REABILITAÇÃO ESTÉTICA E FUNCIONAL ASSOCIANDO IMPLANTES DE ZIRCÔNIA DE DUAS PEÇAS MOLDADOS POR INJEÇÃO, SUBMETIDOS À CARGA IMEDIATA E FACETAS DE CERÂMICA

The present case describes the clinical and radiographic results of 24 months of two-piece injection-molded zirconia implants with immediate loading, as well as the aesthetic and functional planning performed in the anterior maxilla. Case presentation: A 36-year-old female patient was referred to a dental school due to dissatisfaction with the aesthetics of her smile and the absence of dental elements 22 and 24. Prosthetic rehabilitation of the anterior maxilla was performed, including implant-supported prosthesis with zirconia implants and ceramic veneers, using a digital workflow. The patient was followed up for 24 months, with good clinical and radiographic results. Conclusions: The aesthetic and functional rehabilitation performed in the patient's maxilla, with veneers and ceramic crowns, was successful and contributed to the patient's psychological and emotional well-being, in addition to restoring occlusal stability, through the orientation of the canine and the adequate protrusion of the anterior teeth.Objetivo: En el presente caso se describen los resultados clínicos y radiográficos de 24 meses de implantes de zirconio moldeados por inyección de dos piezas con carga inmediata, así como la planificación estética y funcional realizada en el maxilar anterior. Presentación del caso: Paciente femenina de 36 años de edad que fue remitida a una facultad de odontología por insatisfacción con la estética de su sonrisa y ausencia de elementos odontológicos 22 y 24. Se realizó rehabilitación protésica del maxilar anterior, incluyendo prótesis implantosoportada con implantes de zirconio y carillas cerámicas, mediante un flujo de trabajo digital. El paciente fue seguido durante 24 meses, con buenos resultados clínicos y radiográficos. Conclusiones: La rehabilitación estética y funcional realizada en el maxilar del paciente, con carillas y coronas cerámicas, fue exitosa y contribuyó al bienestar psicológico y emocional del paciente, además de restaurar la estabilidad oclusal, a través de la orientación del canino y la adecuada protrusión de los dientes anteriores.The present case describes the clinical and radiographic results of 24 months of two-piece injection-molded zirconia implants with immediate loading, as well as the aesthetic and functional planning performed in the anterior maxilla. Case presentation: A 36-year-old female patient was referred to a dental school due to dissatisfaction with the aesthetics of her smile and the absence of dental elements 22 and 24. Prosthetic rehabilitation of the anterior maxilla was performed, including implant-supported prosthesis with zirconia implants and ceramic veneers, using a digital workflow. The patient was followed up for 24 months, with good clinical and radiographic results. Conclusions: The aesthetic and functional rehabilitation performed in the patient's maxilla, with veneers and ceramic crowns, was successful and contributed to the patient's psychological and emotional well-being, in addition to restoring occlusal stability, through the orientation of the canine and the adequate protrusion of the anterior teeth.Objetivo: O presente caso descreve os resultados clínicos e radiográficos de 24 meses de implantes de zircônia moldados por injeção de duas peças com carga imediata, bem como o planejamento estético e funcional realizado na maxila anterior. Apresentação do caso: Uma paciente de 36 anos foi encaminhada a uma faculdade de odontologia devido à insatisfação com a estética de seu sorriso e à ausência dos elementos dentários 22 e 24. Foi realizada reabilitação protética da maxila anterior, incluindo prótese implanto-suportada com implantes de zircônia e facetas de cerâmica, usando um fluxo de trabalho digital. O paciente foi acompanhado por 24 meses, apresentando bons resultados clínicos e radiográficos. Conclusões: A reabilitação estética e funcional realizada na maxila do paciente, com facetas e coroas de cerâmica, foi bem-sucedida e contribuiu para o bem-estar psicológico e emocional do paciente, além de restaurar a estabilidade oclusal, por meio da orientação do canino e da protrusão adequada dos dentes anteriores

O USO DA CIRURGIA GUIADA NA REABILITAÇÃO UNITÁRIA EM REGIÃO ESTÉTICA

A reabilitação oral por meio dos implantes osseointegrados segundo Branemark foi tradicionalmente proposto com reabilitações múltiplas e implantes ferulizados. Após a criação de pilares unitários houve grande necessidade estética, valorizando novas formas e dimensões para os pilares protéticos e sistemas livres de metal. Este trabalho tem como objetivo o relato de caso clínico em área estética com implante tipo Cone Morse e coroa livre de metal. Paciente M. A. C., 47 anos, compareceu à clínica do Instituto latino Americano de Pesquisa e Ensino Odontológico relatando mobilidade do elemento 11, o qual foi extraído e aguardado o período de 5 meses para instalação de implante tipo Cone Morse e cicatrizador. Após osseointegração, foi instalado munhão com perfil de emergência segundo anatomia dos tecidos periimplantares e coroa provisória durante 45 dias para maturação dos tecidos. A reabilitação final foi realizada em coroa cerâmica livre de metal (In Ceran)

Um Acompanhamento de 12 anos de reabilitação com implantes curtos em região posterior de mandíbula: Relato de caso clínico

The use of short implants has been an alternative treatment option in cases where conventional implant placement is limited by available bone height. The aim of this article is to review the importance of long-term monitoring of short implant use and emphasize the need for maintaining keratinized soft tissue around the implant to enable proper hygiene and reduce bacterial biofilm accumulation. In this clinical case, we report on the rehabilitation of the posterior mandibular region using extra-short implants (≤ 6mm) and a free gingival graft in a 12-year follow-up. We can conclude from this clinical report that the use of short implants can be a viable long-term treatment alternative for mandibular bone atrophies, and the maintenance of peri-implant tissue health is crucial for the success of rehabilitation.La utilización de implantes cortos ha sido una alternativa de tratamiento en casos en los que la instalación de implantes convencionales se ve limitada por la altura ósea disponible. El objetivo de este artículo es revisar la importancia del seguimiento a largo plazo de la utilización de implantes cortos y enfatizar la necesidad de mantener el tejido blando queratinizado alrededor del implante para permitir una correcta higiene y reducir la acumulación de biofilm bacteriano. En este caso clínico, informamos sobre la rehabilitación de la región posterior de la mandíbula con implantes ultracortos (≦ 6 mm) y un injerto de encía libre en un seguimiento de 12 años. A través de este informe clínico, podemos concluir que la utilización de implantes cortos puede ser una alternativa viable a largo plazo para el tratamiento de la atrofia ósea mandibular, y que el mantenimiento de la salud de los tejidos periimplantarios es fundamental para el éxito de la rehabilitación.A utilização dos implantes curtos tem sido uma alternativa de tratamento em casos em que a instalação de implantes convencionais é limitada pela altura óssea disponível. O objetivo desse artigo é revisar a importância do acompanhamento a longo prazo da utilização dos implantes curtos e enfatizar a necessidade da manutenção do tecido mole ceratinizado ao redor do implante permitindo correta higienização e menor acúmulo de biofilme bacteriano. Nesse caso clínico, relatamos uma reabilitação da região posterior de mandíbula com implantes extracurtos (≦ 6mm) e enxerto gengival livre num acompanhamento de 12 anos. Podemos concluir através desse relato clínico que a utilização dos implantes curtos pode ser uma alternativa viável de tratamento das atrofias ósseas mandibulares à longo prazo, e que a manutenção da saúde dos tecidos peri-implantares é indispensável no sucesso da reabilitação

Soft tissue behavior around dental implants placed in fresh extraction sockets and immediately restored in esthetic area: a preliminary short-term evaluation

Abstract Objective To assess the behavior of the peri-implant soft margin after immediate implant placement with immediate function, by (1) direct clinical measurements of peri-implant soft margin height and thickness, (2) measurements of peri-implant soft margin height on photographs and (3) the perception of dental professionals regarding the results considering esthetic parameters. Material and method The study included 8 patients with central or lateral incisors indicated to be extracted. Direct measurements of peri-implant soft margin height and thickness were done immediately before extraction (T0) and 1 (T1), 4 (T2), 8 (T3) and 12 (T4) months after the flapless insertion of the implant. Photographs were taken at the same time intervals. A questionnaire was filled in by implantology professionals regarding their visual perception of color and peri-implant soft margin architecture and harmony in the implant region using the photographs obtained at T4. Result The clinical results showed significant changes to the height of the peri-implant soft margin, but the photographic results did not show significant changes for this measurement. The thickness of the attached gingiva was maintained during all the observation period. Of the professionals interviewed, 35.2% noticed an altered peri-implant soft margin color of the implant region, 39.8% noticed a change in the peri-implant soft margin architecture and 12.5% noticed a change in the peri-implant soft margin harmony. Conclusion The soft tissues around immediate implants changed during this period, but did not affect the aesthetic outcome and in the opinion of professionals, the aesthetic results were satisfactory for these cases

Osseointegration of a novel injection molded 2-piece ceramic dental implant : a study in minipigs

Objectives: This study compared the osseointegrative potential of a novel injection molded zirconia dental implant (Neodent Zi ceramic implant, test) and a commercially available titanium implant (Neodent Alvim implant, control) in terms of histomorphometrically derived bone-to-implant contact (BIC), first bone-to-implant contact (fBIC), and the ratio of bone area to total area (BATA) around the implant. Materials and methods: A total of 36 implants, 18 per individual test device, were implanted in a split-mouth arrangement in either side of the edentulous and fully healed mandible of 6 minipigs. Histomorphometric analysis of BIC, fBIC, and BATA were performed 8 weeks post implantation and subjected to statistical non-inferiority testing. Surface characteristics of both implant types were compared in terms of contact angle, surface topography, and elemental composition. Results: BIC, fBIC, and coronal BATA values of test and control implants were statistically comparable and non-inferior. BIC values of 77.8 ± 6.9% vs. 80.7 ± 6.9% (p = 0.095) were measured for the test and control groups. fBIC lingual values were − 238 ± 328 μm compared with − 414 ± 511 μm (p = 0.121) while buccal values were − 429 ± 648 μm and − 588 ± 550 μm (p = 0.230) for the test and control devices, respectively. BATA in the apical segment was significantly higher in the test group compared with the control group (67.2 ± 11.8% vs. 59.1 ± 11.4%) (p = 0.0103). Surface topographies of both implant types were comparable. Surface chemical analysis indicated the presence of carbonaceous adsorbates which correlated with a comparable and predominantly hydrophobic character of the implants. Conclusion: The results demonstrate that the investigated zirconia implants, when compared with a commercially available titanium implant, show equivalent and non-inferior bone integration, bone formation, and alveolar bone level maintenance. This qualifies the investigated zirconia implant as a potential candidate for clinical development. Clinical relevance: This study investigated the osseointegration of a novel zirconia 2-piece dental implant prototype intended for clinical development. With the aim of translating this prototype into clinical development preclinical models, procedures and materials within this study have been selected as close to clinical practice and human physiological conditions as possible

Retrospective evaluation of the survival rate of single tooth prostheses supported in external hexagonal implants: mean follow-up of 9 years

Abstract Introduction The use of osseointegrated dental implants for the rehabilitation of patients has revolutionized dentistry. Objective To retrospectively evaluate the survival rate and the frequency of complications with external hexagon platform supporting single crowns. Material and method Dental forms of 110 patients who received 143 implants at the Ilapeo College (2004-2015) were used. The variables were: age, gender, systemic involvement at the time of surgery, region, implant design, type of surface, fixation system, pillar type and prosthesis material. The outcome variables were the incidence of complications in the implant or prosthesis and time in use. The mean follow-up period was 9 years. Result 32.8% had some systemic disease. Ninety-six implants (67.1%) were installed in the maxilla and 47 (32.9%) in the mandible, 87 (60.8%) were in the posterior region and 56 (39.2%) in the anterior region, while 40 (28%) were placed in regions that had received bone reconstruction. The majority (97.2%) of the implants presented surface treatment, 42% had a cylindrical design and 58% were tapered. The majority of the prosthetic components (89.6%) used were UCLAs and most of the prostheses were fused-to-metal (79.7%). The rate of prosthetic complications was 19.58% and three implants had been lost (97.9% survival rate). There was no statistical difference between the variables analyzed for both the occurrence of prosthetic complications and for the loss of the implant. Conclusion Implants with external hexagon connection were an effective and predictable option to support crowns and had high survival rates

The behavior of implant-supported dentures and abutments using the cemented cylinder technique with different resinous cements

Objective: Evaluate the behavior of implant-supported dentures and their components, made by cemented cylinder technique, using threetypes of resin cements. Methods: Fifty three patients, of whom 26 were women and 27 men, aged between 25 and 82 years. Results: With partial (54.43%) and total (45.57%) implant-supported dentures, of the Cone Morse, external and internal hexagon types (Neodent®, Curitiba, Brazil), totaling 237 fixations, were analyzed. The resin cements used were Panavia® (21.94%), EnForce® (58.23%) and Rely X® (19.83%) and the components were used in accordance with the Laboratory Immediate Loading - Neodent® sequence. The period of time of denture use ranged between 1 and 5 years. The results reported that 5(2.1%) cylinders were loosened from metal structure (both belonging to Rely X group), 2(0.48%) implants were lost after the first year of use, 16(6.75%) denture retention screws wereloosened and 31(13.08%) abutment screws were unloosened.Conclusion: The reasons for these failures probably are: metal structure internal retention failure, occlusal pattern, cementation technique and loading conditions. The cemented cylinder technique was effective when used in partial and total implant-supported rehabilitations, keeping prosthetic components stable, despite the resin cement utilized. However, further clinical studies must be conducted

Guided osteotomy and implants placed with free hands for double full arch rehabilitation with immediate prosthetic loading

ABSTRACT Precise planning for dental implant placement requires appreciation of anatomical limitations and restorative purpose. Diagnosis can be made by complementary exams such as panoramic radiography and cone-beam computed tomography. The purpose of this study was to rehabilitate the upper and lower jaw of a patient with severe periodontal disease using a guided osteotomy and implants placed with free hands and Morse taper implants. The concept of guided surgery was used to prepare the alveolar bone to place eight implants, four implants in the upper jaw and four implants in the lower jaw, all have achieved a minimum torque of 60 Ncm. The modified suture technique was used to better stabilize the soft tissue around the mini conical abutments. The analogues were scanned by CAD/CAM for confection of the metallic structures of the bridges. On the third day, the upper and lower full arch prostheses were installed and simultaneous bilateral contacts were adjusted. After 12 months of patient follow-up, the implants and prostheses were in good condition of aesthetics and function, maintaining the success of the rehabilitation. Within the limitations of this clinical case, it can be concluded that the implants placed with free hands was facilitated by a previous guided osteotomy

Immediate prosthetic rehabilitation of lower molars with hybrid internal tapered implants: report of two cases

ABSTRACT The immediate rehabilitation of the posterior region of the mandible with dental implants, expands the set of possible actions for the dental surgeon, in the face of tooth loss. The purpose of this study is to describe two cases of single rehabilitation of mandibular molars with hybrid internal tapered implants indicated for immediate loading in post-extraction socket, associated with the maintenance of the prosthetic and peri-implant space. Implants with macrogeometry and surface treatment (Hydrophilic) were used to optimize primary stability, as well as the type of internal connection and prosthetic abutments that allows better accommodation and healing of adjacent tissues, and protection of the bone graft. Different methodologies of surgical guides did not influence the final result. The predictability of associating techniques and components can be observed in the 2-year follow-up. The initial planning combined with the new technologies enable to achieve stable and functional final restorations