Jean Uhlendorf’s research while affiliated with Instituto Latino Americano de Pesquisa e Ensino Odontológico and other places

Objetivo: Identificar a taxa de sobrevivência e comparar a resposta óssea peri-implantar em implantes imediatos instalados ou não por meio de cirurgia guiada. Materiais e Métodos: Foram selecionados 12 pacientes, os quais possuíam 12 implantes imediatos realizados sem retalho em região anterior da maxila há, em média, 2 anos. Estes foram divididos em dois grupos: Grupo I de implantes instalados em cirurgia à mão livre e provisionalização imediata e Grupo II de implantes instalados utilizando o Neodent Guided Surgery (NGS) e submetidos a provisionalização imediata com a utilização de TiBase com pilar de zircônia. Imagens radiográficas foram obtidas em 2 tempos: Imediatamente após a instalação dos implantes (T1), e entre 12 e 59 meses (Média = 24,4 meses) após a instalação dos implantes(T2). O nível ósseo foi avaliado em duas diferentes posições, no ponto onde há o primeiro contato do osso com a face lateral do implante (Alt 1) e na crista óssea (Alt 2), nas faces mesial e distal. Resultados: Observou-se redução na altura óssea em todas as variáveis, porém com significância estatística apenas no grupo I, medida Alt 1 face distal e Alt 2 face mesial. Conclusão: Em ambos os grupos a taxa de sobrevivência foi de 100%, e a redução em altura óssea observada está de acordo com os dados da literatura.

The design of short and extra-short dental implants has evolved to increase their survival rates and reduce levels of bone loss. This case report describes successful rehabilitations of atrophic posterior mandibles using digital workflow for new extra-short and short implants, with one year of follow-up. Two patients with bone height limitations were rehabilitated using extra short and short implants (4 and 5 mm in length) in the posterior mandible. After 3 months, digital workflow was used, provisional restorations were designed and processed in a CAD/CAM. After 5 months of surgical procedure, the final metal-ceramic restorations were delivered following the same digital workflow process. The patients were followed for one-year post-surgery. The new design of extra short and short dental implants used for the prosthetic rehabilitation through digital workflow represented a favorable treatment for atrophic posterior mandible.

The immediate rehabilitation of the posterior region of the mandible with dental implants, expands the set of possible actions for the dental surgeon, in the face of tooth loss. The purpose of this study is to describe two cases of single rehabilitation of mandibular molars with hybrid internal tapered implants indicated for immediate loading in post-extraction socket, associated with the maintenance of the prosthetic and peri-implant space. Implants with macrogeometry and surface treatment (Hydrophilic) were used to optimize primary stability, as well as the type of internal connection and prosthetic abutments that allows better accommodation and healing of adjacent tissues, and protection of the bone graft. Different methodologies of surgical guides did not influence the final result. The predictability of associating techniques and components can be observed in the 2-year follow-up. The initial planning combined with the new technologies enable to achieve stable and functional final restorations. Indexing terms Dental implantation; Dental prosthesis; Dental restoration temporary; Molar; Mouth rehabilitation

Narrow‐diameter implants (≤3.5 mm) have been proposed to address the challenge of implant placement in cases of insufficient bone quantity, thin alveolar crest, and small cervical diameter teeth replacement The aim of this study is to report one‐year outcomes of extra‐narrow implant rehabilitation of maxillary lateral incisors, due to agenesis, in a young adult that presented sites with reduced mesiodistal and buccolingual dimensions. A 26‐year‐old male patient in need of fixed‐implant supported prostheses due to the absence of permanent maxillary lateral incisors and with limited space, was submitted to surgery to receive two 2.9 mm hybrid Morse taper connection implants with hydrophilic surfaces. Immediate loading was applied by means of insertion of provisional prostheses, which were replaced for all‐ceramic prostheses 12 months after surgery. The 1 year follow‐up showed clinical and radiographic success of extra‐narrow implant rehabilitation. Also, both regions presented good evolution of peri‐implant esthetics, as assesses using the pink esthetic score, with improvements at 4 months follow‐up and reaching high scores 12 months after surgery. Although the prosthetic rehabilitation of maxillary lateral incisors is challenging due to limited space for the insertion of implants, the clinical case suggests that the use of extra‐narrow Morse Taper implants with hybrid design and hydrophilic surface is a reliable alternative, presenting good outcomes regarding hard and soft tissue and it is a versatile solution or immediate loading procedure. Further studies are needed to confirm extra‐narrow implant predictability.

This case report describes the treatment of two patients who presented with single edentulous sites in the region of upper premolars and were rehabilitated through the placement of injection‐molded 2‐piece zirconia implants and immediate single crowns. Three months after surgery, definitive prostheses were confectioned through digital workflow. Both patients were followed for 12 months during which clinical and radiographic implant success were observed, concerning implant stability, absence of peri‐implantitis signs, complete implant osseointegration, good marginal bone‐level maintenance, and excellent soft tissue esthetics. No biological or mechanical complications were observed within this period. The clinical cases suggest that treatment with injection‐molded 2‐piece zirconia implants and zirconia abutments is a successful and reliable alternative for single‐unit immediate rehabilitation, with predictable results in the short‐term concerning.

Tooth loss can occur due to several factors including dental caries. Immediate replacement of posterior teeth with dental implants facilitates to plan and to obtain consistent results with good prognosis. Factors such as minimally traumatic extraction, primary implant stability, maintenance of proximal bone ridges, buccal and lingual bone plates, in addition to a temporary or customizable component for tissue stabilization are important parameters to make the case predictable. The immediate technique for implants placement in the posterior regions has been described in the literature since the 1990s, presenting a high success rate and predictability of patients rehabilitation with shorter waiting times and maintenance of soft and bone tissue architecture. This study reports a clinical case of extraction of an upper molar tooth (26) with dental caries and placement of an extra-wide diameter implant, followed by filling of the surgical alveolar socket with bioactive calcium phosphate ceramic and placement of a customizable healing abutment. Clinical and radiographic control was performed after 8 months with success, with maintenance of soft tissue and marginal bone.

A reabilitação de maxilas atróficas com implantes dentários é sempre um desafio, visto que o uso de enxertos ósseos é quase sempre necessário para estabilização dos implantes. Os implantes zigomáticos têm sido utilizados como uma opção viável ao uso de procedimentos de enxertia óssea anterior à cirurgia. A interface cônica interna apresenta gap reduzido entre implante e componente protético, mostrando resultados biológicos e estéticos satisfatórios a longo prazo. Este artigo tem como objetivo relatar a reabilitação protética imediata de uma maxila atrófica com implantes convencionais e zigomáticos com interface cônica interna como opção ao uso de enxertos ósseos prévios. Paciente com 47 anos de idade, do sexo masculino, apresentava maxila atrófica e usava uma prótese total superior. O paciente foi reabilitado com quatro implantes convencionais na região anterior e dois implantes zigomáticos cônicos internos instalados nos ossos zigomáticos. Os torques de instalação dos implantes ≥ 60 N.cm proporcionaram estabilidade primária ideal e uma prótese (protocolo) foi instalada imediatamente utilizando a técnica do assentamento passivo. O caso clínico apresentado mostrou que, após 1 ano, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes zigomáticos combinados com implantes convencionais para reabilitação de maxilas atróficas de forma imediata e sem utilização de enxerto ósseos prévios.

Immediate loading of full-arch prostheses on dental implants in the upper arch is challenging, as the bone is of low quality and obtaining sufficient torque may be difficult. The purpose of this case report is to describe the rehabilitation of a full-arch by means of placement of four internal tapered connection tilted implants and immediate loading. A 65-year-old man sought dental care with a partially edentulous upper arch. The teeth presented mobility and were extracted. In a second step, two conventional-length implants were placed in the anterior region and two tilted and nasal wall–directed extra-long implants in the posterior region. The insertion torques of 60 N.cm allowed the installation of an immediate prosthesis (hybrid). The clinical case report suggests that the placement of tilted and extra-long implants in the paranasal bone and immediate loading may be a viable option for rehabilitation of the edentulous upper arch.

Precise planning for dental implant placement requires appreciation of anatomical limitations and restorative purpose. Diagnosis can be made by complementary exams such as panoramic radiography and cone-beam computed tomography. The purpose of this study was to rehabilitate the upper and lower jaw of a patient with severe periodontal disease using a guided osteotomy and implants placed with free hands and Morse taper implants. The concept of guided surgery was used to prepare the alveolar bone to place eight implants, four implants in the upper jaw and four implants in the lower jaw, all have achieved a minimum torque of 60 Ncm. The modified suture technique was used to better stabilize the soft tissue around the mini conical abutments. The analogues were scanned by CAD/CAM for confection of the metallic structures of the bridges. On the third day, the upper and lower full arch prostheses were installed and simultaneous bilateral contacts were adjusted. After 12 months of patient follow-up, the implants and prostheses were in good condition of aesthetics and function, maintaining the success of the rehabilitation. Within the limitations of this clinical case, it can be concluded that the implants placed with free hands was facilitated by a previous guided osteotomy.