Reabilitação estético-funcional sobre implantes agulhados e endósseos

This report shows the resolution of a case study whose aim was promote the aesthetic and functional rehabilitation of upper left hemi-arch over endosseous and needle implant prostheses. To improve the position of the needle implants, we performed the bucco-palatal bending of needles splinting them with composite resin; we removed the screwed implant prosthesis in the regions of the premolars (24 and 25) and molar (26). The mini-abutments of the last two implants were replaced, and in the first premolar and canine, we used cemented abutments due to implant angulation having planned soldering because of implant size and contact with one needle implant that could interfere with intimate contact bone/implant damaging biomechanics. Pick-up impressions were performed with an open tray, using a retractor cord in the needle implants and respective transfer copings. Therefore, models were related on semi-adjustable articulator after a face-bow recording and interocclusal indexes. After working cast fabrication and try-in of infra-structures, these were adjusted and related into the articulator again. Then, after ceramic build-up, adjustments, finishing, and torque, chemically-activated resin cement was applied on units 21 to 24. At the end of the case, we concluded that a good aesthetic and functional rehabilitation depends on thorough knowledge of techniques for each clinical situation.

Importância do tratamento estético periodontal na reabilitação protética

Gingival recession is a common deformity that affects a large number of people. This condition is frequently associated with esthetic complains and may lead to dental hypersensitivity. Thus, various surgical procedures have been proposed to provide root coverage. Since the 1950s, free and pedicle gingival grafts have been greatly used for treating gingival recession. However, after the 1985 Miller gingival recession classification, and with the development of other appropriated techniques that use subepithelial connective tissue grafts, gingival recession treatments have resulted in more predictable outcomes, especially with respect to Class I and II sites, i.e., in the absence of interproximal bone loss. This article reported the importance of aesthetical periodontal treatment in the prosthetic rehabilitation of a patient with a class I gingival recession with 3 mm of vertical extension in the superior canine. The treatment plan consisted of root coverage using subepithelial connective tissue graft (SCTG) associated with construction of new prosthesis.

Comportamento biomecânico do sistema prótese/implante em região anterior de maxila: análise pelo método de ciclagem mecânica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise metalográfica do titânio puro submetido à soldagem laser Nd: YAG e TIG

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise estrutural e fadiga em prótese implanto-suportada unitária através do método dos elementos finitos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Double-setting alpha-tricalcium phosphate cement provided with interconection channels in rabbits after enucleation: a potential implant for the anophthalmic socket

The purpose of this study was to evaluate the macroscopy and microstructure of a double setting alpha-tricalcium phosphate bone cement sphere provided with interconnection channels (alpha-TCP-i), as well as the integration of the implant with the rabbits' orbital tissue, through macroscopic analysis and histopathology. The external and internal surfaces of the alpha-TCP-i were evaluated macroscopically and by electron microscopy. Twelve New Zealand rabbits received 12mm implants of alpha-TCP-i following enucleation of the left eye. The clinical assessment was undertaken daily during the first 15 days, followed by fortnightly assessment until the end of the study period. For the morphological analysis, exenteration was performed in 3 animals per experimental period (15, 45, 90 and 180 days). The external and internal surfaces of the implant appeared solid, smooth and compact, with six channels which interconnected centrally. The micro-architecture was characterized by the formation of columns of hexagonal crystals. No signs of infection, exposure, dehiscence of sutures or extrusion of the implant were noted in any of the animals during the entire period of the study. The morphological evaluation demonstrated the presence of a thin capsule around the implant, from whence appeared fibro-vascular projections, which penetrated it through the interconnecting channels. In the first days after the insertion of the implant, an intense inflammatory reaction was noted. At 180 days, however, there were no signs of inflammation. The alpha-tricalcium phosphate cement implant was well tolerated in this rabbit model and appeared to be relatively inert with some fibrovascular ingrowth through the large channels.

Load-application devices: a comparative strain gauge analysis

In view of the low loading values commonly employed in dentistry, a load-application device (LAD) was developed as option to the universal testing machine (UTM), using strain gauge analysis. The aim of this study was to develop a load-application device (LAD) and compare the LAD with the UTM apparatus under axial and non-axial loads. An external hexagonal implant was inserted into a polyurethane block and one EsthetiCone abutment was connected to the implant. A plastic prosthetic cylinder was screwed onto the abutment and a conical pattern crown was fabricated using acrylic resin. An impression was made and ten identical standard acrylic resin patterns were obtained from the crown impression, which were cast in nickel-chromium alloy (n=10). Four strain gauges were bonded diametrically around the implant. The specimens were subjected to central (C) and lateral (L) axial loads of 30 kgf, on both devices: G1: LAD/C; G2: LAD/L; G3: UTM/C; G4: UTM/L. The data (με) were statistically analyzed by repeated measures ANOVA and Tukey's test (p<0.05). No statistically significant difference was found between the UTM and LAD devices, regardless of the type of load. It was concluded that the LAD is a reliable alternative, which induces microstrains to implants similar to those obtained with the UTM.

Estudo das microdeformações geradas ao redor de implantes de hexágono externo, sob a aplicação de cargas axiais e não axiais em pilares protéticos retos e angulados

Pós-graduação em Odontologia Restauradora - ICT

Avaliação da resistência à fratura de próteses fixas temporárias reforçadas por uma malha experimental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise in vitro da proliferação celular e produção de mediadores inflamatórios por células da conjuntiva estimuladas por materiais utilizados na confecção de próteses oculares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação eletromiográfica dos músculos masseter e temporal, força de mordida e qualidade de vida em pacientes desdentados antes, durante e após a instalação e adaptação de novas próteses - total maxilar e overdenture mandibular sobre implante

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Maxillary sinus lift without grafting, and simultaneous implant placement: a prospective clinical study with a 51-month follow-up

A prospective clinical study of maxillary sinus lift procedures in the posterior region of the maxilla, using only blood clot as filling material, was conducted. Seventeen patients underwent a maxillary sinus lift procedure; 20 maxillary sinus regions were operated on and a total of 25 implants were placed. The sinus mucosa was lifted together with the anterior wall of the osteotomized maxilla and supported by the implants placed. Computed tomography (CT) scans were obtained immediately postoperative (T-initial) and at 3 (T-1) and 51(T-2) months postoperative for the measurement of linear bone height and bone density (by grey tones). Only one implant was lost in the first stage (96% success). After dental prosthesis placement and during up to 51 months of follow-up, no implant was lost (100% success, second stage). The difference in mean bone height between T-initial (5.94 mm) and T-1 (13.14 mm), and between T-initial and T-2 (11.57 mm), was statistically significant (both P < 0.001); comparison between T-1 and T-2 also presented a statistical difference (P < 0.001). Bone density had increased at the end of the period analyzed, but this was not statistically significant (P > 0.05). Thus, the maxillary sinus lift technique with immediate implant placement, filling with blood clot only, may be performed with a high success rate.

Biomechanical influence of crown-to-implant ratio on stress distribution over internal hexagon short implant: 3-D finite element analysis with statistical test

The study of short implants is relevant to the biomechanics of dental implants, and research on crown increase has implications for the daily clinic. The aim of this study was to analyze the biomechanical interactions of a singular implant-supported prosthesis of different crown heights under vertical and oblique force, using the 3-D finite element method. Six 3-D models were designed with Invesalius 3.0, Rhinoceros 3D 4.0, and Solidworks 2010 software. Each model was constructed with a mandibular segment of bone block, including an implant supporting a screwed metal-ceramic crown. The crown height was set at 10, 12.5, and 15 mm. The applied force was 200 N (axial) and 100 N (oblique). We performed an ANOVA statistical test and Tukey tests; p < 0.05 was considered statistically significant. The increase of crown height did not influence the stress distribution on screw prosthetic (p > 0.05) under axial load. However, crown heights of 12.5 and 15 mm caused statistically significant damage to the stress distribution of screws and to the cortical bone (p <0.001) under oblique load. High crown to implant (C/I) ratio harmed microstrain distribution on bone tissue under axial and oblique loads (p < 0.001). Crown increase was a possible deleterious factor to the screws and to the different regions of bone tissue. (C) 2014 Elsevier Ltd. All rights reserved.

The effect of offset implant configuration on bone stress distribution: a systematic review

Purpose: The aim of this systematic review was to compare straight-line and offset implant configurations for three-element implant-retained prostheses. Materials and Methods: Two independent reviewers conducted a review on PubMed/Medline, EMBASE, and Cochrane Library for studies published in English, from January 1, 1995 to January 17, 2014. A systematic review was conducted following the PRISMA statement. All relevant titles were selected according to inclusion/exclusion criteria. From this pool of titles, abstracts and full texts were reviewed. Results: A total of 6080 titles were identified with the initial search. Twenty-one were selected based on title and abstract. Of these, after discussion and complete reading, 12 studies were selected according to the inclusion and exclusion criteria, all of which were in vitro studies. Conclusions: A systematic review of the current literature showed only in vitro evidence that there is no consensus on the advantage of using an offset configuration implant compared to those in straight-line configuration, even though some studies present a slight improvement of bone stress distribution when an offset implant is under oblique loading (PICO).

Quality of life and satisfaction of patients wearing implant-supported fixed partial denture: a cross-sectional survey of patients from Aracatuba city, Brazil

ObjectivesThe aim of this study was to evaluate the quality of life and satisfaction of patients wearing implant-supported fixed partial dentures.Materials &methodsA total of 106 patients were selected and submitted to clinical examination and collection of the demographic data for evaluation of the implant-supported fixed dentures conditions. All participants agreed to answer to the Oral Health Impact Profile (OHIP-EDENT) questionnaire and another questionnaire about satisfaction with the implant-supported prostheses. The patients were classified into the following three groups for statistical analysis: patients wearing splinted implant-supported prosthesis (E), patients wearing single implant-supported prosthesis (U), and patients wearing single implant-supported prosthesis associated with splinted prosthesis (E+U). Kruskal-Wallis test was used to compare the answers between the groups, and a logistic regression model was measured to verify the relation between variables of the patients and the questionaries'items.ResultsThere were significant differences among groups (P=0.006) for discomfort during surgery itself of the satisfaction questionnaire. The marital status, groups, and hygiene condition were significant mainly for physical pain item.ConclusionsIt was concluded that the patients presented high level of satisfaction and quality of life for the most of the items evaluated as well as the groups showed similar results.