The primary stability of dental implants is fundamental for osseointegration. Therefore, this study aimed to assess the correlation between insertion torque (IT) and resonance frequency analysis (RFA) of implants placed in mandibles and maxillas of different bone densities. Eighty dental implants were placed in maxillas and mandibles, and IT and the implant stability quotient (ISQ) were measured at the time of implant insertion. Bone density was assessed subjectively by the Lekholm and Zarb index. The type I and II densities were grouped together (group A)as were the type III and IV densities (group B). The IT in group A was higher (Student t test, P = .0013) than in group B (46.27 ± 18.51 Ncm, 33.62 ± 14.74 Ncm, respectively). The implants placed in group A showed higher ISQ (Student t test, P = .0004) than those placed in group B (70.09 ± 7.50, 63.66 ± 8.00, respectively). A significant correlation between IT and the ISQ value was observed for group A (Pearson correlation test; r = 0.35; P = .0213) and for group B (r = 0.37; P = .0224). Within the limitations of this study, it was possible to conclude that there is a correlation between IT and RFA of implants placed in mandibles and maxillas of different bone densities.
An oroantral fistula is a complication of the maxillary posterior teeth that can occur after a tooth extraction that affects the maxillary sinus. Improper management may lead to a persistent fistula, which may become chronic. In this case report, platelet-rich fibrin (PRF) was used with a collagen membrane to close a chronic fistula in a single patient. A flap was raised, the oroantral fistula tract was eliminated, and the opening was closed with a resorbable membrane as a first layer and covered with a PRF clot as a second layer. The flap was closed, and the patient was followed up for suture removal and confirmation of complete soft tissue closure. The postsurgical sign and symptoms of the patient disappeared in the first week; complete tissue healing was detected within 2 weeks, and tissue hypertrophy was observed in the fourth week. The use of PRF may have advantages for soft-tissue healing and for accelerating soft tissue formation by subsequent hypertrophy.
A reconstrução da região posterior de maxilas atróficas, visando a reabilitação com implantes dentários, é considerada um desafio. A cirurgia de elevação do assoalho do seio maxilar tornou-se fundamental para o ganho de altura óssea nessa região. A técnica de levantamento do seio maxilar foi descrita inicialmente em 1977 e ao longo dos anos sofreu modificações. Atualmente, diversas variações da técnica original vêm sendo utilizadas para proporcionar o acesso e permitir a elevação da membrana sinusal. No entanto, a técnica pelo acesso à janela lateral é realizada em larga escala para permitir um caminho seguro e eficiente à enxertia óssea na região. No planejamento, é crucial, a fim de evitar complicações, o conhecimento anatômico e sistêmico do paciente. A abordagem via janela lateral, consiste na confecção de uma janela óssea na parede lateral do seio maxilar, possibilitando o levantamento da membrana e a aposição de um biomaterial sob a mesma. Para obtenção do sucesso na técnica, é fundamental que o paciente apresente condições sistêmicas ideais, o profissional tenha consciência de suas indicações e contraindicações. Além disso, a escolha do biomaterial e o tempo cirúrgico para a instalação dos implantes podem ser fatores determinantes para o sucesso da cirurgia.
Purposes: Autogenous bone graft is still considered the “gold standard” for bone augmentation of the jaws prior to dental implants placement. In cases of major bone defects, we can relinquish reconstructive techniques using grafts from extra buccal donor areas, such as the calvarial bone graft. Although this technique is well established in the literature, many professionals feel insecure in indicating this type of treatment to their patients, due to the high degree of complexity for the execution of the procedure and not acceptance by the patient. Case report: A female patient, 42-year-old, had undergone reconstructive surgery by means of a calvarial bone graft for pre-maxilla reconstruction prior to dental implants placement in regions of 14 to 24. The graft collection procedure was performed in a hospital setting and under general anesthesia. The grafts were transplanted from the calvarial bone to reconstruct the anterior maxilla. After 7 months, 4 dental implants were placed, allowing a future prosthetic rehabilitation. After the period of osseointegration, screw-retained partial fixed prosthesis was made, returning function and aesthetics to the patient. Conclusions: In view of the clinical case and literature presented, it is concluded that patients with severe maxillary bone atrophy can undergo a successful reconstruction process with calvarial bone grafts and dental implants.
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