointegrated implant surgery using the principles of a connect procedure, thus allowing their successfully installing increasing the predictability of treatment. It is concluded that the success of rehabilitation treatment is directly related to the initial planning, a correct clinical approach and an integrated multidisciplinary team.

Influence of morphological variables in photoelastic models with implants submitted to axial loading

Purpose: This study used 12 photoelastics models with different height and thickness to evaluate if the axial loading of 100N on implants changes the morphology of the photoelastic reflection. Methods: For the photoelastic analysis, the models were placed in a reflection polariscope for observation of the isochromatic fringes patterns. The formation of these fringes resulted from an axial load of 100N applied to the midpoint of the healing abutment attached to the implant with 10.0mm x 3.75mm (Conexão, Sistemas de Próteses, Brazil). The tension in each photoelastic model was monitored, photographed and observed using the software Phothoshop 7.0. For qualitative analysis, the area under the implant apex was measured including the green band of the second order fringe of each model using the software Image Tool. After comparison of the areas, the performance generated by each specimen was defined regarding the axial loading. Results: There were alterations in area with different height and thickness of the photoelastic models. It was observed that the group III (30mm in height) presented the smallest area. Conclusion: There was variation in the size of the areas analyzed for different height and thickness of the models and the morphology of the replica may directly influence the result in researches with photoelastic models.

A utilização de abutment de zircônia na reabilitação oral: aspectos protéticos e periodontais

Zirconia abutments are used to obtain satisfactory aesthetic results in implant fixed anterior prostheses when metal abutments promote a grayish mucosal discoloration of the peri-implant soft tissues. However, there is a lack of studies to confirm the clinical performance of the peri-implant soft tissues surrouding zirconia abutments. This study described a case report of a patient treated with implant fixed all-ceramic crown made out on zirconia abutment after 3 years of followup. A 47-year-old female patient was admitted to the dental clinic (Aracatuba Dental School) complaining about the fracture of her implant fixed single crown in the region of the left lateral incisor. The patient chose the replacement of the fractured prosthesis for an allceramic crown. After 3 years of follow-up it was observed that maintenance of the aesthetic results and the peri-implant soft tissue without any inflammation or gingival recessions. Within the limitations of a case report, it can be conclude that zirconia abutments is a effective rehabilitation treatment because it preserves the aesthetics and function through the maintenance of peri-implant tissues.

Manutenção em próteses implantossuportadas: higiene oral

The maintenance of Implant-supported Prosthesis is essential to the success of dental implants. Therefore, the aim of the study was to conduct a review the literature addressing maintenance Implant-Supported Prosthesis in order to guide planning for the longevity of oral rehabilitation. We conducted a detailed search strategy for the Pubmed / Medline Dentistry and Oral Science, used as descriptors: “Oral Hygiene“ and “Dental Implant until July, 2013. The results were grouped together in topics (Clinical Exam and Oral Hygiene) and discussed. Conclusion: A regular maintenance program for oral patient implantprosthesis is essential to the longevity of the treatment. Different methods and devices are effective for cleansing. However one orientation (in writing) must be offered to patients, since inadequate cleaning can create regions of abrasion on the surfaces of abutments and dental implants.

Manutenção em próteses implantossuportadas: peri-implantite

The identification and treatment of peri-implant infections are an essential stage in the maintenance of dental implants, reflecting the longevity of rehabilitation. Therefore, the aim of the study was to conduct a literature review addressing peri-implantitis in dental implants in order to guide planning for the longevity of oral rehabilitation. It was conducted a detailed search strategy by the PubMed / Medline Dentistry and Oral Science, it was used as descriptors: “peri-implantitis” and “Dental Implant”, until July 2013. From 566 articles, after a review, according to the inclusion criteria, 34 articles were selected. The results were grouped together in topics (concept, etiology, diagnosis, surgical and nonsurgical, and aspects of oral rehabilitation) for further discussion and conclusions. Conclusions: The accumulation of plaque has been associated with a higher propensity to peri-implantitis. There is a higher incidence of the peri-implantitis disease among patients with previous history of periodontal disease. The local administration of antibiotics and association with mouthwashes / topical use are indicated as suitable for the treatment of moderate peri-implantitis.

Registro do perfil de emergência para mimetização dos dentes naturais na região estética

Introdução: o tratamento com implantes dentários para a reposição de dentes na região estética exige a utilização de materiais e técnicas que permitam o máximo de naturalidade entre a restauração, os dentes vizinhos e o tecido gengival. Dessa forma, torna-se necessário criar o correto perfil de emergência para o dente, assim como a utilização de materiais com alto potencial estético. Objetivo: o objetivo do presente trabalho foi ilustrar, através de um caso clínico, a utilização de uma técnica de moldagem para a correta cópia do perfil de emergência do dente e sua transferência para o modelo de trabalho, tornando possível a confecção de uma restauração totalmente cerâmica, perfeitamente integrada ao tecido gengival. Caso clínico: paciente de 30 anos, procurou o clínica de prótese dentária com desejo de melhorar a estética dos dentes. Após diagnóstico e planejamento, foram confeccionadas 2 coroas totalmente cerâmicas sobre os dentes 12 e 21, e confecção de 1 coroa cerâmica sobre um pilar de zircônia após o estabelecimento e registro do perfil de emergência do dente 11. Conclusão: após a conclusão do tratamento, observou-se naturalidade, estética e perfeita integração entre as restaurações, os dentes remanescentes e o tecido gengival.

Comportamento biomecânico dos sistemas de retenção de overdentures

Objective: to the purpose of this study was to compare the stress distribution in the peri-implant hard tissue on different attachment systems for mandibular or maxillary implant-retained overdentures. Material and methods: the search for published studies was performed on PubMed/Medline database covering the period of January 2000 to April 2014. The selection of the eligible studies was performed according to including and excluding criteria. Results: a total of 140 studies were screened and according to the search strategy, 21 studies were selected for this review. Eight studies perfomed strain-gauge analysis, 5 evaluated the stress distribution though photoelastic test and 7 performed tridimensional finite element analysis. Only one study in vivo was included. Non-splinted O-rings showed better stress distribution than other bar-clip attachment systems. Conclusions: the present study did not find sufficient evidences regarding the most indicated attachment system for overdentures with better stress distribution for the peri-implant hard tissue. The methodologies analyzed should be complemented with other tests and used as a tool for further clinical studies.

A oclusão nas próteses totais implantossuportadas mediatas e imediatas

Rehabilitation of edentulous patients has been a challenge for professionals since the primary concepts and fundaments of occlusal rehabilitation. However, this philosophy has been improved by implant-supported fixed dentures that represent a predictable clinical modality on modern dentistry. Nevertheless, considering that the traditional protocol requires a long period for bone healing and definitive rehabilitation, immediate loading of implants has been advantageous for functional and esthetic rehabilitation of patients in a reduced period. The aim of this study is to discuss the biomechanical and functional fundaments of occlusion for implant-supported fixed dentures with mediate and immediate loading to provide clinical evidences for longevity of this treat ment modality based on the current literature. According to this, some prerequisites as proper bone quality, excellent primary stability, sufficient number of implants, rigid splinting, and control and mastering of biomechanical fundamentals of static and dynamic occlusion are mandatory for treatment predictability and longevity.

Solução estética para prótese sobre implante

Próteses sobre implantes esteticamente favoráveis estão diretamente relacionadas com a condição dos tecidos moles e duros que as envolvem. A preservação dos tecidos mucogengivais ao redor de implantes dentários instalados na maxila anterior propicia um sorriso harmonioso, com uma estética bastante agradável. No entanto, em alguns casos, isso não ocorre principalmente pela grande reabsorção tecidual na região, na qual deveria ter sido realizado enxerto ósseo, antes mesmo da instalação dos implantes. Desse modo, o objetivo deste trabalho foi apresentar uma solução reabilitadora estética para essas possíveis falhas durante o planejamento com reabilitações sobre implantes, por meio de gengiva artificial cerâmica.

Influência do material oclusal na distribuição de tensões em próteses implantossuportadas unitárias

Objective: the aim of this study was to evaluate the influence of occlusal veneering material in single fixed implant-supported crowns through the 3-D finite element method. Material and methods: Four models were fabricated using the Rhinoceros 4.0, SolidWorks, and InVesalius softwares. Each model represented a block of mandibular bone with an external hexagon implant of 5 mm x 10 mm and different veneering materials including NiCr (1), porcelain (2), composite resin (3), and acrylic resin (4). An axial load of 200 N and an oblique load of 100 N were applied. Results: model (2) with porcelain veneering presented a lower stress concentration for the NiCr framework, followed by the composite resin and acrylic resin. The stress distribution to the implant and bone tissue was similar for all models. Conclusions: there is no difference of stress distribution to the implant and supporting structures by varying the veneering material of a single implant-supported prosthesis.

Influência do material oclusal na distribuição de tensões em próteses implantossuportadas unitárias

Objective: the aim of this study was to evaluate the influence of occlusal veneering material in single fixed implant-supported crowns through the 3-D finite element method. Material and methods: Four models were fabricated using the Rhinoceros 4.0, SolidWorks, and InVesalius softwares. Each model represented a block of mandibular bone with an external hexagon implant of 5 mm x 10 mm and different veneering materials including NiCr (1), porcelain (2), composite resin (3), and acrylic resin (4). An axial load of 200 N and an oblique load of 100 N were applied. Results: model (2) with porcelain veneering presented a lower stress concentration for the NiCr framework, followed by the composite resin and acrylic resin. The stress distribution to the implant and bone tissue was similar for all models. Conclusions: there is no difference of stress distribution to the implant and supporting structures by varying the veneering material of a single implant-supported prosthesis.