Abstract Peri-implant diseases, including peri-implant mucositis (PIM) and peri-implantitis, are a chronic inflammatory disorder triggered by bacterial biofilm in susceptible hosts. Potential risk factors for peri-implant diseases include smoking, dental plaque accumulation, poor oral hygiene, genetics, and absence of peri-implant keratinized mucosa. This cohort study aimed to evaluate the influence of patient-, implant-, and prosthetic-related factors on PIM and peri-implant bone loss (PBL) around dental implants after 1 year of loading. A total of 54 subjects (22 males and 32 females) were included in the study. Peri-implant clinical parameters were assessed and standardized periapical radiographs of each dental implant were obtained 15 days after the definitive prosthesis installation (baseline) and at 3, 6, and 12 months of follow-up. A total of 173 implants were evaluated. PIM affected 44.8% of the implants and no significant association was found between the investigated parameters and PIM incidence, except for type of implant connection. A significantly higher incidence of PIM (80.0%) was observed for implants with internal hexagon connection type after 1 year of follow-up (p = 0.015). Moreover, a mean PBL of 0.35 ± 1.89 mm was observed and no dental implant was affected by peri-implantitis after 1 year of function. No specific influence of patient, implant, or prosthetic factors on PBL was observed. No association was found between the occurrence of PIM/PBL and the patient-, implant-, and prosthetic-related factors investigated in this cohort study, except for the type of dental-implant connection. Periimplant Peri periimplant peri (PIM periimplantitis, periimplantitis implantitis, implantitis hosts smoking accumulation hygiene genetics mucosa patient , patient- implant- prostheticrelated related (PBL loading 5 22 (2 3 females baseline (baseline 6 followup. followup follow up. up 17 evaluated 448 44 8 44.8 80.0% 800 80 0 (80.0% p 0.015. 0015 0.015 . 015 0.015) Moreover 035 35 0.3 189 89 1.8 function PIMPBL dentalimplant 2 ( 4 44. 80.0 (80.0 001 0.01 01 03 0. 18 1. 80. (80. 00 0.0 (80 (8

Resumo Esta revisão de escopo teve como objetivo fornecer uma visão geral dos avanços atuais no planejamento virtual e no uso de enxertos bioabsorvíveis personalizados impressos em 3D, e avaliar seus resultados clínicos em cirurgias reconstrutivas maxilofaciais. Foram realizadas buscas eletrônicas nas bases de dados PubMed, EMBASE, Web of Science, Scopus e Cochrane Library para publicações até junho de 2024. Foram incluídos na revisão estudos que avaliaram pacientes submetidos à reconstrução de defeitos ósseos maxilofaciais usando planejamento virtual e enxertos bioabsorvíveis personalizados impressos em 3D. Foram coletados dados sobre complicações pós-operatórias, nova formação óssea, reabsorção do enxerto, sucesso/sobrevivência do implante dentário e satisfação do paciente. A busca eletrônica encontrou 5799 resultados (3438 citações únicas). Um total de 54 estudos foram incluídos para leitura completa do texto, dos quais 41 foram excluídos com base nos critérios de inclusão. Treze estudos (6 relatos de casos, 5 séries de casos, 1 estudo clínico prospectivo e 1 estudo clínico controlado randomizado) foram incluídos. Esses estudos avaliaram a eficácia de enxertos impressos em 3D na reconstrução de defeitos maxilo-faciais, aumento ósseo para colocação de implantes dentários e regeneração de defeitos ósseos periodontais. A maioria dos enxertos impressos em 3D foram considerados biocompatíveis e não causaram eventos adversos locais ou sistêmicos. Entretanto, algumas complicações pós-operatórias foram relatadas, incluindo exposição do enxerto, deiscência da ferida e infecção local. No geral, os andaimes impressos em 3D demonstraram compatibilidade dimensional favorável com deformidades, forneceram suporte durável, promoveram a formação óssea, alcançaram uma união óssea adequada com os tecidos ósseos hospedeiros e permitiram a instalação de implantes dentários sem a necessidade de regeneração óssea guiada adicional. Esta revisão pode concluir que os enxertos bioabsorvíveis personalizados impressos em 3D, guiados por planejamento virtual, apresentam uma opção promissora para reconstrução maxilo-facial devido à sua precisão, osteocondutividade e propriedades biocompatíveis. D PubMed EMBASE Science 2024 pósoperatórias, pósoperatórias pós operatórias, operatórias enxerto sucessosobrevivência sucesso sobrevivência paciente 579 3438 (343 únicas. únicas . únicas) texto 4 inclusão 6 ( casos randomizado maxilofaciais, maxilo faciais, faciais maxilo-faciais periodontais sistêmicos Entretanto relatadas local deformidades durável adicional maxilofacial facial precisão 202 57 343 (34 20 34 (3 2 3

Abstract This scoping review aimed to provide an overview of current advancements in virtual planning and custom-made 3D-printed bioresorbable scaffolds, and to evaluate their clinical outcomes in maxillofacial reconstructive surgeries. Electronic searches of PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were conducted for publications up to June 2024. Included in the review were reports evaluating patients who underwent maxillofacial bone defect reconstruction using virtual planning and custom-made 3D-printed bioresorbable scaffolds. Data on postoperative complications, new bone formation, scaffold resorption, dental implant success/survival, and patient satisfaction were collected. The electronic search found 5799 results (3438 unique citations). A total of 54 studies were evaluated for full-text reading, of which 41 were excluded based on the inclusion criteria. Thirteen studies (6 case reports, 5 case series, one prospective clinical study and one randomized clinical trial) were included. These studies assessed the effectiveness of 3D-printed scaffolds in reconstructing maxillofacial defects, bone augmentation for dental implant placement, and regeneration of periosseous defects. Most of the 3D-printed scaffolds were biocompatible and did not cause local or systemic adverse events. However, some postoperative complications were reported, including graft exposure, wound dehiscence, and local infection. Overall, the 3D-printed scaffolds demonstrated favorable dimensional compatibility with deformities, provided durable support, promoted bone formation, achieved adequate bone union with host bone tissues, and supported dental implant placement without additional guided bone regeneration. In conclusion, custom-made 3D-printed bioresorbable scaffolds, guided by virtual planning, present a promising option for maxillofacial reconstruction due to their accuracy, osteoconductivity, and biocompatible properties. custommade custom made 3Dprinted Dprinted 3D printed D surgeries PubMed EMBASE Science Scopus 2024 formation resorption successsurvival success survival success/survival collected 579 3438 (343 citations. citations . citations) fulltext full text reading 4 criteria 6 ( series trial included defects events However reported exposure dehiscence infection Overall deformities support tissues conclusion accuracy osteoconductivity properties 202 57 343 (34 20 34 (3 2 3

Resumo Introdução O controle do biofilme peri-implantar desempenha um papel importante no sucesso a longo prazo dos implantes dentários. Alternativas de tratamento tópico visando a diminuição ou a prevenção do acumulo de biofilme ao redor dos componentes protéticos do implante é um fator crucial para a sucesso do tratamento. Objetivo Assim, o presente estudo avaliou clinicamente no período de 90 dias, os efeitos de um enxaguatório bucal liberador de oxigênio (BlueM®) após cirurgia de instalação de implante. Material e método Após a instalação dos implantes, os pacientes foram randomizados em dois grupos: grupo controle utilizaram enxaguatório bucal com clorexidina 0,12% e grupo BlueM utilizaram enxaguatório bucal liberador de oxigênio (BlueM). Todos participantes foram orientados a realizarem os bochechos 2 x/dia nos primeiros 10 dias, e 1 x/dia até completar 30 dias da cirurgia. Parâmetros clínicos foram avaliados: índice de placa visível (PV), sangramento marginal (SM), presença de cálculo (PC), presença de supuração (SUP), presença de mucosite (MU), extensão da faixa de gengiva ceratinizada (GC) realizados no ato da remoção da sutura (Baseline). No período de 90 dias do pós-operatório foram realizados os exames de profundidade de sondagem (PS), sangramento à sondagem (SS) e de presença de perimplantite (Pi). Resultado 9 pacientes foram incluídos neste estudo totalizando 38 implantes instalados. O grupo BlueM apresentou redução no SM, maior redução de PV. Os demais parâmetros avaliados foram semelhantes com o grupo controle. Conclusão Pode-se concluir que o enxaguatório BlueM demonstrou benefícios clínicos no controle do biofilme e no controle da inflamação gengival. periimplantar peri implantar dentários Assim BlueM® (BlueM® grupos 012 0 12 0,12 BlueM. . (BlueM) xdia x dia 3 PV, PV , (PV) SM (SM) PC, PC (PC) SUP, SUP (SUP) MU, MU (MU) GC (GC Baseline. Baseline (Baseline) pósoperatório pós operatório PS, PS (PS) SS (SS Pi. Pi (Pi) instalados Podese Pode se gengival (BlueM 01 0,1 (PV (SM (PC (SUP (MU (Baseline (PS (Pi 0,

Abstract Introduction The control of peri-implant biofilm plays a crucial role in the long-term success of dental implants. Topical treatment alternatives aimed at reducing or preventing biofilm accumulation around the implant's prosthetic components are critical for the success of the treatment. Objective The present study has clinically evaluated the effects of an oxygen-releasing mouthwash (BlueM®) over a 90-day period, following implant placement surgery. Material and method Inclusion and exclusion criteria allowed for the selection of participants who, after implant placement, were randomized into two groups: the control group, which used a 0.12% chlorhexidine mouthwash, and the BlueM group, which received the oxygen-releasing BlueM mouthwash. All participants were instructed to rinse twice daily for the first 10 days and once a day up to 30 days post-surgery. Clinical parameters were evaluated, including the visible plaque index (VP), marginal bleeding (MB), presence of calculus (PC), suppuration (SUP), mucositis (MU), and the extent of keratinized gingiva (KG). These data were collected at the time of suture removal (baseline). At 90 days postoperative, in addition to the aforementioned parameters, probing depth (PD), bleeding on probing (BOP), and the presence of peri-implantitis (PI) were evaluated. Result Nine patients were included in this study, with a total of 38 implants. The BlueM group demonstrated a reduction in MB and an even greater reduction in VP. The other assessed parameters showed similar results to those in the control group. Conclusion BlueM mouthwash has clinical benefits for biofilm control and gingival inflammation reduction. periimplant peri longterm long term implants s oxygenreleasing oxygen releasing BlueM® (BlueM® 90day period surgery who groups 012 0 12 0.12 1 3 postsurgery. postsurgery post post-surgery VP, VP , (VP) MB, (MB) PC, PC (PC) SUP, SUP (SUP) MU, MU (MU) KG. KG . (KG) baseline. baseline (baseline) 9 postoperative PD, PD (PD) BOP, BOP (BOP) periimplantitis implantitis PI (PI (BlueM 01 0.1 (VP (MB (PC (SUP (MU (KG (baseline (PD (BOP 0.

Resumo Este estudo avaliou a influência de uma superfície de titânio modificada com flúor na osseointegração em ratos com diabetes induzida. Cento e oitenta ratos foram distribuídos aleatoriamente em 3 grupos com 60 animais cada: Grupo controle (C): Animais sem diabetes; Grupo Diabetes (D): Animais com diabetes induzida descompensada; Grupo Diabetes Controlado (CD): Animais com diabetes induzido controlado pela administração de insulina. O diabetes foi induzido por injeção de estreptozotocina. Cada animal recebeu 2 implantes na metáfise proximal da tíbia, um com superfície usinada (M) e outro com superfície de titânio modificado com flúor (F), após 4 semanas de indução do diabetes. Os animais foram submetidos à eutanásia 2, 4 e 6 semanas após a colocação do implante (n = 20 animais/grupo). A osseointegração foi avaliada pelo teste de torque de remoção do implante e pela análise histométrica dos cortes histológicos não descalcificados: 1) Contato osso-implante (%BIC); 2) Área de tecido ósseo entre as roscas do implante (%BBT). Os implantes com superfície F apresentaram maior torque de remoção do que os implantes com superfície M em todos os grupos. Não houve diferença no %BIC entre os grupos independente da superfície utilizada. A superfície F mostrou tendência a apresentar maiores valores de %BBT para os 3 períodos de avaliação no grupo D. As superfícies de implantes modificadas com flúor não influenciaram nos dados de %BIC e %BBT. Entretanto, essas superfícies aumentaram o travamento dos implantes no tecido ósseo. A hiperglicemia foi associada a menores torques de remoção dos implantes independentemente do tipo de superfície de implante utilizada. cada C (C) D (D) descompensada CD (CD) insulina estreptozotocina tíbia (M F, , (F) n animais/grupo. animaisgrupo animais/grupo . animais/grupo) descalcificados 1 ossoimplante osso BIC (%BIC) BBT (%BBT) utilizada Entretanto (C (D (CD (F (%BIC (%BBT

Abstract This study evaluated the influence of a fluoride-modified titanium surface on osseointegration in rats with induced diabetes. One hundred and eighty rats were randomly allocated into 3 groups with 60 animals each: Control group (C): Animals without diabetes; Diabetes Group (D): Animals with uncontrolled induced diabetes; Controlled Diabetes Group (CD): Animals with diabetes induced controlled by the insulin administration. Diabetes was induced by streptozotocin injection. Each animal received 2 implants in the proximal tibial metaphysis, one with the machined surface (M) and the other one with a fluoride-modified titanium surface (F), after 4 weeks of induction of diabetes. The animals were submitted to euthanasia 2, 4, and 6 weeks after the implant placement (n = 20 animals/group). The osseointegration was evaluated by the implant removal torque test and the histometric analysis of the non-decalcified histological sections: 1) Contact bone/implant (%BIC); 2) Bone tissue area between implant threads (%BBT). Implants with F surface showed a higher removal torque than implants with surface M in all groups. There was no difference in %BIC between the groups regardless of the surface used. The F surface showed a tendency to present higher %BBT values for the 3 evaluation periods in the D group. The fluoride-modified implant surface has no impact on the %BIC and %BBT. However, the fluoride-modified implant surface increases the locking of the implants with the bone. The hyperglycemia was associated with lower removal torque values despite the surfaces of the implant used. fluoridemodified fluoride modified each C (C) (D) CD (CD) administration injection metaphysis (M F, , (F) n animals/group. animalsgroup animals/group . animals/group) nondecalcified non decalcified sections 1 boneimplant bone BIC (%BIC) BBT (%BBT) used However (C (D (CD (F (%BIC (%BBT

Resumo O presente estudo avaliou a influência do carvacrol, terpineno-4-ol e clorexidina nas propriedades físico-químicas de superfícies de titânio, viabilidade celular, proliferação, adesão e esplhamento de fibroblastos e osteoblastos in vitro. Superfícies de titânio (Ti) foram tratadas com Carvacrol (Cvc), Terpinen-4-ol (T4ol), Clorexidina (CHX), DMSO e água ultrapura (Grupo Controle). As modificações físico-químicas foram avaliadas pela molhabilidade da superfície, a energia livre de superfície (ELS) calculada a partir dos valores do ângulo de contato usando a equação de Owens-Wendt-Rabel-Kaeble (OWRK), microscopia eletrônica de varredura (MEV) e espectroscopia de raios X por energia dispersiva (EDS). As células foram semeadas em superfícies tratadas com Ti e incubadas por 24 h e 72 h, e avaliadas pelo ensaio Alamar blue e microscopia de fluorescência. As superfícies tratadas com Cvc e T4ol mostraram a presença de Na, O e Cl. Todas as superfícies apresentaram características hidrofílicas e valores de ELS entre 5,5 mN/m e 3,4 mN/m. Por outro lado, os picos de EDS demonstraram a presença de O e Cl após o tratamento com CHX. Uma redução da viabilidade celular e adesão foi observada em superfícies de titânio tratadas com CHX após 24 e 72h. Em conclusão, os resultados indicam que a descontaminação com Cvc e T4ol em superfícies de Ti não altera as propriedades da superfície e permite uma interação adequada com células envolvidas no processo de reosseointegração como fibroblastos e osteoblastos. carvacrol terpineno4ol terpinenool terpineno 4 ol físicoquímicas físico químicas proliferação vitro (Ti Cvc, , (Cvc) Terpinen4ol Terpinenol Terpinen T4ol, Tol T (T4ol) CHX, (CHX) Grupo Controle. Controle . Controle) (ELS OwensWendtRabelKaeble Owens Wendt Rabel Kaeble OWRK, OWRK (OWRK) MEV (MEV EDS. (EDS) 2 7 fluorescência Na 55 5 5, mNm mN m 34 3 3, lado 72h conclusão (Cvc (T4ol (CHX (OWRK (EDS

Abstract The present study evaluated the influence of carvacrol, terpinene-4-ol, and chlorhexidine on the physical-chemical properties of titanium surfaces, cell viability, proliferation, adhesion, and spreading of fibroblasts and osteoblasts in vitro. Titanium surfaces (Ti) were treated with Carvacrol (Cvc), Terpinen-4-ol (T4ol), Chlorhexidine (CHX), DMSO, and ultrapure water (Control group). Physical-chemical modifications were evaluated by surface wettability, the surface free energy (SFE) calculated from the contact angle values using the Owens-Wendt-Rabel-Kaeble (OWRK) equation, scanning electron microscopy (SEM) and energy dispersive spectrometry probe (EDS) system. Cells were seeded onto Ti-treated surfaces and incubated for 24 h and 72 h, then evaluated by Alamar blue assay and fluorescence microscopy. Surfaces treated with Cvc and T4ol showed the presence of Na, O, and Cl. All surfaces showed hydrophilic characteristics and SFE values between 5.5 mN/m and 3.4 mN/m. On the other hand, EDS peaks demonstrated the presence of O and Cl after CHX treatment. A reduction of cell viability and adhesion was noted on titanium surfaces treated with CHX after 24 and 72h. In conclusion, the results indicate that the decontamination with Cvc and T4ol on Ti surfaces does not alter the surface proprieties and allows an adequate interaction with cells involved in the re-osseointegration process such as fibroblasts and osteoblasts. carvacrol terpinene4ol, terpinene4ol terpineneol terpinene 4 ol, ol terpinene-4-ol physicalchemical physical chemical proliferation vitro (Ti Cvc, , (Cvc) Terpinen4ol Terpinenol Terpinen T4ol, Tol T (T4ol) CHX, (CHX) DMSO Control group. group . group) Physicalchemical Physical wettability (SFE OwensWendtRabelKaeble Owens Wendt Rabel Kaeble OWRK (OWRK equation SEM (SEM (EDS system Titreated 2 7 Na 55 5 5. mNm mN m 34 3 3. hand treatment 72h conclusion reosseointegration re osseointegration (Cvc (T4ol (CHX

Resumo O objetivo deste estudo foi avaliar o efeito da administração de nicotina na osseointegração de implantes com superfície modificada por jateamento de oxidos e ataque ácido instalados em tíbia de ratos. Foram utilizados 32 ratos que foram divididos em 2 grupos de acordo com a administração ou não de nicotina: HH - Instalação de implantes com superfícies superhidrofílicas em animais sadios; e HN - Instalação de implantes com superfícies superhidrofílicas em animais submetidos à administração de nicotina. Os animais foram eutanasiados 15 e 45 dias após a colocação do implante (n = 8). A osseointegração foi avaliada por meio de análises biomecânicas (torque de remoção), microtomografia (volume de osso ao redor dos implantes - %BV/TV) e histomorfometrica (contato osso-implante -%BIC e área óssea entre roscas do implante -%BBT). Os animais submetidos à administração de nicotina apresentaram menor torque de remoção do que os animais controle no período de 45 dias (21,88 ± 2,80 Ncm vs. 17,88 ± 2,10 Ncm). Os implantes colocados nos ratos controle apresentaram maiores %BIC (54,26 ± 6,59% vs. 39,25 ± 4,46%) e %BBT (50,57 ± 5,28% vs. 32,25 ± 5,24%) do que os implantes colocados nos animais submetidos a administração de nicotina no período de 15 dias. A administração de nicotina prejudicou a osseointegração no período de 15 dias. Entretanto, a superfície superhidrofílica equalizou a osseointegração em animais expostos à nicotina em comparação com animais saudáveis após 45 dias da colocação do implante. 3 sadios 1 4 n 8. 8 . 8) remoção, , remoção) volume %BV/TV BVTV BV TV contato ossoimplante BIC %BBT. BBT -%BBT) 21,88 2188 21 88 (21,8 280 80 2,8 vs 1788 17 17,8 210 10 2,1 Ncm. Ncm) 54,26 5426 54 26 (54,2 659 6 59 6,59 3925 39 25 39,2 4,46% 446 46 50,57 5057 50 57 (50,5 528 5 28 5,28 3225 32,2 5,24% 524 24 Entretanto -%BBT 21,8 218 (21, 2, 178 17, 54,2 542 (54, 65 6,5 392 39, 4,46 44 50,5 505 (50, 52 5,2 322 32, 5,24 21, (21 54, (54 6, 4,4 50, (50 5, (2 (5 4, (

Abstract This study aimed to evaluate the effect of nicotine administration on the osseointegration of a superhydrophilic implants surface on rat tibiae. Thirty-two rats were used and divided into 2 groups according to the administration or not of nicotine: HH - Installation of implants with superhydrophilic surfaces in healthy animals; and HN - Installation of implants with superhydrophilic surfaces in animals subjected to nicotine administration. The animals were euthanized 15 and 45 days after implant placement (n = 8). Osseointegration was assessed by means of biomechanical analyses (removal torque), microcomputed tomography (volume of bone around the implants- %BV/TV), and histomorphometry (bone-implant contact -%BIC and the bone area between implant threads -%BBT). The animals subject to the nicotine administration presented lower removal torque than the control animals at the 45-day period (21.88 ± 2.80 Ncm vs. 17.88 ± 2.10 Ncm). The implants placed in the control rats presented higher %BIC (54.26 ± 6.59% vs. 39.25 ± 4.46%) and %BBT (50.57 ± 5.28% vs. 32.25 ± 5.24%) than the implants placed in nicotine animals at 15-day period. The nicotine administration reduces the osseointegration at 15 days, however, the superhydrophilic surface equalized the osseointegration in nicotine-exposed animals compared with healthy animals after 45 days of implant placement. tibiae Thirtytwo Thirty two 1 4 n 8. 8 . 8) torque, , torque) volume %BV/TV, BVTV %BV/TV BV TV %BV/TV) boneimplant BIC %BBT. BBT -%BBT) 45day day 21.88 2188 21 88 (21.8 280 80 2.8 vs 1788 17 17.8 210 10 2.1 Ncm. Ncm) 54.26 5426 54 26 (54.2 659 6 59 6.59 3925 39 25 39.2 4.46% 446 46 50.57 5057 50 57 (50.5 528 5 28 5.28 3225 32 32.2 5.24% 524 24 15day however nicotineexposed exposed -%BBT 21.8 218 (21. 2. 178 17. 54.2 542 (54. 65 6.5 392 3 39. 4.46 44 50.5 505 (50. 52 5.2 322 32. 5.24 21. (21 54. (54 6. 4.4 50. (50 5. (2 (5 4. (

Aim Evaluation of ridge alteration after 1 year follow up after immediate loading implant placement. Methods Ten patients were included in the study, in whom the ridge volume, height, and thickness were evaluated from region of interest (ROI) of tomographic images of the operated areas (test group) and compared to the opposite tooth (control group). Results After one year, there was no implant loss and all patients were satisfied with the treatment. In the test group there was a statistically significant increase in ridge height (2.89±1.05 mm) when compared to the control group. No significant difference in relation to ridge volume and thickness was observed. In the intragroup evaluation, a significant gain in ridge height (2.65±3.08 mm) was observed when compared to baseline. Conclusion The placement of an immediate implant, temporary crown, and tissue regeneration in sockets with buccal defects promotes the regeneration of the buccal wall while preventing the reduction of bone volume and thickness. study ROI (ROI . treatment 2.89±1.05 289105 2 89 05 (2.89±1.0 mm evaluation 2.65±3.08 265308 65 3 08 (2.65±3.0 baseline crown 2.89±1.0 28910 8 0 (2.89±1. 2.65±3.0 26530 6 (2.65±3. 2.89±1. 2891 (2.89±1 2.65±3. 2653 (2.65±3 2.89±1 289 (2.89± 2.65±3 265 (2.65± 2.89± 28 (2.89 2.65± 26 (2.65 2.89 (2.8 2.65 (2.6 2.8 (2. 2.6 2. (2 (

Resumo O objetivo deste foi o de avaliar o efeito de uma superfície modificada por jateamento e ataque ácido e mantida em solução isotônica em comparação a uma superfície lisa sobre a osseointegração de implantes em animais hiperglicêmicos. No estudo foram utilizados 64 ratos, que foram divididos em 4 grupos com 16 animais em cada, e que foram avaliados em dois períodos experimentais (15 e 45 dias), com 8 animais em cada grupo. Os grupos foram divididos de acordo com o tipo de implante que foi instalado na tíbia dos animais e a condição sistêmica dos mesmos: Grupo CM - Implantes maquinados instalados em animais saudáveis; Grupo CH - Implantes maquinados instalados em animais com hiperglicemia; Grupo HM - Implantes hidrofílicos instalados em animais saudáveis, Grupo HH- Implantes hidrofílicos instalados em animais com hiperglicemia. Foram realizadas análises: biomecânicas (contra torque de remoção dos implantes), histométricas (avaliação do contato do osso com os implantes e da área de formação óssea entre as roscas) e microtomográfica (avaliação da área óssea ao redor dos implantes). Foi verificado que os implantes com superfície hidrofílica apresentaram maiores torques de remoção, quantidade de osso ao redor dos implantes e maiores valores de %BIC e %BBT em animais normo e hiperglicêmicos. Conclui-se que a superfície hidrofílica acelera o processo de osseointegração (~15% de %BIC/%BBT aos 15 dias), especialmente em animais com hiperglicêmicos. A superfície hidrofílica igualou a osseointegração entre animais normo- e hiperglicêmicos, revertendo o potencial negativo da hiperglicemia no processo de osseointegração.

Abstract The purpose of this study was to evaluate the effect of a surface modified by blasting and acid attack and maintained in an isotonic solution compared to a machined surface on osseointegration in normo- and hyperglycaemic animals. Sixty-four animals were allocated into 4 groups with 16 animals each, and they were subdivided into two experimental periods (15 and 45 days), with 8 animals in each group. The groups were divided according to the type of implant that was installed in the animals' tibia and the animals’ systemic condition: CM - Machined implants placed in Healthy animals; CH - Hydrophilic implants placed in Healthy animals, HM - Machined implants placed in animals with hyperglycaemia; HH- Hydrophilic implants installed in animals with hyperglycaemia. The following analyses were performed: biomechanical (removal torque), microtomographic (evaluation of the bone volume around the implants- BV/TV), and histomorphometric (evaluation of bone-implant contact BIC% and of the bone formation area between the threads BBT%). It was found that the implants with hydrophilic surfaces presented higher removal torques and quantities of BV/TV% and higher BIC% and BBT% values in normo- and hyperglycaemic animals. The results of this study indicated that the hydrophilic surface accelerates the osseointegration process (~ 15% BIC/BBT at 15-day period), especially in animals with hyperglycaemia. The hydrophilic surface equaled the osseointegration between normo- and hyperglycaemic animals, reversing the negative potential of hyperglycaemia on the osseointegration process.

Resumo Esse estudo tem como objetivo avaliar a acurácia da análise microtomográfica em mensurações lineares e volumétricas em osso nativo (ON) e enxertado (OE). Para isso, 111 biópsias removidas de seios maxilares de pacientes enxertados com osso bovino desproteinizado foram coletadas e avaliadas. As medidas lineares foram realizadas para medir o comprimento do ON e do OE. Além disso, foi realizada a mensuração da quantidade de tecidos mineralizados em ON e OE. Na análise histomorfométrica a porcentagem de tecidos mineralizados do ON e OE foi obtida em dois cortes histológicos enquanto os tecidos mineralizados foram medidos em microtomografias variando os thresholds da escala de cinza variando de 90-250 a 90-150 com 10 níveis de variação entre cada. Em seguida, esses dados foram correlacionados para verificar o maior nível de R entre os intervalos dos thresholds testados na análise microtomográfica em relação aos dados obtidos na histomorfometria. O comprimento linear do ON foi de 2,44±0,91mm e 2,48±1,50mm, respectivamente, para análises microtomográfica e histomorfométrica (r=0,57), enquanto o comprimento linear do OE foi de 3,63±1,66mm e 3,13±1,45mm, respectivamente, para para análises microtomográfica e histomorfométrica (r =0,74) A histomorfometria detectou 45,91±11,69% de osso na porção de ON e 49,57±5,59% de osso e biomaterial na porção de OE. O volume total de tecidos mineralizados detectados pela análise microtomográfica que apresentou valores mais próximos da análise histomorfométrica foi de 43,75±15,39% no ON (Thresholds:90-240; r = 0,50) e 51,68±8,42% no OE (Thresholds:90-180; r =- 0,028). A análise microtomográfica apresentou boa acurácia na análise linear em ambas as porções das biópsias, porém a mesma apresentou boa acurácia para análise volumétrica apenas em áreas de ON.

Abstract The study aimed to evaluate the accuracy of Micro-CT in linear and volumetric measurements in native (NB) and grafted bone (GB) areas. A total of 111 biopsies of maxillary sinuses grafted with deproteinized bovine bone (DBB) in humans were evaluated. The linear measurements were performed to measure the length of the NB and GB. Furthermore, the amount of mineralized tissues at the NB and GB was performed. In the histomorphometry analysis the percentage of mineralized tissues at the NB and GB was obtained in two histological sections while the mineralized tissues were measure in the micro-CT varying the thresholds of the grayscale varying from 90-250 to 90-150 with 10 levels of variation between each one was applied. Then these data were correlated in order to check the higher r level between the histomorphometry and micro-CT thresholds intervals. The linear length of the NB was 2.44±0.91mm and 2.48±1.50mm, respectively, for micro-CT and histomorphometry (r =0.57), while the linear length of the GB was 3.63±1.66mm and 3.13±1.45mm, respectively, for micro-CT and histomorphometry (r =0.74) Histomorphometry showed 45.91±11.69% of bone in NB, and 49.57±5.59% of bone and biomaterial in the GB. The total volume of mineralized tissues that were closest to the histometric analysis were 43.75±15.39% in the NB (Threshold:90-240; r = 0.50) and 51.68±8.42% in the GB (Threshold:90-180; r =-0.028). The micro-CT analysis showed good accuracy in the linear analysis in both portions of the biopsies but for volumetric analysis just in NB.

Resumo Introdução A estabilidade primária é um importante indicador de sucesso da osseointegração. Porém, fatores locais com osso de baixa intensidade podem interferir negativamente na obtenção da estabilidade primária. Objetivo O presente estudo avaliou o efeito de diferentes direções, velocidades de rotação e sistemas de fresagem na expansão de perfurações e estabilidade de implantes instalados em blocos mimetizando osso do tipo IV. Material e método Foram instalados 50 implantes em blocos de poliuretano sólido rígido. Esses implantes foram igualmente divididos em cinco grupos (n = 10): 1) Fresa Maximus (utilizadas no sentido horário a 1200rpm); 2) Fresa Maximus (utilizadas no sentido horário a 600rpm); 3) Fresa Neodent (utilizadas no sentido horário a 800rpm); 4) Fresa Neodent (utilizadas no sentido anti-horário a 800rpm); 5) Fresa Neodent (utilizadas no sentido anti-horário a 600rpm). Foram executadas análises de estabilidade dos implantes através de testes de torque de inserção e remoção, além das análises de frequência de ressonância. Adicionalmente, a expansão associada às perfurações promovida pelas brocas foi avaliada por meio de análises tomográficas. Resultado Verificou-se que os implantes instalados após o preparo da perfuração com as brocas Maximus a 600rpm apresentaram valores de torque de inserção maiores, quando comparados ao grupo de implantes instalados em perfurações confeccionadas com brocas Neodent. Ademais, as brocas Maximus apresentaram valores de expansão maiores que as brocas Neodent. Conclusão As brocas Maximus são mais eficientes em promover a osseodensificação, e sua utilização está associada ao aumento da estabilidade dos implantes instalados em blocos mimetizando osso do tipo IV.

Abstract Introduction Primary stability is an important indicator to obtain a successful osseointegration. However, local factors like bone with low density can negatively interfere in obtaining primary stability. Objective This study assessed the effect of different drilling systems, speeds, and movement directions on the expansion of perforations and the stability of implants placed in blocks that mimicked type IV bone. Material and method Fifty implants were installed in rigid solid polyurethane blocks and equally divided into the following five groups (n = 10): 1) Maximus Driller (on a clockwise direction at 1200rpm); 2) Maximus Driller (on a clockwise direction at 600rpm); 3) Neodent Driller (on a clockwise direction at 800rpm); 4) Neodent Driller (on a counter clockwise direction at 800rpm); 5) Neodent Driller (on a counter clockwise direction at 600rpm). The stability analyses of the implants were performed through insertion and removal torque testing, in addition to resonance frequency analysis. Additionally, the expansion promoted by the drills associated with the perforations was assessed through tomographic analysis. Result We found that implants placed after drilling preparation with Maximus drills at 600 rpm had higher values of insertion torque than the group of implants installed in drillings made with Neodent drills. In addition, the maximus drills showed higher expansion values than the Neodent drills. Conclusion Maximus drills are more efficient in promoting osseodensification and their use was associated with increased stability of implants installed in blocks that mimicked type IV bone.

Abstract Objective This study aimed to retrospectively collect clinical data to evaluate the influence of possible risk factors on the long-term success of implant treatment with extra-narrow (2.9 mm diameter) implants in a daily dental practice setting. Methodology Data were collected from records of patients who received at least one extra-narrow implant from 2012 to 2017, regarding implant survival, prosthesis survival, patient characteristics, and implant characteristics. The association between the dependent variables “implant survival”, “prosthesis survival,” and “adverse events” related to patient and implant characteristics was statistically evaluated by chi-square tests. Moreover, implant and prosthesis survival were analyzed by Kaplan-Meier survival curves. Results The sample was constituted of 58 patients (37 women and 21 men) with a mean age of 54.8 years old (SD: 12.5), followed up for up to eight years. In total, 86 extra-narrow implants were placed within this sample. Four implants were lost, resulting in an implant survival rate of 95.3%. A total of 55 prostheses were inserted and only one (1.8%) was lost, resulting in a prosthesis survival rate of 98.2%. The mean implant and prosthesis survival time was, respectively, 7.1 years and 6.3 years, according to the Kaplan-Meier survival analysis. A correlation was found between smoking and implant loss, which makes implant loss eight times more likely to occur in smokers than non-smokers. A significant association was also found between prosthesis loss and previous need of prosthesis repair. However, it was not considered clinically relevant. No association was found between the occurrence of adverse events and later implant or prosthesis loss. Conclusion High implant and prosthesis survival rates were found in the long term for treatment with extra-narrow implants. Moreover, a significant correlation between smoking and implant loss was observed.

Resumo Introdução A investigação dos fatores indicadores de risco para as doenças peri-implantares auxilia na prevenção e direcionamento das técnicas de tratamento Objetivo O objetivo deste estudo transversal foi determinar a ocorrência de peri-implantite e seus potenciais fatores indicadores de risco, além de avaliar as taxas de sucesso e sobrevida em longo prazo dos implantes dentários após 8 a 10 anos de função Material e método Foram incluídos cinquenta indivíduos que receberam sua reabilitação implanto-suportada entre 2003 e 2005. Dados demográficos, história médica e odontológica foram coletados e um exame clínico completo foi realizado. A análise multivariada foi utilizada para identificar potenciais fatores indicadores de risco relacionados à ocorrência de peri-implantite. Ao todo, 211 implantes foram colocados; 197 estavam em função, 9 ainda estavam submersos e 5 haviam sido perdidos. Resultado As taxas de sucesso e sobrevivência foram de 81,5% e 97,6%, respectivamente. A mucosite peri-implantar afetou 77,1% dos indivíduos e 52,3% dos implantes. A peri-implantite foi diagnosticada em 14 indivíduos (29,2%) e 25 implantes (12,7%). Indivíduos com osteoporose (OR = 2,84) e sangramento generalizado à sondagem (OR = 8,03) foram significativamente associados a uma maior chance de peri-implantite. Ao nível do implante, a placa visível (OR = 4,45) e as maiores profundidades de sondagem (OR = 4,47) foram significativamente associadas à peri-implantite. Conclusão Por meio desses resultados, nosso estudo sugere que a osteoporose e a inflamação generalizada da mucosa periodontal / peri-implantar aumentam a probabilidade de peri-implantite.

Abstract Introduction The investigation of peri-implant diseases risk indicators helps to prevent and target treatment techniques. Objective The aim of this cross-sectional study was to determine the occurrence of peri-implantitis and its potential risk indicator factors, besides to assess the long-term success and survival rates of dental implants after 8 to 10 years of function. Material and method For this, fifty individuals who had received their implant-supported rehabilitation between 2003 and 2005 were included. Data regarding demographics, medical and dental history were collected and a complete clinical examination was performed. Multivariate analysis was used to identify potential risk indicator factors related to the occurrence of peri-implantitis. Overall, 211 implants had been placed; 197 were in function, 9 were still submerged, and 5 had been lost. Result Success and survival rates were 81.5% and 97.6%, respectively. Peri-implant mucositis affected 77.1% of subjects and 52.3% of implants. Peri-implantitis was diagnosed in 14 individuals (29.2%) and 25 implants (12.7%). Subjects with osteoporosis (OR = 2.84) and generalized bleeding on probing (OR = 8.03) were significantly associated with higher odds of peri-implantitis. At the implant level, visible plaque (OR = 4.45) and deep probing depths (OR = 4.47) were significantly associated with peri-implantitis. Conclusion Through these results, our study suggests that osteoporosis and generalized periodontal/peri-implant mucosa inflammation increase the likelihood of peri-implantitis.

Resumo Introdução A quantidade e qualidade óssea na implantodontia é um fator de alta relevância quando se tem por objetivo instalar implantes e reabilitar pacientes. No entanto, essa disponibilidade é comprometida na maioria dos casos, havendo a necessidade da busca de novos biomateriais, membranas e substâncias para uma regeneração mais favorável. Objetivo: O objetivo deste estudo foi avaliar a resposta da neoformação óssea em defeitos críticos em calvárias de ratos utilizando scaffolds de fibras de blenda polimérica a partir de poli (ácido láctico-co-glicólico) e poli-isopreno (Cellprene®). O projeto foi aprovado pelo Comitê de Ética em Experimentação Animal. Material e método Neste estudo, foram utilizados 36 ratos (Rattus Norvegicus), variação albinus, Holtzman, adultos. Os animais foram submetidos à tricotomia na região da calota craniana e à confecção de defeitos ósseos circulares bilaterais com 5 mm de diâmetro. Os animais foram divididos em três grupos: GC – defeito sem colocação de biomaterial; GCol – scaffolds de colágeno (Bio-Gide, da empresa Geistlich Pharma Ag – Biomaterials); GPoli – scaffolds de fibras de blenda polimérica a partir de poli (ácido láctico-co-glicólico - Cellprene®). Cada grupo foi avaliado em quatro períodos experimentais (7, 15, 30 e 60 dias). Após esses períodos, os animais foram sacrificados, e as peças passaram por tramitação laboratorial de rotina e inclusão em parafina. Foram obtidos cortes semisseriados e corados pela técnica de hematoxilina e eosina para análise histométrica e histológica. Foi executada análise histométrica para avaliar a composição do tecido ósseo reparado (% osso). Os dados obtidos foram analisados estatisticamente com nível de significância de 95%. Resultado Foi verificado que o GCol apresentou maior preenchimento do defeito nos períodos de 30 e 60 dias em comparação aos GC e GPoli. Conclusão Os scaffolds de fibras de blenda polimérica a partir de poli (ácido láctico-co-glicólico) e poli-isopreno (Cellprene®) não apresentaram vantagens quando utilizados em defeitos críticos.

Abstract Introduction The bone quantity and quality in implant dentistry is a highly relevant factor when it aims the use of implants and rehabilitation in patients. However, this availability is compromised in most cases, with the need to research new biomaterials, membranes and substances for more favorable regeneration. Objective: The aim of this study was to evaluate the response of bone neoformation in critical defects in rat calvaries using polymeric blend fiber scaffolds from Poly (Lactic-Co-Glycolic Acid) and Polyisoprene (Cellprene®). The project was approved by the Animal Experimentation Ethics Committee. Material and method In this study 36 rats (Rattus Norvegicus), variation albinus, Holtzman, adults were used. The animals had trichotomy in the region of the skull and the confection of bilateral circular bone defects with a diameter of 5 mm. The animals were divided into 3 groups: Group GC - defect without biomaterial placement, Group GCol - collagen scaffolds (Bio-Gide, from Geistlich Pharma Ag - Biomaterials), Group GPoli - polymeric blend fiber scaffolds from Poly (Lactic-Co-Glycolic Acid)-Polyisoprene. Each group was evaluated in 4 experimental periods (7, 15, 30 and 60 days). After these periods the animals were sacrificed and the pieces underwent routine laboratory procedures and paraffin embedding. Semi-serial sections were obtained and stained by hematoxylin and eosin technique for histometric and histological analysis. Histometric analysis was performed to evaluate the composition of repaired bone tissue (% Bone). The data obtained were statistically analyzed with a significance level of 95%. Result It was found that the GCol group presented greater defect filling in the 30 and 60 days periods compared to the GC and GPoli groups. Conclusion Polymer blend fiber scaffolds from Poly (Lactic-Co-Glycolic Acid) and Polyisoprene (Cellprene®) did not have advantages when used in critical defects.

Abstract Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.