Surgical techniques for maxillary bone grafting: literature review

For oral rehabilitation with implant-supported prostheses, there are required procedures to create the bone volume needed for installation of the implants. Thus, bone grafts from intraoral or extraoral donor sites represent a very favorable opportunity. This study aimed to review the literature on the subject, seeking to discuss parameters for the indications, advantages and complications of techniques for autogenous bone grafts.

The Fresh Frozen Bone Allograft (FFBA) to reconstruc the atrophic maxilla: evaluation of the clinical and histological viability at six and nine months in the maxillary sinus

This work aimed to analyze clinically and histologically the allogen bone graft behavior at 6 and 9 months. A leukoderm, female, 55 years old patient sought dental care for oral rehabilitation with dental implants and implant supported fixed prosthesis in the maxilla. Bilateral sinus lifting procedure were performed in a same patient, the analysis were made after 6 and 9 months, respectively. At 6 months, there was lack of a better bone remodeling in the region, associated to the presence of fibrous connective tissue within the collected tissue, showing us that this is not the best stage of tissue maturation to place dental implants. The 9 months period showed an improvement, with a more organized bone tissue surrounding particles of homogenous bone, what possibly had increased implant stability at the time of surgery. There is no doubt about the increase of clinical applications of FFBA, but there are no studies available regarding the standardization of time to load implants inserted in allografts. So papers with long-term monitoring are necessary to eliminate questions that still remain to be answered.

Reconstrução imediata de fenestração peri-implantar com enxerto autógeno em bloco de ramo mandibular

Alveolar wall fenestrations are common during implant placement. The aim of this paper is to report a case where a peri-implant bone fenestration was reconstructed immediately after implant placement by an autogenous mandibular bone block. A male patient was referred to the Department of Surgical and Integrated Clinics to substitute his Kennedy´s Class IV removable partial denture for an implantsupported fixed prosthesis. A peri-implant bone fenestration at the buccal wall was seen at the region of 12, being reconstructed by a mandibular bone block secured by a bicortical screw. Six months later the surgical procedures, an implant-supported complete fixed partial prosthesis was developed. The autogenous bone block harvested from the mandibular ramus was a safe alternative to reconstruct the peri-implant bone defect such as fenestration types.

Regeneração óssea guiada com o uso de matriz óssea bovina desmineralizada em defeitos ósseos experimentais em cães

Background: The principles of tissue regeneration to repair alveolar bone defects are based on the fabrication of a biologic barrier with different biomaterials. Therefore, the present study aimed to investigate the guided bone regeneration (GBR) by using membrane of demineralized bovine bone matrix (DBBM) on experimental defects in tibia of dogs. Methods: Four dogs were used and after anesthesia, shaving and antisepsis, two standardized bone defects were created on the right tibia of each animal with trephine drill. In the Control Group, the defects were filled with blood coagulum, while in the Treated Group, a membrane of DBBM was used to cover the defects. After 90 days, animals were sacrificed. Results: In the Treated Group, 67.4% of new bone formation was observed and, in the Control Group, 32.6% of the bone tissue reabsorbed when compared with initial bone volume. The membrane remained intact and no inflammatory tissue was observed on membrane/ bone interface. Conclusion: It was concluded that the use of DBBM is an osteoconductive material, presents biocompatibility and may be promise option to repair bone defects.

Impacto do uso de fita adesiva na qualidade de vida de pacientes institucionalizados e usuários de próteses totais convencionais

Objective: Evaluate the impact of the use of strip adhesive over the quality of life of institutionalized patients and wearers of complete dentures. Material and method: Twenty-nine institutionalized patients wearers of complete denture were selected to this study and after a clinical exam, a questionnaire (adjusted and based upon the index of Oral Health Impact Profile and Oral Health-Related Quality of Life, OHIP and OHQOL) was applied to evaluate issues related to epidemiological conditions (gender and age), quality of life (pain, discomfort, functional limitations, phonetic, social, psychological and esthetic), taste and notion of implant treatment. Following this part, the patients received instruction to use the strips adhesives (Corega Fita Adesiva, Glaxo-Smith-Kline, Rio de Janeiro, Brazil), considering three in maxillary prosthesis and two in the lower prosthesis during a period of 30 days. After this period, all the patients were recall and the questionnaire was reapplied; add some adhesive performance questions, to compare the results before and after the adhesive use in terms of percentage. Result: After the adhesive strips use there were improvement of the functional, social and physcological limitation aspects, but without percentual increasement of phonetic and esthetics aspects. The results showed 65.5% of the answers stating adhesive maintenance between 6-12 hours, easy removal (68.9%), and without change the taste (89.6%). The notion for implant treatment was decreased changing from 75.8 to 37.9% after the adhesive use. Conclusion: The results enhanced a positive impact over quality of life of the respondents after the strip adhesive use, showing decrease of pain and discomfort, mainly of inferior dental prosthesis.

Perda óssea em prótese sobre implante: revisão de literatura

One of the complications that concern prosthetists is bone loss peri-implant, because the success of dental implant treatment requires long-term maintenance of hard and soft tissues around the implant. Whereby the dental implants have not only the goal of restoring function, but also the aesthetics of the patient, the bone loss peri-implant can dramatically compromise the aesthetics of rehabilitation, particularly in anterior regions. The aim of this study was to analyze and reason, through literature review, the main factors that can cause bone loss in peri-implant and possible ways to prevent it.

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.