Immediate implants placed into infected sockets: a case report with 3-year follow-up

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.A integridade estética/funcional do tecido periodontal pode ser comprometida pela perda do elemento dental. Os implantes imediatos tornaram-se uma opção viável na manutenção da arquitetura periodontal, desde que haja a compatibilidade com o alvéolo e a possibilidade da contaminação local ser totalmente eliminada. O objetivo deste estudo foi descrever o procedimento de instalação de implantes imediatos na região anterior de maxila usados na reposição de dentes com lesões crônicas periapicais, discutindo a relação entre o procedimento e lesões periapicais. A remoção dos dentes condenados (11, 12 e 21) foi feita de forma conservadora a fim de preservar a estética e arquitetura periodontal. Um segundo acesso cirúrgico foi obtido a nível apical, permitindo: o debridamento da loja cirúrgica, orientação visual dos implantes e o preenchimento com enxerto ósseo bovino. A loja óssea foi coberta por uma membrana absorvível e uma prótese parcial removível provisória foi instalada e após 6 meses os implantes foram reabilitados. Após 3 anos de reabilitação, os implantes se apresentam em condições satisfatórias de estética/função, sugerindo que a instalação de implantes imediatos combinados com a regeneração tecidual guiada em lesões periapicais crônicas podem ser indicados para repor dentes perdidos devido a lesões periapicais crônicas com história de insucesso endodôntico na maxila anterior

Bisphosphonate treatment and dental implants : a systematic review

To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in ?PICO? format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed

Effects of bleaching agents and adhesive systems in dental pulp: a literature review

The dental pulp may be exposed to several irritants that are potentially noxious to the health and functions of this tissue. Each type of irritant or injury has different effects on the pulp, which are generally characterized by acute inflammation, chronic inflammation or necrosis. Common examples of irritants are dental caries, cavity preparation procedures, traumatic injuries, and chemical substances like bleaching agents and adhesive systems. The present study aimed to review the current knowledge about the effect of bleaching agents and adhesive systems in the human dental pulp. The review covered literature from 2004 to 2009, and only relevant manuscripts were included. Hand search of the references completed the review. Based on literature review, it may be concluded that all dental procedures associated with bleaching agents or adhesive systems involve risks to cause pulp damage. However, these risks can be minimized if the causal factors were known and avoided

Effect of absorbent tetracycline-loaded membrane used in the reduction of periodontal pockets: an in vivo study

This clinical study evaluated the influence of scaling and root planning (SRP), with and without the use of tetracycline-loaded bovine absorbent membrane, in the reduction of periodontal pockets according to 3 parameters: probing pocket depth (PPD), bleeding on probing (BOP) and plaque index (PI). Twenty-four patients were selected totalizing 144 random teeth divided in 2 groups (n=72 teeth) - control (SRP) and experimental (SRP with tetracycline-loaded absorbent membrane). PPD, BOP and PI were determined before and 28 days after the treatment. In all patients, the PPD values at the end of the treatment were always lower than the baseline values. There was a reduction of the PI for both treatments, but it was more evident on the experimental group. In conclusion, the use of tetracycline-loaded absorbent membrane could result in a better prognosis compared to scaling and root planning after only 28 days of evaluation

Lesão endodôntica com manifestação periodontal. Relato de caso.

Lesão endodôntica com manifestação periodontal. Relato de caso

Effects of bleaching agents and adhesive systems in dental pulp: a literature review

tal pulp may be exposed to several irritants that are potentially noxious to the health and functions of this tissue. Each type of irritant or injury has different effects on the pulp, which are generally characterized by acute inflammation, chronic inflammation or necrosis. Common examples of irritants are dental caries, cavity preparation procedures, traumatic injuries, and chemical substances like bleaching agents and adhesive systems. The present study aimed to review the current knowledge about the effect of bleaching agents and adhesive systems in the human dental pulp. The review covered literature from 2004 to 2009, and only relevant manuscripts were included. Hand search of the references completed the review. Based on literature review, it may be concluded that all dental procedures associated with bleaching agents or adhesive systems involve risks to cause pulp damage. However, these risks can be minimized if the causal factors were known and avoided

Uso de antimicrobianos locais como coadjuvantes à terapia periodontal - Revisão de literatura.

Uso de antimicrobianos locais como coadjuvantes à terapia periodontal - Revisão de literatura

Hydrophilic titanium surface modulates early stages of osseointegration in osteoporosis

ObjectiveUsing a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process.BackgroundBased on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short‐ and long‐term clinical outcomes in osteoporosis is necessary.Material and MethodsFifty female, 3‐month‐old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE‐HD). Calcium (Ca) and phosphorus (P) content was measured by energy‐dispersive X‐ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone‐to‐implant contact (BIC) and bone volume fraction (BV) by nano‐computed tomography (nano‐CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL‐1β, IL‐10, Tnf‐α, and Nos2) by qRT‐PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05.ResultsThe amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE‐HD compared to SAE on the intra‐group analysis. Nano‐CT and histology revealed more BV and BIC for SAE‐HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment.ConclusionBoth surfaces were able to modulate bone responses toward osteoblast differentiation. SAE‐HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167101/1/jre12827_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167101/2/jre12827.pd