Publications by authors named "Cesar Augusto Magalhães Benfatti"

19 Publications

  • Page 1 of 1

Evaluation of Removal Torque and Internal Surface Alterations in Frictional Morse Taper Connections After Mechanical Loading Associated or Not with Oral Biofilm.

Int J Oral Maxillofac Implants 2021 May-Jun;36(3):492-501

Purpose: To evaluate the abutment removal torque and the morphologic aspects of wear in frictional Morse taper connections after axial loading with or without biofilm immersion.

Materials And Methods: Thirty sets of Morse taper implants and prosthetic abutments were divided into six groups based on the number of mechanical loading cycles and immersion in biofilm derived from human saliva: without load, without biofilm; without load, with biofilm; 100,000 cycles of load, without biofilm; 100,000 cycles of load, with biofilm; 500,000 cycles of load, without biofilm; and 500,000 cycles of load, with biofilm. Mechanical loading was applied at a force of 80 ± 15 N with a frequency of 2 Hz for 100,000 or 500,000 cycles. After removal torque evaluation, the internal surface of the implants was evaluated by scanning electron microscopy and optical profilometer. The results were statistically analyzed at a significance level of P = .05.

Results: Overall, the removal torque increased for samples submitted to loading (100,000 cycles of load, without biofilm = 83.8 ± 15.8 Ncm; 100,000 cycles of load, with biofilm = 160.6 ± 16.2 Ncm; 500,000 cycles of load, without biofilm = 147.0 ± 29.3 Ncm; 500,000 cycles of load, with biofilm = 154.5 ± 14.0 Ncm) compared to samples without loading (without load, without biofilm = 23.0 ± 9.4 Ncm; without load, with biofilm = 27.2 ± 7.5 Ncm). The removal torque was not different between groups that received the same number of loading cycles and varied on biofilm exposure (P > .05). However, samples immersed in biofilm showed higher values of removal torque. Surface analysis revealed that the damage on the internal surface of implants was lower in samples not submitted to cyclic mechanical loading (P < .05) independently of immersion in biofilm medium.

Conclusion: Cyclic mechanical load on the frictional implant-abutment connection of Morse taper implants increased the removal torque of abutments. The findings of this research suggest that the presence of biofilm can potentially increase the removal torque in frictional Morse taper connections, although more studies are recommended to support this affirmation. Oral biofilm did not interfere with the presence of wear areas along the internal surface of Morse taper implants but increased the roughness values.
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http://dx.doi.org/10.11607/jomi.8483DOI Listing
June 2021

Challenging replacement of a maxillary canine with an implant-supported restoration: A surgical and prosthetic approach.

J Prosthet Dent 2021 Feb 25. Epub 2021 Feb 25.

Associate Professor, Post-graduate Program in Dentistry, Center for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

This clinical report describes the replacement of a traumatized maxillary canine that was extracted after unsuccessful orthodontic extrusion with an implant-supported restoration. Guided bone regeneration surgery was performed, followed by a second surgery with implant placement plus simultaneous bone and tissue regeneration. Esthetics and function were achieved with the placement of a veneered zirconia implant-supported restoration.
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http://dx.doi.org/10.1016/j.prosdent.2020.09.061DOI Listing
February 2021

Histologic and histomorphometric analysis of two biomaterials of xenogenous origin for maxillary sinus elevation: a clinical study.

Quintessence Int 2021 ;0(0)

Objective: This study analyzed two xenogenous biomaterials based on deproteinized bovine bone mineral applied for maxillary sinus elevation. Method and materials: Fourteen patients were submitted to maxillary sinus augmentation with one of the following biomaterials: Criteria Lumina Bone Porous (test group) or Geistlich Bio-Oss (control group), both of large granules (1 to 2 mm). After 6 months, trephine biopsies were collected at the time of implant placement: 27 samples (11 patients) in the test group; 7 samples (3 patients) in the control group. Biopsies were analyzed by descriptive histology and histomorphometry, in which the percentages of newly formed bone, residual biomaterial particles, and connective tissue were evaluated. Results: Histomorphometry showed means for test and control groups, respectively, of 32.41% ± 9.42% and 26.59% ± 4.88% for newly formed bone, 22.89% ± 4.58% and 25.00% ± 4.81% for residual biomaterial, and 44.70% ± 9.54% and 48.41% ± 3.36% for connective tissue. There were no differences between groups (P > .05). Conclusion: This study concluded that Criteria Lumina Bone Porous presented similar histologic and histomorphometric characteristics to Geistlich Bio-Oss 6 months after sinus elevation surgery, identifying the tested biomaterial as an interesting alternative for bone augmentation in the maxillary sinus.
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http://dx.doi.org/10.3290/j.qi.a45601DOI Listing
January 2021

Effect of dexamethasone as osteogenic supplementation in in vitro osteogenic differentiation of stem cells from human exfoliated deciduous teeth.

J Mater Sci Mater Med 2021 Jan 19;32(1). Epub 2021 Jan 19.

Center for Research on Dental Implants, Federal University of Santa Catarina, Delfino Conti Street, Florianópolis, 88040-900, Brazil.

In in vitro culture systems, dexamethasone (DEX) has been applied with ascorbic acid (ASC) and β-glycerophosphate (βGLY) as culture media supplementation to induce osteogenic differentiation of mesenchymal stem cells. However, there are some inconsistencies regarding the role of DEX as osteogenic media supplementation. Therefore, this study verified the influence of DEX culture media supplementation on the osteogenic differentiation, especially the capacity to mineralize the extracellular matrix of stem cells from human exfoliated deciduous teeth (SHED). Five groups were established: G1-SHED + Dulbecco's Modified Eagles' Medium (DMEM) + fetal bovine serum (FBS); G2-SHED + DMEM + FBS + DEX; G3-SHED + DMEM + FBS + ASC + βGLY; G4-SHED + DMEM + FBS + ASC + βGLY + DEX; G5-MC3T3-E1 + α Minimal Essential Medium (MEM) + FBS + ASC + βGLY. DNA content, alkaline phosphatase (ALP) activity, free calcium quantification in the extracellular medium, and extracellular matrix mineralization quantification through staining with von Kossa, alizarin red, and tetracycline were performed on days 7 and 21. Osteogenic media supplemented with ASC and β-GLY demonstrated similar effects on SHED in the presence or absence of DEX for DNA content (day 21) and capacity to mineralize the extracellular matrix according to alizarin red and tetracycline quantifications (day 21). In addition, the presence of DEX in the osteogenic medium promoted less ALP activity (day 7) and extracellular matrix mineralization according to the von Kossa assay (day 21), and more free calcium quantification at extracellular medium (day 21). In summary, the presence of DEX in the osteogenic media supplementation did not interfere with SHED commitment into mineral matrix depositor cells. We suggest that DEX may be omitted from culture media supplementation for SHED osteogenic differentiation in vitro studies.
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http://dx.doi.org/10.1007/s10856-020-06475-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815568PMC
January 2021

Effect of cyanoacrylate tissue adhesive in postoperative palatal pain management: a systematic review.

Clin Oral Investig 2021 Jun 17;25(6):3609-3622. Epub 2020 Nov 17.

Ceramic and Composite Materials Research Group, Federal University of Santa Catarina, Florianópolis, Brazil.

Objective: To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management.

Materials And Methods: Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed.

Results: Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment.

Conclusions: Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG.

Clinical Relevance: The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.
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http://dx.doi.org/10.1007/s00784-020-03683-wDOI Listing
June 2021

Strategies to Reduce Biofilm Formation in PEEK Materials Applied to Implant Dentistry-A Comprehensive Review.

Antibiotics (Basel) 2020 Sep 16;9(9). Epub 2020 Sep 16.

Integrated Laboratories Technologies (InteLab), Department Chemical Engineering (EQA), Federal University of Santa Catarina (UFSC), Florianópolis SC 88040-970, Brazil.

Polyether-ether-ketone (PEEK) has emerged in Implant Dentistry with a series of short-time applications and as a promising material to substitute definitive dental implants. Several strategies have been investigated to diminish biofilm formation on the PEEK surface aiming to decrease the possibility of related infections. Therefore, a comprehensive review was carried out in order to compare PEEK with materials widely used nowadays in Implant Dentistry, such as titanium and zirconia, placing emphasis on studies investigating its ability to grant or prevent biofilm formation. Most studies failed to reveal significant antimicrobial activity in pure PEEK, while several studies described new strategies to reduce biofilm formation and bacterial colonization on this material. Those include the PEEK sulfonation process, incorporation of therapeutic and bioactive agents in PEEK matrix or on PEEK surface, PEEK coatings and incorporation of reinforcement agents, in order to produce nanocomposites or blends. The two most analyzed surface properties were contact angle and roughness, while the most studied bacteria were and . Despite PEEK's susceptibility to biofilm formation, a great number of strategies discussed in this study were able to improve its antibiofilm and antimicrobial properties.
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http://dx.doi.org/10.3390/antibiotics9090609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559429PMC
September 2020

Biomarkers in biological fluids in adults with periodontitis and/or obesity: A meta-analysis.

J Indian Soc Periodontol 2020 May-Jun;24(3):191-215. Epub 2020 May 4.

Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil.

Obesity and periodontal diseases have been investigated to be interconnected, but the molecular mechanism underlying this association is still not clear. The aim of this systematic review is to assess the association of serum, salivary and gingival crevicular fluid (GCF) inflammatory markers (IMs), obesity, and periodontitis. Studies that evaluated IM of adults according to obesity status (O) and periodontitis status (P) (O+P+; O-P+; O+P-) were screened on several electronic databases and grey literature up until February 2019. Risk of bias assessment and level of evidence were evaluated through Fowkes and Fulton scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were grouped according to the biological matrix studied (serum/GCF) and groups (O+P+ vs. O-P+/O+P+ vs. O+P-). Out of the 832 studies screened, 21 were considered in qualitative synthesis and 15 in quantitative synthesis (meta-analysis). Although included studies showed mostly "no" or "minor" problems during the quality assessment, GRADE assessment indicated very low to moderate level of evidence based on the question answered. O+P+ adults exhibited significantly higher serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), leptin, and tumor necrosis factor-α (TNF-alpha) and higher resistin GCF levels than O-P+. O+P+ adults showed significantly higher serum levels of IL-6 and leptin and lower adiponectin serum levels than O+P-. Only qualitative information could be obtained of the IM vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and interferon-γ (IFN-γ). Obesity and periodontitis, together or separately, are associated with altered serum and GCF levels of CRP, IL-6, leptin, TNF-alpha, adiponectin, and resistin. It was not possible to evaluate the association between obesity and periodontitis at salivary levels. The role of recently investigated biomarkers as vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and IFN-γ, which can be key points underlying the association between obesity and periodontitis, remains to be further investigated.
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http://dx.doi.org/10.4103/jisp.jisp_512_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307467PMC
May 2020

Effects of Short-Chain Fatty Acids on Human Oral Epithelial Cells and the Potential Impact on Periodontal Disease: A Systematic Review of In Vitro Studies.

Int J Mol Sci 2020 Jul 11;21(14). Epub 2020 Jul 11.

Department of Oral Biology, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.

Short-chain fatty acids (SCFA), bacterial metabolites released from dental biofilm, are supposed to target the oral epithelium. There is, however, no consensus on how SCFA affect the oral epithelial cells. The objective of the present study was to systematically review the available in vitro evidence of the impact of SCFA on human oral epithelial cells in the context of periodontal disease. A comprehensive electronic search using five databases along with a grey literature search was performed. In vitro studies that evaluated the effects of SCFA on human oral epithelial cells were eligible for inclusion. Risk of bias was assessed by the University of Bristol's tool for assessing risk of bias in cell culture studies. Certainty in cumulative evidence was evaluated using GRADE criteria (grading of recommendations assessment, development, and evaluation). Of 3591 records identified, 10 were eligible for inclusion. A meta-analysis was not possible due to the heterogeneity between the studies. The risk of bias across the studies was considered "serious" due to the presence of methodological biases. Despite these limitations, this review showed that SCFA negatively affect the viability of oral epithelial cells by activating a series of cellular events that includes apoptosis, autophagy, and pyroptosis. SCFA impair the integrity and presumably the transmigration of leucocytes through the epithelial layer by changing junctional and adhesion protein expression, respectively. SCFA also affect the expression of chemokines and cytokines in oral epithelial cells. Future research needs to identify the underlying signaling cascades and to translate the in vitro findings into preclinical models.
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http://dx.doi.org/10.3390/ijms21144895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402343PMC
July 2020

Butyrate Decreases ICAM-1 Expression in Human Oral Squamous Cell Carcinoma Cells.

Int J Mol Sci 2020 Feb 29;21(5). Epub 2020 Feb 29.

Department of Oral Biology, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.

Short-chain fatty acids (SCFA) are bacterial metabolites that can be found in periodontal pockets. The expression of adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) within the epithelium pocket is considered to be a key event for the selective transmigration of leucocytes towards the gingival sulcus. However, the impact of SCFA on ICAM-1 expression by oral epithelial cells remains unclear. We therefore exposed the oral squamous carcinoma cell line HSC-2, primary oral epithelial cells and human gingival fibroblasts to SCFA, namely acetate, propionate and butyrate, and stimulated with known inducers of ICAM-1 such as interleukin-1-beta (IL1β) and tumor necrosis factor-alfa (TNFα). We report here that butyrate but not acetate or propionate significantly suppressed the cytokine-induced ICAM-1 expression in HSC-2 epithelial cells and primary epithelial cells. The G-protein coupled receptor-43 (GPR43/ FFAR2) agonist but not the histone deacetylase inhibitor, trichostatin A, mimicked the butyrate effects. Butyrate also attenuated the nuclear translocation of p65 into the nucleus on HSC-2 cells. The decrease of ICAM-1 was independent of Nrf2/HO-1 signaling and phosphorylation of JNK and p38. Nevertheless, butyrate could not reverse an ongoing cytokine-induced ICAM-1 expression in HSC-2 cells. Overall, these observations suggest that butyrate can attenuate cytokine-induced ICAM-1 expression in cells with epithelial origin.
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http://dx.doi.org/10.3390/ijms21051679DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084181PMC
February 2020

Acellular dermal matrix allograft versus free gingival graft: a histological evaluation and split-mouth randomized clinical trial.

Clin Oral Investig 2019 Feb 30;23(2):539-550. Epub 2018 Apr 30.

Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Al. Octávio Pinheiro Brisolla 9-75, Bauru, SP, 17012-901, Brazil.

Objectives: This split-mouth controlled randomized clinical trial evaluated clinical and histological results of acellular dermal matrix allograft (ADM) compared to autogenous free gingival graft (FGG) for keratinized tissue augmentation.

Material And Methods: Twenty-five patients with the absence or deficiency of keratinized tissue (50 sites) were treated with FGG (control group) and ADM (test group). Clinical parameters included keratinized tissue width (KTW) (primary outcome), soft tissue thickness (TT), recession depth (RD), probing depth (PD), and clinical attachment level (CAL). Esthetic perception was evaluated by patients and by a calibrated periodontist using visual analog scale (VAS). Histological analysis included biopsies of five different patients from both test and control sites for each evaluation period (n = 25). The analysis included percentage of connective tissue components, epithelial luminal to basal surface ratio, tissue maturation, and presence of elastic fibers. Data were evaluated by ANOVA complemented by Tukey's tests (p < 0.05).

Results: After 6 months, PD and CAL demonstrated no differences between groups. ADM presented higher RD compared to FGG in all periods. Mean tissue shrinkage for control and test groups was 12.41 versus 55.7%. TT was inferior for ADM group compared to FGG. Esthetics perception by professional evaluation showed superior results for ADM. Histomorphometric analysis demonstrated higher percentage of cellularity, blood vessels, and epithelial luminal to basal surface ratio for FGG group. ADM group presented higher percentage of collagen fibers and inflammatory infiltrate.

Conclusions: Both treatments resulted in improvement of clinical parameters, except for RD. ADM group presented more tissue shrinkage and delayed healing, confirmed histologically, but superior professional esthetic perception.

Clinical Relevance: This study added important clinical and histological data to contribute in the decision-making process between indication of FGG or ADM.
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http://dx.doi.org/10.1007/s00784-018-2470-6DOI Listing
February 2019

Effect of γ-lactones and γ-lactams compounds on Streptococcus mutans biofilms.

J Appl Oral Sci 2018 22;26:e20170065. Epub 2018 Feb 22.

Centro de Ensino e Pesquisa em Implantes Dentários, Departamento de Odontologia, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brasil.

Considering oral diseases, antibiofilm compounds can decrease the accumulation of pathogenic species such as Streptococcus mutans at micro-areas of teeth, dental restorations or implant-supported prostheses.

Objective: To assess the effect of thirteen different novel lactam-based compounds on the inhibition of S. mutans biofilm formation.

Material And Methods: We synthesized compounds based on γ-lactones analogues from rubrolides by a mucochloric acid process and converted them into their corresponding γ-hydroxy-γ-lactams by a reaction with isobutylamine and propylamine. Compounds concentrations ranging from 0.17 up to 87.5 μg mL-1 were tested against S. mutans. We diluted the exponential cultures in TSB and incubated them (37°C) in the presence of different γ-lactones or γ-lactams dilutions. Afterwards, we measured the planktonic growth by optical density at 630 nm and therefore assessed the biofilm density by the crystal violet staining method.

Results: Twelve compounds were active against biofilm formation, showing no effect on bacterial viability. Only one compound was inactive against both planktonic and biofilm growth. The highest biofilm inhibition (inhibition rate above 60%) was obtained for two compounds while three other compounds revealed an inhibition rate above 40%.

Conclusions: Twelve of the thirteen compounds revealed effective inhibition of S. mutans biofilm formation, with eight of them showing a specific antibiofilm effect.
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http://dx.doi.org/10.1590/1678-7757-2017-0065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831975PMC
April 2018

Mechanical Complications Related to the Retention Screws of Prefabricated Metal Abutments With Different Angulations: A Retrospective Study With 916 Implants.

Implant Dent 2018 04;27(2):209-212

Adjunct Professor, Discipline of Periodontology, Department of Periodontology, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Objectives: The present retrospective study assessed the clinical performance of abutment screws from prefabricated metal abutments and compared technical complication rates between straight and angled abutments.

Materials And Methods: Dental charts were selected for patients with dental implant rehabilitations delivered between 1998 and 2012. Abutment angulation, prosthetic screw type, and presence of complications that occurred during the selected time period were collected. Technical complications registered included abutment screw loosening and/or fractures detected during clinical and radiographic examinations. The chi-square test was used for statistical analysis.

Results: Abutment angulations were divided into 2 groups: G1) prefabricated straight abutments and G2) prefabricated angled conical mini UCLA-type abutments. A total of 916 implants (799 straight and 117 angled conical mini UCLA-type abutments) were evaluated. G1 showed 91.1% had absence of failures, which were clinically defined as any screw loosening or fracture; and 8.9% reported some type of technical complication. G2 showed 92.3% and 7.7%, with and without technical complications, respectively.

Conclusions: No significant differences were observed between abutment angulation and technical complications.
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http://dx.doi.org/10.1097/ID.0000000000000742DOI Listing
April 2018

Modified Double-Papillae Flap Technique With Subepithelial Connective Tissue Graft for Root Coverage in the Esthetic Zone: Case Report.

Compend Contin Educ Dent 2017 Mar;38(3):e4-e8

Associate Professor, School of Dentistry-Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Gingival recession can compromise the esthetic appearance, leading to functional problems, hypersensitivity, and root caries. Several techniques have been implicated for root coverage, which includes pedicle grafts, free gingival grafts, connective tissue grafts, and guided-tissue regeneration. The double-papillae flap associated with subepithelial connective tissue is a predictable technique to cover isolated areas with insufficient attached gingiva apical to a recession. This case report demonstrates a surgical alternative to the technique using a sling periosteal suture to stabilize the connective tissue and pedicle flap during the initial phase of healing, increasing the potential of this periodontal procedure for gingival recession coverage.
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March 2017

A Step-by-Step Management of Extraction Sites in Areas of Maxillary Sinus Pneumatization: A Literature Review and a Case Presentation of a New Surgical Technique.

J Int Acad Periodontol 2016 Oct 7;18:102-108. Epub 2016 Oct 7.

School of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.

Introduction: The rehabilitation of the posterior maxilla with implant-supported prosthesis is often complicated by pneumatization of the maxillary sinus. Bone grafting is commonly required in these cases. Over the years, a number of techniques have been developed for this type of reconstruction.

Aim: Present and discuss the possibility of alveolar bone regeneration for subsequent placement of oral implants using Fugazzotto's technique in combination with particulate autograft harvested from the mandibular ramus and a connective tissue pedicle flap to cover the graft.

Methods: A case of a 37-year-old woman with a molar perforated during endodontic treatment and indicated for extraction and implant placement is reported.

Result And Conclusion: The clinical case showed the possibility of grafting of extraction sites combined with atraumatic elevation of the maxillary sinus floor can be achieved using non-conventional techniques such as Fugazzotto's technique associated with alveolar bone regeneration.
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October 2016

Nasal Floor Elevation with Simultaneous Implant Placement: A Case Report.

J Int Acad Periodontol 2016 Jul 18;18(3):94-100. Epub 2016 Jul 18.

Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Objective: The aim of this paper is to report a clinical case of nasal floor elevation and simultaneous dental implant placement.

Case Report: The patient presented to the clinic of the Center of Education and Research on Dental Implants (CEPID) in the Department of Dentistry at the Federal University of Santa Catarina (UFSC, Florianópolis, Brazil), for follow-up for peri-implantitis control. After clinical and radiographic assessment, two of three implants on anterior maxilla were removed. A cone beam computed tomography (CBCT) scan revealed no bone height for conventional length implant insertion. Nasal floor elevation and simultaneous implant placement were performed, with nasal cavity augmentation carried out with bovine bone graft. After six months, the implants were reopened successfully.

Conclusions: Nasal floor elevation proved to be a reliable method for dental implants insertion on the anterior atrophic maxilla when bone height reconstruction was necessary. The use of bovine bone substitutes for nasal cavity augmentation showed predictable results as well as simultaneous implant placement.
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July 2016

Does the number of implants have any relation with peri-implant disease?

J Appl Oral Sci 2014 Sep-Oct;22(5):403-8

Department of Periodontics, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Objective: The aim of this study was to evaluate the relationship between the number of pillar implants of implant-supported fixed prostheses and the prevalence of periimplant disease.

Material And Methods: Clinical and radiographic data were obtained for the evaluation. The sample consisted of 32 patients with implant-supported fixed prostheses in function for at least one year. A total of 161 implants were evaluated. Two groups were formed according to the number of implants: G1) ≤5 implants and G2) >5 implants. Data collection included modified plaque index (MPi), bleeding on probing (BOP), probing depth (PD), width of keratinized mucosa (KM) and radiographic bone loss (BL). Clinical and radiographic data were grouped for each implant in order to conduct the diagnosis of mucositis or peri-implantitis.

Results: Clinical parameters were compared between groups using Student's t test for numeric variables (KM, PD and BL) and Mann-Whitney test for categorical variables (MPi and BOP). KM and BL showed statistically significant differences between both groups (p<0.001). Implants from G1 - 19 (20.43%)--compared with G2 - 26 (38.24%)--showed statistically significant differences regarding the prevalence of peri-implantitis (p=0.0210).

Conclusion: It seems that more than 5 implants in total fixed rehabilitations increase bone loss and consequently the prevalence of implants with periimplantitis. Notwithstanding, the number of implants does not have any influence on the prevalence of mucositis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245752PMC
http://dx.doi.org/10.1590/1678-775720140055DOI Listing
August 2015

Creeping attachment involving dental implants: two case reports with a two-year follow-up from an ongoing clinical study.

Case Rep Dent 2014 3;2014:756908. Epub 2014 Sep 3.

Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil.

Introduction. This paper describes case reports where coronal growth of soft tissue on implant threads was observed after surgery for soft tissue graft. This phenomenon is known as "creeping attachment." Methods. Two patients were submitted to gingival graft procedure including subepithelial connective tissue graft and masticatory mucosal graft. A two-year follow-up appointment was performed. Results. After a two-year follow-up gingival growth over titanium surfaces characterizing the "creeping attachment" phenomenon was observed. This gingival growth happened over abutment and threads surfaces. Conclusion. The creeping attachment phenomenon is possible over titanium surfaces and has not yet been reported in the relevant literature over this kind of structure.
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http://dx.doi.org/10.1155/2014/756908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168148PMC
October 2014

Comparative histological and histomorphometrical evaluation of marginal bone resorption around external hexagon and Morse cone implants: an experimental study in dogs.

Implant Dent 2014 Jun;23(3):270-6

*Research Fellow, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. †Private Practice, São Paulo, Brazil. ‡Professor, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil. §Professor of Oral Pathology, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. ‖Research Fellow, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy. ¶Researcher, Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.

Purpose: Aim of this study was to evaluate the histological and histomorphometrical differences at the marginal bone level with the use of 2 different implant-abutment assembly designs (the traditional External Hexagon and the Morse Cone tapered connections).

Methods: Nine Morse Cone and 9 External Hexagon implants were inserted in 6 mongrel dogs. The Morse Cone implants were installed 2 mm below the crestal bone level, whereas the External Hexagon flush. The implants were retrieved after 2 months. Mean distance between the original level of coronal bone to the top of the implant and the mean distance between the top of the implant and the first bone-to-implant contact (fBIC) were recorded.

Results: No significant differences were found when the mean distance between the original level of coronal bone to the top of the implant was evaluated; however, there were statistically significant differences in the mean distances between the top of the implants and fBIC, suggesting a smaller amount of bone loss or remodeling in the Morse Cone compared to the External Hexagon group.

Conclusion: Subcrestal placement had a positive impact on crestal bone remodeling in Morse Cone implants.
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http://dx.doi.org/10.1097/ID.0000000000000089DOI Listing
June 2014

Viability analysis of subepithelial connective tissue grafts subjected to a mechanical expansion process: a histologic study in dogs.

Int J Periodontics Restorative Dent 2011 Sep-Oct;31(5):e37-44

Department of Periodontics, Dentistry College of Federal University of Santa Catarina, Florianópolis, SC, Brazil.

The aim of this study was to histologically evaluate the viability of mechanically expanded subepithelial connective tissue grafts. Sixteen samples of palatal connective tissue were collected from eight beagle dogs. Half of the samples were subjected to the expansion procedure and used as subepithelial grafts in the canine region, and the samples not subjected to expansion were grafted at the contralateral side. After 60 days, biopsies were collected and examined histologically by light and confocal laser microscopy and immunohistochemically with anti-CD31 antibody for endothelial cells. There were no significant differences between the control and test groups. It was concluded that this new method to expand the area of connective tissue grafts was not only viable biologically, but also decreased surgical risks without increasing processing time.
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February 2012