Browsing by Author "Borges, Tiago"
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- #019. Abordagem cirúrgica na tração ortodôntica de dente 1.1 retidoPublication . Carreiro, Elisa; Martins, Inês; Martins, André Alves; Borges, Tiago; Almeida, Bruno Leitão deIntrodução: A abordagem de situações de retenção dentária é frequente na clínica de cirurgia oral, sendo relatado na literatura que aproximadamente 20% da população possui pelo menos um dente retido, não sendo o incisivo central um dente com prevalência de retenção assinalável. A etiologia das retenções dentárias é muito variada, nomeadamente fatores hereditários, embriológicos, disfunções endócrinas e causas locais. As complicações associadas incluem, entre outras, lesões quísticas associadas, reabsorção de dentes vizinhos, alterações no processo de erupção e comprometimento estético e funcional. O tratamento poderá ser alcançado através da exposição cirúrgica associada ou não a tração ortodôntica, translocação, transplante ou exodontia. O exame radiográfico, a par do exame clínico, é fundamental na elaboração do diagnóstico e planeamento cirúrgico‐ortodôntico, permitindo a resolução destes casos, restabelecendo a estética e a função. Descrição do caso clínico: Paciente do sexo masculino, saudável, com 14 anos, apresentou‐se com queixa de ausência de um incisivo central. O plano de tratamento selecionado incluiu a colocação de aparatologia ortodôntica fixa, exodontia do 5.1 e exposição cirúrgica do 1.1 para tração. Foi realizada uma incisão em envelope de espessura total intrassulcular sem descargas, estendida do dente 2.1 ao 1.3, descolamento, osteotomia conservadora até à linha amelocementária, e colagem de bracket e cadeia metálica para tração. O paciente prosseguiu o tratamento ortodôntico durante 2 anos, tendo optado pela sua remoção após posicionamento adequado do 1.1 na arcada. Discussão e conclusões: A tração de dentes retidos é um desafio que necessita uma abordagem multidisciplinar, nomeadamente ortodôntica e cirúrgica. No caso clínico em questão, o tratamento revelou‐se eficaz, visto que foram atingidos os objetivos principais: o dente ficou corretamente posicionado na arcada dentária (sem reabsorções radiculares ou outro tipo de complicações) e com restabelecimento estético e funcional.
- #056. Análise da distribuição de tensões em implantes angulados de diferentes comprimentosPublication . Xavier, Joana; Borges, Tiago; Marques, Marco; Parente, Marco; Faria‐Almeida, Ricardo; Tavares, João Manuel R. S.Objetivos: O principal objetivo deste estudo in vitro foi avaliar, com base no método dos elementos finitos, o uso de implantes curtos em reabilitação mandibular total e como o comprimento desses implantes influencia a distribuição de tensões durante a aplicação de cargas mastigatórias em reabilitações mandibulares, de acordo com o conceito All‐on‐4®. Materiais e métodos: Foi realizada a modelização de um implante comercial em SolidWorks®. Foram também modelizadas 2 mandíbulas: uma real, baseada num exame de tomografia computorizada (TC) e usando o Mimics®; e uma segunda construída virtualmente em SolidWorks®. De seguida, os implantes foram colocados de acordo com o protocolo All‐on‐4®. Os 2 implantes anteriores, com um comprimento constante de 8 mm, foram colocados verticalmente na zona incisivos inferiores. Os 2 implantes posteriores foram colocados na área pré‐molar com uma angulação distal constante de 30°, e com comprimentos de 8, 6 e 4 mm. Nos implantes, foi colocada uma barra fixa ferulizada que simula a reabilitação implantossuportada. O conjunto foi colocado tanto sobre a mandíbula virtual, como sobre a mandíbula real. Sobre os modelos construídos foram simuladas cargas mastigatórias, tendo sido registados os valores máximos obtidos. Resultados: Concluiu‐se que os valores médios obtidos para as amostras geradas em cada tipo de mastigação no modelo virtual para o implante e osso foram significativamente diferentes dos valores médios registados no modelo real, excetuando na mastigação bilateral no modelo com implantes de 8 mm e na mastigação unilateral sobre o cantilever no modelo com implantes de 4 mm. Os níveis mais baixos de tensão implantar foram registados nos modelos com implantes de 8 mm. Conclusões: A utilização de implantes curtos deve ser feita cuidadosamente, sobretudo em reabilitações tipo All‐On‐4®. Mais estudos devem ser realizados, a fim de compreender a influência da angulação do implante na distribuição de tensões. Esforços futuros devem procurar a criação de modelos virtuais mais fidedignos.
- A 3D digital analysis of the hard palate wound healing after free gingival graft harvestPublication . Marques, Tiago; Ramos, Sara; Santos, Nuno Bernardo Malta dos; Borges, Tiago; Montero, Javier; Correia, André; Fernandes, Gustavo Vicentis de OliveiraPurpose: Within this context, this pilot study aimed to evaluate the healing dynamics process of the hard palate after free gingival graft harvesting in the short term (3 months), utilizing digital imaging technology and tridimensional analysis software. Furthermore, assessing the results found to verify the existence of a relationship between gender or age with tissue loss. Materials and Methods: For connective-tissue harvesting, fifteen patients with gingival recessions type (RT) 1 and RT2 were selected. On the surgery day (before the procedure) and after three months, palatal impressions were taken in all patients, and cast models were done for posterior model scanning. The following variables were analyzed: mean thickness alterations (x¯ TA), maximum thickness loss (MTL), mean maximum thickness loss (x¯ MTL), and volume alterations (VA). A descriptive and bivariate analysis of the data was done. The data were submitted for statistical evaluation and were significant if p < 0.05. Results: Fifteen patients were analyzed, 11 females (73.3%) and four males (26.7%). The patients’ average age was 28 ± 8.52 years (ranging between 16 and 48 years old). The palatal wound region’s mean thickness and volume changes were −0.26 mm (±0.31) and 46.99 mm3 (±47.47 mm3) at three months. There was no statistically significant result correlating age/gender with any variable evaluated. Conclusions: Connective tissue graft harvesting promoted changes with a standard volume and thickness loss of palatal soft tissue. A 3D digital evaluation was a non-invasive method with a reproducible technique for measuring thickness or volume after connective tissue is collected. There was no relationship between age/gender and any variables analyzed.
- Adaptação marginal de coroas provisórias de implantes colocados imediatamente após exodontiasPublication . Borges, Tiago; Carvalho, Ana Rita; Carvalho, C.; Carvalho, V.A literatura científica descreve bons resultados de osteointegração em implantes dentários colocados em carga imediata através da utilização de coroas provisórias. As diferenças verificadas entre as taxas de sucesso relativas a este tipo de procedimentos estão relacionadas com factores anatómicos (locais de colocação), tipo de soluções protéticas utilizadas, tipo de fixação das soluções protéticas e procedimentos complementares à colocação do implante, como regenerações ósseas ou de tecidos moles. Com este trabalho pretendemos optimizar uma técnica de adaptação marginal de coroas provisórias imediatas após a colocação de implantes dentários unitários no sector anterior. Descreve-se um método de adaptação marginal de coroas provisórias aparafusadas sobre implantes unitários, colocados após extracções dentárias, através da utilização de um pilar provisório em plástico, coroas em vinil, resina auto-polimerizável e um modelo em silicone putty, utilizado para a adaptação fi nal com compósito flow. Esta técnica possibilita uma boa adaptação dos tecidos moles peri-implantares, uma redução do tempo de tratamento e melhoria na satisfação dos pacientes em relação ao tratamento realizado.
- Autotransplante dentário para preservação óssea com posterior colocação de implante dentário: caso clínicoPublication . Carvalho, V.; Carvalho, C.; Carvalho, A; Borges, Tiago; Afonso, A.; Carvalho, V.
- Clinical outcome of inter-proximal papilla between a tooth and a single implant treated with CAD/CAM abutments: a cross-sectional studyPublication . Borges, Tiago; Lima, Tiago; Carvalho, Ágata; Carvalho, VascoObjectives: The aim of this study was to assess the clinical outcomes achieved with Computer-Assisted Design/Computer-Assisted Manufacturing implant abutments in the anterior maxilla. Material and Methods: Nineteen patients with a mean age of 41 (range form 26 to 63) years, treated with 21 single tooth implants and 21 Computer-Assisted Design/Computer-Assisted Manufacturing (CAD/CAM) abutments in the anterior maxillary region were included in this study. The patients followed 4 criteria of inclusion: (1) had a single-tooth implant in the anterior maxilla, (2) had a CAD/CAM abutment, (3) had a contralateral natural tooth, (4) the implant was restored and in function for at least 6 months up to 2 years. Cases without contact point were excluded. Presence/absence of the interproximal papilla, inter tooth-implant distance (ITD) and distance from the base of the contact point to dental crest bone of adjacent tooth (CPB) were accessed. Results: Forty interproximal spaces were evaluated, with an average mesial CPB of 5.65 (SD 1.65) mm and distal CPB of 4.65 (SD 1.98) mm. An average mesial ITD of 2.49 (SD 0.69) mm and an average distal ITD of 1.89 (SD 0.63) mm were achieved. Papilla was present in all the interproximal spaces accessed. Conclusions: The restoration of dental implants using CAD/CAM abutments is a predictable treatment with improved aesthetic results. These type of abutments seem to help maintaining a regular papillary filling although the variations of the implant positioning or the restoration teeth relation.
- Comparative clinical behavior of zirconia versus titanium dental implants: a systematic review and meta-analysis of randomized controlled trialsPublication . Morena, Danilo; Leitão-Almeida, Bruno; Pereira, Miguel; Resende, Rodrigo; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira; Borges, TiagoObjective: The goal of this systematic review and meta-analysis was to assess whether there were clinically relevant differences in the treatment of edentulous areas comparing zirconia (Zr) and titanium (Ti) dental implants. The null hypothesis is that no differences can be observed in terms of the clinical parameters; the positive hypothesis I is that Zr implants have generally better results compared to Ti implants; and the positive hypothesis II is that Ti implants have a generally superior result than Zr implants. Methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized controlled trials (RCTs) from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. The quality assessment and risk of bias were evaluated using a Cochrane risk-of-bias assessment tool specifically designed for randomized trials (RoB2). A meta-analysis was conducted to correlate different treatment options based on the described outcomes; a random-effects model was used in the analysis of the variables. The analysis of heterogeneity was conducted by means of Cochran’s Q-test and Higgins’ I2 statistic. Results: Six RCTs were enrolled; 152 patients (90 males and 62 females) and 448 implants (267 Zr and 181 Ti) were included. Dental implant placement involved both the maxillary and mandibular arches. The implant sites showed heterogeneity in receiving Zr and Ti dental implants; in particular, 22 dental implants were placed in the mid-palatal region and 426 dental implants in the alveolar region (255 were in Zr and 171 in Ti). Regarding the success rate, it was better for Zr but with no statistical difference (p > 0.05); bleeding on probing had slight differences between Ti with 0.34% ± 0.42 and Zr with 0.26% ± 0.36 (p > 0.05); plaque score showed 0.46 ± 0.47 for Ti compared to 0.44 ± 0.49 for Zr (p > 0.05); no statistically significant difference was observed for pink esthetic score (PES). Statistically significant results were found for survival rate, which favored Ti implants (77.6%) compared to Zr (70.3%) (p < 0.05), and for marginal bone loss, which showed less loss in Ti implants (0.18 mm ± 0.47) compared to 0.42 mm ± 0.40 in Zr at 12 months (p < 0.001). Conclusions: The present systematic review and meta-analysis identified the positive hypothesis I and rejected the null and positive hypothesis II; it was possible to conclude that Ti dental implants have a better survival rate and less marginal bone loss than Zr dental implants after 1-year follow-up.
- Dental implant outcomes in grafted sockets: a systematic review and meta-analysisPublication . Ramanauskaite, Ausra; Borges, Tiago; Almeida, Bruno Leitão; Correia, AndréObjectives: To assess the treatment outcomes of the dental implants placed in the grafted sockets.Material and Methods: A search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles.Results: The present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseases.Conclusions: Implants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.
- Editorial: role of the surface in peri-implant bone biologyPublication . López-Valverde, Antonio; Borges, Tiago; Vale, Francisco; Sousa, Bruno Macedo de
- Effect of customized healing abutments on the peri-implant linear and volumetric tissue changes at maxillary immediate implant sites: a 1-year prospective randomized clinical trialPublication . Fernandes, Danilo; Nunes, Sílvia; López-Castro, Gonzalo; Marques, Tiago; Montero, Javier; Borges, TiagoBackground: Immediate implant placement (IIP) associated with the use of bone substitutes and collagen matrices (CM) seems to reduce the amount of resorption at peri-implant areas. Recently, customized healing abutments (CA) appeared as another solution in order to seal the socket and preserve the original soft tissue contour. Purpose: To evaluate peri-implant tissues dimensional changes after using customized healing abutments compared with the use of xenogeneic collagen matrices as socket sealing options in flapless maxillary immediate implant placement. Material and methods: The present study was designed as a prospective, randomized, controlled clinical trial. Patients were allocated into two groups depending on the socket sealing option: in the CM group a collagen matrix was used and in the CA group a customized abutment. Digital impressions were taken prior to extraction, 1, 4, and 12 months after implant insertion and the digital files allowed to evaluate linear buccal changes (MBC) and the buccal volumetric variation (BVv) between the different time points at peri-implant tissue areas. Additionally, mucosa variation was computed assessing the papilla presence and the midfacial mucosa height. Statistical significance was set at 0.05. Results: Twenty-eight patients were observed during a 12-month period. Significant differences between mean values of BVv at the first month were observed at the CM and CA group (−9.75 ± 6.65% and −4.76 ± 5.29%, respectively) (p = 0.043). At the 1-year follow-up, no significant differences were found in terms of BVv between the two groups, although the thin bone phenotype (≤1 mm) significantly influenced the volumetric variations that occurred in each group. No significant differences were noticed in midfacial mucosa and papillae alteration between groups, after 1 year of treatment. Conclusion: Both treatment options are predictable solutions for socket sealing in IIP, although a higher volumetric variation can be expected in the presence of thin bone phenotypes.