RESUMO

Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization.

RESUMO

This study evaluated the clinical survival rates of 170 Morse taper implants through clinical and mechanical parameters in different therapeutic approaches such as single crowns, fixed partial prostheses, and fixed full-arch prostheses. Patients referred to the Center on Education and Research on Dental Implants from May 2017 to July 2018 with the indication for dental implant therapy, aged >18 years, without periodontal disease, recent evidence of inflammatory activity or other oral disorders, current pregnancy, uncontrolled diabetes mellitus or heavy smoking habit were included in this study. After 12 weeks of healing since the implants were placed in the mandible and after 16 weeks following implants placed in the maxilla, patients returned to the Center for prosthetic rehabilitation. After implant therapy, all patients underwent periodical, clinical, and prosthetic examinations every 6 months. Prosthetic restorations involved 109 fixed reconstructions in function. Few prosthetic complications were reported (6.55%). Twenty implants were rehabilitated with cemented prostheses; from those, 1 crown suffered a loss in retention/decementation. Of the 148 implants rehabilitated with screwed-retained prostheses, 6.76% suffered prosthetic screw loosening. The cumulative implant survival rate was 98.2%. When peri-implant tissue health was evaluated, the keratinized mucosa band appeared related to peri-implant tissue stability. Thus, Morse taper implants represented a successful procedure for implant rehabilitation, with a high cumulative implant survival rate, low prevalence of biological and prosthetic complications, and good stability of peri-implant tissues over the assessed period.

Assuntos

RESUMO

PURPOSE: Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model. METHODS: Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema. RESULTS: The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (P<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group. CONCLUSIONS: Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.

RESUMO

AIM: The present systematic review aimed to identify and summarize the clinical, radiographic, and histological outcomes of alveolar ridge preservation using bone xenografts and absorbable sealing materials compared with spontaneous healing in the esthetic zone. MATERIALS AND METHODS: Randomized clinical trials (RCTs) fulfilling specific eligibility criteria were included. Two review authors independently searched for eligible studies, extracted data from the published reports and performed the risk of bias assessment (RoB 2 tool). Study results were summarized using random effects meta-analyses. RESULTS: Thirteen articles concerning 10 RCTs were included, involving a total of 357 participants. Most of studies were considered as "low" risk of bias. Meta-analyses indicated less horizontal (difference in means-MD = 1.88 mm; p < 0.001), vertical mid-buccal (MD = 1.84 mm; p < 0.001) and vertical mid-lingual (MD = 2.27 mm; p < 0.001) bone resorption in alveolar ridge preservation compared to spontaneous healing as assessed clinically. Bone changes assessed radiographically showed consistent results in terms of horizontal (at 1 mm: MD = 1.84 mm, p < 0.001), vertical mid-buccal (MD = 0.95 mm; p < 0.001) and mid-lingual (MD = 0.62 mm; p = 0.05) resorption. Part of the bone resorption in the spontaneous healing group was compensated by soft-tissues, since the observed differences between groups in linear ridge reduction evaluated through cast models superimposition were smaller (MD = 0.52 mm; p < 0.001). CONCLUSIONS: Alveolar ridge preservation with xenogeneic bone substitutes and non-autogenous resorbable socket sealing materials is efficacious in reducing post-extraction bone and ridge changes in the esthetic region.

Assuntos

RESUMO

AIM: This bibliometric study analyzed the characteristics of the 100 most cited articles on bone grafts in dentistry. MATERIALS AND METHODS: A database search was performed on the Web of Science Core Collection using a specific search strategy. Scopus and Google Scholar were also consulted for citation comparisons. Data extracted included: title, citation metrics, publication year, journal, study design, graft material, surgical technique, authors, institution, and country. Bibliometric networks were generated using VOSviewer. RESULTS: The identified articles were published between 1991 and 2019. Citation counts ranged from 120 to 1161 (mean: 240, 30). Clinical Oral Implants Research was the most cited journal (5175 citations; 25/100). Xenogeneic bone graft material was the most frequently used (5130 citations; 22/100). Europe had 62 articles (14,604 citations), and the United States was the most prominent country (5209 citations; 22/100). The University of Bern had the highest number of citations (2565 citations; 13/100), with Buser D as the author with the largest number of articles (2648 citations; 12/100). CONCLUSION: This study shows the scientific progress on bone grafts in dentistry. The use of xenogeneic grafts for horizontal and/or vertical ridge augmentation was the most prominent trend.

Assuntos

RESUMO

This case report presents a novel approach for root coverage of multiple gingival recessions with a volume-stable collagen matrix functionalized with injectable platelet-rich fibrin (i-PRF). A patient with multiple gingival recessions in the anterior maxilla was submitted to root coverage by coronally advanced flap with split-full-split incisions. Blood collection was performed before surgery and i-PRF was obtained after centrifugation (relative centrifugal force (RCF) 400 g, 2700 rpm, 3 minutes). A volume-stable collagen matrix was soaked with i-PRF and applied as a substitute for autogenous connective tissue graft. A mean root coverage of 83% was observed after a 12-month follow-up period, and only slight modifications were detected in a 30-month follow-up consultation. The association of a volume-stable collagen matrix with i-PRF successfully treated multiple gingival recessions with reduced morbidity since a connective tissue collection was avoided.

RESUMO

A static magnetic field generated by neodymium-iron-boron (NdFeB) magnets placed in the inner cavity of dental implants can enhance bone regeneration in rabbits. It is, however, unknown whether static magnetic fields support osseointegration in a canine model. We therefore determined the potential osteogenic effect of implants carrying NdFeB magnets inserted in the tibia of six adult canines in the early stages of osseointegration. Here, we report that after 15 days of healing, magnetic and regular implants showed a high variation with a median new bone-to-implant contact (nBIC) in the cortical (41.3% and 7.3%) and the medullary (28.6% and 44.8%) region, respectively. Consistently, the median new bone volume/tissue volume (nBV/TV) in the cortical (14.9% and 5.4%) and the medullary (22.2% and 22.4%) region were not significantly different. One week of healing only resulted in negligible bone formation. These findings suggest that considering the large variation and the pilot nature of this study, magnetic implants failed to support peri-implant bone formation in a canine model.

RESUMO

In in vitro culture systems, dexamethasone (DEX) has been applied with ascorbic acid (ASC) and ß-glycerophosphate (ßGLY) as culture media supplementation to induce osteogenic differentiation of mesenchymal stem cells. However, there are some inconsistencies regarding the role of DEX as osteogenic media supplementation. Therefore, this study verified the influence of DEX culture media supplementation on the osteogenic differentiation, especially the capacity to mineralize the extracellular matrix of stem cells from human exfoliated deciduous teeth (SHED). Five groups were established: G1-SHED + Dulbecco's Modified Eagles' Medium (DMEM) + fetal bovine serum (FBS); G2-SHED + DMEM + FBS + DEX; G3-SHED + DMEM + FBS + ASC + ßGLY; G4-SHED + DMEM + FBS + ASC + ßGLY + DEX; G5-MC3T3-E1 + α Minimal Essential Medium (MEM) + FBS + ASC + ßGLY. DNA content, alkaline phosphatase (ALP) activity, free calcium quantification in the extracellular medium, and extracellular matrix mineralization quantification through staining with von Kossa, alizarin red, and tetracycline were performed on days 7 and 21. Osteogenic media supplemented with ASC and ß-GLY demonstrated similar effects on SHED in the presence or absence of DEX for DNA content (day 21) and capacity to mineralize the extracellular matrix according to alizarin red and tetracycline quantifications (day 21). In addition, the presence of DEX in the osteogenic medium promoted less ALP activity (day 7) and extracellular matrix mineralization according to the von Kossa assay (day 21), and more free calcium quantification at extracellular medium (day 21). In summary, the presence of DEX in the osteogenic media supplementation did not interfere with SHED commitment into mineral matrix depositor cells. We suggest that DEX may be omitted from culture media supplementation for SHED osteogenic differentiation in vitro studies.

Assuntos

RESUMO

OBJECTIVE: To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management. MATERIALS AND METHODS: Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed. RESULTS: Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment. CONCLUSIONS: Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG. CLINICAL RELEVANCE: The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.

Assuntos

RESUMO

Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were Escherichia coli and Staphylococcus aureus. Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.

RESUMO

Obesity and periodontal diseases have been investigated to be interconnected, but the molecular mechanism underlying this association is still not clear. The aim of this systematic review is to assess the association of serum, salivary and gingival crevicular fluid (GCF) inflammatory markers (IMs), obesity, and periodontitis. Studies that evaluated IM of adults according to obesity status (O) and periodontitis status (P) (O+P+; O-P+; O+P-) were screened on several electronic databases and grey literature up until February 2019. Risk of bias assessment and level of evidence were evaluated through Fowkes and Fulton scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were grouped according to the biological matrix studied (serum/GCF) and groups (O+P+ vs. O-P+/O+P+ vs. O+P-). Out of the 832 studies screened, 21 were considered in qualitative synthesis and 15 in quantitative synthesis (meta-analysis). Although included studies showed mostly "no" or "minor" problems during the quality assessment, GRADE assessment indicated very low to moderate level of evidence based on the question answered. O+P+ adults exhibited significantly higher serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), leptin, and tumor necrosis factor-α (TNF-alpha) and higher resistin GCF levels than O-P+. O+P+ adults showed significantly higher serum levels of IL-6 and leptin and lower adiponectin serum levels than O+P-. Only qualitative information could be obtained of the IM vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1ß, and interferon-γ (IFN-γ). Obesity and periodontitis, together or separately, are associated with altered serum and GCF levels of CRP, IL-6, leptin, TNF-alpha, adiponectin, and resistin. It was not possible to evaluate the association between obesity and periodontitis at salivary levels. The role of recently investigated biomarkers as vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1ß, and IFN-γ, which can be key points underlying the association between obesity and periodontitis, remains to be further investigated.

RESUMO

OBJECTIVES: This split-mouth controlled randomized clinical trial evaluated clinical and histological results of acellular dermal matrix allograft (ADM) compared to autogenous free gingival graft (FGG) for keratinized tissue augmentation. MATERIAL AND METHODS: Twenty-five patients with the absence or deficiency of keratinized tissue (50 sites) were treated with FGG (control group) and ADM (test group). Clinical parameters included keratinized tissue width (KTW) (primary outcome), soft tissue thickness (TT), recession depth (RD), probing depth (PD), and clinical attachment level (CAL). Esthetic perception was evaluated by patients and by a calibrated periodontist using visual analog scale (VAS). Histological analysis included biopsies of five different patients from both test and control sites for each evaluation period (n = 25). The analysis included percentage of connective tissue components, epithelial luminal to basal surface ratio, tissue maturation, and presence of elastic fibers. Data were evaluated by ANOVA complemented by Tukey's tests (p < 0.05). RESULTS: After 6 months, PD and CAL demonstrated no differences between groups. ADM presented higher RD compared to FGG in all periods. Mean tissue shrinkage for control and test groups was 12.41 versus 55.7%. TT was inferior for ADM group compared to FGG. Esthetics perception by professional evaluation showed superior results for ADM. Histomorphometric analysis demonstrated higher percentage of cellularity, blood vessels, and epithelial luminal to basal surface ratio for FGG group. ADM group presented higher percentage of collagen fibers and inflammatory infiltrate. CONCLUSIONS: Both treatments resulted in improvement of clinical parameters, except for RD. ADM group presented more tissue shrinkage and delayed healing, confirmed histologically, but superior professional esthetic perception. CLINICAL RELEVANCE: This study added important clinical and histological data to contribute in the decision-making process between indication of FGG or ADM.

Assuntos

RESUMO

Introdução: As técnicas de enxerto gengival livre têm como principal objetivo a criação/aumento da faixa de mucosa ceratinizada. Quando se utiliza o tratamento químico da raiz e o correto posicionamento do enxerto no leito receptor podem acarretar em um fenômeno incomumdenominado de Creeping Attachment. Objetivo: descreverum caso de recobrimento radicular apósum enxerto gengival livre e Creeping Attachment. Relato do caso: Paciente sexo masculino, 28 anos de idade, não fumante e sem alterações sistêmicas apresentouse a faculdade de odontologia Universidade Federal de Santa Catarinacom a queixa principal de comprometimento estético e hipersensibilidade dentinária na região anterior-inferior. No exame clínico verificou-se uma recessão gengival unitária no dente 41, classificada como classe I de Miller. Logo indicou-se a cirurgia de enxerto gengival livre, obtido da região de palato duro, visandouma melhora estética efuncional, bem como a remissão da hipersensibilidade. Conclusão: Diante dos resultados clínicos podemos concluir que o enxerto gengival livre é uma técnica previsível e de fácil realização para o aumentoda faixa de mucosa queratinizada para posterior recobrimento radicular, contudo apesar de incomum o fenômeno Creeping Attachment deve ser esperado como alternativa a etapade recobrimento radicular. (AU)

Introduction: Free gingival graft techniques have as main objective the creation / increase of the keratinized mucosa band. When using the chemical treatment of the root surfaceand the correct positioning of the graft in the recipiente bed can lead to anuncommon phenomenon calledCreeping Attachment. Objective: This scientific paper describes a clinical case of root coverage after a free gingival graft and Creeping Attachment. Case Report: A 28-year-old male patient, non-smoker, was assisted in the Federal University of Santa Catarina by students and teachers of dentistry presented the main complaint the aesthetic impairment and dentin hypersensitivity in the anterior region of the jaw. In the clinical examination was observed an unitary gingival recession in tooth 41, classified as Miller class I. The gingival graft surgery, obtained from the hard palate region, was then indicated to improve the esthetic and functional condition, as well as to promove the end of symptoms of hypersensitivity. Conclusion: Inview of the clinical results we can conclude that the free gingival graft is a predictable and easy to perform technique to increase the line of keratinized mucosa for the subsequent root coverage. However, although the Creeping Attachment phenomenon is uncommon, it should be expected as an alternative to the root coverage (AU)

Assuntos

RESUMO

Considering oral diseases, antibiofilm compounds can decrease the accumulation of pathogenic species such as Streptococcus mutans at micro-areas of teeth, dental restorations or implant-supported prostheses. OBJECTIVE: To assess the effect of thirteen different novel lactam-based compounds on the inhibition of S. mutans biofilm formation. MATERIAL AND METHODS: We synthesized compounds based on γ-lactones analogues from rubrolides by a mucochloric acid process and converted them into their corresponding γ-hydroxy-γ-lactams by a reaction with isobutylamine and propylamine. Compounds concentrations ranging from 0.17 up to 87.5 µg mL-1 were tested against S. mutans. We diluted the exponential cultures in TSB and incubated them (37°C) in the presence of different γ-lactones or γ-lactams dilutions. Afterwards, we measured the planktonic growth by optical density at 630 nm and therefore assessed the biofilm density by the crystal violet staining method. RESULTS: Twelve compounds were active against biofilm formation, showing no effect on bacterial viability. Only one compound was inactive against both planktonic and biofilm growth. The highest biofilm inhibition (inhibition rate above 60%) was obtained for two compounds while three other compounds revealed an inhibition rate above 40%. CONCLUSIONS: Twelve of the thirteen compounds revealed effective inhibition of S. mutans biofilm formation, with eight of them showing a specific antibiofilm effect.

Assuntos

RESUMO

Abstract Considering oral diseases, antibiofilm compounds can decrease the accumulation of pathogenic species such as Streptococcus mutans at micro-areas of teeth, dental restorations or implant-supported prostheses. Objective To assess the effect of thirteen different novel lactam-based compounds on the inhibition of S. mutans biofilm formation. Material and methods We synthesized compounds based on γ-lactones analogues from rubrolides by a mucochloric acid process and converted them into their corresponding γ-hydroxy-γ-lactams by a reaction with isobutylamine and propylamine. Compounds concentrations ranging from 0.17 up to 87.5 μg mL-1 were tested against S. mutans. We diluted the exponential cultures in TSB and incubated them (37°C) in the presence of different γ-lactones or γ-lactams dilutions. Afterwards, we measured the planktonic growth by optical density at 630 nm and therefore assessed the biofilm density by the crystal violet staining method. Results Twelve compounds were active against biofilm formation, showing no effect on bacterial viability. Only one compound was inactive against both planktonic and biofilm growth. The highest biofilm inhibition (inhibition rate above 60%) was obtained for two compounds while three other compounds revealed an inhibition rate above 40%. Conclusions Twelve of the thirteen compounds revealed effective inhibition of S. mutans biofilm formation, with eight of them showing a specific antibiofilm effect.

Assuntos

RESUMO

Este artigo teve por objetivo apresentar um caso clínico cuja prótese provisória utilizou um componente protético multifuncional de PEEK. Este é um polímero biocompatível personalizável e de boa aderência às resinas. O caso descrito é um implante imediato com carga imediata na região do 21. Foi realizado um approach palatino do implante, preenchimento do gap vestibular com um enxerto aloplástico (Nanosynt), um provisório imediato utilizando um componente provisório multifuncional de PEEK e um dente de estoque. O caso foi acompanhado até a fase de confecção da prótese defi nitiva, na qual foi verifi cada a arquitetura dos tecidos peri-implantares quanto à saúde e manutenção. Na Implantodontia contemporânea, o PEEK é a opção biológico-funcional com melhor custo-benefício nos casos de implantes colocados e carregados imediatamente.

The aim of this article was to present a clinical case where the provisional restoration was fabricated over a multifunctional PEEK healing abutment. This biocompatible polymer can be customized and has excellent bond strength to resin composites. A dental implant was loaded at the region of tooth 21. After a palatal approach for implant placement, the buccal gap was fi lled with an alloplastic graft (Nanosynt). Then, the immediate restoration was fabricated with the multifunctional PEEK and an acrylic tooth form. At the delivery of the defi nitive restoration, the peri-implant soft tissue health and architecture were preserved. In the contemporary implant dentistry, PEEK abutments provide the best biological and functional option with a signifi cant cost-benefi t ratio for cases of immediate implant loading

Assuntos

RESUMO

Objetivos: avaliar o desempenho de furação de brocas. Material e métodos: três sistemas de implantes brasileiros foram testados: A (FGM, Joinville); B (Neodent, Curitiba); e C (SIN, São Paulo). A força de furação foi mantida constante e igual a 35 N. A rotação das brocas foi de 800 rpm e os corpos-de-prova foram mantidos em temperatura de 36°C ± 2°C, sendo a água destilada como fluido refrigerante. Dados sobre a temperatura e torque de furação foram adquiridos, e o desgaste das brocas foi avaliado por MEV. Os testes Anova e Tukey (α=5%) foram utilizados na análise estatística. Resultados: as brocas são eficazes, não ultrapassando a temperatura de limite biológico (47°C). Conclusão: de acordo com os ensaios realizados, a broca do grupo A reúne características que a habilitam como broca de perfuração única no preparo do leito do implante dentário. A análise em MEV mostrou que os grupos A e B mantiveram os gumes de corte bem defi nidos e sem desgaste aparente.

Objectives: to evaluate the osteotomy performance of implant drills. Material and methods: three different Brazilian dental implant systems were tested: A (FGM, Joinville), B (Neodent, Curitiba), and C (SIN, São Paulo). Drilling force was kept at 35 N. Drill rotation was set at 800 RPM and samples were kept at 36 ± 2°C under water coolant. Data regarding temperature and torque were acquired and drill wear evaluated under SEM. The Anova and Tukey tests (α=5%) were applied for statistical analyses. Results: all drills were effi cient and remained below the biologic limit level (47°C). Conclusion: according to the tests, drills of the A group had characteristics for a single osteotomy at the bone bed for implant placement. The SEM analysis demonstrated that groups A and B still had sharp, well-defi ned cutting edges with no visible wear.

Assuntos

RESUMO

O planejamento protético sobre os atuais sistemas de implantes dentais tipo cone-morse junto à prótese parafusada procura obter uma versatilidade protética, facilidade de elaboração, boa resposta biológica, reversibilidade e estética, apresentando-se como um pilar protético com cilindro de plástico que permite fabricação diretamente para a fixação no implante, envolvendo o mecanismo antirrotacional, e sendo uma alternativa no tratamento de reabilitação em casos de requerimento estético em implantes instalados no nível ósseo (Bone level, Straumann). Este relato de caso descreveu o procedimento de exodontia atraumática, seguida da instalação de implante imediato com preenchimento de gap, e subsequente sequência clínica da reabilitação sobre implante cone-morse com componente protético com cilindro de plástico (Gold abutment, Straumann), que promove maior previsibilidade estética na reabilitação em implantes instalados no nível ósseo, apresentando um prognóstico satisfatório e equilíbrio mecânico/funcional que envolve mecanismo antirrotacional.

The prosthetic design on the current cone morse dental implant systems, together with the screwed prosthesis, seeks prosthetic versatility, ease of preparation, good biological response, retrievability and aesthetics, presenting a prosthetic abutment with a plastic burnout cylinder for direct connection to the implant with an antirrotational mechanism for esthetic situations involving a bone level implant (Straumann). This case report describes the atraumatic extraction procedure, followed by the installation of an immediate gap filling implant, and a subsequent clinical sequence using the Gold abutment (Straumann) plastic prosthetic component, which promotes greater aesthetic predictability in the rehabilitation of implants installed at the bone level, presenting a satisfactory prognosis and mechanical/functional balance involving antirotation mechanism.

Assuntos

RESUMO

Gingival recession can compromise the esthetic appearance, leading to functional problems, hypersensitivity, and root caries. Several techniques have been implicated for root coverage, which includes pedicle grafts, free gingival grafts, connective tissue grafts, and guided-tissue regeneration. The double-papillae flap associated with subepithelial connective tissue is a predictable technique to cover isolated areas with insufficient attached gingiva apical to a recession. This case report demonstrates a surgical alternative to the technique using a sling periosteal suture to stabilize the connective tissue and pedicle flap during the initial phase of healing, increasing the potential of this periodontal procedure for gingival recession coverage.

Assuntos

RESUMO

O objetivo deste trabalho foi apresentar um caso clínico de reabilitação entre dentes e implantes. Na situação inicial, havia escurecimento do dente 11 e ausência do dente 22, sobre o qual estava instalada uma prótese parcial removível. Uma intensa reabsorção óssea na região do dente ausente foi observada através de análises clínica e tomográfica. A técnica de expansão óssea associada ao deslocamento vestibular de tecido conjuntivo palatino, conhecido como "técnica do rolo", foi realizada, juntamente à instalação de implante cone-morse (Arcsys). Após quatro meses, foi realizada a reabertura. Selecionou-se um munhão universal angulável (Arcsys), o qual teve sua angulação personalizada com base na posição obtida através de um referenciador angular, e uma prótese provisória cimentada foi confeccionada sobre este. Um preparo para coroa metalocerâmica foi realizado no dente 11 e sobre o elemento 21, além da substituição das restaurações antigas, também foi realizada faceta em resina composta. Assim, o caso foi finalizado com uma coroa metalocerâmica sobre implante e uma coroa metalocerâmica sobre dente, entremeadas por dente natural facetado com resina composta. Apesar da complexidade de um caso clínico envolvendo dentes naturais e próteses, foi possível alcançar um resultado satisfatório e um sorriso esteticamente harmônico.

The aim of this paper was to present a clinical rehabilitation case with teeth and implants. In the clinical scenario, there was darkening of tooth 11 and the lack of tooth 22, where a removable prosthesis was installed. Also, considerable bone resorption was observed after clinical and CBCT exams. In this way, bone expansion technique was associated to the roll technique. Four months after implant placement, (morse taper, Arcsys), the opening procedure was performed. A universal abutment (Arcsys) was selected and angled in real time according a pre-fabricated guiding device, receiving a cemented provisional single-tooth crown. Then, tooth 11 received a dental preparation for fused-to-metal crown, and tooth 21 received a direct composite veneer. Thus, the final scenario was composed by a fused-to-metal crowns over dental implant and tooth, and a natural tooth with resin composite veneer. Despite its complexity, satisfactory results and a harmonious smile were achieved.

Assuntos