André Luis Caúla

Crestal bone loss around submerged and exposed unloaded dental implants: a radiographic and microbiological descriptive study.

The successful maintenance of crestal bone surrounding dental implants is imperative for long-term implant success. Crestal bone loss is reportedly related to stress. However, early perforation and partial exposure of the implant’s covering device are a focus for plaque accumulation, which, if left untreated, may result in inflammation. The objective of this study was to evaluate the crestal bone levels adjacent to submerged and exposed unloaded dental implants during the initial healing phase. In addition, the microbiota around exposed implants were studied. Bilateral implants were placed in the mandible of 10 patients. In one quadrant, the implants were covered by the flap. In the other quadrant, the flap was sutured, leaving the cover screws completely exposed. Standardized periapical radiographs were obtained at implant placement and 4 months later. Radiographs were digitalized, aligned, and analyzed with a computer-assisted method. Cultures were obtained from exposed implant sites. All patients showed more crestal bone loss around exposed dental implants compared to submerged implants. Prevotella sp., Streptococcus beta-hemoliticus, and Fusobacterium sp. were the microorganisms identified in most of the sites. The exposure of the implant covering device created foci for bacterial plaque accumulation, which may have facilitated periimplant crestal bone loss. The initial healing phase follow-up may be critical for implant success.

Implant-retained removable prosthesis with ball attachments in partially edentulous maxilla.

This clinical report presents a restorative option for the partially edentulous maxilla utilizing an implant-retained removable partial denture without retentive clasps. This approach required (1) fewer patient visits and laboratory procedures; (2) the use of minimal number of implants; (3) lower financial obligations; and (4) no sinus elevation surgery. The use of O-ring attachments provided excellent retention and stability. The detachable prosthesis over implants allows easier oral hygiene by the patient and provides superior esthetics and phonetics in cases involving advanced ridge resorption.

Implants for single first molar replacement: important treatment concerns.

The success rates of implants placed in the posterior region of both jaws are less than the anterior segments. Anatomic features, mastication dynamics, and adequate implant selection are all significant for long-term prognosis in the molar region. This article discusses important aspects in planning the use of dental implants in the areas of first molars.

Potential of recombinant human bone morphogenetic protein-2 in bone regeneration.

Recombinant human bone morphogenetic protein (rhBMP-2) has been used as a bone substitute. This article describes the rhBMP-2 structure, mechanisms of action, carriers, advantages, safety, and recent clinical studies relevant to dentistry.

Diagnoses, clinical classification, and proposed treatment of spontaneous early exposure of submerged implants.

Spontaneous early exposure of implants can become a serious complication during the initial healing phase. These early perforations and partial exposure of the coverscrews are a foci for plaque accumulation which, if left untreated, may result in inflammation, damage to the periimplant mucosa, and possible bone loss. Sometimes, these exposures are so small so as not to be clinically visible. This article presents methods of diagnoses of perforated mucosa around submerged implants. In addition, an easy-to-use classification of the spontaneous early exposure is proposed. Treatment modalities to prevent or intercept mucositis during the initial healing phase, when early exposures occur, are suggested.