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Regenerative and reconstructive periodontal plastic surgery are important options for treating marginal tissue recession and can be indicated for root coverage or periodontal procedures prior to implant placement. Among the available procedures, periodontal flaps with subepithelial connective tissue graft (CTG) is the most common treatment option to achieve proper tissue manipulation. The present study proposes a modification of a previous technique for inducing spontaneous gingival growth around teeth that will be extracted prior to implant placement, through successive reduction of the buccal root surface. This successive reduction of root surfaces is performed with diamond burs, and such reductions create space for the gingival tissue to grow coronally by reducing root convexity and, consequently, stimulating the healing process with the formation of granulation tissue that will then differentiate into keratinized tissue. The presented technique is suggested to improve the esthetic outcomes for cases involving tooth extraction, implant placement in the extraction socket, and immediate loading with interim restoration and CTG. [ABSTRACT FROM AUTHOR]

Purpose: The "one-abutment, one-time" concept entails the placement of a definitive abutment at the time of implant placement, without removal during prosthesis manufacture, with the aim to promote a safer environment for the periimplant tissues. Identifying surgical and radiographic parameters that can assist with the abutment height selection would facilitate the adoption of the one-abutment, one-time concept. Therefore, the aim of this study was to assess the role of surgical and radiographic parameters as predictive factors for abutment height selection in implant-retained single crowns. Materials and Methods: This prospective study assessed the role of surgical and radiographic measurements in the implant survival and success rates and marginal bone loss in implant-retained single crowns. Implants were placed in both healed sites and extraction sockets, and the distances between the implant platform and alveolar bone crest, implant platform and gingival margin, and buccal gap (when present) were recorded using a straight periodontal probe. Digital radiographs were made at implant placement (T0), abutment height selection (Ta), and 1-year follow-up (Tf), and the distance between the implant platform and the alveolar bone crest (mm) was assessed. Linear regression models and Pearson correlation were used to assess the influence of primary and secondary outcomes on abutment height. Results: A total of 130 implants were placed in 68 patients. The mean surgical distance between the bone crest and the implant platform was 1.71 ± 1.01 mm, and the mean distance from the gingival margin to the implant platform was 3.94 ± 1.90 mm, while at the abutment selection appointment, the mean transmucosal height was 3.58 ± 1.50 mm. A high linear correlation was found between the selected abutment height and two primary outcomes: the radiographic implant platform to alveolar bone crest distance at T0 (r² = 0.66; P < .001) and the transmucosal height at Ta (r² = 0.81; P < .001). Conclusion: Radiographic measurements of the distance between the implant platform and the alveolar bone crest at implant placement can serve as an important parameter to select the abutment height for definitive restorations. [ABSTRACT FROM AUTHOR]

This systematic scoping review aimed to map available evidence regarding endodontic therapy in patients with inherited bleeding disorders (IBDs). Studies in medicine or dentistry were selected if they reported on endodontic therapy in individuals with IBDs such as hemophilia A, hemophilia B, or von Willebrand disease. Two independent researchers performed searches and screening in PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane Library. The search initially yielded 676 potentially relevant studies, 14 of which were included in the final analysis. Of these 14 studies, 3 were classified as consensus statements or guidelines, 3 as observational studies, 2 as reviews, 5 as case reports, and 1 as an editorial. Most of the evidence regarding prophylactic treatment (eg, blood transfusion, replacement therapy, or medication administration) prior to endodontic therapy was derived from observational studies. The most frequently reported procedure was endodontic therapy, while 1 case report described a surgical endodontic procedure. Most studies included in the analysis reported that these procedures could be performed under local anesthesia. Two case reports and 1 observational study described complications after endodontic therapy in patients with IBDs. This scoping review revealed a lack of well-designed studies related to the topic of endodontic therapy in patients with IBDs. The available evidence suggests that endodontic therapy in patients with IBDs can be considered a low-risk procedure; local anesthesia should be used in most cases when patients with IBDs are treated, but the use of prophylactic measures is preferred when nerve block anesthesia is required; endodontic therapy can be conducted in a clinical setting without the need for hospital admittance; and, although the number of reported complications is small, the risk should not be ignored. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the axial tightening force applied by conventional and diamondlike carbon (DLC)-coated screws and to verify, through three-dimensional finite element analysis (FEA), the stress distribution caused by different framework materials and prosthetic screws in over denture frameworks with different misfit levels. Materials and Methods: The axial tightening force applied by the screw was evaluated by means of a titanium matrix connected to a load cell. Conventional titanium or DLC-coated screws were tightened with a digital torque wrench, and the load values were recorded. The values were applied in an FEA to a bar-clip attachment system connected to two 4.0 x 11-mm external-hexagon titanium implants placed in an anterior edentulous arch. DLC-coated and conventional screws were modeled with their respective axial forces obtained on the experimental evaluation for three bar framework materials (titanium, nickel-chromium, and cobalt-chromium) and three levels of misfit (100,150, and 200 pm). Von Mises stresses for prosthetic components and maximum principal stress and microstrains (maximum principal strains) for bone tissue were measured. Results: The mean force applied by the conventional screw was 25.55 N (± 1.78); the prosthetic screw coated with a DLC layer applied a mean force of 31.44 N (± 2.11), a statistically significant difference. In the FEA, the DLC screw led to higher stresses on the framework; however, the prosthetic screw suffered lower stress. No influence of screw type was seen in the bone tissue. Conclusion: Titanium frameworks reduced the stress transmitted to the bone tissue and the bar framework but had no influence on the screws. Higher misfit values resulted in an increased stress/strain in bone tissue and bar framework, which was not the case for retention screws. [ABSTRACT FROM AUTHOR]

This study evaluated the influence of implant-abutment connections on stress distribution through 3D finite element analysis. Three-dimensional models of an implant-supported fixed prosthesis in the jaw retained by four implants with different connection systems (external hex and Morse taper) were analyzed. External hex connection promoted higher microstrain values, which were concentrated on the cervical region of the distal implants extending into the trabecular bone, while Morse taper connection provided a more even distribution of the microstrain on all implants. Implant-supported fixed prostheses with external hex connections tend to concentrate strain in the distal implants, while Morse taper connection promoted a better situation. On the other hand, there was greater demand on the prosthetic screws and abutments of Morse taper connections than on external hex connections. [ABSTRACT FROM AUTHOR]

Aim: This retrospective study aims to describe and analyze the number of dental implants and implant-retained prostheses performed by the Unified Health System (SUS) in the last decade. Methods: This study is based on secondary data from the official government database (DATASUS) performed from January 2010 to December 2019 and is reported following the STROBE. A descriptive analysis was performed of the total sample and the stratified sample divided by Brazilian states. Results: A total of 143,037 dental implants and 93,325 implant-retained prostheses were provided by SUS. It is possible to observe that some states played a massive role on the provision of dental implants and implant-retained prostheses (Parana state: 58.4% and 55.9% and Paraiba state: 21.1% and 25.2% of the total amount of dental implants and implant-retained prostheses, respectively) while some states did not provide a single implant-retained prosthesis. Also, inland cities were mostly responsible for the number of procedures compared to the state capitals. Conclusion: Although dental implant therapy is available in SUS across the country, the number of treatments provided in the last decade is still very limited and is also mainly concentrated in the southeastern region of Brazil. [ABSTRACT FROM AUTHOR]

This study evaluated patients' expectation before and satisfaction after full-arch fixed implant-prosthesis rehabilitation. Other variables that could influence patient satisfaction with this therapy were also evaluated. Using a visual analog scale (VAS), a sample of 28 patients assigned scores for their expectation before and satisfaction after therapy regarding chewing, esthetics, comfort, and phonetics. They also completed a questionnaire concerning their evaluation of the dentists' conduct. The average VAS scores were high for both expectation prior to treatment and satisfaction after treatment, and there was no statistical difference between them. Women presented higher expectations than men regarding esthetics (P = 0.040), phonetics (P = 0.043) and comfort (P = 0.013). Significant differences were not found between VAS scores with clinical variables (arch, radiographic bone quality, surgical bone quality, and implant inclination), educational level, and patients' evaluation of the dentists' conduct. Considering the results obtained in this study, expectation before implant-supported, full-arch fixed prosthesis therapy were met following treatment, with women having higher expectations than men. [ABSTRACT FROM AUTHOR]

This study's aims was to evaluate the stress distribution in a mandibular implant-supported prosthesis and peri-implant bone considering implant quantity, diameter and position using linear 3-D finite element analysis. Models of an anterior jaw comprised 4 groups according to implant quantity, diameter, and position: control group C, 5 regular implants; R, 3 regular implants; W, 3 wide implants; and DTR, 3 regular implants with the distal ones tilted 30° distally. The cantilever was loaded with an axial load of 50 N. Data was evaluated using von Mises stress on implants and maximum principal stress and microstrain on the bone. The W group showed the lowest value of maximum principal stress in peri-implant bone of the loaded side (4.64 MPa) when compared to C (5.27 MPa), DTR (5.94 MPa), and R (11.12 MPa). Lower stress values in the loaded implants were observed in the experimental groups when compared to the C group. However, the unloaded implants presented opposite results. All the screws of the W group presented lower stress values when compared to the C group. However, the R and DTR groups presented an increase in stress values with the exception of the loaded screw. A reduction in the number of implants associated with wider implants reduced the stress in the bone and prosthetic components. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the stress distribution in the bone adjacent to submerged implants during masticatory function in conventional complete dentures with different soft liners through finite element analysis. Three-dimensional models of a severely resorbed mandible with 2 and 4 submerged implants in the anterior region were created and divided into the following situations: (1) conventional complete dentures (control group); and conventional complete dentures with different soft liner materials, (2) Coe-Comfort, (3) Softliner, and (4) Molteno Hard. The models were exported to mechanical simulation software and 2 simulations were done with the load in the inferior right canine (35 N) and the inferior right first molar (50 N). The data were qualitatively evaluated using the maximum principal stress and microstrain values given by the software. The use of soft liners provides decreased levels of stress and microstrains in peri-implant bone when the load was applied to canine teeth. Considering all of the values obtained in this study, the use of softer materials is the most suitable for use during the period of osseointegration. [ABSTRACT FROM AUTHOR]

Purpose: Sleep bruxism (SB) in children may be related to headaches and causes extensive damage of primary teeth. This paper evaluates the incidence of SB in children from Itanhandu, MG, Brazil. Methods: The presence of teeth wear facets was verified through clinical examinations on a sample of children, whose parents answered a questionnaire about their children's behavior and habits. Analysis of variance and chi-square tests ( p = 0.05) were applied to identify possible correlations between the presence of SB and the parents' responses to the questionnaire. Results: The sample comprised of 170 children, 51.76% ( n = 88) of which were girls, while the average age was 4.37 (±1.69) years. A total of 15.29% ( n = 26) had been diagnosed as bruxers, 46.47% displayed restless behavior, and only 10% used medication. The average duration of breastfeeding was 4.4 (±0.25) months. A positive correlation was found between restless behavior and the presence of SB ( p < 0.001). No correlation was found between SB and medication ( p = 0.573), or between the duration of breastfeeding and restless behavior ( p = 0.102), SB ( p = 0.565) and medication ( p = 0.794). Conclusion: Restless behavior was positively correlated with SB, although no correlation was found between SB and medication or duration of breastfeeding. [ABSTRACT FROM AUTHOR]

The use of low-level laser (LLL) may be an useful tool to promote reduction of muscular pain caused by TMD. Aim: This study evaluated the immediate efficacy of low-level laser therapy on women reporting pain and diagnosed with temporomandibular dysfunction (TMD). Methods: Diode laser (GaAlAs) at 790 nm wavelength (infrared spectrum) was applied as experimental treatment. Irradiations of 1.5 J/cm² were made at 4 points of the temporomandibular joint (TMJ) and of 3 J/cm² at 3 points in the temporal muscle. An electromyographic (EMG) evaluation of the masseter and anterior temporal was done at the following intervals: before, immediately after, 5 min and 20 min after laser application. Results: Comparison of the electrical activity at the times of measurement revealed a statistically significant difference in masseter muscles before (P=0.025) and immediately after (P=0.013) LLLT. Conclusions: Both masseter and temporal muscles showed a reduction in the measured EMG activities at all times after LLLT, and the temporal muscle showed higher EMG activity than the masseter muscle at all the evaluation times. LLLT caused significant immediate relaxation of the masseter muscles. [ABSTRACT FROM AUTHOR]