Fábio Gonçalves

Effectiveness of 980-mm Diode and 1064-nm Extra-Long-Pulse Neodymium-Doped Yttrium Aluminum Garnet Lasers in Implant Disinfection

OBJECTIVE To evaluate the potential of 980-nm gallium aluminum arsenide (GaAlAs) and 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers to reduce bacteria after irradiation of implant surfaces contaminated with Enterococcus faecalis and Porphyromonas gingivalis and on irradiated implant surface morphology. BACKGROUND Despite the frequency of implant success, some implant loss is related to peri-implantitis because of difficulty in eliminating the biofilm. METHODS Implants (3.75 x 13 mm) with machined surfaces, surfaces sand blasted with titanium oxide (TiO(2)), and sand-blasted and acid-etched surfaces were exposed to P. gingivalis and E. faecalis cultures and irradiated with 980-nm GaAlAs or 1064-nm Nd:YAG lasers. After laser treatments, the number of remaining colony-forming units and implant surface morphology were analyzed using scanning electron microscopy (SEM). RESULTS The Nd:YAG laser was able to promote a total contamination reduction on all implants irradiated. The results with the GaAlAs laser showed 100% bacteria reduction on the implants irradiated with 3 W. Irradiation with 2.5 W and 3 W achieved 100% of bacteria reduction on P. gingivalis-contaminated implants. Decontamination was not complete for the sand-blasted TiO(2) (78.6%) and acid-etched surfaces (49.4%) contaminated with E. faecalis and irradiated with 2.5 W. SEM showed no implant surface changes. CONCLUSION The wavelengths used in this research provided bacteria reduction without damaging implant surfaces. New clinical research should be encouraged for the use of this technology in the treatment of peri-implantitis.

Clinical and histopathological analysis of intramucosal zirconia inserts used for improving maxillary denture retention

Intramucosal inserts made of zirconia ceramic have been used for the rehabilitation of edentulous patients. This study aimed to follow up on patients with complete dentures having intramucosal zirconia inserts and to perform a histological analysis of biopsies of the epithelium surrounding the inserts. Twelve 31-66-year-old subjects of both genders received complete denture treatment having the intramucosal inserts in place. Detailed clinical, prosthetic and surgical procedures were described. Clinical exams were done on postoperative days 3, 7, 15, 120 and 360. One year after denture placement, the subjects received local anesthesia and the tissues surrounding the insertion sites in the alveolar ridge were removed using a scalpel blade. Biopsies were fixed for up to 48 h in 10% phosphate-buffered formaldehyde and 5-microm-thick sections were cut and stained with hematoxylin and eosin and Gomori Trichrome. Immunohistochemistry was used to identify endothelium (anti-CD3) and T lymphocytes (anti-CD31). Removing and reinserting the denture was painful until day 15, but all patients reported a marked increase in the retention and stability of the complete denture with little or no discomfort after 30 days. The histopathological analysis showed that zirconia inserts were well tolerated by the oral mucosa, with the presence of collagen fibers in the tissue around the insert, with mild inflammatory response and allowing reepithelialization, expressed by parakeratosis, epithelial hyperplasia and presenting granular layer. In conclusion, intramucosal zirconia inserts did not affect the health of oral mucosa and provide adequate retention and stability of the complete denture and comfort to the patients.