RESUMEN
The surface characteristics of dental implants play an important role in the osseointegration process. Over the years implant surfaces have been subjected to different treatments, including turning, plasma spraying, coating, sand blasting, acid etching, and anodization. FBR coating is a fully resorbable calcium phosphate (CaP) coating made of brushite, obtained by electrochemical deposition on titanium plasma-sprayed (TPS) implants; this bioactive layer may be totally resorbable in 6-12 weeks and once the FBR coating has been resorbed, the newly formed bone is in contact with the roughness of the TPS surface. Human biopsy of immediately-loaded implants is certainly the most definitive means of determining the occurrence of osseointegration. In this case series the histologic and histomorphometric features of the bone-implant interface are analyzed and discussed in 3 immediately restored implants, retrieved from human subjects at 8, 10 and 12 weeks, respectively. All 3 implants were osseointegrated, with a bone to implant contact (BIC) ranging from 54.4% to 70.1%. The FBR coating was resorbed and replaced by new bone. Osteoconduction was especially noticeable between the implant threads, where the pristine bone was removed during implant bed preparation. The results suggest that the resorption window of 6-12 weeks for the CaP coating seems to be confirmed at least in the human mandible, and that immediately loaded FBR-coated implants placed in the posterior mandible can achieve osseointegration within 6-12 weeks of loading.
Asunto(s)
Fosfatos de Calcio , Implantes Dentales , Carga Inmediata del Implante Dental , Osteogénesis , Adulto , Anciano , Regeneración Ósea , Materiales Biocompatibles Revestidos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Propiedades de Superficie , Factores de TiempoRESUMEN
Replacement therapy with immediate postextraction single dental implants has gained wider acceptance in clinical practice. However, because bone tissue volume may be insufficient for primary stability and subsequent osteointegration, many dentists prefer delaying implantation 2 or 3 months later, which may lead to greater loss of vestibular bone tissue and worsen postextraction atrophy. To avert these problems, a new surgical technique has been developed that allows immediate loading on postextraction single implants and atrophic socket remodeling. Socket remodeling is known to occur when the extraction site is completely ossified, but, depending on the length of time since tooth extraction, surgical complications may still arise, resulting in suboptimal wound healing of the socket, with unacceptable esthetic and functional outcome.
Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Implantación Dental/métodos , Implantes Dentales , Extracción Dental , Alveolo Dental/patología , Alveolo Dental/cirugía , Adulto , Femenino , Humanos , Masculino , Enfermedades Maxilares/cirugía , Persona de Mediana Edad , Adulto JovenRESUMEN
The edentulous ridge expansion has been introduced in recent years to reestablish an appropriate alveolar ridge width. This technique consists of the placement of implants in the space formed after the dislocation of the buccal plate in a labial direction. In guided bone regeneration, the quantity of bone regenerated under the membranes has been demonstrated to be directly related to the amount of the space under the membranes. This space can diminish as a result of membrane collapse. To avoid this problem, a new technique of edentulous ridge expansion, which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, was used in association with autologous bone in 25 patients. At second-stage surgery in all patients, it was possible to see tissue, under the mesh, that had the macroscopic characteristics of mature bone and was superficially covered by a thin soft tissue layer. The microscopic examination showed that all autologous bone particles were embedded in newly formed bone. The use of a rigid mesh can assist bone regeneration in non-space-making defects, since it probably does not interfere with the blood flow to the underlying tissues because of the presence of microholes within the mesh.