PurposeSeveral parameters have been described for determining the success or failure of dental implants. The surface properties of transgingival implant components have had a great impact on the long-term success of dental implants. The purpose of this study was to compare the tendency of two periodontal pathogens to adhere to and colonize zirconia abutments and titanium alloys both in hard surfaces and soft tissues.MethodsTwelve patients participated in this study. Three months after implant placement, the abutments were connected. Five weeks following the abutment connections, the abutments were removed, probing depth measurements were recorded, and gingival biopsies were performed. The abutments and gingival biopsies taken from the buccal gingiva were analyzed using real-time polymerase chain reaction to compare the DNA copy numbers of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and total bacteria. The surface free energy of the abutments was calculated using the sessile water drop method before replacement. Data analyses used the Mann Whitney U-test, and P-values below 0.05 find statistical significance.ResultsThe present study showed no statistically significant differences between the DNA copy numbers of A. actinomycetemcomitans, P. gingivalis, and total bacteria for both the titanium and zirconia abutments and the biopsies taken from their buccal gingiva. The differences between the free surface energy of the abutments had no influence on the microbiological findings.ConclusionsZirconia surfaces have comparable properties to titanium alloy surfaces and may be suitable and safe materials for the long-term success of dental implants.
ObjectivesThe aim of this study was to compare the mechanical resistance of four different osteosyntheses modeled in two different sagittal split ramus osteotomy (SSRO) designs and to determine the linear loading in a universal testing machine.Materials and MethodsAn in vitro experiment was conducted with 40 polyurethane hemimandibles. The samples were divided into two groups based on osteotomy design; Group I, right angles between osteotomies and Group II, no right angles between osteotomies. In each group, the hemimandibles were distributed into four subgroups according to the osteosynthesis method, using one 4-hole 2.0 mm conventional or locking plate, with or without one bicortical screw with a length of 12.0 mm (hybrid technique). Each subgroup contained five samples and was subjected to a linear loading test in a universal testing machine.ResultsThe peak load and peak displacement were compared for statistical significance using PASW Statistics 18.0 (IBM Co., USA). In general, there was no difference between the peak load and peak displacement related to osteotomy design. However, when the subgroups were compared, the osteotomy without right angles offered higher mechanical resistance when one conventional or locking 2.0 mm plate was used. One locking plate with one bicortical screw showed higher mechanical resistance (162.72±42.55 N), and these results were statistically significantly compared to one conventional plate with monocortical screws (P=0.016) and one locking plate with monocortical screws (P=0.012). The difference in peak displacement was not statistically significant based on osteotomy design or internal fixation system configuration.ConclusionThe placement of one bicortical screw in the distal region promoted better stabilization of SSRO. The osteotomy design did not influence the mechanical behavior of SSRO when the hybrid technique was applied.
RESUMEN:Los injertos óseos para elevación del piso sinusal han sido utilizados por largo tiempo con buenas tazas de éxito. EL objetivo de esta investigación fue estudiar el comportamiento intraoperatorio y postoperatorio de 91 cirugías consecutivas de elevación de seno maxilar. Fueron seleccionados 72 pacientes de entre 18 y 66 años para realizar el procedimiento con anestesia local o general; se estudiaron variables preoperatorias, intraoperatorias, postoperatorias, instalación de implante y complicaciones de la cirugía. El análisis de datos se realizó con la prueba test de Fisher con p<0,05 para establecer significancia estadística. En el 74,7% se utilizó hueso autólogo con o sin ayuda de biomaterial, siendo que en 86,8% se utilizó un sitio donante intrabucal. Se instalaron 101 implantes siendo un 69,3% instalado en un segundo procedimiento quirúrgico y los restantes 31 implantes instalados en el mismo tiempo quirúrgico de instalación de injerto óseo; no se observó diferencia estadística entre el éxito de los implantes instalados en uno o dos tiempos quirúrgicos (p>0,05); se observo la pérdida de 4 implantes, los cuales no fueron asociados a ningún tipo de material utilizado para el relleno óseo (p>0,05). La principal complicación fue la laceración de membrana, presente en el 18,7%, postergándose el procedimiento para ser realizado nuevamente en 13 de los 17 casos. Finalmente se puede concluir que la elevación de seno es un procedimiento reconocido y que es viable de presentar y asegurar estabilidad de los implantes instalados para el desarrollo de la oseintegración.PALABRAS CLAVE: seno maxilar, implante dental, reconstrucción ósea. INTRODUCCIÓNLa reconstrucción ósea para la instalación de implantes ha demostrado altas tazas de éxito (Adell et al., 1981). Diferentes técnicas han sido aplicadas para la reconstrucción ósea, tales como la instalación de injertos en bloque, injertos en partículas con o sin ayuda de malla de titanio, entre otros, mostrando versatilidad y predictibilidad en las técnicas reconstructivas (Breine & Branemark, 1980). En maxila posterior, las condiciones anatómi-cas, la etiología de la pérdida dentaria, el tiempo transcurrido sin dientes posteriores son importantes elementos que determinan la cantidad de reabsorción ósea y las limitaciones para la instalación de implantes (Misch, 1997). En estos casos, una opción es la instalación de implantes cortos (Griffin & Cheung, 2004), la cual ha presentado buenos resultados en buena parte de los estudios publicados; sin embargo, algunas investigaciones han evidenciado una menor taza de éxito debido a la curva de aprendizaje del cirujano, la calidad ósea, calidad y tipo de implantes y la técnica quirúrgica empleada (Ivanoff et al., 1999;Olate et al., 2010). Por otra parte, la maxila posterior presenta menos hueso cortical (Ulm et al., 1999), permitiendo muchas veces la migración de los implantes instalados hacia dentro del seno maxilar (Kluppel et al., 2010). Finalmente, otra opción está en la modificación del hueso con el uso de osteotomos, compa...
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