RESUMO
The stability of peri-implant soft tissues is essential for long-term success. Integrins play a vital role in biological processes through developing and maintaining cell interactions; however, few studies have evaluated the effects of modifications to abutment surfaces on cell adhesion across integrin expression. Therefore, this pilot study assessed the influence of different surface topographies of titanium healing abutments prepared by additive manufacturing (AM) on the gene expression levels of the integrin subunits α2, ß1, αv, and ß6 in the human peri-implant mucosa. Thirteen healthy adults were included. Depending on the number of required implants, the subjects were distributed in different groups as a function of healing abutment topography: group 1 (fully rough surface); group 2 (upper machined + lower rough); group 3 (rough upper surface + lower machined); group 4 (fully machined). A total of 40 samples (n = 10/group) of the peri-implant mucosa around the abutments were collected 30 days after implant placement, and subsequently, the gene expression levels were evaluated using real-time PCR. The levels of gene expression of ß1-subunit integrin were upregulated for individuals receiving fully rough surface abutments compared with the other surface topographies (p < 0.05). However, the healing abutment topography did not affect the gene expression levels of the α2, αv, and ß6 integrin subunits in the human peri-implant mucosa (p > 0.05). This preliminary study suggested that controlled modifications of the surface topography of titanium healing abutments produced by AM may influence the quality of the peri-implant mucosa in the early stages of the soft tissue healing process.
RESUMO
Resumen Se considera un fracaso estético la visible decoloración grisácea de la mucosa periimplantar, después de la inserción del pilar y la cementación de la corona, esto se debe al uso de pilares metálicos о a un biotipo periodontal delgado. El objetivo de este reporte de caso es mejorar la apariencia estética gingival en pacientes con biotipo delgado, modificando el color en la región submucosa de un pilar personalizado atornillado de zirconio en un incisivo lateral derecho.
Abstract Greyish pigmentation of the mucosa around implants after abutment insertion and crown cementation is considered an esthetic failure. This pigmentation is due to use of metallic abutments or a thin periodontal biotype. The purpose of the present report was to improve gingival esthetic appearance of patients with thin biotype, by modifying color in the sub-mucosal region of a screwed-on, custom made, zirconium abutment, successfully improving gingival aesthetics in a right lateral incisor.
RESUMO
O objetivo deste trabalho foi relatar um caso clínico e sua respectiva resolução estético/funcional, no qual o implante instalado apresentava uma recessão da mucosa peri-implantar com comprometimento estético. O enxerto de tecido conjuntivo (ETC) subepitelial é uma das opções de tratamento para correção destas deformidades, tendo a capacidade de melhorar a quantidade de mucosa queratinizada ao redor do implante, o que beneficia a manutenção da saúde e a estética da região em longo prazo. A técnica da incisão vestibular subperiosteal de acesso em túnel é uma abordagem minimamente invasiva e foi empregada neste caso com sucesso.
This paper presents a clinical case report about a dental implant with mucosal recession and its aesthetic-functional resolution. The subepithelial connective tissue graft (SCTG) is one of the treatment options to correct these deformities, having the ability to improve the amount of keratinized mucosa around the implant, which benefits the maintenance of the heath of the area. The minimally invasive, vestibular incision with subperiosteal tunnel access (Vista) technique was also used with success in this case.
Assuntos
Humanos , Feminino , Adulto , Implantes Dentários , Estética Dentária , Procedimentos Cirúrgicos Minimamente Invasivos , Mucosa Bucal/cirurgia , Transplante de Tecidos/métodos , Transplante AutólogoRESUMO
A good amount and width of keratinized tissue around implants has been associated with better peri-implant health, less bone loss and improved esthetics. The purpose of this case was to evaluate a new porcine xenograft (collagen matrix) used as an interpositional graft to augment thickness of the peri-implant mucosa. There are few studies using a collagen matrix as a substitute for subepithelial connective graft around implants. This case involved a clinical implant in teeth 15 in which it was made the most of it during placement of healing abutment by taking the opportunity to increase peri-implant mucosa with a collagen matrix. Thickness increased 1.5mm while the amount of keratinized mucosa was kept at 4mm. It is concluded that the collagen matrix of porcine origin is a good alternative to increase thickness of the peri-implant mucosa and reduce morbidity. It is easy to handle and suture as well.
Una buena cantidad y grosor de tejido queratinizado alrededor de implantes ha sido asociado con una mejor salud periimplantaria, menos pérdida ósea y una mejora en la estética. El propósito de este caso clínico fue evaluar un nuevo xenoinjerto de origen porcino (matriz de colágeno) al ser utilizada como un injerto interposicional para au¬mentar el grosor de la mucosa periimplantaria. Son pocos los estudios que utilizan la matriz de colágeno como sustituto del injerto conectivo subepitelial alrededor de implantes. El caso clínico incluyó un implante a nivel de la pieza 15, en el cual durante la colocación del pilar de cicatrización se aprovechó para engrosar la mucosa periimplantaria utilizando una matriz de colágeno. Se obtuvo un aumento de grosor de 1,5mm manteniéndose la cantidad de mucosa queratinizada de 4mm. Se concluyó que la matriz de colágeno de origen porcino es una buena alternativa para aumentar el grosor de la mucosa periimplantaria, además de reducir la morbilidad, ser de fácil manejo y de fácil sutura.
Assuntos
Humanos , Pessoa de Meia-Idade , Colágeno/uso terapêutico , Estética Dentária , Implantação Dentária Endóssea/métodos , Mucosa Bucal/cirurgia , Queratinas , SuínosRESUMO
Las enfermedades que involucran a los tejidos que rodean a los dientes y a los implantes osteointegrados son el resultado de una interacción entre algún tipo de agente patológico (bacteriano, viral, etc.) y la respuesta inmunitaria del huésped. Estas interacciones se pueden dar tanto en los tejidos dentarios como en aquellos biomateriales que se introducen para tratar de corregir algún tipo de patología periodontal; los implantes al ser sustitutos biocompatibles de las piezas dentarias no están exentas de este tipo de interacciones que muchas veces cursan con patologías periodontales y periimplantarias. La periimplantitis es un tipo de patología que resulta de dicha interacción; los factores de riesgo e indicadores de riesgo de la periimplantitis son amplios y complejos. El presente artículo resume las múltiples fuentes de información de la literatura científica para abordar al detalle los aspectos de los principales factores de riesgo y la periimplantitis en la terapia implantológica.
Diseases involving tissue around the teeth and osseo integrated implants are the result of an interaction between some type of pathological agent (bacterial, viral, etc.) and host immune response. These interactions can occur both in the dental tissues as those biomaterials which are introduced to attempt to correct some type of periodontal disease, the implant being a biocompatible substitute of the teeth is not free from this type of interaction often enrolled periodontal and peri-implant pathology. The peri-implantitisis a type of disease that results from this interaction, the risk factors and risk indicators of peri-implantitis are broad and complex. This article summarizes the multiple sources of information in the scientific literature to address in detail the aspects of the main risk factors and the peri-implantitis in the peri implant therapy.
Assuntos
Humanos , Implantes Dentários/efeitos adversos , Peri-Implantite/epidemiologia , Periodontite Crônica/epidemiologia , Peri-Implantite/etiologia , Periodontite Crônica/etiologia , Fatores de RiscoRESUMO
Com a evolução da Implantodontia, começaram a ser produzidos estudos comparando as estruturas que suportavam dentes e depois passariam a suportar implantes. Estes estudos foram, e ainda são, importantes, por esclarecerem semelhanças e diferenças entre os tecidos que podem determinar o sucesso ou o fracasso no manejo dos tecidos periimplantares. O objetivo desta revisão é estabelecer diferenças e semelhanças entre os tecidos moles periimplantares e periodontais, em estudos feitos em cães.
With the evolution of the lmplantology studies comparing tissues that supported teeth and later would support fixtures started to be produced. These studies had been important to clarify similarities and differences between tissues, that can determine the success or failure in the handling of peri-implant tissues. The aim of this revision is to establish differences and similarities between soft tissues around implants and teeth, in studies in dogs.