One-abutment one-time effect on peri-implant marginal bone: A prospective, controlled, randomized, double-blind study Filipe Moreira, Salomão Rocha, Francisco Caramelo, João P. Tondela Materials, 2021 Objective: To evaluate the peri-implant hard tissue change at 6 and 12 months after implant placement between definitive abutment placed at the same time of implant surgery, never removing it, and healing abutment disconnected and reconnected three times until the placement of the final rehabilitation. Material and methods: Each partial edentulous patient could receive between 1 and 4 platform-switched implants in the posterior regions. If the implants had primary stability—implant stability quotient (ISQ) equal to or greater than 50, they were randomized to the test group with the abutment inserted at the same time of implant placement (DA) or to the control group, receiving a healing abutment (PA). At 6 and 12 months after surgery, data related with vertical bone level changes (primary outcome) and other clinical parameters (implant mobility, bleeding on probing, probing depth, plaque index) were assessed. Results: 53 implants were included in the trial and completed 12 months follow-up (overall survival rate: 100%). All implants achieved primary stability, with an average ISQ value of 80.9 on the day of surgery. From surgery to 6 months, the mean bone loss was 0.14 ± 0.18 mm for the DA group and 0.23 ± 0.29 mm for the PA group, without statistical significance difference. Between 6 and 12 months, the mean bone loss was 0.14 ± 0.21 mm for the DA group and 0.21 ± 0.27 mm for the PA group, also without statistical significance between the two groups. There were no statistically significant differences (p = 0.330) in total bone loss after 12 months between the control and the study groups. Conclusions: The one abutment one time protocol has at least an equivalent effect on the peri-implant bone level changes when compared with the use of healing abutments that are disconnected and reconnected at least three times.
Clinical and radiographic performance of self-locking conical connection implants in the posterior mandible: Five-year results of a two-centre prospective study Maximilian Moergel, Salomão Rocha, Ana Messias, Pedro Nicolau, Fernando Guerra, et al. Clinical Oral Implants Research, 2021 Objective This prospective study aims to assess the 5‐year clinical performance of implants with internal conical connection and platform‐switched abutments in the posterior mandible. Material and Methods Healthy adults missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent implants. After a transmucosal healing period single crown restorations were cemented on platform‐switched abutments. Changes in marginal bone levels were investigated in standardized periapical radiographs from surgery and loading (baseline) to 60‐months post‐loading. Results Twenty‐four patients received 52 implants. Bone remodelling took place between surgery and loading (mean:‐0.5, SD:±0.4 mm). From loading to 60 months, there was a mean bone change of 0.27 (SD:±0.47 mm) which stabilized 24 months after prosthesis delivery (mean:0.2, SD:±0.46 mm). 71.7% of all implants presented bone preservation at 60 months irrespective of the initial insertion depth. Two implants were lost after 5 years and the success rate was 95.1%. Patient enquiry revealed high satisfaction. Conclusion Internal conical connection implants with platform‐switched abutments presented a high success rate and preservation of marginal bone levels at the implant shoulder after 5 years of loading.
Risk and limits in dental practice: A Portuguese approach to medical-legal evaluation and professional liability Journal of Forensic Odonto Stomatology, 2020
UC-USP collaborative exercise on photobiomodulation therapy in neurological orofacial disturbances T. Nunes, C. Caetano, M. Pimenta, J. Saraiva, S. Rocha, et al. Journal of Clinical and Experimental Dentistry, 2020 Background Neurosensory peripheral disorders are one of the most common risks associated with iatrogenic and/or post-traumatic injuries. It is often related to disability. Photobiomodulation therapy (PBMT) is a nonsurgical and safe procedure which can accelerate and improve the regeneration of injured biological tissue. This study aims to analyze the impact of PBMT, in the quality of life and impairment of individuals with orofacial neurological peripheral disturbance. Material and Methods A retrospective analysis in the database of the dental traumatology clinic of the Hospital Centre of the University of Coimbra/Faculty of Medicine of the University of Coimbra was performed.5 out of 50 individuals were selected, according to the selection criteria. The neurosensory activity was assessed by a pinprick nociceptive test and the EQ-5D-5L self-report questionnaire was used to analyse the quality of life. The study was performed in two phases:1) inactive laser or placebo phase, for one month and 2) active laser or treatment phase. A diode low-level laser device (SIROLaserBlue;Sirona,Germany) was used, according to our protocol. A collaborative protocol in the PBMT influence in individuals with neurosensory peripheral disturbances was studied. Results There was no improvement in the neurosensory activity nor in the quality of life, in the placebo phase. After the treatment phase, the EQ-5D-5L final results reported no problems in all of the five dimensions, except for anxiety/depression in individuals with long-standing neurosensory peripheral disturbances. The EQ-VAS scores increased in all the individuals. Conclusions Our results supported the improvement of quality of life and impairment reduction in the individuals submitted to PBMT. Key words:Low-level light therapy, peripheral nerve injuries, sensation disorders, quality of life, forensic medicine.
Peri-implant marginal bone loss reduction with platform-switching components: 5-Year post-loading results of an equivalence randomized clinical trial Ana Messias, Salomão Rocha, Wilfried Wagner, Jörg Wiltfang, Maximilian Moergel, et al. Journal of Clinical Periodontology, 2019 Aim To compare the clinical performance and marginal bone levels of implants restored with platform‐switching (PS) or platform‐matching (PM) abutments. Materials and Methods Adult patients missing two or more adjacent teeth in the posterior mandible received 2–4 CAMLOG SCREW‐LINE implants and were randomly allocated to the PM or PS group, receiving the corresponding prosthetic components from surgery onwards. Implants were conventionally loaded with single cemented crowns. Patients were followed annually for 5 years. Outcome measures were marginal bone level changes, implant survival, performance of the prosthetic components and clinical parameters plaque index, sulcus bleeding index and pocket probing depth. Results Thirty‐three patients received 72 implants in the PM group, and thirty‐five patients received 74 implants in the PS group. Sixty patients attended the final appointment, 31 had received PS components and 29 had received PM components with 65 and 63 implants, respectively. Global survival rate was 96.6% with no differences between groups (p = 0.647). After 5 years of functional loading, PS restored implants presented 0.23mm (95% CI: [0.03, 0.43], p = 0.025) lower marginal bone level changes. The two groups were declared non‐equivalent. Conclusion Patients requiring implant supported restorations in healed bounded or free end edentulous gaps of the mandible benefit from the use of PS components in terms of peri‐implant marginal bone level maintenance, though it may not be clinically noticeable.
Effect of intentional abutment disconnection on the micro-movements of the implant–abutment assembly: a 3D digital image correlation analysis Ana Messias, Salomão Rocha, Nuno Calha, Maria Augusta Neto, Pedro Nicolau, et al. Clinical Oral Implants Research, 2017 BACKGROUND Implant-abutment assembly stability is critical for the success of implant-supported rehabilitation. The intentional removal of the prosthetic components may hamper the achievement of the essential stability due to preload reduction in the screw joint and implant-screw mating surface changes. OBJECTIVE To evaluate the effect of intentional abutment disconnection and reconnection in the stability of internal locking hex implants and corresponding abutments using the method of 3D digital image correlation. MATERIAL AND METHODS Ten conical shape and internal hexagon connection implants were embedded in acrylic resin and assembled to prosthetic abutments with 30 Ncm torque and assigned to two groups: group 1 - tested for static load-bearing capacity at 30° off-axis for two times and group 2 - underwent intentional disconnection and reconnection between tests. Micro-movements were captured with two high-speed photographic cameras and analyzed with video correlation system in three spacial axes U, V and W. Screw abutment and internal implant thread morphology was observed with a field-emission scanning electron microscopy. RESULTS After the intentional disconnection of the abutment, group 2 showed generally higher maximum displacements for U and V directions. Under 50N load, mean difference was 24.7 μm (P = 0.008) for U direction and -7.7 μm (P = 0.008) for V direction. No significant differences were found for maximum and minimum displacements in the W direction. Mean displacement of the speckle surface presented was statistically different in the two groups (P = 0.016). SEM revealed non-homogenous screw surfaces with scoring on group 2 plus striations and debris in the implant threads. CONCLUSION Micro-movements were higher for the group submitted to intentional disconnection and reconnection of the abutment, particularly under average bite forces.
Radiographic evaluation of conical tapered platform-switched implants in the posterior mandible: 1-year results of a two-center prospective study Maximilian Moergel, Salomão Rocha, Ana Messias, Pedro Nicolau, Fernando Guerra, et al. Clinical Oral Implants Research, 2016 Objective Long‐term success of dental implants depends on healthy peri‐implant soft tissues and adequate bone levels. This prospective study aims to assess bone level changes around implants with internal conical connection and platform‐switching abutments in the posterior mandible. Material and methods Adult patients missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent internal conical connection implants. After a minimum transmucosal healing period of 8 weeks, single crown restorations were cemented over platform‐switching abutments. Changes in marginal bone levels were measured in standardized periapical radiographs from surgery and loading (baseline) to 12 months post‐loading. Results Twenty‐four patients received 52 implants. Bone remodeling took place between surgery and loading (−0.53 ± 0.40 mm). From loading to 12 months, there was a mean bone gain of 0.12 ± 0.42 mm which occurred mainly in the first 6 months after prosthesis delivery (0.11 ± 0.36 mm) and stabilized afterward. A total of 71.7% of all implants presented bone preservation or gain. No implant was lost at 1 year and the success rate was 100%. Patient inquiry revealed high satisfaction. Conclusion Internal conical connection implants with platform‐switching abutments presented high success rate and enhancement or preservation of marginal bone levels after 1 year of loading.
Effect of platform switching on crestal bone levels around implants in the posterior mandible: 3 years results from a multicentre randomized clinical trial Salomão Rocha, Wilfried Wagner, Jörg Wiltfang, Pedro Nicolau, Maximilian Moergel, et al. Journal of Clinical Periodontology, 2016 Objective Evaluation of differences in the clinical performance and crestal bone levels between implants restored with single crowns with platform‐matched or platform‐switched abutments after 3 years. Material and Methods The study enrolled adult patients missing two or more adjacent teeth in the posterior mandible with natural teeth mesial to the implant site. Randomization followed open‐flap implant insertion and the corresponding matching or switching healing abutments placed at surgery. Conventional loading was made with cemented crowns. Clinical follow‐up took place annually after loading up to 3 years. Bone level changes were measured in standardized radiographs as the variation in crestal bone from one evaluation to the next. Results Sixty‐three patients with a total of 135 implants (66 platform matching, 69 platform switching) were analysed. From surgery to 36 months, mean bone loss was 0.28 ± 0.56 mm for the platform‐switching group and 0.68 ± 0.64 mm for the platform‐matching group. A statistically significant difference was found between groups (p = 0.002) with an estimate of 0.39 mm (0.15–0.64, 95% CI) in favour of platform switching. Conclusions After 3 years, platform‐switching restorations showed a significant effect in the preservation of marginal bone levels compared to platform‐matching restorations.
New method and software prototype for automatized measurement of crestal bone levels around implants Biodental Engineering II Proceedings of the 2nd International Conference on Biodental Engineering Biodental 2012, 2014
