Publications by authors named "Salomão Rocha"

9 Publications

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Clinical and radiographic performance of self-locking conical connection implants in the posterior mandible: Five-year results of a two-centre prospective study.

Clin Oral Implants Res 2021 Jun 11. Epub 2021 Jun 11.

Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University Medical Centre, Mainz, Germany.

Objective: This prospective study aims to assess the 5-year clinical performance of implants with internal conical connection and platform-switched abutments in the posterior mandible.

Material And Methods: Healthy adults missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent implants. After a transmucosal healing period single crown restorations were cemented on platform-switched abutments. Changes in marginal bone levels were investigated in standardized periapical radiographs from surgery and loading (baseline) to 60-months post-loading.

Results: Twenty-four patients received 52 implants. Bone remodelling took place between surgery and loading (mean:-0.5, SD:±0.4 mm). From loading to 60 months, there was a mean bone change of 0.27 (SD:±0.47 mm) which stabilized 24 months after prosthesis delivery (mean:0.2, SD:±0.46 mm). 71.7% of all implants presented bone preservation at 60 months irrespective of the initial insertion depth. Two implants were lost after 5 years and the success rate was 95.1%. Patient enquiry revealed high satisfaction.

Conclusion: Internal conical connection implants with platform-switched abutments presented a high success rate and preservation of marginal bone levels at the implant shoulder after 5 years of loading.
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http://dx.doi.org/10.1111/clr.13794DOI Listing
June 2021

Patient Safety in Dental Practice: Lessons to Learn About the Risks and Limits of Professional Liability.

Int Dent J 2021 Feb 24. Epub 2021 Feb 24.

Faculty of Medicine, University of Coimbra, Portugal.

Introduction: Health professionals should work with the notion of risk involved in the health care process. Dental practice risk is of particular interest because it encompasses both aesthetic and functional components. Focusing on guidelines suggested by the World Health Organization and objectives on patient safety, this study has 2 objectives: to present Portuguese medicolegal data on corporal damage evaluation related to iatrogenic sequelae during dental practice and to present updated evidence on patient safety.

Materials And Methods: A retrospective study was performed by analysing data from the database of the Laboratory of Forensic Dentistry of the Faculty of Medicine, University of Coimbra, Portugal, from 2013 to 2018.

Results: One hundred seven medicolegal files were selected according to the inclusion and exclusion criteria. Iatrogenic sequelae (73.8%, 79 out of 107) were categorised as risks (60 out of 79) and malpractice (19 out of 79). The risk was associated mostly with mandibular dysfunction and orthodontic treatment (62.2%). Malpractice was mostly associated with neurological deficit and implant rehabilitation (47.4%).

Discussion And Conclusion: Greater attention to these data by professionals was emphasised, especially when considering patient safety and health care quality. This article presents the Portuguese data on professional liability in the field of dental practice, categorising iatrogenic sequelae into risks and malpractice, as well as the oral rehabilitation procedure and timeline.
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http://dx.doi.org/10.1016/j.identj.2020.12.014DOI Listing
February 2021

UC-USP collaborative exercise on photobiomodulation therapy in neurological orofacial disturbances.

J Clin Exp Dent 2020 Jul 1;12(7):e650-e655. Epub 2020 Jul 1.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Background: Neurosensory peripheral disorders are one of the most common risks associated with iatrogenic and/or post-traumatic injuries. It is often related to disability. Photobiomodulation therapy (PBMT) is a nonsurgical and safe procedure which can accelerate and improve the regeneration of injured biological tissue. This study aims to analyze the impact of PBMT, in the quality of life and impairment of individuals with orofacial neurological peripheral disturbance.

Material And Methods: A retrospective analysis in the database of the dental traumatology clinic of the Hospital Centre of the University of Coimbra/Faculty of Medicine of the University of Coimbra was performed.5 out of 50 individuals were selected, according to the selection criteria. The neurosensory activity was assessed by a pinprick nociceptive test and the EQ-5D-5L self-report questionnaire was used to analyse the quality of life. The study was performed in two phases:1) inactive laser or placebo phase, for one month and 2) active laser or treatment phase. A diode low-level laser device (SIROLaserBlue;Sirona,Germany) was used, according to our protocol. A collaborative protocol in the PBMT influence in individuals with neurosensory peripheral disturbances was studied.

Results: There was no improvement in the neurosensory activity nor in the quality of life, in the placebo phase. After the treatment phase, the EQ-5D-5L final results reported no problems in all of the five dimensions, except for anxiety/depression in individuals with long-standing neurosensory peripheral disturbances. The EQ-VAS scores increased in all the individuals.

Conclusions: Our results supported the improvement of quality of life and impairment reduction in the individuals submitted to PBMT. Low-level light therapy, peripheral nerve injuries, sensation disorders, quality of life, forensic medicine.
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http://dx.doi.org/10.4317/jced.56839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462374PMC
July 2020

Peri-implant marginal bone loss reduction with platform-switching components: 5-Year post-loading results of an equivalence randomized clinical trial.

J Clin Periodontol 2019 06;46(6):678-687

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Aim: To compare the clinical performance and marginal bone levels of implants restored with platform-switching (PS) or platform-matching (PM) abutments.

Materials And Methods: Adult patients missing two or more adjacent teeth in the posterior mandible received 2-4 CAMLOG SCREW-LINE implants and were randomly allocated to the PM or PS group, receiving the corresponding prosthetic components from surgery onwards. Implants were conventionally loaded with single cemented crowns. Patients were followed annually for 5 years. Outcome measures were marginal bone level changes, implant survival, performance of the prosthetic components and clinical parameters plaque index, sulcus bleeding index and pocket probing depth.

Results: Thirty-three patients received 72 implants in the PM group, and thirty-five patients received 74 implants in the PS group. Sixty patients attended the final appointment, 31 had received PS components and 29 had received PM components with 65 and 63 implants, respectively. Global survival rate was 96.6% with no differences between groups (p = 0.647). After 5 years of functional loading, PS restored implants presented 0.23mm (95% CI: [0.03, 0.43], p = 0.025) lower marginal bone level changes. The two groups were declared non-equivalent.

Conclusion: Patients requiring implant supported restorations in healed bounded or free end edentulous gaps of the mandible benefit from the use of PS components in terms of peri-implant marginal bone level maintenance, though it may not be clinically noticeable.
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http://dx.doi.org/10.1111/jcpe.13119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594132PMC
June 2019

Effect of platform switching on crestal bone levels around implants in the posterior mandible: 3 years results from a multicentre randomized clinical trial.

J Clin Periodontol 2016 Apr 30;43(4):374-82. Epub 2016 Mar 30.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Objective: Evaluation of differences in the clinical performance and crestal bone levels between implants restored with single crowns with platform-matched or platform-switched abutments after 3 years.

Material And Methods: The study enrolled adult patients missing two or more adjacent teeth in the posterior mandible with natural teeth mesial to the implant site. Randomization followed open-flap implant insertion and the corresponding matching or switching healing abutments placed at surgery. Conventional loading was made with cemented crowns. Clinical follow-up took place annually after loading up to 3 years. Bone level changes were measured in standardized radiographs as the variation in crestal bone from one evaluation to the next.

Results: Sixty-three patients with a total of 135 implants (66 platform matching, 69 platform switching) were analysed. From surgery to 36 months, mean bone loss was 0.28 ± 0.56 mm for the platform-switching group and 0.68 ± 0.64 mm for the platform-matching group. A statistically significant difference was found between groups (p = 0.002) with an estimate of 0.39 mm (0.15-0.64, 95% CI) in favour of platform switching.

Conclusions: After 3 years, platform-switching restorations showed a significant effect in the preservation of marginal bone levels compared to platform-matching restorations.
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http://dx.doi.org/10.1111/jcpe.12522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071662PMC
April 2016

Radiographic evaluation of conical tapered platform-switched implants in the posterior mandible: 1-year results of a two-center prospective study.

Clin Oral Implants Res 2016 Jun 21;27(6):686-93. Epub 2015 Jun 21.

Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University, Medical Centre, Mainz, Germany.

Objective: Long-term success of dental implants depends on healthy peri-implant soft tissues and adequate bone levels. This prospective study aims to assess bone level changes around implants with internal conical connection and platform-switching abutments in the posterior mandible.

Material And Methods: Adult patients missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent internal conical connection implants. After a minimum transmucosal healing period of 8 weeks, single crown restorations were cemented over platform-switching abutments. Changes in marginal bone levels were measured in standardized periapical radiographs from surgery and loading (baseline) to 12 months post-loading.

Results: Twenty-four patients received 52 implants. Bone remodeling took place between surgery and loading (-0.53 ± 0.40 mm). From loading to 12 months, there was a mean bone gain of 0.12 ± 0.42 mm which occurred mainly in the first 6 months after prosthesis delivery (0.11 ± 0.36 mm) and stabilized afterward. A total of 71.7% of all implants presented bone preservation or gain. No implant was lost at 1 year and the success rate was 100%. Patient inquiry revealed high satisfaction.

Conclusion: Internal conical connection implants with platform-switching abutments presented high success rate and enhancement or preservation of marginal bone levels after 1 year of loading.
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http://dx.doi.org/10.1111/clr.12644DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054904PMC
June 2016

Effect of intentional abutment disconnection on the micro-movements of the implant-abutment assembly: a 3D digital image correlation analysis.

Clin Oral Implants Res 2017 Jan 6;28(1):9-16. Epub 2015 May 6.

Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Background: Implant-abutment assembly stability is critical for the success of implant-supported rehabilitation. The intentional removal of the prosthetic components may hamper the achievement of the essential stability due to preload reduction in the screw joint and implant-screw mating surface changes.

Objective: To evaluate the effect of intentional abutment disconnection and reconnection in the stability of internal locking hex implants and corresponding abutments using the method of 3D digital image correlation.

Material And Methods: Ten conical shape and internal hexagon connection implants were embedded in acrylic resin and assembled to prosthetic abutments with 30 Ncm torque and assigned to two groups: group 1 - tested for static load-bearing capacity at 30° off-axis for two times and group 2 - underwent intentional disconnection and reconnection between tests. Micro-movements were captured with two high-speed photographic cameras and analyzed with video correlation system in three spacial axes U, V and W. Screw abutment and internal implant thread morphology was observed with a field-emission scanning electron microscopy.

Results: After the intentional disconnection of the abutment, group 2 showed generally higher maximum displacements for U and V directions. Under 50N load, mean difference was 24.7 μm (P = 0.008) for U direction and -7.7 μm (P = 0.008) for V direction. No significant differences were found for maximum and minimum displacements in the W direction. Mean displacement of the speckle surface presented was statistically different in the two groups (P = 0.016). SEM revealed non-homogenous screw surfaces with scoring on group 2 plus striations and debris in the implant threads.

Conclusion: Micro-movements were higher for the group submitted to intentional disconnection and reconnection of the abutment, particularly under average bite forces.
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http://dx.doi.org/10.1111/clr.12607DOI Listing
January 2017

Platform switch versus platform match in the posterior mandible – 1-year results of a multicentre randomized clinical trial.

J Clin Periodontol 2014 May;41(5):521-9

Objective: The purpose of this ongoing randomized study was to assess differences in bone level changes and success rates using implants supporting single crowns in the posterior mandible either with platform matched or platform switched abutments.

Material And Methods: Patients aged 18 and above, missing at least two teeth in the posterior mandible and with a natural tooth mesial to the most proximal implant site were enrolled. Randomization followed implant placement. Definitive restorations were placed after a minimum transgingival healing period of 8 weeks. Changes in crestal bone level from surgery and loading (baseline) to 12-month post-loading were radiographically measured. Implant survival and success were determined.

Results: Sixty-eight patients received 74 implants in the platform switching group and 72 in the other one. The difference of mean marginal bone level change from surgery to 12 months was significant between groups (p < 0.004). Radiographical mean bone gain or no bone loss from loading was noted for 67.1% of the platform switching and 49.2% of the platform matching implants. Implant success rates were 97.3% and 100%, respectively.

Conclusions: Within the same implant system the platform switching concept showed a positive effect on marginal bone levels when compared with restorations with platform matching.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282357PMC
http://dx.doi.org/10.1111/jcpe.12244DOI Listing
May 2014

A method for segmentation of dental implants and crestal bone.

Int J Comput Assist Radiol Surg 2013 Sep 2;8(5):711-21. Epub 2012 Dec 2.

LOME-Laboratory of Optics and Experimental Mechanics, INEGI-Institute of Mechanical Engineering and Industrial Management, Faculty of Engineering, University of Porto, Porto, Portugal,

Purpose: Medical imaging and in particular digital radiographic images offer a great deal of information to dentists in the clinical diagnosis and treatment processes on a daily basis. This paper presents a new method aimed to produce an accurate segmentation of dental implants and the crestal bone line in radiographic images. With this, it is possible computing several measures to biomechanical and clinical evaluation of dental implants positioning and evolution.

Methods: The proposed segmentation method includes two major steps: (1) the preprocessing that combine denoising filters, morphological operations and histogram threshold techniques and (2) the final segmentation involving made-to-measure adjusted and trained active shape models for detecting the precise location of the intended structures.

Results: Resulting measurements were compared to manual measurements made by experts on representative radiographs from patients. The calculated intraclass correlation coefficient was 0.75 and showed good reliability of the method, and the Bland-Altman analysis showed 95% of the values within the limits of agreement. The mean of the differences between the manual and method-driven measurements was 0.049 mm ([Formula: see text]) 95% CI, inferior to the established limit (0.15mm).

Conclusions: It was demonstrated that the method achieved a precise segmentation of the intended structures. The validation process on standardized periapical radiographs showed good agreement between the manual measurements and the ones produced by the new method. Future work will be focused on making the method more robust to densitometry changes and to validate the method on non-standardized radiographs.
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http://dx.doi.org/10.1007/s11548-012-0802-6DOI Listing
September 2013
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