Clinical Viability of Immediate Loading of Dental Implants: Part I-Factors for Success

Two-stage procedure for dental implants presents corroborated clinical success over 40 years. The evolution of surgical techniques, development of diagnostic methods, knowledge about tissue biology, and quality of implants regarding design and surface supported studies with I surgical stage followed by immediate prosthesis placement. However, several factors influence the treatment success with immediate loading. SO, this Study aimed to evaluate some factors regarding the success and characteristics of implants and patients.

Integrated treatment to resolve a horizontal root fracture

Root fractures are defined as those that involve cement, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition. Diagnosis is made through clinical and radiographic exams, the latter frequently being limited by the position of the fracture. Treatment varies according to the displacement and vitality of the fragments. The authors present a clinical case of recurrent trauma of tooth 21 causing a horizontal root fracture in the middle third. After several attempts at endodontic treatment, the option was to remove the apical fragment by surgery. The postoperative period of 4 years shows very satisfactory results with regard to wound repair and tooth mobility, or implantation of the coronal segment.

Digital Radiographic Evaluation of the Level of Alveolar Bone Crest in External Hexagon Implants Submitted to 2 Types of Implant Abutments Under Immediate Loading

Purpose: The aim of this study was to evaluate by means of digital radiography the behavior of the alveolar bone crest in external hexagon implants following the use of 2 different types of abutments, one for conventional cemented prosthesis and one for modified cemented prosthesis.Methods: Ten external hexagon implants (platform 4.1) were placed in 5 patients. Initial instrumentation was carried out to obtain primary stability of the temporary prostheses under immediate loading. Each patient received both abutments for conventional and modified cemented prosthesis. Standardized digital periapical radiographies were performed at times T0 (immediately after implant placement) and T1 (4 months after implant placement). A straight line was initially established from the implant platform to the distal and mesial periimplantar marginal bone tissue (immediately in contact with the implant) and measured by digital radiography, using Sidexis version 2.3 (Sirona Dental Systems GmbH, Bensheim, Germany) software. The data were submitted to paired-samples t-test analysis.Results: There was no significant difference between the conventional and modified cemented prosthesis. In both cases, t-test results were within the null hypothesis level.Conclusion: The abutment for the modified cemented prosthesis resulted in no significant radiographic difference of alveolar bone crest height, when compared with the conventional cemented prostheses.

Influence of Ridge Inclination and Implant Localization on the Association of Mandibular Kennedy Class I Removable Partial Denture

The aim of this study was to evaluate the tendency of displacement of the supporting structures of the distal extension removable partial denture (DERPD) associated to the implant with different inclinations of alveolar ridge and implant localizations through a two-dimensional finite-element method. Sixteen mandibular models were fabricated, presenting horizontal, distally descending, distally ascending, or descending-ascending ridges. All models presented the left canine and were rehabilitated with conventional DERPD or implant-retained prosthesis with the ERA system. The models were obtained by the AutoCAD software and transferred to the finite-element software ANSYS 9.0 for analysis. A force of 50 N was applied on the cusp tips of the teeth, with 5 points of loading of 10 N. The results were visualized by displacement maps. For all ridge inclinations, the assembly of the DERPD with distal plate retained by an anterior implant exhibited the lowest requisition of the supporting structures. The highest tendency of displacement occurred in the model with distally ascending ridge with incisal rest. It was concluded that the association of the implant decreased the displacement of the DERPD, and the anterior positioning of the implant associated to the DERPD with the distal plate preserved the supporting structures for all ridges.

Technique for Indexing an Immediate Loading Implant Position for a Provisional Restoration

The transfer of an intraoral implant position to the cast for an immediate loading implant is an important step and may be difficult to achieve with commonly used transfer and impression methods. Thus, the purpose of this report is to describe a technique for the use of a surgical template to transfer the implant position for fabrication of a provisional restoration. This technique simplifies the procedure, eliminates the need for taking an impression, avoids surgical site contamination, and maintains an adequate emergence profile during fabrication of the definitive restoration. An indexing technique for transferring the position of the implant from the treated surface after extraction is described.

Biomechanical Evaluation of Platform Switching in Different Implant Protocols: Computed Tomography-Based Three-Dimensional Finite Element Analysis

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

Effect of relining, water storage and cyclic loading on the flexural strength of a denture base acrylic resin

Objectives: This study investigated the effect of relining, water storage and cyclic loading on the ultimate flexural strength (FSU) and on the flexural strength at the proportional limit (FSPl) of a denture base acrylic resin (Lucitone 550-L).Methods: Rectangular bars of L were made (64 mm x 10 mm x 2 mm) and relined (1.3 mm) with four relining resins (Kooliner-K, Ufi Gel Hard-UGH, Tokuso Rebase Fast-TR and New Truliner-NT). In addition, specimens relined with L and intact L specimens were made (64 mm x 10 mm x 3.3 mm). A three-point flexural test was applied on the specimens (n = 10) after (1) polymerization; (2) water storage (30 days); (3) cyclic loading (10,000 cycles at 5 Hz) and (4) water storage (30 days) + cyclic loading. Data (MPa) were analyzed with three-way ANOVA and Tukey's HSD tests (alpha = 0.05). To test for a possible correlation between FSU and FSPl, a linear regression coefficient 'r' was calculated.Results: After water storage, L-UGH and L-TR demonstrated an increased FSU (41.4950.64 MPa and 49.95-57.36 MPa, respectively) (P < 0.05). Only L-TR demonstrated an increased FSPl (20.58-24.21 MPa) after water storage (P < 0.05). L-L had the highest FSU (between 78.57 and 85.09 MPa) and FSPl (between 31.30 and 34.17 MPa) (P < 0.05). The cyclic loading decreased the FSU and FSPl of all materials (P < 0.05). Regression analysis showed a strong linear correlation between the two variables (r = 0.941).Conclusions: Water storage improved the FSU of L-UGH and L-TR and the FSPl of L-TR. L-L produced the highest FSU and FSPl. The FSU and FSPl of all materials were detrimentally influenced by cyclic loading.

Effectiveness of Screw Surface Coating on the Stability of Zirconia Abutments After Cyclic Loading

Purpose: Different surface treatments have been developed in attempts to prevent the loosening of abutment screws. The aim of the current study was to compare the effectiveness of titanium alloy screws with tungsten-doped diamond-like carbon (W-DLC) coating and uncoated screws in providing stability to zirconia (ZrO2) ceramic abutments after cyclic loading. Materials and Methods: Twenty prefabricated ZrO2 ceramic abutments on their respective external-hex implants were divided into two groups of equal size according to the type of screw used: uncoated titanium alloy screw (Ti) or titanium alloy screw with W-DLC coating (W-DLC/Ti). The removal torque value (preload) of the abutment screw was measured before and after loading. Cyclic loading between 11 and 211 N was applied at an angle of 30 degrees to the long axis of the implants at a frequency of 15 Hz. A target of 0.5 x 10(6) cycles was defined. Group means were calculated and compared using analysis of variance and the F test (alpha=.05). Results: Before cyclic loading, the preload for Ti screws was significantly higher than that for W-DLC/Ti screws (P=.021). After cyclic loading, there was no significant difference between them (P=.499). Conclusions: Under the studied conditions, it can be concluded that, after cyclic loading, both abutment screws presented a significant reduction in the mean retained preload and similar effectiveness in maintaining preload. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:1061-1067

Cyclic-loading of the human gracilis and semitendinosus muscle tendons: Study of young adult cadavers

During knee ligament reconstruction, the tendon graft is tensioned to prevent the occurrence of excessive graft elongation during the postoperative period. Tensioning may be achieved by applying a cyclic or static load to the graft during fixation. Although this procedure is part of the surgery, there is no consensus in international literature regarding ideal tension levels to be used in this procedure. This study was conducted on 10 tendons of the human gracilis muscle and 10 tendons of semitendinosus muscle removed from five male cadavers whose mean age was 20.8 years. These tendons underwent 10 in vitro strain cycles at three levels of deformation (2.5, 3, and 4%) and the value of the deforming load used for each cycle was recorded. The statistical analysis demonstrated that in order to attain the same level of deformation during the 10 cycles there was a reduction in the value of strain applied to the graft, observed at the three levels of deformation. It was concluded that the semitendinosus tendon presents a more uniform mechanical behavior and that there is a need for new graft tensioning protocols that consider the force associated with deformation.

Boron transport in Eucalyptus. 2. Identification in silico of a putative boron transporter for xylem loading in eucalypt

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

Horizontal transfers of Mariner transposons between mammals and insects

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

Horizontal and vertical tree community structure in a lowland atlantic rain forest, southeastern Brazil

A estrutura horizontal e vertical do componente arbóreo foi investigada em um trecho de Floresta Atlântica baixo-montana através de um levantamento fitossociológico em dois blocos amostrais de 0,99 ha cada no Parque Estadual Intervales. Todos os indivíduos com DAP > 5 cm foram registrados. Foram amostrados 3.078 indivíduos distribuídos em 172 espécies. O índice de diversidade de Shannon foi de H' = 3,85 nat.ind.-1. A família Myrtaceae se destacou tanto em número de espécies (38) quanto em número de indivíduos (745) no levantamento. Euterpe edulis Mart. teve o maior valor de importância (33,98%), abrangendo 21,8% do total de indivíduos registrados. O índice de similaridade quantitativo foi maior do que o qualitativo, mostrando pouca variação estrutural entre os blocos amostrais, mas a grande quantidade de espécies pouco abundantes, resultou em pronunciadas diferenças florísticas entre eles. Uma análise de correspondência retificada (DCA) gerou três estratos verticais arbitrários. O estrato A (> 26 m) teve a menor densidade e foi bem representado pelas espécies Sloanea guianensis (Aubl.) Benth. e Virola bicuhyba (Schott. ex A.DC.) Warb. O estrato B (8 m < h < 26 m) mostrou a maior riqueza e diversidade florística, e o estrato C (< 8 m) a maior densidade. Euterpe edulis, Guapira opposita (Vell.) Reitz, Garcinia gardneriana (Planch. & Triana) Zappi e Eugenia mosenii (Kausel) Sobral foram bem representadas nos estratos B e C da floresta. A existência de estratos verticais em florestas tropicais é discutida, recomendando-se o uso da DCA para estudos da estratificação vertical em outras florestas tropicais.

Effect of Static and Cyclic Loading on Ceramic Laminate Veneers Adhered to Teeth with and Without Aged Composite Restorations

Purpose: Existing composite restorations on teeth are often remade prior to the cementation of fixed dental prostheses. The aim of this study was to evaluate the effect of static and cyclic loading on ceramic laminate veneers adhered to aged resin composite restorations.Materials and Methods: Eighty sound maxillary incisors were collected and randomly divided into four groups: group 1: control group, no restorations; group 2: two Class III restorations; group 3: two Class IV restorations; group 4: complete composite substrate. Standard composite restorations were made using a microhybrid resin composite (Anterior Shine). Restored teeth were subjected to thermocycling (6000 cycles). Window preparations were made on the labial surface of the teeth for ceramic laminate fabrication (Empress II). Teeth were conditioned using an etch-and-rinse system. Existing composite restorations representing the aged composites were silica coated (CoJet) and silanized (ESPE-Sil). Ceramic laminates were cemented using a bis-GMA-based cement (Variolink Veneer). The specimens were randomly divided into two groups and were subjected to either static (groups 1a, 2a, 3a, 4a) or cyclic loading (groups 1b, 2b, 3b, 4b). Failure type and location after loading were classified. Data were analyzed using one-way ANOVA and Tukey's test.Results: Significantly higher fracture strength was obtained in group 4 (330 +/- 81 N) compared to the controls in group 1 (179 +/- 120 N) (one-way ANOVA, p < 0.05). Group lb survived a lower mean number of cyclic loads (672,820 cycles) than teeth of groups 2b to 4b (846x10(3) to 873x10(3) cycles). Failure type evaluation after the fracture test showed predominantly adhesive failures between dentin and cement, but after cyclic loading, more cohesive fractures in the ceramic were seen.Conclusion: Ceramic laminate veneers bonded to conditioned aged composite restorations provided favorable results. Surface conditioning of existing restorations may eliminate the necessity of removing aged composite restorations.

Evaluation of interface characterization and adhesion of glass ceramics to commercially pure titanium and gold alloy after thermal- and mechanical-loading

Objectives. This study evaluated the effect of thermal- and mechanical-cycling on the shear bond strength of three low-fusing glassy matrix dental ceramics to commercial pure titanium (cpTi) when compared to conventional feldspathic ceramic fused to gold alloy.Methods. Metallic frameworks (diameter: 5 min, thickness: 4 mm) (N = 96, n = 12 per group) were cast in cpTi and gold alloy, airborne particle abraded with 150 mu m aluminum oxide. Low-fusing glassy matrix ceramics and a conventional feldspathic ceramic were fired onto the alloys (thickness: 4mm). Four experimental groups were formed; Gr1 (control group): Vita Omega 900-Au-Pd alloy; Gr2: Ticeram-cpTi; Gr3: Super Porcelain Ti-22-cpTi and G4: Vita Titankeramik-cpTi. While half of the specimens from each ceramic-metal combination were randomly tested without aging (water storage at 37 C for 24h only), the other half were first thermocycled (6000 cycles, between 5 and 55 C, dwell time: 13 s) and then mechanically loaded (20,000 cycles under SON load, immersion in distilled water at 37 C). The ceramic-alloy interfaces were loaded under shear in a universal test machine (cross-head speed: 0.5 mm/min) until failure occur-red. Failure types were noted and the interfaces of the representative fractured specimens from each group were examined with stereo microscope and scanning electron microscope (SEM). in an additional study (N = 16, n = 2 per group), energy dispersive X-ray spectroscopy (EDS) analysis was performed from ceramic-alloy interfaces. Data were analyzed using ANOVA and Tukey's test.Results. Both ceramic-metal combinations (p < 0.001) and aging conditions (p < 0,001) significantly affected the mean bond strength values. Thermal- and mechanical-cycling decreased the bond strength (MPa) results significantly for Gr3 (33.4 +/- 4.2) and Gr4 (32.1 +/- 4.8) when compared to the non-aged groups (42.9 +/- 8.9, 42.4 +/- 5.2, respectively). Gr1 was not affected significantly from aging conditions (61.3 +/- 8.4 for control, 60.7 +/- 13.7 after aging) (p > 0.05). Stereomicroscope images showed exclusively adhesive failure types at the opaque ceramic-cpTi interfacial zone with no presence of ceramic on the substrate surface but with a visible dark titanium oxide layer in Groups 2-4 except Gr1 where remnants of bonder ceramic was visible. EDS analysis from the interfacial zone for cpTi-ceramic groups showed predominantly 34.5-85.1% O(2) followed by 1.1-36.7% Aland 0-36.3% Si except for Super Porcelain Ti-22 where a small quantity of Ba (1.4-8.3%), S (0.7%) and Sn (35.3%) was found. In the Au-Pd alloy-ceramic interface, 56.4-69.9% O(2) followed by 15.6-26.2% Si, 3.9-10.9% K, 2.8-6% Na, 4.4-9.6% Al and 0-0.04% Mg was observed.Significance. After thermal-cycling for 6000 times and mechanical-cycling for 20,000 times, Triceram-cpTi combination presented the least decrease among other ceramic-alloy combinations when compared to the mean bond strength results with Au-Pd alloy-Vita Omega 900 combination. (c) 2008 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Fracture resistance of endodontically treated teeth with different heights of crown ferrule restored with prefabricated carbon fiber post and composite resin core by intermittent loading

This study evaluated the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts and varying quantities of coronal dentin. Sixty freshly extracted upper canines were randomly divided into groups of 10 teeth each. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis. Data were analyzed by 1-way analysis of variance and Tukey test (alpha = .05). Significant differences (P < .001) were found among the mean fracture forces of the test groups (positive control, 0 mm, 1 mm, 2 mm, 3 mm, and negative control groups: 1022.82 N, 1008.22 N, 1292.52 N, 1289.19 N, 1255.38 N, and 1582.11, respectively). These results suggested that the amount of coronal dentin did not significantly increase the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber post and composite resin core. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e52-e57)