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Bone grafts and titanium implants are commonly used for surgical/prosthetic rehabilitation of the atrophic edentulous maxilla. The factors which influence bone graft healing and implant integration are not sufficiently understood. The aim of this dissertation was to evaluate autogenous bone grafting and delayed placement of titanium endosteal implants for reconstruction of the atrophic maxilla, including the effects of different patient factors on bone graft healing and integration of titanium implants into grafted bone. A total of 46 patients with severe maxillary atrophy received onlay- (n=35) or interpositional bone grafts (n=11) and 6 mo. later received 341 titanium endosteal implants. All bone grafts were harvested from the iliac crest. All patients received fixed dental bridges and were followed clinically and with radiographical examinations for 3 yr. In Papers I and II, a total of 68 titanium microimplants were placed and retrieved from the bone grafts at various time points for histological analysis of the bone graft-implant interface. Integration was better after 6 mo. healing than placement in conjunction with bone grafting. Implant integration was similar for the two bone-grafting techniques. In Papers III and IV, originally including 29 patients and 222 implants, implant stability was measured with resonance frequency analysis (RFA) at placement, abutment connection, after 6 mo. of loading (III) and after 3 yr. of loading (IV). Ten non-grafted patients measured at the same time points were used as controls (III). RFA showed equal implant stability in grafted bone vs. non-grafted bone (III). Stability did not change from the 6-mo. to the 3-yr. control. Cumulative survival was 90% after 3 yr. (21 implants failed). Thirteen implants were lost prior to loading and 8 during functional loading. The group of failed implants showed a lower primary RFA stability than those that remained stable for 3 yr. All patients received and maintained a fixed dental bridge throughout the study. In Paper V, the graft volume changes (GVC) during the 6-mo. healing period prior to implant placement were studied in 30 patients using computerized tomography. Blood samples were taken from 25 patients in conjunction with bone grafting and were analysed for 13 haematological factors. Bone mineral density (BMD) was measured in 21 patients. Biopsies of the bone grafts were analysed for bone volume fraction (BVF). GVC (loss) was correlated with decreased BMD of the lumbar vertebrae L2-L4. There was no correlation between the haematological factors and GVC. Implant failure was not correlated with BMD, BVF or GVC. This dissertation shows that surgical/prosthetic rehabilitation of the atrophic edentulous maxilla with autogenous iliac crest bone grafts and delayed placement of titanium implants after 6 mo. of graft healing is effective, reproducible and functional. RFA at placement may be able to predict later implant failure.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2015-03-13T20:51:57Z No. of bitstreams: 2 Dissertação - Geovane Miranda Ferreira - 2010.pdf: 1112321 bytes, checksum: e69a5e93643d9b7879c12725fd642a20 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2015-03-13T20:59:55Z (GMT) No. of bitstreams: 2 Dissertação - Geovane Miranda Ferreira - 2010.pdf: 1112321 bytes, checksum: e69a5e93643d9b7879c12725fd642a20 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-03-13T20:59:55Z (GMT). No. of bitstreams: 2 Dissertação - Geovane Miranda Ferreira - 2010.pdf: 1112321 bytes, checksum: e69a5e93643d9b7879c12725fd642a20 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2010-08-20 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / The aim objective of this study was to evaluate the association of the classifications subjected of bone tissue in areas to dental implants and compare it with objective parameters for assessment of primary stability: final insertion torque (TIF) and the frequency of resonance (AFR). Method: 52 patients previously selected partially edentulous were treated with 135 dental implants (TI Cortical Titamax - Neodent ®, Curitiba, PR, Brazil) in the posterior and anterior maxilla (N = 58) and mandible (N = 77) using method conventional two stage. The diameter of the implants ranged from 3.75 mm to 5.0 mm and length of 9.0 mm to 15.0 mm. The bone sites selected for rehabilitation with implants were subjectively classified as bone quality by three independent observers using three subjective methods different: radiographs panoramic and periapical and tactile perception of the operator during drilling site implantable - classification of Lekholm & Zarb original (L&Zoriginal); panoramic radiograph and periapical - classification of Lekholm & Zarb modified (PP), trabecular bone pattern - classification Lindh (Lindh). And objectively assessed by recording the final insertion torque (TIF) obtained electronically by the engine BLM 600 Plus Driller or manually by the turnstile and through analysis of resonance frequency (AFR) obtained at the time of implant installation and four months later, during to reopen. Results: The TIF ranged from 15 to 80 Ncm (Mean = 37.91, SD = 16.87) showing a significant correlation with the ratings L&Zoriginal, PP, AFR initial and reopened and the diameter of the implants (p <0.01). The initial ISQ values ranged from 37-90 (mean = 73.31, SD = 9.80) and ISQ reopening ranged from 22 to 95 (mean = 77.86, SD = 10.08) with significant correlation of the initial ISQ and reopened with all sorts of subjective type bone, with the TIF and the diameter of the implants (p <0.01). The classification of type bone that he thought the tactile perception of the operator (L&Zoriginal) group had better ability to predict the values of EP (AFR and TIF). In conclusion, the classification of L&Zoriginal is an effective method for predicting values of EP and modifications in the implementation of the method as originally proposed could undermine that assertion. / O objetivo desse estudo foi avaliar a associação das classificações do tecido ósseo em áreas submetidas a implantes dentários e compará-la com parâmetros objetivos de avaliação da estabilidade primária: torque de inserção final (TIF) e análise de freqüência de ressonância (AFR). Método: 52 pacientes parcialmente edêntulos e previamente selecionados foram tratados com 135 implantes dentários (Titamax TI Cortical – Neodent®, Curitiba, PR, Brasil) em região posterior e anterior de maxila (N=58) e mandíbula (N=77) utilizando método convencional de dois estágios com perspectiva de reabilitação com prótese fixa. O diâmetro dos implantes variou de 3,75mm a 5,0mm e o comprimento de 9,0mm a 15,0mm. Os sítios ósseos selecionados para reabilitação com implantes foram classificados subjetivamente quanto à qualidade óssea por 3 examinadores independentes usando 3 métodos subjetivos diferentes: radiografia panorâmica e periapical e a percepção tátil do operador durante a perfuração do sítio implantável – classificação de Lekholm & Zarb original (L&Zoriginal); radiografia panorâmica e periapical – classificação de Lekholm & Zarb modificada (PP); padrão ósseo trabecular em radiografias periapicais– classificação de Lindh (Lindh) e avaliados objetivamente por meio do registro do torque de inserção final (TIF) obtido eletronicamente ou manualmente pela catraca e através da análise de freqüência de ressonância (AFR) obtida no momento da instalação do implante e quatro meses após, durante a reabertura. Resultados: O TIF variou de 15 a 80 Ncm (Média=37,91; SD=16,87) mostrando significante correlação com as classificações L&Zoriginal, PP, a ISQ inicial e reabertura e com o diâmetro dos implantes (p<0,01). Os valores de ISQ inicial variaram de 37 a 90 (Média=73.31, SD = 9.80) e o ISQ reabertura variou de 22 a 95 (Média=77.86, SD = 10.08) com correlação significativa da ISQ inicial e reabertura com todas as classificações subjetivas do tipo ósseo, com o TIF e com o diâmetro dos implantes (p<0,01). A classificação do tipo ósseo que considerava a percepção tátil do operador (L&Zoriginal) foi a que teve melhor capacidade de predizer os valores da EP (AFR e TIF). Em conclusão, a classificação de L&Zoriginal é um método eficaz para predizer valores de EP e modificações na execução do método como originalmente proposto podem comprometer a referida afirmação.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-11-22T11:04:41Z No. of bitstreams: 1 maraisaaparecidapintoresende.pdf: 6162684 bytes, checksum: 81f875f5effd371befe15f0ee40da393 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-11-23T12:58:47Z (GMT) No. of bitstreams: 1 maraisaaparecidapintoresende.pdf: 6162684 bytes, checksum: 81f875f5effd371befe15f0ee40da393 (MD5) / Made available in DSpace on 2018-11-23T12:58:47Z (GMT). No. of bitstreams: 1 maraisaaparecidapintoresende.pdf: 6162684 bytes, checksum: 81f875f5effd371befe15f0ee40da393 (MD5) Previous issue date: 2018-09-19 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo deste estudo clínico controlado randomizado microtomográfico foi comparar a qualidade óssea entre dois métodos diferentes de preservação do rebordo alveolar e avaliar as estabilidades primária e secundária dos implantes instalados nessas regiões. Vinte pacientes foram divididos aleatoriamente em dois grupos de tratamento após uma única extração dentária. Dez alvéolos foram enxertados com fosfato de cálcio bifásico (SBC, n = 10) associado a um retalho de tecido conjuntivo subepitelial pediculado para o fechamento primário. Dez alvéolos foram selados com uma restauração provisória de pôntico ovóide (PROV, n = 10) sem material de enxertia. Após 12 meses, 9 pacientes perderam-se no acompanhamento e 11 pacientes receberam implantes dentários. As biópsias ósseas foram avaliadas por microtomografia computadorizada (8 μm), quanto às características do osso trabecular. Valores de torque de inserção (ITV) e quociente inicial de estabilidade do implante (ISQI) foram registrados no momento da instalação dos implantes. O ISQ também foi registrado aos 7 dias, 30 dias e 60 dias pós-operatórios. Todos os onze pacientes tiveram os implantes osseointegrados sem intercorrências. O grupo PROV apresentou trabéculas mais espessas (0,17 ± 0,03) em relação ao grupo SBC (0,11 ± 0,03) (p = 0,03). O osso trabecular foi mais anisotrópico em PROV (0,3 ± 0,08) comparado com SBC (0,1 ± 0,07) (p = 0,01). O grupo PROV apresentou menor superfície óssea (26,02 ± 10,36) que o grupo SBC (40,09 ± 10,94) (p = 0,05). Além disso, o PROV apresentou ISQ inicial mais alto (72,3 ± 21) em comparação com o SBC (67 ± 3,9) (p = 0,05). O osso trabecular revelou diferenças na microarquitetura entre os dois métodos de preservação do rebordo alveolar e ambos os métodos foram satisfatórios para a instalação do implante e resultaram em altos valores de ITV e ISQ. / This randomized controlled clinical microtomographic trial aimed to compare the bone quality between two different methods of alveolar ridge preservation and to evaluate the primary and secondary implant stability. Twenty patients were randomly divided into two groups following a single tooth extraction: SBC group (n=10), sockets were grafted with alloplastic biphasic calcium phosphate and a pedicle subepithelial connective tissue flap was used for primary closure; and PROV group (n=10), sockets were sealed with an ovate pontic provisional restoration. After 12 months, 11 patients received dental implants, with nine patients lost to follow-up. Bone biopsies were evaluated by microcomputed-tomography (8 μm) to determine cancellous bone characteristics. Insertion torque values (ITV) and initial implant stability quotient (ISQI) were recorded at installation. The ISQ was also recorded 7, 30 and 60 days after the implant was installed. All implants showed uneventful osseointegration. The PROV group presented thicker trabeculae (0.17±0.03) compared to the SBC group (0.11±0.03; p 0.03). Trabeculae bone was more anisotropic in the PROV group (0.3±0.08) compared with the SBC group (0.1±0.07; p 0.01). The PROV group presented less bone surface (26.02±10.36) than the SBC group (40.09±10.94; p 0.05). Also, PROV showed higher ISQI (72.3±21) than SBC (67±3.9; p 0.05). The characteristics of the trabecular bone differed between the two alveolar ridge preservation methods and the both preservation methods gave satisfactory results with regard to implant placement, and both resulted in high values for ITV and ISQ.

Bone formation and bone healing were studied in the mandible, tibia and skull bones in adult, healthy and estrogen deficient rabbits implanted with different bone substitutes. In the first study an evaluation of the differences in bone regeneration in and around solid (Alveograf *) and porous hydroxyapatite (Interpore 200*) was undertaken. The implant material was placed into experimentally made bone defects and in half of the defects hydroxyapatite was mixed with a fibrin sealant (Tisseel *). The material alone or mixed with Tisseel was also placed subperiostally in the mandible. The observation time was six month. No difference in bone regeneration was found between solid or porous hydroxyapatite granulas and the addition of Tisseel* did not seem to disturb the bone healing process. The implant material placed subperiostally did not induce bone formation nor did it provoke any bone resorption. The addition of Tisseel made the implant material much easier to handle and retain in the tissue during surgery. Bone healing around hydroxyapatite implants was also evaluated in the second study. Experimental cavities in the mandible and tibia were filled with hydroxyapatite in granules or blocks (Interpore 200*) but now with or without autolyzed, antigen-extracted, allogeneic bone (AAA). Also in this study Tisseel* was used to facilitate the handling of the material. All cavities implanted with AAA-bone, regardless of the combination with hydroxyapatite or Tisseel, demonstrated excessive bone formation resembling exostosis formation. Thus, hydroxyapatite, both as granules and blocks, can be successfully combined with AAA bone utilizing the bone inductive capacity of AAA bone. The same model was used to study the healing in ovariectomized animals in the third study. Bone cavities were implanted with or without AAA bone and left to heal. The results indicate that the osteoinductive capacity of AAA bone is in operation also in animals deprived of a normal estrogen production. The effect of using AAA bone prior to implant insertion was studied in paper four. The bone-implant contact was significant higher when AAA bone had been used. The implant stability did not seem to be affected. In paper five defects were made in skull and tibial bone in estrogen deficient animals. The deficiency of estrogen was confirmed through blood analysis, the decrease in the weight of uterus and bone mineral density. The whole body scanning with DEXA showed that the ovariectomized animals developed osteopenia. Various degree of bone formation was seen in the defects due to the influence of the bone inductive substance AAA bone. The studies indicate that a conductive material like hydroxyapatite in granules or blocks could be useful in oral reconstructive surgery. The combination with AAA bone enhanced the bone formation in calvarial and tibial bone in healthy and estrogen deficient animals. Tisseel* could be used to facilitate handling and retention of the material in the intended position during the healing process without negative effects.

Avaliou-se o comportamento biomecânico, quanto à área de estabilidade protética, extensão de cantilever e estabilidade por análise freqüência de ressonância (AFR); parâmetros clínicos: índice de placa (IP), índice de sangramento (IS), supuração, distância da plataforma do implante-margem da mucosa (DPM), profundidade de sondagem (PS), nível de inserção (NI), sangramento à sondagem (SS), largura (LM), espessura (EM) da mucosa e análise radiográfica, em dois sistemas de reabilitações implanto-suportadas. Foram instalados 104 implantes, submetidos à ativação imediata, em 26 pacientes, divididos em dois grupos: A (n= 16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). As próteses foram instaladas em tempo médio de 32h. (T0), e controles realizados em seis (T6), doze (T12) e 24 meses (T24). Como resultado, a taxa de sucesso foi de 100% para o grupo A e 90% para o grupo B para implantes e próteses. Diferenças significantes (p<0,05) foram apresentadas entre o cantilever posterior 10,96mm e 18,81mm e o braço de resistência (BR) 13,87mm e 5,50mm, respectivamente para os grupos A e B. A área de estabilidade, no grupo A foi de 373,5mm2 e no B de 112,8mm2; a média da AFR (em ISQ) do grupo A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 e do grupo B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, com diferenças (p<0,05) entre os tempos (grupo A) e posição dos implantes (grupo B). O IP no grupo A=1,0 e 0,7; grupo B=0,6 e 0,9, o IS (0,7), supuração (ausente) e SS (presença) no grupo A=50% e 37,9%; grupo B=70,1 e 52,1%, no controle de 12 e 24 meses, não mostraram diferenças estatísticas entre os grupos. As médias (em mm) da LM para o grupo A (2,05 e 2,21) e B (2,29 e 2,40) e EM grupo A (1,53 e 1,56) e B (1,31 e 1,43), DPM do grupo A (2,54e 2,52) e B (0,18mm e -0,12mm), PS grupo A (3,52 e 3,52) e B (3,52 e 4,0), NI grupo A (0,98 e 0,99) e B (3,05 e 3,57) e perda óssea grupo A (0,45mm e 0,23mm ) grupo B(0,66mm e 0,22mm), respectivamente para 12 e 24 meses, apresentaram diferenças estatísticas entre os controles. Concluindo-se que 1- O grupo A apresentou área de estabilidade e extensão de cantilever anterior e posterior, com comportamento biomecânico mais favorável do que no grupo B; 2- A estabilidade primária e secundária (AFR) foi diferente entre os tempos (grupo A) e posição dos implantes (grupo B), mas semelhantes entre os grupos; 3- Os parâmetros clínicos de índice de placa, sangramento marginal, supuração, profundidade de sondagem (exceto para os períodos de controle no grupo B), sangramento a sondagem, largura e espessura de mucosa ceratinizada foram semelhantes entre os grupos; 4- A distância da plataforma do implante-margem da mucosa foi maior no grupo A e o nível de inserção foi maior no grupo B; 5- A perda na altura da crista óssea foi semelhante entre os grupos; 6- A perda óssea foi menor nos implantes anteriores do que nos posteriores, nos grupos. / Two implant-supported rehabilitation systems were evaluated considering their biomechanical behavior, the area of prosthetic stability, cantilever extensions, stability using resonance frequency analysis (RFA) and clinical parameters, such as: modified plaque index (PI), modified bleeding index (BI), suppuration, distance between the implant shoulder and the mucosal margin (DIM), probing pocket depth (PD), probing attachment level (PAL), bleeding on probing (BP), thickness (TM) width (WM) of keratinized mucosa and radiographic analysis. One hundred and four implants had been installed in twenty six patients, submitted to immediate loading and divided into two groups: A (n=16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). The prosthesis had been installed in average time of 32h (T0), and controls made in (T6), 12 (T12) and 24 months (T24). As result, the success rate was 100% for the group A and 90% for the group B for both implants and prosthesis. Significant differences (p<0,05) 10,96mm and 18,81mm had been presented between posterior cantilever and the resistance arm (RA) 13,87mm and 5,50mm, respectively for the groups A and B. The stability area, in the group A was of 373,5mm2 and in B of 112,8mm2; the average of RFA (in ISQ) of the group A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 and of the group B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, with differences (p<0,05) between the periods (Group A) and implant position (Group B). The PI in group A was of 1,0 and 0,7 and 0,6 and 0,9 for group B, o BI (0,7), suppuration (absent), DP (presence) in group A=50% and 37,9%; group B=70,1 and 52,1%, in the control of 12 and 24 months, did not present statistical differences between the groups. The average (in mm) of WM for the group A (2,05 and 2,21) and B (2,29 and 2,40) and TM group A (1,53 and 1,56) and B (1,31 and 1,43), DIM of group A (2,54 and 2,52) and B (0,18mm and -0,12mm), DP group.

<p>Bone formation and bone healing were studied in the mandible, tibia and skull bones in adult, healthy and estrogen deficient rabbits implanted with different bone substitutes. </p><p>In the first study an evaluation of the differences in bone regeneration in and around solid (Alveograf *) and porous hydroxyapatite (Interpore 200*) was undertaken. The implant material was placed into experimentally made bone defects and in half of the defects hydroxyapatite was mixed with a fibrin sealant (Tisseel *). The material alone or mixed with Tisseel was also placed subperiostally in the mandible. The observation time was six month. No difference in bone regeneration was found between solid or porous hydroxyapatite granulas and the addition of Tisseel* did not seem to disturb the bone healing process. The implant material placed subperiostally did not induce bone formation nor did it provoke any bone resorption. The addition of Tisseel made the implant material much easier to handle and retain in the tissue during surgery.</p><p>Bone healing around hydroxyapatite implants was also evaluated in the second study. Experimental cavities in the mandible and tibia were filled with hydroxyapatite in granules or blocks (Interpore 200*) but now with or without autolyzed, antigen-extracted, allogeneic bone (AAA). Also in this study Tisseel* was used to facilitate the handling of the material. All cavities implanted with AAA-bone, regardless of the combination with hydroxyapatite or Tisseel, demonstrated excessive bone formation resembling exostosis formation. Thus, hydroxyapatite, both as granules and blocks, can be successfully combined with AAA bone utilizing the bone inductive capacity of AAA bone.</p><p>The same model was used to study the healing in ovariectomized animals in the third study. Bone cavities were implanted with or without AAA bone and left to heal. The results indicate that the osteoinductive capacity of AAA bone is in operation also in animals deprived of a normal estrogen production.</p><p>The effect of using AAA bone prior to implant insertion was studied in paper four. The bone-implant contact was significant higher when AAA bone had been used. The implant stability did not seem to be affected.</p><p>In paper five defects were made in skull and tibial bone in estrogen deficient animals. The deficiency of estrogen was confirmed through blood analysis, the decrease in the weight of uterus and bone mineral density. The whole body scanning with DEXA showed that the ovariectomized animals developed osteopenia. Various degree of bone formation was seen in the defects due to the influence of the bone inductive substance AAA bone. </p><p>The studies indicate that a conductive material like hydroxyapatite in granules or blocks could be useful in oral reconstructive surgery. The combination with AAA bone enhanced the bone formation in calvarial and tibial bone in healthy and estrogen deficient animals. Tisseel* could be used to facilitate handling and retention of the material in the intended position during the healing process without negative effects. </p>

Avaliou-se o comportamento biomecânico, quanto à área de estabilidade protética, extensão de cantilever e estabilidade por análise freqüência de ressonância (AFR); parâmetros clínicos: índice de placa (IP), índice de sangramento (IS), supuração, distância da plataforma do implante-margem da mucosa (DPM), profundidade de sondagem (PS), nível de inserção (NI), sangramento à sondagem (SS), largura (LM), espessura (EM) da mucosa e análise radiográfica, em dois sistemas de reabilitações implanto-suportadas. Foram instalados 104 implantes, submetidos à ativação imediata, em 26 pacientes, divididos em dois grupos: A (n= 16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). As próteses foram instaladas em tempo médio de 32h. (T0), e controles realizados em seis (T6), doze (T12) e 24 meses (T24). Como resultado, a taxa de sucesso foi de 100% para o grupo A e 90% para o grupo B para implantes e próteses. Diferenças significantes (p<0,05) foram apresentadas entre o cantilever posterior 10,96mm e 18,81mm e o braço de resistência (BR) 13,87mm e 5,50mm, respectivamente para os grupos A e B. A área de estabilidade, no grupo A foi de 373,5mm2 e no B de 112,8mm2; a média da AFR (em ISQ) do grupo A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 e do grupo B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, com diferenças (p<0,05) entre os tempos (grupo A) e posição dos implantes (grupo B). O IP no grupo A=1,0 e 0,7; grupo B=0,6 e 0,9, o IS (0,7), supuração (ausente) e SS (presença) no grupo A=50% e 37,9%; grupo B=70,1 e 52,1%, no controle de 12 e 24 meses, não mostraram diferenças estatísticas entre os grupos. As médias (em mm) da LM para o grupo A (2,05 e 2,21) e B (2,29 e 2,40) e EM grupo A (1,53 e 1,56) e B (1,31 e 1,43), DPM do grupo A (2,54e 2,52) e B (0,18mm e -0,12mm), PS grupo A (3,52 e 3,52) e B (3,52 e 4,0), NI grupo A (0,98 e 0,99) e B (3,05 e 3,57) e perda óssea grupo A (0,45mm e 0,23mm ) grupo B(0,66mm e 0,22mm), respectivamente para 12 e 24 meses, apresentaram diferenças estatísticas entre os controles. Concluindo-se que 1- O grupo A apresentou área de estabilidade e extensão de cantilever anterior e posterior, com comportamento biomecânico mais favorável do que no grupo B; 2- A estabilidade primária e secundária (AFR) foi diferente entre os tempos (grupo A) e posição dos implantes (grupo B), mas semelhantes entre os grupos; 3- Os parâmetros clínicos de índice de placa, sangramento marginal, supuração, profundidade de sondagem (exceto para os períodos de controle no grupo B), sangramento a sondagem, largura e espessura de mucosa ceratinizada foram semelhantes entre os grupos; 4- A distância da plataforma do implante-margem da mucosa foi maior no grupo A e o nível de inserção foi maior no grupo B; 5- A perda na altura da crista óssea foi semelhante entre os grupos; 6- A perda óssea foi menor nos implantes anteriores do que nos posteriores, nos grupos. / Two implant-supported rehabilitation systems were evaluated considering their biomechanical behavior, the area of prosthetic stability, cantilever extensions, stability using resonance frequency analysis (RFA) and clinical parameters, such as: modified plaque index (PI), modified bleeding index (BI), suppuration, distance between the implant shoulder and the mucosal margin (DIM), probing pocket depth (PD), probing attachment level (PAL), bleeding on probing (BP), thickness (TM) width (WM) of keratinized mucosa and radiographic analysis. One hundred and four implants had been installed in twenty six patients, submitted to immediate loading and divided into two groups: A (n=16, All-on-4®-Nobel Biocare) e B (n=10, Neopronto®-Neodent). The prosthesis had been installed in average time of 32h (T0), and controls made in (T6), 12 (T12) and 24 months (T24). As result, the success rate was 100% for the group A and 90% for the group B for both implants and prosthesis. Significant differences (p<0,05) 10,96mm and 18,81mm had been presented between posterior cantilever and the resistance arm (RA) 13,87mm and 5,50mm, respectively for the groups A and B. The stability area, in the group A was of 373,5mm2 and in B of 112,8mm2; the average of RFA (in ISQ) of the group A T0= 68,62; T6=64,40; T12=67,07; T24=66,53 and of the group B T0= 68,37; T6=66,29; T12=67,09; T24=67,10, with differences (p<0,05) between the periods (Group A) and implant position (Group B). The PI in group A was of 1,0 and 0,7 and 0,6 and 0,9 for group B, o BI (0,7), suppuration (absent), DP (presence) in group A=50% and 37,9%; group B=70,1 and 52,1%, in the control of 12 and 24 months, did not present statistical differences between the groups. The average (in mm) of WM for the group A (2,05 and 2,21) and B (2,29 and 2,40) and TM group A (1,53 and 1,56) and B (1,31 and 1,43), DIM of group A (2,54 and 2,52) and B (0,18mm and -0,12mm), DP group.

O presente estudo teve por objetivo avaliar por meio da análise de freqüência de ressonância (AFR) o efeito da irradiação com laser de GaAlAs na estabilidade de implantes de titânio, como cociente de estabilidade do implante (ISQ) instalados em pacientes parcialmente edentados na região posterior da mandíbula; assim como avaliar a evolução da estabilidade dos implantes, durante o período de osseointegração. Foram selecionados 8 pacientes adultos, com boa saúde para a instalação cirúrgica de 30 implantes Xive S® (Dentsply). Portanto, foram instalados de 2 a 5 implantes por paciente, distribuídos bilateralmente. Cada paciente atuou como seu próprio controle. Os implantes do lado controle não foram irradiados, e os do lado experimental foram submetidos a terapia com laser de diodo GaAlAs com ?= 830 nm, densidade de energia de 8 j/cm2, potência de 100 mW, modo contínuo, de forma pontual em 20 pontos, durante 3 segundos por ponto. A primeira sessão de irradiação foi no pós-operatório imediato, sendo repetida a cada 48 horas nos primeiros 14 dias, totalizando 7 irradiações. Após a instalação dos implantes foi medida a estabilidade primária destes com o aparelho Osstell?. Novas medidas de ISQ foram realizadas após 10 dias, e 3, 6, 9 e 12 semanas. No momento da instalação, os valores de ISQ na região posterior da mandíbula oscilaram de 65-84 com média de 76, sofrendo queda significativa da estabilidade do 100 dia para a 6a semana no grupo irradiado e apresentando um aumento gradual a partir da 6a semana até a 12a semana. Os valores mais altos de ISQ foram observados no 100 dia no grupo irradiado, embora sem significância estatística, e os mais baixos foram observados na 6a semana em ambos os grupos. Não foi evidenciado o efeito do laser de GaAlAs na estabilidade dos implantes com o aparelho OsstellTM, porém não se pode afirmar que os padrões de reparação óssea e a taxa de osseointegração entre os implantes irradiados e não irradiados tenham sido similares. / JThe present study was carried out to evaluate the effect of irradiation with the GaALAs laser in the stability of titanium implants (ISQ), inserted in partially edentulous patients, by means of resonance frequency analysis (RFA); as well as to evaluate the evolution of the stability during the osseointegration processs. A group of 8 patients were seleted for the insertion of 30 implants (Xive S® - Dentsply). The implants in the control site were not irradiated, and the implants in the experimentall site were submitted to laser therapy with a GaAlAs with ?= 830 nm, energy density of 8 j/cm2, power of 100 mW, continuing mode, in 20 points, for 3 seconds per point. The first irradiation was immediately after the surgery, and it was repeated every 48 hours in the first 14 days, totalizing 7 irradiations. After the implants insertion, the primary stability was measured using Osstell?. New measurements were carried out after 10 days, 3, 6, 9, 12 weeks. The incial ISQ values ranged from 65-84, with a mean of 76, showing a significative decrease in the stability from the 10th day to the 6th weeks in the irradiated group, and showing a gradual increase from 6th to 12th week. The highest ISQ values were observed in the 10th day in the irradiated group, and the lower ISQ values were observed in the 6th week in both groups. The effect of the irradiation with GaAlAs laser in implant stability was not evicenced; however, it can not be affirmed that irradiated and not irradiated implants have similar bone repair patterns and osseointegration rates.

O presente estudo teve por objetivo avaliar por meio da análise de freqüência de ressonância (AFR) o efeito da irradiação com laser de GaAlAs na estabilidade de implantes de titânio, como cociente de estabilidade do implante (ISQ) instalados em pacientes parcialmente edentados na região posterior da mandíbula; assim como avaliar a evolução da estabilidade dos implantes, durante o período de osseointegração. Foram selecionados 8 pacientes adultos, com boa saúde para a instalação cirúrgica de 30 implantes Xive S® (Dentsply). Portanto, foram instalados de 2 a 5 implantes por paciente, distribuídos bilateralmente. Cada paciente atuou como seu próprio controle. Os implantes do lado controle não foram irradiados, e os do lado experimental foram submetidos a terapia com laser de diodo GaAlAs com ?= 830 nm, densidade de energia de 8 j/cm2, potência de 100 mW, modo contínuo, de forma pontual em 20 pontos, durante 3 segundos por ponto. A primeira sessão de irradiação foi no pós-operatório imediato, sendo repetida a cada 48 horas nos primeiros 14 dias, totalizando 7 irradiações. Após a instalação dos implantes foi medida a estabilidade primária destes com o aparelho Osstell?. Novas medidas de ISQ foram realizadas após 10 dias, e 3, 6, 9 e 12 semanas. No momento da instalação, os valores de ISQ na região posterior da mandíbula oscilaram de 65-84 com média de 76, sofrendo queda significativa da estabilidade do 100 dia para a 6a semana no grupo irradiado e apresentando um aumento gradual a partir da 6a semana até a 12a semana. Os valores mais altos de ISQ foram observados no 100 dia no grupo irradiado, embora sem significância estatística, e os mais baixos foram observados na 6a semana em ambos os grupos. Não foi evidenciado o efeito do laser de GaAlAs na estabilidade dos implantes com o aparelho OsstellTM, porém não se pode afirmar que os padrões de reparação óssea e a taxa de osseointegração entre os implantes irradiados e não irradiados tenham sido similares. / JThe present study was carried out to evaluate the effect of irradiation with the GaALAs laser in the stability of titanium implants (ISQ), inserted in partially edentulous patients, by means of resonance frequency analysis (RFA); as well as to evaluate the evolution of the stability during the osseointegration processs. A group of 8 patients were seleted for the insertion of 30 implants (Xive S® - Dentsply). The implants in the control site were not irradiated, and the implants in the experimentall site were submitted to laser therapy with a GaAlAs with ?= 830 nm, energy density of 8 j/cm2, power of 100 mW, continuing mode, in 20 points, for 3 seconds per point. The first irradiation was immediately after the surgery, and it was repeated every 48 hours in the first 14 days, totalizing 7 irradiations. After the implants insertion, the primary stability was measured using Osstell?. New measurements were carried out after 10 days, 3, 6, 9, 12 weeks. The incial ISQ values ranged from 65-84, with a mean of 76, showing a significative decrease in the stability from the 10th day to the 6th weeks in the irradiated group, and showing a gradual increase from 6th to 12th week. The highest ISQ values were observed in the 10th day in the irradiated group, and the lower ISQ values were observed in the 6th week in both groups. The effect of the irradiation with GaAlAs laser in implant stability was not evicenced; however, it can not be affirmed that irradiated and not irradiated implants have similar bone repair patterns and osseointegration rates.