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1.
Braz Dent J ; 35: e245599, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38537013

RESUMEN

The aim was to evaluate primary implant stability and bone microarchitecture in two drilling situations, by comparing the conventional technique (CT) and osseodensification (OD) (Versah Burs - Jackson - Mississippi - USA). The implant insertion torque (IT), implant stability quotient (ISQ), and the peri-implant trabecular microstructure were assessed on bone fragments obtained from pig's tibia (n=12), divided between CT (n=6) and OD (n=6). After the drilling procedure, the implants were installed (3.5x8.5 mm, Epikut - SIN - São Paulo - Brazil). The IT and ISQ were measured using a digital torque wrench and resonance frequency analysis. Then, the bone fragments containing the implants were removed with a trephine and analyzed by Microtomography (µCT, 8.0 µm). The comparison between groups was performed using the unpaired t-test (α=0.05). The results revealed that OD promotes a higher insertion torque (CT: 7.67±2.44 Ncm; OD: 19.78±5.26 Ncm) (p=0.0005), although ISQ was not different (CT: 61.33±4.66; OD: 63.25±4.58) (p=0.48). There was a significant increase in peri-implant bone volume (CT: 23.17±3.39 mm3; OD: 32.01±5.75 mm3) (p=0.008), and trabecular parameters: separation (CT: 0.4357±0.03 mm; OD: 0.3865±0.04 mm) (p=0.0449), number (CT: 1.626±0.18 1/mm; OD: 1.946±0.13 1/mm) (p=0.007), and thickness (CT: 0.1130±0.009 mm; OD: 0.1328±0.015 mm) (p=0.02). Structure model index (SMI) data demonstrate no significant differences between groups (CT: 1.7±0.2; OD: 1.4±0.4) (p=0.12). In conclusion, OD increases the insertion torque values and promotes beneficial changes regarding bone microarchitecture compared with CT, revealing more peri-implant bone volume with consequent higher primary stability.


Asunto(s)
Implantes Dentales , Brasil , Torque , Implantación Dental Endoósea
2.
Braz. dent. j ; 35: e24, 2024. tab, graf
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1550089

RESUMEN

Abstract: The aim was to evaluate primary implant stability and bone microarchitecture in two drilling situations, by comparing the conventional technique (CT) and osseodensification (OD) (Versah Burs - Jackson - Mississippi - USA). The implant insertion torque (IT), implant stability quotient (ISQ), and the peri-implant trabecular microstructure were assessed on bone fragments obtained from pig's tibia (n=12), divided between CT (n=6) and OD (n=6). After the drilling procedure, the implants were installed (3.5x8.5 mm, Epikut - SIN - São Paulo - Brazil). The IT and ISQ were measured using a digital torque wrench and resonance frequency analysis. Then, the bone fragments containing the implants were removed with a trephine and analyzed by Microtomography (µCT, 8.0 µm). The comparison between groups was performed using the unpaired t-test (α=0.05). The results revealed that OD promotes a higher insertion torque (CT: 7.67±2.44 Ncm; OD: 19.78±5.26 Ncm) (p=0.0005), although ISQ was not different (CT: 61.33±4.66; OD: 63.25±4.58) (p=0.48). There was a significant increase in peri-implant bone volume (CT: 23.17±3.39 mm3; OD: 32.01±5.75 mm3) (p=0.008), and trabecular parameters: separation (CT: 0.4357±0.03 mm; OD: 0.3865±0.04 mm) (p=0.0449), number (CT: 1.626±0.18 1/mm; OD: 1.946±0.13 1/mm) (p=0.007), and thickness (CT: 0.1130±0.009 mm; OD: 0.1328±0.015 mm) (p=0.02). Structure model index (SMI) data demonstrate no significant differences between groups (CT: 1.7±0.2; OD: 1.4±0.4) (p=0.12). In conclusion, OD increases the insertion torque values and promotes beneficial changes regarding bone microarchitecture compared with CT, revealing more peri-implant bone volume with consequent higher primary stability.


Resumo O objetivo deste estudo foi avaliar a estabilidade de implante e a microarquitetura óssea em duas técnicas de fresagem, comparando a técnica convencional (CT) e a osseodensificação (OD) (Versah Burs - Jackson - Mississippi - EUA). O torque de inserção do implante (IT), quociente de estabilidade primária (ISQ) e a estrutura trabecular peri-implantar foram avaliados em fragmentos ósseos obtidos de tíbia de porco (n=12), divididos entre CT (n=6) e OD (n=6). Após o procedimento de fresagem, foram instalados implantes (3,5x8,5 mm, Epikut - SIN - São Paulo - Brasil). O IT e o ISQ foram aferidos por meio de um torquimetro digital e análise de frequência de ressonância. Em seguida, os fragmentos ósseos contendo os implantes foram removidos com trefina e analisados ​​por microtomografia computadorizada (µCT, 8,0 µm). A comparação entre os grupos foi realizada por meio do teste-t não-pareado (α=0.05). Os resultados revelaram que a OD promove maior torque de inserção (CT: 7,67 ± 2,44º Ncm; OD: 19,78 ± 5,26 Ncm) (p=0,0005), embora a estabilidade primária não tenha sido diferente (CT: 61.33 ± 4.66; OD:63.25 ± 4.58) (p=0,48). Houve um aumento significativo no volume ósseo peri-implantar (CT: 23,17±3,39 mm3; OD: 32,01±5,75 mm3) (p=0,0089) e parâmetros trabeculares: separação (CT: 0,4357 ± 0,03 mm; OD: 0,3865 ± 0,04 mm) (p=0,0449), número (CT: 1,626 ± 0,18 1/mm; OD: 1,946 ± 0,13 1/mm) (p=0,007) e espessura (CT: 0,1130 ± 0,009 mm; OD: 0,1328 ± 0,015 mm) (p=0,02) O índice de modelo estrutural (SMI) não demostrou diferença estatisticamente significativa (p=0.1228). Concluindo, OD apresenta maiores valores de torque de inserção e promove mudanças benéficas na microarquitetura óssea em comparação com a TC, revelando maior volume ósseo peri-implantar.

3.
Braz Oral Res ; 37: e109, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37970929

RESUMEN

The objective of this study was to assess the remodeling-associated gene expression in the mandible of patients diagnosed with oral squamous cell carcinoma (OSCC), investigating the cortical microarchitecture, and their influence on disease-free survival (DFS) and overall survival (OS) rates. A total of twenty-four patients who underwent mandibulectomy for OSCC treatment had two bone fragments harvested from the mandible for gene expression (RANK, RANKL, OPG, and SOST), and microarchitecture analysis, including bone volume, surface, mineral density, degree of anisotropy, and fractal dimension. The prognosis of the patients was assessed. The results revealed that RANK, RANKL, and SOST were predominantly downregulated, while OPG was completely downregulated. Tumors located adjacent to the posterior region of the mandible (p = 0.02), with a bone mineral density below 1.03 g/cm3 HA (p = 0.001), and a bone volume less than 86.47% (p = 0.03) were associated with poor outcomes. In conclusion, bone-remodeling-associated genes exhibited downregulation in the cortex of the mandible in OSCC patients. Additionally, the tumor's location within the mandible, bone volume, and cortical bone mineral density were identified as factors impacting DFS.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Neoplasias de la Boca , Humanos , Neoplasias de la Boca/genética , Neoplasias de la Boca/cirugía , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/cirugía , Carcinoma de Células Escamosas de Cabeza y Cuello , Pronóstico , Ligando RANK/genética , Expresión Génica , Osteoprotegerina/genética
4.
J Prosthet Dent ; 129(4): 573-581, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34334178

RESUMEN

STATEMENT OF PROBLEM: Long-term clinical studies are lacking on the influence of the type of abutment, titanium or zirconia, on peri-implant tissues. PURPOSE: The purpose of this randomized clinical trial was to evaluate peri-implant tissues with titanium or zirconia abutments. MATERIAL AND METHODS: A total of 26 single-tooth implant-supported prostheses in 14 participants were analyzed. They received either a titanium abutment with a metal-ceramic crown (TAG) or a zirconia abutment with a ceramic crown (ZAG). Data were collected immediately, at 5 months, and at a minimum of 7 years after crown delivery. The success rate, plaque and bleeding indexes, bleeding on probing, white and pink esthetic scores, and the relationships of the gingival phenotype with the pink esthetic score were analyzed. Statistical analyses were conducted with the t test for paired and independent data (α=.05). RESULTS: The mean follow-up time was 95.2 ±2.6 months, showing an implant success rate of 96.7%. No statistically significant differences were found between TAG and ZAG among the time intervals evaluated for plaque or bleeding indexes (P>.05). A statistically significant difference was found for peri-implant probing depths in the mid-buccal sites between the groups at all the time intervals evaluated (TAG, P=.008; ZAG, P=.021): TAG showed an increase between 5 months (3.65 ±0.93 mm) and over 7 years (4.47 ±1.32 mm); and ZAG showed a reduction (5 months=5.22 ±1.71 mm; over 7 years=4.25 ±1.28 mm) in values. For the pink (PES) and white esthetic score (WES), ZAG (PES: immediately=6.33 ±1.41; 5 months=7.44 ±1.81; over 7 years=8.25 ±1.03; WES: immediately=7.67 ±1.50; over 7 years=8.38 ±0.74) showed higher mean values than TAG (PES: immediately=5.94 ±2.35; 5 months=6.53 ±2.15; over 7 years=7.44 ±1.81; WES: immediately=7.00 ±1.17; over 7 years=8.35 ±1.27) (P<.05). Statistically significant differences were found for gingival phenotype and for PES in TAG (P=.031), and the participants with thick phenotype showed higher PES in the 3 time intervals studied. CONCLUSIONS: Zirconia abutments exhibited better results than titanium abutments in terms of the peri-implant tissues. Moreover, in those with a thin phenotype, zirconia provided improved gingival esthetics.


Asunto(s)
Implantes Dentales , Placa Dental , Humanos , Titanio , Estudios de Seguimiento , Estética Dental
5.
Braz. oral res. (Online) ; 37: e109, 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1520520

RESUMEN

Abstract The objective of this study was to assess the remodeling-associated gene expression in the mandible of patients diagnosed with oral squamous cell carcinoma (OSCC), investigating the cortical microarchitecture, and their influence on disease-free survival (DFS) and overall survival (OS) rates. A total of twenty-four patients who underwent mandibulectomy for OSCC treatment had two bone fragments harvested from the mandible for gene expression (RANK, RANKL, OPG, and SOST), and microarchitecture analysis, including bone volume, surface, mineral density, degree of anisotropy, and fractal dimension. The prognosis of the patients was assessed. The results revealed that RANK, RANKL, and SOST were predominantly downregulated, while OPG was completely downregulated. Tumors located adjacent to the posterior region of the mandible (p = 0.02), with a bone mineral density below 1.03 g/cm3 HA (p = 0.001), and a bone volume less than 86.47% (p = 0.03) were associated with poor outcomes. In conclusion, bone-remodeling-associated genes exhibited downregulation in the cortex of the mandible in OSCC patients. Additionally, the tumor's location within the mandible, bone volume, and cortical bone mineral density were identified as factors impacting DFS.

6.
Gen Dent ; 70(1): 72-77, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34978995

RESUMEN

This study evaluated the quantity of metal artifacts produced by dental implants placed in different mandibular regions using various cone beam computed tomography (CBCT) protocols. Titanium implants were placed in 4 regions (incisor, canine, premolar, and molar) of an artificial mandible and subjected to CBCT examinations with the mandibular model placed in different positions within the field of view (FOV) and imaged with different FOV and voxel sizes. An axial section of the cervical region of each implant was selected for artifact quantification. The artifacts were measured by normalizing the actual standard deviation (ASD) of the voxel values. Kruskal-Wallis and Student-Newman-Keuls tests were used to compare the tooth regions and the different positions of the mandible. The Wilcoxon test was used to compare changes in FOV and voxel size. The intraobserver agreement was calculated using the intraclass correlation coefficient. The significance level was 5%. The incisor region showed significantly more artifacts than other regions (P = 0.0315). No statistically significant difference was found when the position of the mandible varied within the FOV (P = 0.7418). Smaller FOV and smaller voxels produced more artifacts (P < 0.0001). The quantity of metal artifacts was affected by FOV and voxel size as well as by anatomical region. Variation of the mandible location within the FOV did not affect the artifacts as defined by the normalized ASD of the voxel values.


Asunto(s)
Artefactos , Tomografía Computarizada de Haz Cónico Espiral , Tomografía Computarizada de Haz Cónico , Humanos , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Titanio
7.
RGO (Porto Alegre) ; 70: e20220053, 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1406511

RESUMEN

ABSTRACT Objective: The aim of this study was to evaluate bone microdamage in sites prepared for implant placement by using an ex vivo model with three drilling rotation speeds. Methods: Bovine bone ribs were used for the creation of 18 osteotomy sites at different rotation speeds: 1200 rpm, 800 rpm, and 400 rpm. Specimens were stained with xylenol orange and prepared for histological analysis by using fluorescence and polarized light microscopies. Bone microdamage was evaluated by number and based on total bone area, as follows: microfracture density (Fr.D = n/mm2), microcrack morphology (diffuse or linear), and density (Cr.D = n/mm2), and presence of bone chips. To complement the analysis, linear microcracks were assessed by using confocal microscopy for three-dimensional visualization. Results: Bone microdamage on the osteotomy sites included microcracks, diffuse damages, microfracture, and bone chip formation. There was an association between bone microdamage and cancellous bone (p 0.0016), as well as a positive correlation between Fr.D and Cr.D (p 0.05, r 0.54). BM occurrence was not different between the three rotation speeds. In 3D, the height of the microcrack depth was 60.81 µm. Conclusion: Bone microdamage occurs during osteotomy, and the ex vivo model used was effective for the assessment of these biomechanical parameters. In addition, microdamage was not influenced by the drilling rotation speed in this experimental condition.


RESUMO Objetivo: O objetivo desse estudo foi avaliar os microdanos ósseos em locais preparados para a instalação de implantes utilizando um modelo ex vivo acessando três velocidades de rotação de perfuração. Métodos: Fragmentos ósseos de costela bovina foram utilizados para a criação de 18 sítios de osteotomia em diferentes velocidades de rotação: 1200 rpm, 800 rpm e 400 rpm. As amostras foram coradas com Alaranjado de Xilenol e preparadas para análise microscópica em fluorescência e luz polarizada. Os microdanos ósseos foram avaliados em número e calibrados com base na área total óssea: densidade de microfraturas (Fr.D = n/mm2), morfologia (difusa ou linear) e densidade de microtrincas (Cr.D = n / mm2) e presença de espículas ósseas. Para complementar a análise, microtrincas lineares foram avaliadas por meio de microscopia confocal para visualização tridimensional. Resultados: Os microdanos ósseos incluíram microtrincas, danos difusos, microfraturas e formação de espículas. Houve uma associação entre MO e localização em osso esponjoso (p=0,0016), bem como uma correlação positiva entre Fr.D e Cr.D (p=0,05, r = 0,54). A ocorrência de microdanos ósseos não foi diferente entre as três velocidades de rotação utilizadas. Em 3D, a profundidade maior da microfissura atingiu 60,81 µm. Conclusão: Microdanos ósseos ocorrem durante a osteotomia e podem ser acessados em um modelo ex vivo na condução de experimentos em biomecânica. Sugere-se que a presença de microdanos não é influenciada pela velocidade de rotação durante a perfuração.

8.
J Clin Exp Dent ; 13(4): e334-e341, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33841731

RESUMEN

BACKGROUND: A retrospective cohort study was performed to evaluate the immediate effect on the oropharynx dimensions from different mandibular advancements in patients undergone counterclockwise rotation (CCW) of the maxillomandibular complex. MATERIAL AND METHODS: 138 CBCT images of patients, who had undergone orthognathic surgery, were identified from Dolphin Imaging archive according to pre- (T0) and post-operative (T1) times. Each pre-operative CBCT image was selected considering retrognathic mandible. Superimpositions of CBCT images were performed to measure mandibular advancement at B point in millimeters (mm) and divided into three groups: G1 (< 5 mm), G2 (between 5 and 10 mm) and G3 (> 10 mm). For evaluating oropharynx dimension at T0 and T1 for each group, medial sagittal area (MSA), volume, and minimum cross-sectional axial area (CSA) were measured on Dolphin Imaging. Pearson correlation verified reliability of method. Paired t-test were applied to compare values of measurements between T0 and T1 (p ≤ 0.05). RESULTS: 88 CBCT images were included. Method was reliable (r ≥ 0.93). According to MSA, volume and CSA values from G1, there was no significant difference between T0 and T1. CSA values presented significant difference comparing T0 and T1 in G2 (p ≤ 0.05). In subjects of G3, measurements increased in T1 significantly affecting oropharynx dimension. CONCLUSIONS: MSA, volume and CSA values showed a significant increase affecting upper airway in advancements higher than 10 mm. Mandibular advancement range showed different effects in the airway space and should be considered to achieve favorable post-operative results in the oropharynx dimensions. Key words:Retrognathia, orthognathic surgery, three-dimensional imaging, oropharynx, airway.

9.
Int J Prosthodont ; 33(2): 212-216, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32069346

RESUMEN

PURPOSE: To evaluate the effect of different concentrations of hydrofluoric acid (HF) on the surface roughness of a ceramic reinforced by lithium disilicate and on the bond strength formed between the ceramic and self-adhesive resin cement. MATERIALS AND METHODS: A total of 100 disks of IPS e.max Press ceramic (Ivoclar Vivadent) reinforced by lithium disilicate were prepared as follows: group 1 remained untreated (control group); in groups 5-20, 5-40, and 5-60, the surfaces were etched with 5% HF for 20, 40, and 60 seconds, respectively; in groups 10-20, 10-40, and 10-60, the surfaces were etched with 10% HF for 20, 40, and 60 seconds, respectively; and in groups 10-20P, 10-40P, and 10-60P, the surfaces were etched with 10% HF for 20, 40, and 60 seconds, respectively, followed by treatment with 37% phosphoric acid for 5 seconds. Surface roughness and bond strength were analyzed with confocal microscopy and microshear testing, respectively. The values obtained were statistically analyzed using paired t test and two-way ANOVA followed by Tukey post hoc test at a 5% significance level. RESULTS: Surface roughness was influenced by the concentration and exposure time of acid applied (P < .05) and by the combination of these two factors (P < .05). Treatment with 10% HF for 40 seconds (group 10-40) achieved the highest roughness value. In contrast, bond strength was affected only by the acid exposure time (P < .05). CONCLUSION: Conditioning of lithium disilicate ceramics can change the surface morphology, thereby affecting bond strength with resin cement.


Asunto(s)
Recubrimiento Dental Adhesivo , Cerámica , Porcelana Dental , Ensayo de Materiales , Cementos de Resina , Propiedades de Superficie
10.
Dentomaxillofac Radiol ; 49(4): 20190265, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-31724883

RESUMEN

OBJECTIVES: The aim of this systematic review was to verify whether CBCT in comparison with panoramic radiography reduced the cases of temporary paresthesias of the inferior alveolar nerve (IAN) associated with third molar extractions. METHODS: The literature search included five databases (PubMed, Scopus, Web of Science, Cochrane, SciELO), in addition to gray literature and hand search of reference list of included studies. Two reviewers independently screened titles/abstracts, and full texts according to eligibility criteria, extracted data and evaluated risk of bias through Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB 2.0). Data were meta-analyzed by comparing CBCT versus panoramic radiographs for number of events (temporary paresthesia after third molar surgery). Fixed effect model was used for non-significant heterogeneity; relative risk (RR) and 95% CI were calculated. The certainty of evidence was evaluated by Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: Four randomized controlled trials (RCTs) were included in meta-analysis, and for the majority of domains they presented low risk of bias. RR was 1.23 (95% IC: 0.75-2.02; I2: 0%; p = 0.43) favouring panoramic radiography, but without significant effect, and with moderate certainty of evidence. CONCLUSIONS: We concluded that both interventions had a similar ability to reduce temporary paresthesia of the IAN after third molar surgery with moderate certainty of evidence.


Asunto(s)
Parestesia/etiología , Tomografía Computarizada de Haz Cónico Espiral , Humanos , Nervio Mandibular/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica , Extracción Dental
11.
Braz. j. oral sci ; 19: e209247, jan.-dez. 2020. ilus
Artículo en Inglés | BBO - Odontología, LILACS | ID: biblio-1152075

RESUMEN

Aim: The aim of this study is to offer an overview of the MedicalEmergencies (ME) discipline offer in Dentistry graduations insoutheastern Brazil and to observe the curricular characteristicsof the discipline when present. Methods: This cross-sectionaldocumentary study analyzed the available curricular frameworksin the official websites of Higher Education Institutions (HEI)in southeastern Brazil registered on the Ministry of Education'se-MEC website. The data were analyzed and tabulated using theGraphPad Prism 8.1.2 software, being described by absolute andrelative frequencies. Fisher's exact test was used to compare theproportions between public and private institutions. Results:Of the 176 courses in the Southeast, 144 were included in thestudy for providing access to the curriculum, 19 (13.19%) werepublic and 125 (86.81%) were private. Only 27 (18.75%) of the HEIpresent the discipline of ME, with a greater tendency of supply inprivate HEIs (20.80%) when compared to public HEIs (5.26%),but this difference was not statistically significant (p> 0.05).As a positive aspect, the discipline is predominantly mandatory(88.88%), and the with regard to the teaching methodology ispredominantly theoretical (68.18%). The average workload is50.14 hours (SD=19.54). Conclusions: In only 18.75% of thedental institutions in Southeast Brazil, ME discipline were offered.When offered, the discipline is predominantly theoretical andmandatory. This study raises an important discussion regardingthe need to include specific and mandatory subjects on ME inthe dentistry curricula in Brazil and reflects the need to updateand standardize the national curricular guidelines for dentistry


Asunto(s)
Educación en Odontología , Servicio de Urgencia en Hospital , Primeros Auxilios
12.
Int J Oral Maxillofac Implants ; 33(6): 1450-1456, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31711085

RESUMEN

PURPOSE: This prospective clinical study evaluated the influence of an interposed bone graft with inferior alveolar nerve lateralization in terms of rates of sensory disturbance, mean sensation recovery time, and survival rates for placement of osseointegrated implants. MATERIALS AND METHODS: Patients with an atrophic posterior mandible were enrolled in this study and randomized into two groups: bone graft group (a bone graft was placed between the implant and inferior alveolar nerve after lateralization) and control group (implants were placed in direct contact with the inferior alveolar nerve after lateralization). Neurosensory disturbances were evaluated via questionnaire 1 week after surgery and at the end of each month during the first year after surgery. RESULTS: Eighty-two implants were placed, with a survival rate of 97.56%. Two implants were removed due to mandibular fracture. All patients reported initial sensory disturbances arising from the surgical procedure. In the control group, the mean time for recovery from sensory disturbance was 3.95 ± 2.33 months, compared with 4.11 ± 4.68 months in the bone graft group (P = .587). CONCLUSION: The interposition of a bone graft between implants and the inferior alveolar nerve after lateralization did not prevent sensory disturbances and did not influence the sensation recovery time or implant survival rates.


Asunto(s)
Trasplante Óseo , Implantes Dentales , Implantación Dental Endoósea , Humanos , Mandíbula , Nervio Mandibular , Estudios Prospectivos
13.
Artículo en Inglés | MEDLINE | ID: mdl-31449582

RESUMEN

Peri-implant bone remodeling occurs in all osseointegrated implants and can be defined as an adaptive process of bone around the implant in response to functional loading. This retrospective study evaluated the marginal bone remodeling around dental implants with external hexagonal connections in function for more than 10 years. The sample consisted of 17 implants placed in the posterior region of the mandible to replace one or several teeth. For all cases, the initial periapical radiograph was assessed together with a subsequent follow-up periapical radiograph. Image analysis was performed using ImageJ software to establish the initial bone measurements and subsequent bone loss. The data were statistically analyzed using paired t test at a significance level of 5%. There was significant bone remodeling when the baseline and follow-up were compared (P < .001). The mean values of peri-implant bone remodeling on the mesial aspect were 0.90 ± 0.63 mm vertically and 1.17 ± 0.60 mm horizontally. The distal aspect of the implants showed 1.01 ± 0.82 mm and 1.06 ± 0.75 mm of marginal bone remodeling vertically and horizontally, respectively. Within the limitations of this study, marginal bone remodeling was visible, and bone levels around the external hexagon implants remain stable after 10 years of function.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Remodelación Ósea , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Mandíbula , Estudios Retrospectivos
14.
J Prosthodont ; 28(2): e548-e551, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29896787

RESUMEN

PURPOSE: To evaluate the fracture resistance after the thermal and mechanical fatigue of feldspathic, lithium disilicate, and resin-modified CAD/CAM monolithic crowns cemented onto a universal post abutment. MATERIALS AND METHODS: A right second mandibular molar was designed in CAD/CAM software, and 30 crowns were machined using three different materials (n = 10): feldspathic ceramic, finished only with a glaze cycle (G1); lithium disilicate, sintered and finished with a glaze cycle (G2); and resin, modified by nanoceramic and finished with rubber (G3). All crowns were cemented under a constant 50 N load, the excess cement was removed, and the crowns were light-cured for 30 seconds. After being immersed in deionized water for 7 days, the crowns were submitted to thermal cycling, which consisted of varying the temperature from 2 to 50°C for 350,000 cycles, and mechanical cycling in a fatigue simulator, where a 250 N load was applied for 1,000,000 cycles at 2 Hz. The resistance of each crown was verified in a compression-to-failure test at 1 mm/min in a universal test machine. The groups were compared using one-way ANOVA with a Bonferroni post hoc test and Weibull statistics. RESULTS: The resin-modified group was the least resistant group (1755 ± 124 N), followed by the feldspathic (2147 ± 412 N) and lithium disilicate groups (2804 ± 303 N). The Weibull statistics demonstrated that lithium disilicate is the most reliable material and has the lowest fracture probability. CONCLUSIONS: It was possible to conclude that all of the tested CAD/CAM materials can be used as monolithic, implant-supported molar crowns.


Asunto(s)
Diseño Asistido por Computadora , Coronas , Materiales Dentales/química , Fracaso de la Restauración Dental , Resinas Acrílicas , Silicatos de Aluminio , Porcelana Dental , Análisis del Estrés Dental , Humanos , Técnicas In Vitro , Mandíbula , Ensayo de Materiales , Diente Molar , Compuestos de Potasio , Propiedades de Superficie
15.
HU rev ; 45(2): 170-176, 2019.
Artículo en Portugués | LILACS | ID: biblio-1048952

RESUMEN

Introdução: As doenças cardiovasculares são responsáveis por vinte por cento das mortes na população acima de trinta anos de idade e correspondem a um grave problema da saúde pública no Brasil.Dessas doenças a parada cardiorrespiratória é o quadro emergencial predominante. Nesse contexto, destaca-se a importância do conhecimento sobre as manobras de suporte básico de vida e manutenção da vida do paciente até a chegada de uma equipe de suporte avançado. Objetivo: Avaliar o nível de conhecimento dos estudantes de Odontologia da Universidade Federal de Juiz de Fora quanto ao suporte básico de vida. Material e métodos: Questionário contendo questões de múltipla escolha, aplicado a 126 alunos, abordando as condutas para o suporte básico de vida de acordo com as diretrizes atuais da American Heart Association. Para avaliar o nível de conhecimento foram utilizadas duas categorias com base no percentual individual de acertos das questões: nível de conhecimento satisfatório (acertos ≥51%) e nível de conhecimento insatisfatório (acertos ≤50%).Resultados: 104 (82,5%) estudantes acertaram até 50% do questionário. 100 estudantes (79,4%) responderam não ter recebido treinamento prático para o suporte básico de vida, enquanto que 26 (20,6%) afirmaram ter recebido algum treinamento, embora sem certificação pela American Heart Association.Quanto à capacitação teórica, 77(61,1%) estudantes afirmaram ter recebido alguma orientação durante a graduação. Ao comparar os resultados entre os alunos do 1º, 6º e 10º período, observa-se uma evolução do conhecimento apenas entre o 1º e o 6º período, não havendo melhoria significante no aprendizado entre o 6º e 10º período. Conclusão:Os estudantes de Odontologia do campus sede da Universidade Federal de Juiz de Fora apresentam nível de conhecimento insatisfatório sobre a atuação no suporte básico de vida.


Introduction: The cardiovascular diseases are responsible for twenty percent of deaths among the population over thirty years of age, which means they are a serious public health problem in Brazil, being the cardiopulmonary arrest the main emergency situation of these diseases. In this context, the knowledge about the basic life support is crucial for the maintenance of the patient's life until the arrival of advanced support. Objective: Evaluating the knowledge of the dentistry students of the Juiz de Fora Federal University about basic life support. Material and methods: A questionnaire applied to 126 students, composed by fourteen multiple choice questions about the conduct for basic life support according to the current guidelines of the American Heart Association. In order to evaluate the knowledge level, two different categories based on the student's score have been utilized: satisfactory knowledge level (rightanswers≥51%) and unsatisfactory knowledge level (rightanswers≤50%). Results: 104 (82,5%) of the students scored up to 50% of the questionnaire. 100 students (79,4%) claimed that they hadn't received any training for basic life support, while 26 (20,6%) claimed that they had received some training, although without the American Heart Association certification. 77 (61,1%) claimed that they had received some theoretical orientation during the graduation. By comparing the results between1st, 6th and 10th grade students, evolution has only been noticed between 1st and 6th grades. However, no significant evolution has been noticed between 6thand 10th grades. Conclusion: The dentistry students of the Juiz de Fora Federal University have presented unsatisfactory knowledge level on basic life support.


Asunto(s)
Humanos , Masculino , Femenino , Pacientes , Estudiantes de Odontología , Enfermedades Cardiovasculares , Reanimación Cardiopulmonar , Educación en Odontología , Evaluación Educacional , Paro Cardíaco
16.
HU rev ; 45(3): 244-253, 2019.
Artículo en Portugués | LILACS | ID: biblio-1048967

RESUMEN

Introdução: Como uma opção de tratamento ao edentulismo mandibular foi desenvolvido o conceito All-on-4®, uma técnica de ancoragem com a instalação de quatro implantes distribuídos na região anterior da mandíbula edêntula para uma reabilitação total implantossuportada. Objetivo: Neste estudo, analisamos pelo método de elementos finitos o comportamento biomecânico dos implantes e tecidos ósseos. Material e métodos: Foram utilizados 3 modelos tridimensionais computadorizados, cada um com 4 implantes hexágono externo 3,75x13mm na região interforames mentuais, os implantes anteriores mantidos na posição axial e a variação ocorreu nos implantes posteriores: grupo 1, implantes posteriores retos; grupo 2, implantes posteriores com inclinação em 17° e grupo 3, com implantes posteriores inclinados em 30°. Uma carga axial de 150N foi aplicada nos molares e de 100N nos pré-molares bilateralmente. Resultados: Após análises evidenciou-se que nos grupos 17° (13,68Mpa, 34,76Mpa e 14,36Mpa para as tensões de tração, compressão e cisalhamento respectivamente) e 30° (14,26Mpa, 23,14Mpa e 10,31Mpa para as tensões de tração, compressão e cisalhamento respectivamente) apresentaram menores picos de tensão no osso. O mesmo padrão de distribuição de tensões foi observado para os implantes, com redução quando inclinamos os implantes distais. Conclusão: Os resultados mostraram que a angulação dos implantes favoreceu a distribuição das tensões no osso e implantes, interferindo positivamente na performance biomecânica das reabilitações totais implantossuportadas em mandíbulas edêntulas, considerando que no grupo dos implantes retos os valores das tensões foram maiores.


Introduction: As a treatment option for mandibular edentulism, the All-on-4® concept was developed, an anchoring technique with the installation of four implants distributed in the anterior region of the edentulous mandible for total implant-supported rehabilitation. Objective: In this study, we analyzed by the finite element method the biomechanical behavior of implants and bone tissues. Material and methods: Three computerized three-dimensional models were used, each with 4 external hexagon 3.75x13mm implants in the mental interforam region, the anterior implants kept in the axial position and the variation occurred in the posterior implants: group 1, straight posterior implants; group 2, posterior implants inclined at 17° and group 3, posterior implants inclined at 30°. An axial load of 150 N was applied to the molars and 100 N to the premolars bilaterally. Results: After analysis, it was found that in the 17° (13.68Mpa, 34.76Mpa and 14.36Mpa groups for tensile, compressive and shear stresses respectively) and 30 ° (14.26Mpa, 23.14Mpa and 10.31Mpa for tensile, compressive and shear stresses respectively) presented lower stress peaks in the bone. The same pattern of stress distribution was observed for the implants, with reduction when the distal implants were tilted. Conclusion: The results showed that the angulation of the implants favored the distribution of stresses in the bone and implants, positively interfering in the biomechanical performance of the total implant-supported rehabilitations in edentulous jaws, considering that in the group of straight implants the stress values were higher.


Asunto(s)
Humanos , Tejidos , Diente Premolar , Huesos , Diente Molar , Rehabilitación Bucal , Arcada Parcialmente Edéntula , Implantación Dental , Mandíbula
17.
Int J Oral Maxillofac Implants ; 33(4): 888-894, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30025006

RESUMEN

PURPOSE: The aim of this study was to evaluate volumetric stability of autologous and xenogeneic block grafts and primary stability of implants in maxillary grafted areas. MATERIALS AND METHODS: Each patient received one autologous block and xenogeneic block, both covered with a membrane. Bone thickness measurements clinically and tomographically were made before, immediately, and 6 months postoperatively. After 6 months, identical implants were placed in each grafted area, and primary stability was measured. RESULTS: Eight patients with anterior horizontal bone defects were selected. Clinical outcomes at 6 months postgrafting in the autologous block revealed a mean thickness of 7.4 ± 1.6 mm, with an initial mean measurement of 3.4 ± 1.7 mm and 2.6% resorption, whereas the mean in the xenogeneic block was 8.9 ± 1.5 mm, 3.3 ± 1.6 mm, and 7.3%, respectively. Tomographic evaluation of the thickness at 6 months postgrafting in the autologous block was a mean 7.8 ± 1.8 mm, with an initial mean of 3.7 ± 1.6 mm and resorption of 0%, while the mean in the xenogeneic block was 9.3 ± 1.6 mm, 3.6 ± 1.4 mm, and 2.1%, respectively. No significant difference in bone thickness was observed immediately or 6 months after the procedure. The mean implant placement torque was 32 ± 22 Ncm in the autologous block and 18 ± 9 Ncm in the xenogeneic block (P = .004). CONCLUSION: Xenogeneic block was shown to be a suitable alternative to reconstruct horizontal defects in the alveolar ridge that had undergone extensive resorption, though lower insertion torques were obtained during implant placement.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Trasplante Óseo , Implantación Dental Endoósea/métodos , Implantes Dentales , Maxilar/cirugía , Adulto , Proceso Alveolar/cirugía , Tomografía Computarizada de Haz Cónico , Femenino , Xenoinjertos , Humanos , Masculino , Persona de Mediana Edad , Oseointegración , Estudios Prospectivos , Torque , Trasplante Autólogo
18.
Dentomaxillofac Radiol ; 47(3): 20170281, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29231055

RESUMEN

OBJECTIVES: To quantitatively compare metal artefacts produced by implants in different maxillomandibular regions on cone beam CT (CBCT) images. METHODS: A total of 200 implants selected from CBCT examinations were divided into four groups: Group 1 (n = 50)-implants located in the anterior maxilla; Group 2 (n = 50)-implants located in the posterior maxilla; Group 3 (n = 50)-implants located in the anterior mandible and Group 4 (n = 50)-implants located in the posterior mandible. The implants were further classified as isolated or adjacent to other implants. Three axial reconstructions were selected for each sampled implant (apical, middle and cervical). On each slice, the artefacts produced by the implants were counted. The Mann-Whitney test was used to compare the variables between groups. The Kruskal-Wallis and Student-Newman-Keuls tests were used to compare the axial reconstructions. RESULTS: The mandible showed a greater number of artefacts than the maxilla (apical image: p = 0.0024; middle image: p < 0.0001). The anterior region produced more artefacts than the posterior region (apical image: p = 0.0105; middle image: p < 0.0316). There was no significant difference in the number of artefacts between isolated and adjacent implants, and the cervical image was most affected by artefacts. CONCLUSIONS: Dental implants always produce metal artefacts in CBCT images, and these artefacts are affected by the anatomical location in the dental arch.


Asunto(s)
Artefactos , Tomografía Computarizada de Haz Cónico , Implantes Dentales , Maxilares/diagnóstico por imagen , Estudios Transversales , Humanos , Estudios Retrospectivos
20.
HU rev ; 44(1): 41-47, 2018.
Artículo en Portugués | LILACS | ID: biblio-986437

RESUMEN

O processo alveolar é uma estrutura dente dependente que sofre alterações dimensionais após a exodontia. Defeitos ósseos resultantes prejudicam a colocação de implantes e o sucesso em longo prazo. Diversas técnicas cirúrgicas e biomateriais tem sido apresentados como opções terapêuticas para preservação e recuperação dos rebordos edêntulos. Assim, o objetivo desta revisão narrativa é evidenciar o estado atual dos biomateriais disponíveis bem como as possíveis perspectivas futuras. A utilização de biomateriais para cirurgias de reconstrução e manutenção de rebordo alveolar com sucesso é evidente. As cirurgias de reconstrução e preservação de rebordo alveolar com a utilização de novos biomateriais apresentam sucesso evidente. A impressão em 3D de estruturas biocompatíveis, fatores de crescimento, a matriz de dentina desmineralizada (DDM), parafusos e membranas reabsorvíveis podem ser as perspectivas futuras.


The alveolar bone depends on the presence of teeth and dimensional changes occurs after tooth extraction. The resulting bone defects impair both implant installation and long term success. Surgical procedures and biomaterials are considered as treatment options for maintenance and recovery of edentulous ridge. Thus, the aim of this narrative review is to present the current biomaterials as well as future perspectives. Surgical procedures for alveolar ridge preservation and reconstruction with new biomaterials are successful. 3D-Printed biocompatible scaffolds, growth factors, decellularized extracellular matrix (dECM), resorbable pins and membranes could be the future perspectives.


Asunto(s)
Implantes Dentales , Sustitutos de Huesos , Cirugía Bucal , Materiales Biocompatibles , Huesos , Regeneración Ósea , Proceso Alveolar
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