RESUMO
A reabilitação provisória rígida implantossuportada tem sido reconhecida por ter um impacto significativo sobre a resposta do tecido peri-implantar em carga imediata, uma vez que reduz a tensão mecânica exercida sobre cada implante. Um protocolo de sucesso para a carga imediata com implantes múltiplos depende de uma fixação adequada e da ausência de mobilidade dos implantes para evitar o risco de micromovimentos em relação ao osso circundante. O objetivo deste artigo foi demonstrar um conceito de prótese implantossuportada com uma esplintagem rígida rápida de vários implantes cone-morse com carregamento imediato para o mesmo dia da cirurgia, com uma reabilitação provisória reforçada por uma liga metálica, usando uma técnica de soldagem dos pilares de implantes diretamente na cavidade bucal com uma barra de titânio pré-fabricada.
The rigid implant-supported provisional rehabilitation has been recognized to have a significant impact on the peri-implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant. A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was show a implant-supported rehabilitation concept with a fast rigid splinting of multiple tapered connection implants for same-day immediate loading with metal-reinforced provisional restorations using a technique of welding implant abutments with a prefabricated titanium bar directly in the oral cavity.
Assuntos
Humanos , Soldagem em Odontologia , Carga Imediata em Implante DentárioRESUMO
BACKGROUND: The role of osteocytes in bone structure and function remains partially unresolved. Their participation in mechanotransduction, i.e., the conversion of a physical stimulus into a cellular response, has been hypothesized. The present study was an evaluation of the osteocyte density in the peri-implant bone of immediately loaded and submerged dental implants. METHODS: Fourteen male patients were included in the study; all of them were partially edentulous and needed a posterior mandibular restoration. Implants were inserted in these areas; half of the sample was loaded immediately (included in a fixed provisional prosthesis on the same day as implant surgery), whereas the other half was left to heal submerged. Fourteen implants (seven immediately loaded and seven unloaded) were retrieved with a trephine after a healing period of 8 weeks. The specimens were treated to obtain thin ground sections, and histomorphometry was used to evaluate the osteocyte index in the peri-implant bone. RESULTS: A higher and statistically significant number of osteocytes was found in the peri-implant bone around immediately loaded implants (P = 0.0081). A correlation between the percentage of bone-implant contact and osteocyte density was found for immediately loaded implants (P = 0.0480) but not for submerged implants (P = 0.2667). CONCLUSION: The higher number of osteocytes in the peri-implant bone around immediately loaded implants could be related to the functional adaptation required by the loading stimulus, which also explains the hypothesized involvement of the osteocytes in the maintenance of the bone matrix.
Assuntos
Dente Suporte , Implantação Dentária Endóssea/métodos , Implantes Dentários , Mandíbula/patologia , Osteócitos/patologia , Adaptação Fisiológica/fisiologia , Adulto , Medula Óssea/patologia , Remodelação Óssea/fisiologia , Calcificação Fisiológica/fisiologia , Contagem de Células , Prótese Dentária Fixada por Implante , Prótese Parcial Fixa , Prótese Parcial Temporária , Humanos , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Masculino , Mecanotransdução Celular/fisiologia , Pessoa de Meia-Idade , Osseointegração/fisiologia , Osteócitos/fisiologia , Estresse Mecânico , Propriedades de SuperfícieRESUMO
BACKGROUND: The purpose of this study was to compare and evaluate bone and soft tissue levels between immediately placed, immediately restored implants positioned in the esthetic anterior region with different interimplant distances (IID). METHODS: Forty-nine patients requiring multiple implant restorations in the anterior regions received 152 implants, which were restored immediately. Periapical radiographs and digital images of 99 interimplant sites were taken at the regular follow-up examinations at 0, 6, 12, and 24 months after surgery. They were digitally recorded and analyzed. The presence of the interproximal papilla was assessed and compared to the distances between the bone crest and the contact point between the natural teeth and the restoration crowns. RESULTS: Implants with an IID <2 mm seemed to lose less bone laterally. When the IID was <2 mm, vertical crestal bone loss was significantly greater than in the group with IID >4 mm. The percentage of the interproximal papilla presence decreased when the distance between the bone crest and the contact point between the two restoration crowns was >6 mm and when two implants were placed at a distance > or =4 mm. CONCLUSIONS: To guarantee a better esthetic result in immediately placed, immediately restored implants, the contact point between the two prosthetic crowns should be placed at 3 to 4 mm, and never >6 mm, from the bone peak. Two adjacent implants should be placed at a distance >2 and <4 mm.