Browsing by Author "Carvalho, Jorge José de"
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- Clinical analysis of the influence of surface roughness in the primary stability and osseointegration of dental implants: study in humansPublication . Brum, Igor da Silva; Elias, Carlos Nelson; Lopes, João Carlos Amorim; Frigo, Lucio; Santos, Paulo Gonçalo Pinto dos; Carvalho, Jorge José deIn past decades, the success rates of the first dental implant treatments were low (75%). Nowadays, oral rehabilitation with titanium dental implants has a high success rate (95%–98%). The success rate significantly increases due to increased scientific knowledge about osseointegration, changes in surgical techniques, and the development of implant surface treatments. Despite the high success rate of implants, there are no protocols to define the time for the prosthesis to be installed, the insertion torque, and the prosthesis loaded after surgery. This work compares a new dental implant’s primary (mechanical) and secondary (osseointegration) stability. Dental implants with micro- and nano-roughness surfaces were placed in 24 patients with a minimum of 35 N·cm and a maximum of 60 N·cm. Primary stability was quantified with a torque wrench and an Ostell Mentor Device. The secondary stability 45 and 60 days after surgery was measured with Ostell. The results showed no statistical difference in secondary stability at 45 and 60 days postoperatively among implants. The success rate of dental implants can be associated with the surface morphology with micro- and nano-roughness, the insertion torque value, and the shape of the implant threads. When the manufacturer’s guidelines are followed, it is possible to prosthetically rehabilitate the patient with an implant 45 days after surgery.
- Digital planning for immediate implants in anterior esthetic area: immediate result and follow-up after 3 years of clinical outcome - case reportPublication . Salviano, Saulo Henrique; Lopes, João Carlos Amorim; Silva Brum, Igor da; Machado, Kelly; Pedrazzi, Marco Tulio; Carvalho, Jorge José deIn this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. Objective: We aimed to use dental implants to rehabilitate the area of elements #11 and #21 in a satisfactory surgical and prosthetic manner, using guided surgery, connective tissue, nano-biomaterials, and a porcelain prosthesis. Case Report: A 32-year-old male patient presented with bone loss of elements #11 and #21, which was proven radiographically and clinically. Thus, oral rehabilitation with the use of dental implants was required. It was decided to proceed via digital planning with the DSD program (Digital smile design) and with the software Exoplan, (Smart Dent-Germany) whenever it was possible to plan immediate provisional and accurate dental implant positioning through reverse diagnostics (Software Exoplan, Smart Dent-German). The dental elements were extracted atraumatically; then, a guide was established, the implants were positioned, the prosthetic components were placed, the conjunctive tissue was removed from the palate and redirected to the vestibular wall of the implants, the nano-graft (Blue Bone®) was conditioned in the gaps between the vestibular wall and the implants, and, finally, the cemented provision was installed. Results: After a 5-month accompaniment, an excellent remodeling of the tissues had been achieved by the implants; consequently, the final prosthetic stage could begin, which also achieved a remarkable aesthetic result. Conclusions: This report demonstrates that the correct planning of dental implants, which is associated with appropriate soft tissue and bone manipulation, allows for the achievement of admirable clinical results.
- Histomorphometric evaluation of bone-guided regeneration in maxillary sinus floor augmentation using nano-hydroxyapatite/beta-tricalcium phosphate composite biomaterial: a case reportPublication . Salviano, Saulo Henrique; Lopes, João Carlos Amorim; Brum, Igor da Silva; Frigo, Lúcio; Santos, Mário José dos; Consonni, Sílvio Roberto; Carvalho, Jorge José deBackground: The development of techniques in biomaterials design and production added to advanced surgical procedures which enabled better and more predictable clinical out-comes. Maxillary sinus floor augmentation (MSFA) is among the more studied bone-guided regeneration procedure in the literature. The MSFA could be considered the gold standard procedure for bone-guided regeneration as it provides suitable functional and aesthetic solutions to alveolar ridge atrophy due to tooth loss. Purpose: This study aimed to conduct a detailed histomorphometric evaluation of collagen production in SFAs bone-guided regeneration, using nano-hydroxyapatite/beta-tricalcium phos-phate (nano-HA/beta-TCP) composite. Patients and Methods: A 52-year-old female had the left upper second premolar con-demned due to periodontal disease, then a tooth implant replacement was planned. Due to maxillary sinus pneumatization, the MSFA had to be done before implant placement. Nano-HA/beta-TCP composite (2g) was used in the MSFA procedure. After nine months of the healing process, during the Cone Morse implant installation process, bone samples were collected for histologic analysis (sirius red, hematoxylin/eosin, polarized microscopy). Six months after implant installation, a ceramic crown was installed according to the patient's request. Results: Proper masticatory function and aesthetics were re-established. The histomorpho-metric evaluation indicated that nano-HA/beta-TCP composite did not show any area devoid of cellular activity in sirius red or hematoxylin/eosin staining and the percentage (%) of new bone collagen fibers was achieved using polarization technique evaluation. Conclusion: According to these results, nano-HA/beta-TCP composite presented clinical and histomorphometric properties suit to be used as bone-guided regeneration biomaterial in MSFA. Furthermore, nano-HA/beta-TCP composite provided a favorable nano-environment to bone cells, enhancing bone matrix production.