v. 07, no. 4
Dental Press Implantology – ISSN 2237-650X
Dental Press Implantol.
v. 07, no. 4
October / November / December
A feeling of accomplishment...
The opportunity and privilege of being the editor of this journal for seven years, following those who expected its publication with great interest and worked hard to develop a journal of which high quality, not only in terms of display, but also content, has been proved within a short period of time, certainly give me the freedom to assert that this has been one of the most rewarding experiences of my career.
Interacting with friendly and active experts, professors and researchers, assimilating their knowledge and experience, and connecting with advanced technology companies that bring news of the global dental market, created an opportunity to link with modernity of which Implantology, always combined with other specialties, is enfolded.
Dental Press Implantology, published in Brazilian Portuguese and English, is currently indexed in BBO, LILACS, EBSCO, Ulrichsweb and Latindex. It offers more than 3,000 pages of excellence in reading, study and research published in the form of 190 articles, 25 interviews and other reference sections.
Congratulations to the always active and engaged team that has worked on the development of this journal. They are also responsible for achieving the objectives set in the first issue available since early 2007, in which it is emphasized that biological bases and scientific researches is what lays the foundation for good periodontists and implantologists.
With a feeling of accomplishment and a sense of pride at acknowledging that this journal has gradually occupied a unique position in national and international specialized literature as a result of an unceasing search for the best way to meet the demand for serious studies that deal with up-to-date themes, I exchange my position as an editor for that of a reader who can enjoy and celebrate the expressive approaches, results and contributions offered by this journal.
Different matters and projects have been implemented over the years, enriching the journal with new views on biomaterial and oral rehabilitation techniques. Moreover, the journal has offered up-to-date and motivating articles to professors, specialists, students and researchers, demonstrating that modern Dentistry requires its subareas to interconnect in order to establish a sensible and consistent practice that meets ethical and moral standards and embraces broad and up-to-date knowledge.
From this issue on, I end my contribution as the editor of this journal — but only as one of the editors. I believe that others may and must succeed those who took the first steps to accomplish this mission. My contribution remains as I continue to be one of the effective supporters of Dental Press Implantology, a journal that, in seven years of existence, has become a reference of content, proving that science and technology are strongly interconnected with progress, given that technology applies the knowledge produced by science.
I am certain that new accomplishments and challenges will come, and I believe that the key to success is searching and working to serve and accomplish.
My most sincere gratitude to all!
Stem cells: hope and reality
“Chinese researchers generate teeth from stem cells!” “Spanish laboratory grows bone from stem cells!” “Hamburger meat is produced from bovine stem cells swallowed by volunteers in London!” In no time, we will come across the news: “Central Bank grows money from stem cells!” Or would they be “stem cents”? [...]
Luis Guillermo Peredo Paz
Dr. Luis Guillermo Peredo Paz is Bolivian. He lives in Santa Cruz de La Sierra, Bolivia, and speaks perfect, accentless Brazilian Portuguese.
He is widely known in Latin America for belonging to the group of professionals that comprise the New Generation Latin American Dental Seminars (SOLA NG) and the International Academy of Integral Dentistry. Nevertheless, Dr. Luis Guillermo Peredo Paz is especially known for leaving the mark of his high-quality work and extensive Integrated Dentistry knowledge wherever he gives courses and conferences, a result of the four specialization courses as well as Master’s and Doctorate’s courses taken in Brazil, and his eagerness to be updated in all fields of study.
His Master’s thesis in Implantodontics was evaluated by a renowned board of examiners consisted of Professors Dr. P-I Brånemark and Dr. Waldir Janson. On that occasion, his adviser Prof. Dr. Carlos Eduardo Francischone emphasized: “Guillermo has a very interesting global education. His multi and interdisciplinary integration makes him stand out from the crowd.”
Dr. Luis Guillermo Peredo Paz has received many awards as recognition of his work inside and outside his country. One of them was the Galardão Mexicano de Odontologia given by the Ibero-Latin American Federation of Dentistry as a recognition of his fatigueless effort at broadening scientific knowledge and his renowned professional expertise.
He is currently an honorary member of the Chilean Society of Prosthetics and Oral Rehabilitation and a founder member of the European Academy of Implant Dentistry.
A charismatic and excellent person, he considers Brazil as his second home.
Dr. Luis Guillermo Peredo Paz feels blessed and deeply thankful to Brazil for his successful achievements. He had the opportunity to study at excellent universities in Curitiba and Bauru where he met many renowned professors. He was also privileged to share experiences and have a close relationship with Dr. Per Ingvar Brånemark, the “discoverer” of osseointegration and titanium dental implants, during his Master’s course in Implantodontics.
His fluency in English allowed him to present his scientific researches at the University of Tufts (USA) and Gothenburg (Sweden), eternizing his lessons in journals and books overseas. He is deeply thankful for the lifelong and loyal friends he has made, and reveres his masters, particularly highlighting the professional example and advice given by his adviser Dr. Ado Francischone who was responsible for introducing him to Implantodontics.
It could be said that the professional career of Professor Dr. Luis Guillermo Peredo Paz has been extremely successful. It is clear that he does what he loves and is fully supported by his wife Maria Paula, a Brazilian dentist graduated from the University of São Paulo (USP) / Bauru. Such support is proportionally given by their three kids.
An interview with Dr. Luis Guillermo gives the reader an outstanding example of professionalism and personal life.
Luis Rogério Duarte
Explanations and Applications
Focal osteoporotic bone marrow defect: Concept, diagnosis and osseointegrated implants
Focal osteoporotic defects in adult patients. Mandibular lesions.
Focal osteoporotic defects in adult patients must be on the list of differential diagnosis of small and medium uni and multiocular radiolucent lesions, especially in the jaw. Clinical and imaginologic diagnoses are safe; however, a biopsy must be performed in case of doubt, in which case the report will include hematopoietically active medullary tissue. Focal osteoporotic defects in adult patients do not hinder osseointegrated implant placement because, biologically speaking, they do not hamper bone repair. In fact, they may even favor it as a result of the large number of stem and osteoprogenitor cells comprising the bone marrow. Safe diagnosis is essential to differentiate focal osteoporotic defects from more severe similar lesions also found in the mandible. This study highlights the main characteristics of focal osteoporotic defect in adult patients, considering the condition as a variation of normal bone and medullary trabecula.
Dental Press Implantology assistant editor defends a dissertation on the use of bone substitute in animal with systemic disease
On November 13th, 2013, Dental Press Implantology assistant editor Dario Miranda received his Doctor of Implantodontics degree. Professors Dr. Carlos Eduardo Francischone and Alberto Consolaro (editors in-chief) were his advisers. For 20 years, Prof. Dario has worked with bone reconstruction material. Within the same scope, he developed his dissertation on the use of bone substitute in animals with systemic disease. His board of examiners was composed of the aforementioned professors as well as by Profs. Drs. Teresinha Santana and Viviane Sarmento. He has recently participated in a discussion on biomaterial in Philadelphia, and, in Chicago, he took part in a “task force” on scientific researches published around the world.
In addition to being Dental Press Implantology assistant editor, Dr. Dario Miranda is the editor of the Journal of Periodontology, Professor at the State University of Feira de Santana and owner of a dental clinic in the city of Salvador, Bahia.
Image and Science
Giving wings to imagination!
A) In bone repair, after 30 days, granulation tissue was replaced by primary bone tissue with extracellular matrix (1) rich in osteocytes (2) and with several basophilic reversal lines highlighting intense bone remodeling. In medullary spaces (3), haematopoietic tissue is established, with the inner walls full of osteoblasts (4) arranged in palisade and undergoing osteogenesis. In bone repair, photomicrograph registered White-bellied Nothura-shaped medullary space (HE, 40x).
B) The White-bellied Nothura is a species of tinamou found in South America, including Brazil. The bird feeds on insects and fruits. It can fly, but spends most of its time on the ground, hidden in the bushes to escape from predators. It is yellow, brown, white and black. Its scientific name is Nothura boraquira (http://brunochavesanimais.blogspot.com.br/2011/12/codorna-do-nordeste.htm; painting by Joseph Smit: http://commons.wikimedia.org/wiki/File:NothuraMarmorataSmit.jpg).
Overdentures and masticatory efficiency: literature review
Overdenture. Complete denture. Dental prosthesis.
Overdenture is defined as a completely or partially removable denture that covers or is supported by one or more remaining natural teeth, roots and / or dental implants. This study aims to examine the masticatory efficiency and patient acceptability of overdentures compared to conventional dentures. A literature review was performed to analyze the importance of dental prosthetic treatment to provide patients with proper function and optimal esthetics.
Imitating nature in prosthetic rehabilitation
Dental prosthesis. Dental esthetics. Dental implant.
Treating single-tooth edentulism with implants is a successful method used in Dentistry. However, restoring function with esthetic quality and natural gingival contour is a challenge that depends on the skills and esthetic sense of the professionals involved. This article aimed at discussing the clinical aspects of single-tooth edentulism by reporting a clinical case.
Surfaces in Implantology: Characteristics of the main Brazilian implants
Introduction: The superiority of rough-surface implants over machined ones seems to be consensual today. Different surface treatment methods have been developed to improve potential tissue response. This study critically reviewed the information that some Brazilian companies provide to dentists about the characteristics of surface treatment, methods as well as the recommended loading time, and analyzed whether these important data are based on scientific findings.
Methods: Six Brazilian companies, Conexão®, Kopp®, Neodent®, P-I Branemark®, S.I.N® and Titaniumfix® received a questionnaire about their products and respective surface treatment, recommended loading time and scientific evidence.
Results: Different treatment methods were reported: acid etching, abrasion followed by acid etching, and plasma immersion ion implantation (PIII). According to the information provided, loading time ranged from 1 to 6 months.
Conclusions: Although some companies conduct scientific studies to evaluate their implants, this study found that there was no scientific evidence to support the recommended loading times and that the information provided was not accurate.
Artificial gingiva with papilla restoration in single prostheses over malpositioned implants: an aesthetic and easy to clean alternative
Dental implants. Prosthetic complications. Dental esthetics. Artificial gingiva.
This study aimed at describing an alternative approach to the clinical condition of unfavorable implant positioning and unfavorable initial prosthetic planning. This article reports a viable alternative for these situations: the use of single crowns placed over implants with artificial gingiva. This technique reestablishes proper papillae region and proves to be an effective alternative with esthetic benefits and easy cleaning, as well as an important factor that favours the maintenance of peri-implant health.
Anatomic-functional transference of implants
Dental implants. Anatomic transfer. Passive fit. Implant impression.
In the oral cavity, there are rigid (teeth) and resilient structures (soft tissue) that are reproduced and, unfortunately, present different behaviors when in contact with impression material: Rigid structures do not undergo deformation and can generate accurate copies; whereas resilient structures undergo deformations that need to be conveniently treated so that the prosthesis does not cause injuries to soft tissues. It is essential that implants be precisely transferred to the work models, thus favoring precise positioning of analogues and, as a result, providing the lab technician with the appropriate conditions to fabricate prosthetic pieces that are appropriately adapted to the mouth. We use screwed impression copings that are placed by means of the direct transfer technique. Models are fabricated in two steps: (I) anatomical impression with stock tray and use of impression material of different consistencies, in layers; (II) functional impression carried out with customized tray and polyether or addition-cured silicones with different flows, in layers. After curing the impression material, excesses are removed and the impression copings are fixed to the customized acrylic tray with low shrinkage resin by means of the brush technique. After the impression material is cured, the impression copings are unscrewed and the model is removed from the oral cavity. The anatomical and functional transfer of multiple implants is essential for obtaining faithful models on which prostheses, which properly fit on implants with proper contact with soft tissues, are built, thus preventing potential injuries.
Histological evaluation of critical size bone repair treated with xenogen graft in rats induced to hypothyroidism
Bone repair. Hypothyroidism. Biomaterial.
This study aimed at assessing bone repair of critical-size defects by comparing normal animals with hypothyroid animals, with or without bone graft (Bio-Oss® Geistlich Pharma AG, Wolhusen, Switzerland) at two times of evaluation (30 and 60 days). Forty-two Wistar rats were used and divided into two major groups, namely: Group 1: Euthyroid, without graft, 30 days (G1E30); euthyroid, without graft, 60 days (G1E60); hypothyroid, without graft, 30 days (G1H30) and hypothyroid, without graft 60 days (G1H60). Group 2: Euthyroid, grafted, 30 days (G2E30); euthyroid, grafted, 60 days (G2E60); hypothyroid, grafted, 30 days (G2H30) and hypothyroid, grafted, 60 days (G2H60). The animals were induced to hypothyroidism by propylthiouracil (PTU) diluted with drinking water. Critical-size defects were created by trephine burs in the rats’ calvarium. Treatment was performed to prepare histological slides and analysis as well as to carry out statistical tests. 95% confidence interval (P < 0.05) was employed. Results revealed no statistically significant differences in cortical repair between hypothyroid and euthyroid animals at both times of evaluation. However, statistically significant differences were found in comparing 30 x 60 days (G1E60> G1E30, p = 0.01 G1H60> G1H30 and p = 0.01 G2h60> G2H30). Bone formation around graft particles was not statistically different when groups with the same time of evaluation were compared. Nevertheless, animals with hypothyroidism had bone formation associated with graft particles statistically greater 60 days after repair (G2H60> G2H30 P = 0.03). Based on the results of this study it is reasonable to conclude that the systemic condition did not significantly affect bone repair. Additionally, graft seemed to positively contribute to bone formation in induced animals.
Neuropathic pain. Post-implant neuropathy. Dental implants.
The use of dental implants in partial or total edentulous arches is considered the gold standard of oral rehabilitation. This procedure has high success rates mainly due to the advanced features of imaging exams such as cone beam computed tomography (CBCT). However, some intra- and postoperative complications may occur. One potential complication is post-implant neuropathy (PIN), a traumatic trigeminal neuropathy caused by direct or indirect nerve trauma. The most affected nerves are the inferior alveolar nerve and lingual nerve. This condition can be clinically reported as anesthesia, paresthesia, hypoesthesia, hyperesthesia and/or dysesthesia. PIN is not a frequent condition, but it significantly affects patient’s social life. Additionally, it is very difficult to be diagnosed and treated. The aim of this article is to review the literature about PIN so as to clarify its concept, possible causes, as well as best diagnostic and treatment approach.
Biomechanical study of prosthetic interfaces: A literature review
Dental implants. Biomechanics. Prosthesis failure.
Implantology has improved its biological and mechanical characteristics. However, the big challenge nowadays is to offer esthetic rehabilitation treatment that is durable and, at the same time, enables maintenance of the surrounding structures, such as bone and mucosa, where this balance depends on several factors, including the type of prosthetic interface. The first implants were developed by superimposing external hexagonal interface, however, several reports have described clinical complications that resulted in loosening of screws, as well as fractures of implants and prosthetic components. To reduce these failures, mechanical connections — hexagonal, triangular, octagonal or conical — were developed with internal fitting. With the advent and the several options of prosthetic interfaces available for rehabilitation planning, greater knowledge about their biomechanical characteristics and longevity is required.
Using synthetic biomaterial to fill peri-implant defects (gap) in immediate implants
Dental implants. Bone transplant. Biocompatible material.
Osseointegrated implant placement requires proper bone volume, however, tooth extraction requires different standards of bone resorption and bone remodeling. Alveolar ridge resorption has been considered an inevitable consequence of tooth extraction and may be a significant issue for Implantodontics. Despite immediate implant placement, the edentulous site of the alveolar process undergoes substantial bone remodeling, with reduction in the dimensions of the alveolar crest after tooth extraction. After implant placement in a fresh extraction site, a gap is often formed between the ridge and the implant surface. With a view to overcoming this issue and to favor bone formation within the gap, several grafting procedures have been employed in association or not with barrier membranes as well as several types of bone substitutes. In this context, this article aims at conducting a literature review to discuss the use of synthetic biomaterial to fill the gaps that form around implants placed in fresh sockets. Nevertheless, no biomaterial available to date provides the desirable properties. Additionally, residual bone volume must be assessed before tooth extraction in order to allow the dental surgeon to employ different techniques with a view to preserving the alveolar bone.
Abstracts of articles published in important Implantology, Prosthodontics and Periodontics journals from around the world