Clinico – radiologic evaluation of the perimplantary tissue regeneration in the flapless surgery

Catedra Chirurgie OMF FPM şi Stomatologie ortopedicăClinico – radiologicaly the perimplantary tissue regeneration in the dental endobone implant installation in two levels using flapless surgery has been studied. It is possible the gum regeneration with complete covering of the endobone segment of the implant. Gum recovery dynamics depends on the implant diameter and its depth. The resorption level of the perimplantary cortical in the flapless technique is less than in the flop technique, respectivly 0,6 and 1,8 mm. Clinico-radiologic a fost studiată regenerarea ţesuturilor perimplantare la instalarea implantelor dentare endoosoase în două etape utilizînd tehnica chirurgicală fără lambou. A fost dovedit că e posibilă regenerarea gingiei cu acoperirea completă a segmentului endoosos al implantului. Dinamica vindecării gingiei e în dependenţă de diametrul implantului şi profunzimea inserării lui. Gradul de rsorbţie a corticalei perimplantare în tehnica fără lambou este mai mic decît în tehnica cu lambou, respectiv 0,6 şi 1,8 mm

Secondary stability of the endosteal dental implants inserted in 2 surgical steps without elevation of the mucoperiosteal flaps

Rezumat. La 46 pacienţi cu aparatul „Periotest“ (Siemens Gulden‑Medizintechnik, Bensheim, Germany) a fost studiată stabilitatea secundară a 109 implante (58 la mandibulă,51 la maxilă ) instalate în doi timpi chirurgicali fără decolarea lambourilor mucoperiostale. Grupa de referinţă au alcătuit‑o 52 de persoane cărora 127 implantele (79 la mandibulă, 48 la maxilă) au fost instalate conform protocolului standard. La mandibulă în grupa de referinţă media valoarii periotestului a fost M= ‑ 4,09±0,20, în grupa de studiu M = ‑ 4,26±0,19; la maxilă în grupa de referinţă M = ‑ 3,67±0,24, în grupa de studiu M = ‑ 3,84±0,24. Diferenţa (t‑test Student) valorilor stabilitatăţii secundare a implantelor dintre grupuri este nesemnificativă (P ). Concluzie: implantele instalate fără lambou în doi timpi chirurgicali se osteointegrează cu succes ca şi implantele instalate în mod standard.Summary. Secondary stability of the endosteal dental implants inserted in 2 surgical steps without elevation of the mucoperiosteal flaps At 46 patients with „Periotest“ device (Siemens Gulden‑Medizintechnik, Bensheim, Germany) have been studied secondary stability of the 109 implants inserted in 2 stage surgical technique with mucoperiosteal flap elevation (58 at the mandible, 51 at the maxilla). The reference group was formed by 52 persons with 127 implants inserted after standard protocol (mandible — 79, maxilla — 48). The medium value of the periotest at mandible reference group was M = ‑ 4,09±0,20, in the study group M = ‑ 4,26±0,19; at the maxilla the reference group M = ‑ 3,67±0,24, in the study group M = ‑ 3,84±0,24. The difference (t‑test Student) of the secondary stability values of the implants between groups was non essential (P ). Conclusion: dental implants inserted without flap in 2 step surgical technique are successfully osseointegreted like implants conventional placed

Flapless implant surgery in oral implantology. Clinical considerations.

Catedra Chirurgie OMF, stomatologie ortopedică şi implantologie orală FPM USMF „Nicolae Testemiţanu”, Dentalmedcom SRL, Braşov, RomâniaA clinical postoperative study was performed in two groups of patients after dental two stage implantation. 88 implants were installed at 34 patients from control group using open technique (open flap method), 102 implants were installed at 38 patients from main group transgingival using flapless method. Algic syndrome and postoperative soft tissue oedema at patients from main group was considerable less evident (p<0,001). La două grupe de pacienţi după instalarea implantelor dentare endoosoase a fost efectuat studiul comparativ a evoluţiei clinice postoperatorii. La 34 pacienţii din grupa de referinţă 88 implantele au fost instalate cu decolarea lambourilor mucoperiostale, iar la 38 pacienţi (102 implante) din grupa de studiu – transgingival, fără decolarea lambourilor. Sindromul algic şi edemul ţesuturilor moi la pacienţii din grupa de studiu semnificativ (p<0,001) au fost mai puţin pronunţate

Resorbţia osului cortical periimplantar în perioada osteointegrării implantelor dentare endoosoase

Rezumat. La 46 pacienţi (grupul de studiu), după metoda elaborată de autori, au fost instalate fără crearea lambourilor muco‑prtiostale 109 implante (58 — la mandibulă, 51 — la maxilă). Grupul de referinţă l‑au alcătuit 52 persoane cărora, conform protocolului convenţional, au fost instalate 127 implante (79 — la mandibulă, 48 — la maxilă). Implantele (Alpha‑Bio ‑Israel), utilizate în studiu, erau instalate, ca regulă, cu 1‑2 mm sub corticală. A doua etapă chirurgicală la mandibulă a fost efectuată peste 3‑4, la maxilă — peste 5‑6 luni. Evoluţia nivelului osului cortical periimplantar a fost apreciată la a doua etapă vizual şi radiografic — măsurările pe OPG efectuate după instalarea implantelor şi înainte de a doua etapă. Cercetările au demonstrat că resorbţia osului cortical periimplantar în grupul de studiu este semnificativ mai mică (P< 0,001) iar 18,9% de implante la mandibulă şi 35,2 % la maxilă au fost parţial sau în totalitate acoperite cu os.Summary. At 46 patients (the study group), according to the method elaborated by the authors, 109 implants have been installed without creating mucous‑parietal flaps (58 — on the mandible, 51 — on the maxilla). The reference group included 52 persons to whom, according to the conventional protocol, 127 implants have been installed (79 — on the mandible, 48 — on the maxilla). The implants (Alpha-Bio-Israel) used for the study, were installed, as a rule, at 1‑2 mm under the cortex. The second surgical stage on the mandible was performed after 3‑4 months, and that on the maxilla — after 5‑6 months. The evolution of the peri‑implant cortical bone was evaluated on the 2nd stage visually and by radiography — the panoramic dental radiography measurements were accomplished after the installation of the implants and before the second stage. The researches have proved that the resorbtion of the peri‑implant cortical bone in the study group is significantly less (P<0.001), and 18.9% of the implants on the mandible and 35.2% of the maxilla have been partially or totally covered with bone

Fiziologia şi metabolismul oaselor maxilare (vezi reabilitarea implanto-protetică)

Implanturile endoosoase reprezintă un tratament de elecţie, pentru rezolvarea unei largi varietăţi de probleme clinice. Deşi s-au făcut progrese privind studiul calitativ şi cantitativ al diferitelor sisteme implantare de pe piaţă, precum şi al aplicaţiilor clinice ale acestora, ele rămân totuşi limitate. Este esenţial pentru fiecare clinician să cunoască conceptele moderne, privind fiziologia, metabolismul şi biomecanica osoasă. Acest aspect este de cele mai multe ori singurul obiectiv, pentru a crea şi a implementa un plan de tratament inovativ

The rehabilitation of single tooth mandibular molar edentulism using two-stage dental implants

Rezumat Reabilitarea pacienţilor cu edentaţii unidentare molare mandibulare este dificilă şi însoţită de diverse complicaţii. Scopul lucrării este de a optimiza reabilitarea implanto-protetică a acestei categorii de pacienţi prin implimentarea în practică a metodelor miniinvazive de instalare a implantelor dentare. Pentru reabilitarea a 214 pacienţi cu absenţa unui molar (uni sau bilaterală) la mandibulă au fost confecţionate 237 restaurări protetice dintre care 220 cu sprijin pe un implant şi 17 cu sprijin pe două implante. Implanturile au fost instalate după metodele: cu lambou, prin tehnica flapless într-un timp şi doi timpi chirurgicali, şi timpuriu (peste 6-8 săptămâni după extracţia dintelui). Au fost evaluate: stabilitatea implantelor, starea osului cortical periimplantar şi frecvenţa complicaţiilor. Studiul comparativ al indicilor a demonstrat că modalitatea de instalare a implantelor nu influienţează semnificativ stabilitatea şi resorbţia osului periimplantar.Summary The rehabilitation of patients with single tooth missing in posterior sides of the mandible is difficult and often complication appears. Aim: to optimize the implant-prosthetic rehabilitation of these patients by using minimally invasive methods of implant placement. For rehabilitation of 214 patients with single tooth missing in posterior sides of the mandible, 237 prosthetic restorations from which 220 on single implant and 17 on two implants has been performed. The implants have been installed using conventional technique, flapless method (in one and two-steps) and early placement (6-8 weeks after tooth extraction). The following parameters have been evaluated: implants stability, periimplant bone loss and complication frequency. The comparative analysis of these indices demonstrated that the modality of implant placement doesn’t have a significant influence upon implants stability and bone loss

The rehabilitation of single tooth mandibular molar edentulism using two-stage dental implants

Catedra Chirurgie OMF şi Implantologie orală „Arsenie Guţan“ USMF „N. Testemiţanu“ Catedra Propedeutică Stomatologică şi Implantologie dentară USMF „N. Testemiţanu“ Catedra Stomatologie Ortopedică USMF „N. Testemiţanu“ „Dentalment“ SRL Spitalul nr. 5Reabilitarea pacienţilor cu edentaţii unidentare molare mandibulare este dificilă şi însoţită de diverse complicaţii. Scopul lucrării este de a optimiza reabilitarea implanto-protetică a acestei categorii de pacienţi prin implimentarea în practică a metodelor miniinvazive de instalare a implantelor dentare. Pentru reabilitarea a 214 pacienţi cu absenţa unui molar (uni sau bilaterală) la mandibulă au fost confecţionate 237 restaurări protetice dintre care 220 cu sprijin pe un implant şi 17 cu sprijin pe două implante. Implanturile au fost instalate după metodele: cu lambou, prin tehnica flapless într-un timp şi doi timpi chirurgicali, şi timpuriu (peste 6-8 săptămâni după extracţia dintelui). Au fost evaluate: stabilitatea implantelor, starea osului cortical periimplantar şi frecvenţa complicaţiilor. Studiul comparativ al indicilor a demonstrat că modalitatea de instalare a implantelor nu influienţează semnificativ stabilitatea şi resorbţia osului periimplantar. The rehabilitation of patients with single tooth missing in posterior sides of the mandible is difficult and often complication appears. Aim: to optimize the implant-prosthetic rehabilitation of these patients by using minimally invasive methods of implant placement. For rehabilitation of 214 patients with single tooth missing in posterior sides of the mandible, 237 prosthetic restorations from which 220 on single implant and 17 on two implants has been performed. The implants have been installed using conventional technique, flapless method (in one and two-steps) and early placement (6-8 weeks after tooth extraction). The following parameters have been evaluated: implants stability, periimplant bone loss and complication frequency. The comparative analysis of these indices demonstrated that the modality of implant placement doesn’t have a significant influence upon implants stability and bone loss

Microbial biofilms development on the surface of biomaterials in dental medicine

Introduction: Microbial biofims have an important role in oral pathology, in the etiology of periodontitis, but also in contamination of some materials frequently used in dentistry. Objective: This study aims to determine the ability of adhesion and formation of microbial biofilms on the surface of common materials in dental medicine: the impression materials compared to other materials of general interest in dentistry. Material and methods: From September 2010 to December 2010, the microbial dental plaque was taken from a number of 50 patients with conjunct ceramic dentures on nickel-chromium metal support. Materials selected for determining the ability of adhesion and formation of microbial biofilms were inert substrates, consisting of: impression materials (irreversible hydrocolloids, silicones, polyethers) compared with diacrylic composite resins, zinc phosphate cement and self-curing acrylic resinS. They were followed the following points: - isolation and identification of microbial strains isolated from dental plaque; - quantitative assessment of the degree of training and adherence of microbial biofilms on inert layer surface mentioned above. Results: There was a wide variety of aerobic and anaerobic strains. It was shown that materials tested differently influence the rate of microbial adhesion and biofilm development. Thus, microbial biofilms grown on these inert substrates, gradually increase after the first 24 hours, have a maximum development at 72 hours, then followed by a sharp decline phase, without disappearing completely. Conclusions: experiments showed that materials tested differently influence the rate of adherence and the development of microbial biofilms. The capacity of adhesion and formation of microbial biofilms proved to be a strain characteristi

Repartition of microbial biofilms on metallic structures in dental medicine

Introduction. Microbial biofilms have constituted an extremely serious problem for dental professionals. The presence of microbial biofilms has been evidenced by electron microscopy techniques on the surface of all materials used in dentistry, but the best were found on the surface of dental alloys. Aims. The constitution of microbial strains collection isolated from dental plaque. We studied the development of monospecific biofilms on dental alloys, in order to establish the influence of the physical and chemical structure of the alloys with the dynamics of experimental biofilms. Material and methods. The analysis of bacterial diversity of dental plaque samples was realised with: optic microscope, scanning electronic microscope, determination of bacterial loading, identification of the most important bacterial species and genus after cultivating and isolation in anaerob and aerob media and also automatic identification with VITEK systems. Were tested the patogenity and the virulent status and also the resistance of the cells with no adherence and of the cells included in artificial developed biofilms on dental alloys. Selected materials were: noble alloys (gold-palladium and gold-platinum alloys); seminoble alloys (silver-palladium alloys) and stainless alloys (cobalt-chromium, nikel-chromium alloys). Results. Dental plaque has a great structural complexity (there are, in the same time: spiral bacterium, fungus, some gram positive morphological type). Tested strains have a high capacity of adherence on dental alloys above mentioned, even after 24 hours of incubation. The bacteria are more resistant in adhered state comparing with initial condition. Conclusions. Repartition of the selected monospecifc microbial biofilms on dental alloys is determined by antiseptic potential of the alloys components: the development on stainless alloys of much more thicker biofilms than seminoble and noble alloys. Microbial biofilms appeared preferentially in surface irregularities, with on flat surfaces bacteria formed a continuous layer

Fiziologia şi metabolismul oaselor maxilare (vezi reabilitarea implanto-protetică)

Implanturile endoosoase reprezintă un tratament de elecţie, pentru rezolvarea unei largi varietăţi de probleme clinice. Deşi s-au făcut progrese privind studiul calitativ şi cantitativ al diferitelor sisteme implantare de pe piaţă, precum şi al aplicaţiilor clinice ale acestora, ele rămân totuşi limitate. Este esenţial pentru fiecare clinician să cunoască conceptele moderne, privind fiziologia, metabolismul şi biomecanica osoasă. Acest aspect este de cele mai multe ori singurul obiectiv, pentru a crea şi a implementa un plan de tratament inovativ