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The treatment of atrophic jaw fracture is a challenge in maxillofacial surgery, due to both local and systemic factors of the affected patients. This article aims to report a case of bilateral atrophic fracture of the mandible treated with an intraoral approach through a thinner and locked 2.0 mm system mandibular plate and subsequent rehabilitation with an implant- supported prosthesis. This technique provided the patient with excellent masticatory, aesthetic, and functional recovery with less morbidity and faster recuperation. El tratamiento de la fractura atrófica de mandíbula es un desafío en la cirugía maxilofacial, debido a factores tanto locales como sistémicos de los pacientes afectados. Este artículo tiene como objetivo reportar un caso de fractura atrófica bilateral de mandíbula tratada con abordaje intraoral a través de una placa mandibular más fina y bloqueada del sistema de 2.0 mm y posterior rehabilitación con una prótesis implantosoportada. Esta técnica proporcionó al paciente una excelente recuperación masticatoria, estética y funcional con menor morbilidad y una recuperación más rápida. O tratamento da fratura atrófica da mandíbula é um desafio na cirurgia maxilofacial, tanto por fatores locais quanto sistêmicos dos pacientes afetados. Este artigo tem como objetivo relatar um caso de fratura atrófica bilateral de mandíbula tratada com abordagem intraoral por meio de placa mandibular mais fina e travada com sistema de 2,0 mm e posterior reabilitação com prótese implantossuportada. Essa técnica proporcionou ao paciente excelente recuperação mastigatória, estética e funcional, com menor morbidade e recuperação mais rápida.

Current treatment of odontogenic tumors (OT) ranges from simple enucleation by curettage or segmental resection. But the treatment does not stop here, we need to think about the rehabilitation of the patients. The Mandibular reconstruction can begin immediately postoperatively, but the delayed reconstruction can be the best option for treatment, because of the high risk of recurrence in some OT, but it is always a challenge. The aim of this study is to describe the approach of a case of mandibular odontogenic myxoma and your total rehabilitations. The segmental hemi-mandibulectomia was performed with an intraoral. After 2 year the iliac crest grafting to intraoral approach was done and after 6 months osseointegrated implants were put and the immediate load with hybrid prostheses was done. After 2 years of complete rehabilitation we can consider that this sequence looks like to be a good form to become social, psychological, esthetic and function in the patients. El tratamiento actual de los tumores odontogénicos (OT) varía desde una simple enucleación mediante curetaje o resección segmentaria. Pero el tratamiento no se detiene ahí, hay que pensar en la rehabilitación de los pacientes. La reconstrucción mandibular puede comenzar inmediatamente después de la operación, pero la reconstrucción tardía puede ser la mejor opción de tratamiento debido al alto riesgo de recurrencia en algunos OT, pero siempre es un desafío. El objetivo de este estudio es describir el abordaje de un caso de mixoma odontogénico mandibular y su rehabilitación total administrada. Se realizó hemimandibulectomía segmentaria por vía intraoral. A los 2 años se realizó injerto de cresta ilíaca para acceso intraoral y a los 6 meses se colocaron implantes osteointegrados y se realizó carga inmediata con prótesis híbridas. Después de 2 años de rehabilitación completa, podemos considerar que esta secuencia parece ser una buena forma de hacer que los pacientes sean sociales, psicológicos, estéticos y funcionales. O tratamento atual de tumores odontogênicos (TO) varia de simples enucleação por curetagem ou ressecção segmentar. Mas o tratamento não para por aqui, precisamos pensar na reabilitação dos pacientes. A reconstrução mandibular pode começar imediatamente no pós-operatório, mas a reconstrução tardia pode ser a melhor opção de tratamento, devido ao alto risco de recorrência em alguns TO, mas sempre é um desafio. O objetivo deste estudo é descrever a abordagem de um caso de mixoma odontogênico mandibular e suas reabilitações totais administradas. A hemi-mandibulectomia segmentar foi realizada por via intraoral. Após 2 anos foi feito enxerto de crista ilíaca para acesso intraoral e após 6 meses foram colocados implantes osseointegrados e realizada carga imediata com próteses híbridas. Após 2 anos de reabilitação completa podemos considerar que esta sequência parece ser uma boa forma de se tornar social, psicológico, estético e funcional dos pacientes.

Background: Despite the technological advances the zygomatic implants (ZI) and its proven success, this rehabilitation option is sensitive, not a routine in dental practice, requiring technical mastery, surgical experience, and in-depth anatomical knowledge, which makes it quite susceptible to complications. In addition, little is discussed about these disorders, whether immediate or late, although they are essential knowledge for the surgeons who perform this procedure. Aim: The objective of the study was to answer the question through literature review: "Are there surgical complications in zygomatic implants?" As well as to argue the main intercurrences found. Material and Methods: The review of the literature was conducted on PubMed/Medline, Cochrane and SciELO using the descriptors: “Complications” or “Failure” and “Zygomatic Implants”. The included articles were observational studies that related ZI and complications. The initial research identified 448 articles, but 42 of them that mentioned complications associated with ZI were considered in this study. Results: The most common complication is sinusitis followed by peri-implantitis, problems with the prosthetic connection, fistula towards the implant, paresthesia, hematoma, lip laceration, ecchymosis, penetration of the orbital cavity, aspergillosis, intracranial penetration, and intraorbital hemorrhage. 44 out of 2835 ZIs placed in immediate or late loading were lost (1.5%). There were 223 minor or major complications in the 2827 implants (7.86%). Conclusions: The low morbidity of this treatment for maxillary atrophy, there are some immediate and late complications to be considered in the choice of rehabilitation treatment and that these should be reported preoperatively to the patients. Apesar dos avanços tecnológicos dos implantes zigomáticos (ZI) e de seu sucesso comprovado, essa opção de reabilitação é sensível, não uma rotina na prática odontológica, exigindo domínio técnico, experiência cirúrgica e conhecimento anatômico profundo, o que a torna bastante suscetível a complicações. Além disso, pouco se discute sobre essas complicações, imediatas ou tardias, embora sejam conhecimentos essenciais para os cirurgiões que realizam esse procedimento. Objetivo: Responder à questão através de revisão da literatura: "Existem complicações cirúrgicas nos implantes zigomáticos?" Além de discutir as principais intercorrências encontradas. Material e Métodos: A revisão da literatura foi realizada no PubMed / Medline, Cochrane e SciELO usando os descritores: “Complications” or “Failure” and “Zygomatic Implants”. Os artigos incluídos foram estudos observacionais que relacionaram ZI e complicações. A pesquisa inicial identificou 448 artigos, mas 42 deles que mencionaram complicações associadas à ZI foram considerados neste estudo. Resultados: A complicação mais comum é sinusite seguida de peri-implantite, problemas na conexão protética, fístula em direção ao implante, parestesia, hematoma, laceração labial, equimoses, penetração da cavidade orbital, aspergilose, penetração intracraniana e hemorragia intraorbital. 44 de 2835 ZIs colocados em carregamento imediato ou tardio foram perdidos (1,5%). Houve 223 complicações menores ou maiores nos 2827 implantes (7,86%). Conclusões: A baixa morbidade deste tratamento para atrofia maxilar, existem algumas complicações imediatas e tardias a serem consideradas na escolha do tratamento de reabilitação e que devem ser relatadas no pré-operatório aos pacientes.

Made available in DSpace on 2021-06-25T10:28:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-04-01 Background: This photoelastic analysis evaluated stress distribution in different osteosynthesis systems, conventional and locking, used for treatment of mandibular angle fractures with a single plate. Material and Methods: Angle fractures were simulated in mandibles made of photoelastic resin. Following Champy’s method, plate osteosynthesis was performed. The samples were divided into five groups: Group 1, non-fractured mandible; Group 2, two screws were installed in each segment using a conventional system; Group 3, two screws were installed in each segment using a locking system; Group 4, three screws were installed in the proximal segment and four screws in the distal segment using a conventional plate; Group 5, three screws were installed in the proximal segment and four screws in the distal segment using a locking plate. In universal testing machine coupled to a polariscope, a load was applied to the first molar 10 times. The 50 images were randomly numbered and analyzed qualitatively and quantitatively by two raters. Results: The locking system promoted better stress distribution along the osteosynthesis. The locking system redu- ced stress magnitude in the distal segment, with a significant between-group difference (P≤ 0.001). Conclusions: The locking plate/screw system can distribute stress more evenly throughout the osteosynthesis, especially when long seven-hole plates are used. Department of Oral and Maxillofacial Surgery Universidade do Oeste Paulista (UNOESTE), R. José Bongiovani, 700 Department of Prosthodontics UNOESTE, R. José Bongiovani, 700 Department of Health Sciences Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP) Department of Oral and Maxillofacial Surgery Universidade do Sagrado Coração, R. Irmã Arminda, 10-50 Department of Dental Materials and Prosthodontics School of Dentistry Universidade Estadual Paulista (UNESP)

Made available in DSpace on 2020-12-12T01:19:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-02-01 Mandibular reconstruction techniques are always a challenge to oral and maxillofacial (OMF) surgeons. Techniques and treatment plans that offer the patient OMF rehabilitation should always be available. Technological innovations have enabled more rapid, safer, and more secure treatment than in the past. This article describes a case using a different approach. The patient was treated with marginal mandibulectomy and immediate rehabilitation with osseointegrated implants; a hybrid prosthesis was fabricated a short time thereafter. This treatment plan demonstrated its utility and efficiency in this case. An approach with fewer surgeries and OMF rehabilitation needs be considered in all cases. Universidade do Sagrado Coração Instituto Americano de Pesquisa Odontológica ILAPEO College Tufts University School of Dental Medicine Tufts Medical Center Universidade Estadual Paulista UNESP Universidade Estadual Paulista UNESP

This retrospective study evaluated the use of a single miniplate for the treatment of mandibular angle fractures (MAF).Fifty patients with 53 MAF were treated by open reduction and internal fixation with the use of a single miniplate and were analyzed in this study.Five patients with MAF had postoperative complications that required additional procedures. Three patients had postoperative infection, one patient complained of malocclusion in the first postoperative week, and one patient had miniplate exposure three months after surgery. Every additional procedure was performed in the office under local anesthesia without disruption of the initial fracture treatment. Postoperative maxillomandibular fixation (MMF) was performed in four patients. Treatment of MAF using a single miniplate was effective, with low morbidity and with low rates of postoperative complications. MAF can be treated without MMF, and stability is improved when long miniplates are used.The use of a single miniplate is therefore encouraged. However, postoperative MMF should be considered with the presence of little contact between bone segments, malocclusion, or extensive tooth loss.

It is important to understand the factors that can increase the incidence of complications after mandibular fracture (MF) treatment. The objective of the present study was to investigate whether occlusal stability influences the occurrence of postoperative complications in MFs treated with internal rigid fixation.We performed a prospective cohort study of patients treated for MF by osteosynthesis with plate and screw fixation. The primary predictor variable was the occlusal stability (yes vs no). Occlusion was scored as stable (group 1) if the patients had all their teeth and no free ends in either dental arch. Occlusion was coded as unstable (group 2) if the patients were partially edentulous with free ends in either dental arch or had edentulism involving more than 6 dental elements. The primary outcome variable was postoperative complication (yes vs no). The secondary outcome variables were the osteosynthesis system used (2.0 or 2.4 mm), local factors, age, and gender. Statistical analysis was performed using the χOf 115 patients with 121 MFs, 73 (63.48%) had stable occlusion (group 1) and 42 (36.52%) had unstable occlusion (group 2). The mean age was 34.11 years, and 71.3% were men. The postoperative complication rate was 8.70% (10 patients). Of the 10 patients with complications, 3 (2.6%) were in group 1 and 7 (6.1%) were in group 2 (P = .021 and P .05, respectively). The 2.0-mm system was used in 107 cases (93%). All the complications were associated with use of the 2.0-mm osteosynthesis plates, occurring in 3 of 69 patients in group 1 (4.34%) and 7 of 38 patients in group 2 (18.42%; P = .032 and P .05, respectively). The greatest number of complications was associated with unilateral MF (9 of 109). The occurrence of postoperative complications in angle and symphysis/parasymphysis fracture sites was equal.The results of the present study suggest that unstable occlusion could increase the rate of postoperative complications in MFs treated with plates and screws. Future studies are required with occlusal stability included as a variable.

The surgical treatment of dentofacial deformities is performed routinely and predictably in dentate patients. However, when dealing with the edentulous maxilla, treatment becomes more challenging and less predictable. In these cases, the combination of orthognathic surgery and osseointegrated implants could be a viable alternative to enable fixed rehabilitation. A patient with an edentulous and atrophic maxilla with maxillomandibular discrepancy and high esthetic requirement was treated with a combination of osseointegrated implants and orthognathic surgery. The rehabilitative sequence was composed of maxillary grafting procedures, installation of dental implants, placement of a fixed implant-supported prosthesis, and bimaxillary orthognathic surgery. During provisional restoration before orthognathic surgery, smaller teeth were used, allowing achievement of appropriate tooth length for the final restoration, even after natural and expected postoperative relapse. This restorative approach provided an implant-supported fixed prosthesis without prosthetic compensation and with optimum esthetics and biomechanics.

Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning. One of the advantages of decoronation followed by dental implants placement in ankylosed teeth with replacement resorption is the maintenance of bone volume in the region, both vertical and horizontal. If possible, the buccal part of the root, even if thin, should be preserved in the preparation of the cavity for the implant, as this will maintain gingival tissues looking fully normal for long periods. In the selection of cases for decoronation, the absence of microbial contamination in the region - represented by chronic periapical lesions, presence of fistula, old unconsolidated root fractures and active advanced periodontal disease - is important. Such situations are contraindications to decoronation. However, the occurrence of dentoalveolar ankylosis and replacement resorption without contamination should neither change the planning for implant installation, nor the criteria for choosing the type and brand of dental implant to be used. Failure to decoronate and use dental implants has never been reported. RESUMO Áreas dos maxilares com dentes em anquilose alveolodentária e reabsorção dentária por substituição podem ser consideradas como portadoras de osso normal, em pleno processo fisiológico contínuo de remodelação; e os implantes osseointegráveis podem ser aplicados com sucesso. A remodelação óssea promoverá sua osseointegração, independentemente de haver raízes em anquilose e/ou em reabsorção por substituição. Após 1 a 10 anos, todos os tecidos dentários terão sido substituídos por osso. O local, a angulação e o posicionamento ideal no espaço para se colocar o implante devem ser ditados pela conveniência clínica associada, exclusivamente, ao planejamento prévio. Uma das vantagens da decoronação com colocação imediata de implantes em dentes anquilosados e com reabsorção por substituição é a manutenção do volume ósseo na região, tanto vertical quanto horizontalmente. Se possível, deve-se preservar, na preparação da cavidade para o implante, a parte vestibular da raiz, mesmo que fina; isso deixará os tecidos gengivais com aspecto de plena normalidade por longos períodos. O importante na seleção de casos para a decoronação é a ausência de contaminação microbiana na região, representada por lesões periapicais crônicas, presença de fístula, fraturas radiculares antigas não consolidadas e doença periodontal avançada ativa. Essas situações são contraindicações para a decoronação. A ocorrência de anquilose alveolodentária e reabsorção por substituição sem contaminação não deve mudar o planejamento para instalação de implantes, nem mesmo os critérios de escolha do tipo e marca de implante dentário a ser utilizado. Nunca foi relatado fracasso na decoronação e uso de implantes dentários.

Odontoma is the most common mixed epithelial and mesenchymal tumour-like malformation which affects maxillary bones. Clinically, Odontomas present as lesions of benign behavior, causing little or no deformity, are asymptomatic, with self-limited growth and usually detected on routine radiographs. Radiographically, they are radiopaque lesions, well-demarcated surrounded by a thin soft tissue capsule. Compound odontomas consist of numerous tooth-like structures, whereas in complex odontomas it consists of a disorganized mass of calcified tissue. The aim of this article was to report an atypical case of intracranial compound odontoma, in the middle cranial fossa, reaching the sphenoidal sinus, which has been followed for 10 years.

Introduction: Sports' practitioners are vulnerable to dental trauma; if this occurs, the emergency treatment should be fast and efficient. This may be performed by any person at the site of the accident, not only by dental professionals. Physical educators may face dental trauma and should be able to provide proper care. This study had the objective evaluated the knowledge of physical education graduates on dental trauma. Materials and Methods: A questionnaire containing questions on dental trauma was applied to 199 physical education students; after collection of the questionnaires, data were tabulated and processed on the software Epi Info 2000 (Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, USA). As a result, only 36.7% of participants would take the individual suffering trauma to the dental professional, 56.8% believe that the avulsed tooth should be replanted, and 42.2% would replant it. Only 7.5% would store the avulsed tooth in an ideal storage medium for transportation. Conclusion: It was concluded that there is a lack of knowledge on dental trauma among physical education graduates, evidencing the need of public policies to allow education on this issue.

This study verified the resistance to displacement of six miniplate fixation methods after sagittal split osteotomy (SSO). SSO was performed in 30 polyurethane synthetic mandible replicas. The distal segments were advanced (4 mm) and specimens were grouped according to the fixation method: four-hole standard miniplate; four-hole locking miniplate; six-hole standard miniplate; six-hole locking miniplate; six-hole standard sagittal miniplate; six-hole locking sagittal miniplate. Biomechanical evaluation was performed by applying compression loads to three points on the second molar region, using an Instron universal testing machine until a 3mm displacement of the segments occurred. Compression loads able to produce 3mm displacement were recorded in kN and subjected to analysis of variance (P0.01) and Tukey's tests for comparison between groups (P0.05). The locking sagittal miniplate showed higher resistance to displacement than the regular four- and six-hole locking and standard miniplates. No significant differences were observed between the locking sagittal miniplate and the regular sagittal or the four-hole locking miniplates. Two of the three groups with the best results had locking plate fixation methods. Fixation of SSO with a single miniplate is better accomplished using six-hole locking sagittal miniplates, six-hole standard sagittal miniplates, or four-hole locking miniplates; these methods are more resistant to displacement.

This in vitro study evaluated the influence of the type of miniplate and the number of screws installed in the proximal and distal segments on the stability and resistance of Champy's osteosynthesis in mandibular angle fractures. Sixty polyurethane hemimandibles with bone-like consistency were randomly assigned to four groups (n=15) and sectioned in the mandibular angle region to simulate fracture. The bone segments were fixed by different osteosynthesis methods using 2.0 mm miniplates and 2.0 mm × 6 mm monocortical screws. In groups 1 and 2, two conventional (G1) or locking (G2) screws were installed in each bone segment using a conventional (G1) or a locking (G2) straight miniplate; in groups 3 and 4, three conventional (G3) or locking (G4) screws were installed in the proximal segment and four conventional (G3) or locking (G4) screws were installed in the distal segment using a conventional (G3) or a locking (G4) seven-hole straight miniplate. The hemimandibles were loaded in compressive strength until a 4mm displacement occurred between the segments, vertically or horizontally. Locking plate/screw systems provided significantly greater resistance to displacement than conventional ones (p

The implant-supported rehabilitation of atrophic mandibles (AM) with severe bone resorption is challenging for both surgical and prosthetic procedures due to the high risk of mandible fracture during implant surgery and postoperatively due to the masticatory load. The aim of case presentations was to demonstrate treatment alternatives for patients with AM who required oral rehabilitation with osseointegrated implants (OIs) according to the residual mandibular bone volume. When bone is 9 mm in height, the ideal treatment is the use of narrow, short OIs. When the bone height is 5 to < 9 mm, mandibular reinforcement with reconstruction plates using the intraoral approach and simultaneous placement of osseointegrated implants are proposed. In cases where bone height is < 5 mm, the choice of treatment is mandibular reconstructive surgery with an autogenous bone graft and biomaterials. The fundamental principles of this protocol are to reduce the morbidity and complications associated with the surgical procedure, which would reduce both the time and cost of full dental rehabilitation. The choice of the technique for mandibular reconstruction should be indicated according to the magnitude of the atrophy.

Selective cyclooxygenase-2 non-steroidal anti-inflammatory drugs are known to inhibit bone repair, especially when long-term administration is required due to chronicle inflammatory diseases. In order to evaluate the action of this drug in bone repair during short-term administration, 48 rats underwent surgical bone defects in their tibias, being randomly distributed into three groups: (Group 1) negative control; (Group 2) animals treated with celecoxib, and (Group 3) animals treated with ketoprofen, both experimental groups at 1 mg/kg dose, beginning 1 h before the surgical procedure and after every 12 h for the following 3 days, or until the day of sacrifice. The animals were killed after 48 h, 7, 14, and 21 days. The tibias were removed for morphological, morphometric, and immunohistochemistry analysis for COX-2. No statistical significant differences were observed in the quality of bone repair and quantity of formed bone among the groups. COX-2 immunoreactivity of the celecoxib treated specimens was more intense in the first analyzed period, and no longer observed in the periods of 14 and 21 days. Such results suggest that the administration of the analyzed drugs in short periods does not interfere with the process of bone repair in the tibia of rats.

Facial nerve has great functional and aesthetic importance to the face, and damage to its structure can lead to major complications. This article reports a clinical case of neuroanastomosis of the facial nerve after facial trauma, describing surgical procedure and postoperative follow-up. A trauma patient with extensive injury cut in right mandibular body causing neurotmesis of the VIIth cranial nerve and mandibular angle fracture right side was treated. During surgical exploration, the nerve segments were identified and a neuroanastomosis was performed using nylon 10-0, after reduction and internal fixation of the mandibular fracture. Postoperatively, an 8-month follow-up showed good evolution and preservation of motor function of the muscles of facial mime, highlighting the success of the surgical treatment. Nerve damage because of facial trauma can be a surgical treatment challenge, but when properly conducted can functionally restore the damaged nerve.

PURPOSE The aim of this study was to evaluate deformation, roughness, and mass loss of stainless steel, diamond-like carbon (DLC)-coated and zirconia drills after multiple osteotomies with sterilization procedures. MATERIALS AND METHODS Drilling procedures were performed using stainless steel (G1), DLC-coated (G2), and zirconia (G3) drills. All groups were divided in subgroups 1, 2, 3, 4, and 5, corresponded to drills used 0, 10, 20, 30, and 40 times, respectively. RESULTS No significant differences in mass and roughness were detected among all groups and subgroups. In SEM images, all groups revealed signs of wear while coating delamination was detected in G2. Drills from G1 displayed more irregular surface, whereas cutting edges were more regular in G3. CONCLUSION Zirconia drills presented more regular surfaces whereas stainless steel drills revealed more severe signs of wear. Further studies must be performed to evaluate the putative influence of these findings in heat generation.

The purpose of this paper was to analyze specimens of autogenous bone block grafts exposed to the oral cavity after ridge reconstructions. Specimens of chronic suppurative osteomyelitis (CSO) of the jaws were used as comparison for bacterial colonization pattern. For this, 5 specimens of infected autogenous bone grafts were used and 10 specimens of CSO embedded in paraffin were stained with Brown and Brenn technique and analyzed under light microscopy. The results showed a similar colonization pattern in both situations, with the establishment of bacterial biofilm and the predominance of Gram-positive bacteria. The conclusion was that the similarity in bacterial distribution and colonization between autogenous bone grafts and CSO stresses the necessity of more invasive procedures for the treatment of the autogenous bone grafts early exposed to the oral cavity.

The rehabilitation of edentulous maxillae is a complex procedure due to the involvement of esthetic and functional requirements. A trial maxillary denture can be used to identify the need for adequate upper lip support when replacing removable complete dentures by implant-fixed dental prostheses. This clinical report describes the outcome of the rehabilitation of an edentulous atrophic maxilla with unfavorable maxillomandibular relationship and deficient upper lip support. A trial denture was fabricated and used to diagnose the need for a prosthesis capable of restoring the upper lip support. The reduced upper lip support was also confirmed by a lateral cephalogram. The patient was rehabilitated by an implant-fixed dental prosthesis associated with an attachment-retained gingival prosthesis. The case presented shows that when loss of upper lip support is detected and the patient does not wish to undergo further surgical reconstruction procedure, the retention of a gingival prosthesis using a ball attachment is a satisfactory treatment option.

Success of alveolar reconstructions using onlay autogenous block bone grafts depends on their adequate integration to the recipient bed influenced by a number of local molecules. Considering the fundamental role of cyclooxygenase (COX-2) in bone repair, the aim of this study was to analyze the effect of its inhibition in the integration of endochondral (EC) iliac crest, and intramembranous (IM) calvaria bone grafts. Thirty-two rabbits were divided into 4 groups: Calvaria Control (CC) and Iliac Control--treated with oral 0.9 % saline solution, and Calvarial-NSAID (C-NSAID) and Iliac-NSAID (I-NSAID) groups--treated with oral 6 mg/Kg non-steroidal anti-inflammatory drug etoricoxib. After 7, 14, 30 and 60 days the animals were euthanized and the specimens removed for histological, histomorphometric and immunohistochemistry analysis. At day 60, a tight integration of IM blocks could be seen with the presence of remodeling bone, whereas integration of EC grafts was mainly observed at the edges of the grafts. A significant higher percentage of bone matrix in the interface region of the CC grafts in comparison to C-NSAID only at day 14, whereas no differences were detected comparing the EC grafts. No differences were observed in Runx-2 and vascular endothelial growth factor (VEGF) immunolabeling when comparing CC and C-NSAID groups, while a significant weaker Runx-2 and VEGF labeling was detected in I-NSAID group at day 60. Although some influence was detected in osteogenesis, it is concluded that drug induced inhibition of COX-2 does not impair onlay bone grafts' healing of both embryologic origins in rabbits.

The objective of this study is to discuss problems associated with dental retention through three clinical cases of mandible fractures related to the presence of retained lower third molars, emphasizing the possibility of mandible fractures resulting from this or from the extraction procedure. The three evaluated patients had a fracture in the mandible angle. The third molars were present in all the cases, as was the relationship of the fracture with the teeth. After evaluating the three cases and reviewing literature, it is believed that the presence of the retained lower third molars and the surgical procedures for their extraction increase the risk of mandible angle fractures.

The aim of this in vitro study was to assess the biomechanical stability of 9 different osteosynthesis methods after sagittal split ramus osteotomy by simulating the masticatory forces and using a 3-point biomechanical test method.Forty-five polyurethane hemimandibles with bone-like consistency were randomly assigned to 9 groups (n = 5) and subjected to sagittal split ramus osteotomy. After 4-mm advancement of the distal segment, the bone segments were fixed by different osteosynthesis methods using 2.0-mm miniplate/screw systems: group A, one 4-hole conventional straight miniplate; group B, one 4-hole locking straight miniplate; group C, one 4-hole conventional miniplate and one bicortical screw; group D, one 4-hole locking miniplate and 1 bicortical screw; group E, one 6-hole conventional straight miniplate; group F, one 6-hole locking straight miniplate; group G: two 4-hole conventional straight miniplates; group H, two 4-hole locking straight miniplates; and group I, 3 bicortical screws in an inverted-L pattern. All models were mounted on a base especially constructed for this purpose. Using a 3-point biomechanical test model, the hemimandibles were loaded in compressive strength in an Instron machine (Norwood, MA) until a 3-mm displacement occurred between segments vertically or horizontally. Data were analyzed by analysis of variance and Tukey test (alpha = 1%).The multiparametric comparison of the groups showed a statistically significant difference (P.01) between groups that used 2 miniplates (groups G and H), 1 miniplate and 1 bicortical screw (groups C and D), and only bicortical screws (group I) compared with groups that used only 1 miniplate with 2 screws per segment (groups A and B) and 3 screws per segment (groups E and F).The placement of 2.0-mm-diameter bicortical screws in the retromolar region, associated or not with conventional and locking miniplates with monocortical screws, promoted a better stabilization of bone segments. Locking miniplates presented a better performance in bone fixation in all groups.

The atrophic maxilla often results in lateral, anteroposterior and vertical disproportion of the maxillary arches. This paper presents the case of a 40-year-old male with a severely atrophic maxilla who underwent oral rehabilitation. He was treated with onlay and inlay iliac bone grafts followed by vestibuloplasty and dental implant placement 170 days after initial bone grafting. The dental implants were uncovered after 4 months of healing. The patient also underwent orthognathic surgery for correction of the maxillary basal bone and to improve implant positioning. At the 48-month follow-up there were no complications.

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) A ostectomia é uma manobra cirúrgica fundamental que pode afetar a reparação tecidual de modo a aumentar a morbidade do procedimento. O tipo de equipamento e/ou instrumental utilizado para a ostectomia pode influenciar diretamente no reparo ósseo. O objetivo deste trabalho foi analisar o processo de reparação óssea em defeitos realizados em mandíbula de coelho com três diferentes equipamentos. Quinze coelhos foram aleatoriamente divididos em 3 grupos (n=5) de acordo com o equipamento usado para preparacão de 3 cavidades ósseas com brocas padronizadas: I) motor de baixa rotação pneumático, II) motor de alta rotação pneumático e III) motor de baixa rotação elétrico, todos com refrigeração constante. Após os períodos experimentais de 2, 7e 30 dias, as peças anatômicas foram removidas e submetidas a análises microscópica e histomorfométrica. Não houve diferença estatisticamente significante (p>0,05) entre os grupos nos 3 períodos experimentais, considerando-se a área total de matriz óssea mineralizada, embora a análise microscópica tenha revelado uma tendência a um processo de reparação óssea um pouco mais adiantado no grupo III, quando comparado aos demais grupos. Os resultados deste estudo sugerem que o tipo de equipamento rotatório utilizado em cirurgia bucomaxilofacial não interfere no reparo ósseo. In oral surgery, the quality of bone repair may be influenced by several factors that can increase the morbidity of the procedure. The type of equipment used for ostectomy can directly affect bone healing. The aim of this study was to evaluate bone repair of mandible bone defects prepared in rabbits using three different rotary devices. Fifteen New Zealand rabbits were randomly assigned to 3 groups (n=5) according to type of rotary device used to create bone defects: I - pneumatic low-speed rotation engine, II - pneumatic high-speed rotation engine, and III - electric low-speed rotation engine. The anatomic pieces were surgically obtained after 2, 7 and 30 days and submitted to histological and morphometric analysis. The morphometric results were expressed as the total area of bone remodeling matrix using an image analysis system. Increases in the bone remodeling matrix were noticed with time along the course of the experiment. No statistically significant differences (p>0.05) were observed among the groups at the three sacrificing time points considering the total area of bone mineralized matrix, although the histological analysis showed a slightly advanced bone repair in group III compared to the other two groups. The findings of the present study suggest that the type of rotary device used in oral and maxillofacial surgery does not interfere with the bone repair process. Sacred Heart University Department of Oral Surgery Federal University of São Paulo Department of Health Sciences UNIFESP, Department of Health Sciences SciELO

OBJETIVOS: o presente estudo pretendeu investigar se o padrão facial acarreta implicações no desempenho das funções de respiração, mastigação, deglutição e fala em indivíduos com má oclusão Classe III esquelética. METODOLOGIA: analisaram-se os dados da avaliação de 40 pacientes adultos com má oclusão Classe III, sendo 25 dolicocefálicos e 15 mesocefálicos. Consideraram-se aspectos relacionados à postura habitual de lábios e língua, modo respiratório, tipo mastigatório, padrão de deglutição e fala. RESULTADOS: a postura alterada de lábios foi significantemente maior para o grupo de dolicocefálicos, enquanto a postura de língua no assoalho da boca foi predominante em ambos os grupos. Quanto ao modo respiratório, verificou-se que o modo oral ou oro-nasal foi significantemente maior para o grupo de dolicocefálicos. A mastigação mostrou-se alterada para ambos os grupos, enquanto a interposição de língua durante a deglutição predominou no grupo mesocefálico e a anteriorização de língua na fala no dolicocefálico. A interposição de língua na deglutição mostrou-se relacionada com a ocorrência de anteriorização de língua na fala. CONCLUSÕES: o tipo dolicocefálico contribui para a ocorrência de alterações na postura habitual dos lábios, bem como nas funções de respiração e fala, enquanto o tipo mesocefálico influenciou as características de deglutição de indivíduos com má oclusão Classe III esquelética.

Made available in DSpace on 2018-11-12T17:27:13Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-01. Added 1 bitstream(s) on 2021-07-14T17:51:28Z : No. of bitstreams: 1 S1807-25772017000600357.pdf: 587218 bytes, checksum: e2d86cda717b84a02154d4d7aa82e612 (MD5) ResumoIntrodução A reabilitação oral de pacientes com atrofia óssea maxilar representa um grande desafio por estes pacientes apresentarem comprometimento da qualidade de vida, dificuldades alimentares, complicações nutricionais, dificuldades sociais e emocionais. Propostas de reabilitações de maxilas mutiladas e/ou atróficas com próteses totais fixas implantossuportadas, utilizando implantes zigomáticos, foram relatadas.Objetivo O objetivo deste estudo foi avaliar o grau de satisfação dos pacientes reabilitados com implantes zigomáticos e convencionais, em função de carga imediata com prótese do tipo protocolo através de um estudo retrospectivo, por meio de questionário respondido pelos pacientes.Material e método Foram incluídos dezenove pacientes, tratados na clínica do Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO) em Curitiba, PR (Brasil), entre dezembro de 2005 e junho de 2010. Os pacientes foram reabilitados com 41 implantes zigomáticos e 73 implantes convencionais, todos do tipo cone Morse. As próteses, tipo híbridas, foram instaladas em carga imediata.Resultado O índice de satisfação encontrado foi de 100%.Conclusão Pode-se concluir que esta técnica de reabilitação restabelece fatores primordiais ao ser humano como mastigação, fonética e estética. Os pacientes relataram satisfação com o resultado do tratamento, conseguindo desenvolver atividades sociais dentro da normalidade, elevando sua autoestima. AbstractIntroduction Rehabilitation of patients with atrophic maxilla is challenging. Atrophic maxilla patients present compromised quality of life, impaired function, deficient nutrition, social and emotional difficulties. The rehabilitation of atrophic maxilla by zygomatic fixtures has been previously proposed.Objective This retrospective study evaluated the degree of satisfaction of patients rehabilitated by immediately loaded conventional and zygomatic fixtures supporting full-arch fixed dental prosthesis. A satisfaction questionnaire was used for patient assessment.Material and method Nineteen patients treated at the Latin American Institute for Dental Research and Education (ILAPEO) between December 2005 and June 2010 were evaluated. Patients were rehabilitated with 41 zygomatic implants and 73 conventional implants under immediate load.Result All assessed patients were completely satisfied with the provided rehabilitation.Conclusion It can be concluded that rehabilitation with zygomatic fixtures is capable of restoring function, phonetics, and esthetic for patients with atrophic maxilla. The patients were satisfied with the treatment outcomes and showed increased self-esteem after the rehabilitation. Universidade Estadual Paulista Faculdade de Odontologia de Araraquara Instituto Latino Americano de Ensino e Pesquisa Odontológico Universidade Sagrado Coração Universidade Estadual Paulista Faculdade de Odontologia de Araraquara

A funcionalização de superfícies nanoestruturadas de implantes metálicos com moléculas orgânicas vem se destacando como estratégia importante para o controle de eventos biológicos que ocorrem na região interfacial durante o reparo ósseo. O objetivo do presente estudo foi avaliar, in vitro, aspectos chaves da interação de células das linhagens osteoblástica e macrofágica com superfície de liga de titânio com nanotopografia rica em grupos hidroxila (Ti Nano), funcionalizada com polifenóis de extrato de bagaço de uva na concentração de 5 mg/mL (PPHE). Cultura de células pré-osteoblásticas MC3T3-E1 foram avaliadas em relação a morfologia e viabilidade celulares, atividade in situ da enzima fosfatase alcalina e detecção de acúmulos de cálcio/formação de matriz mineralizada, enquanto que a de células macrofágicas RAW 264.7, avaliadas em relação a morfologia e viabilidade celulares e expressão de marcadores macrofágicos por Real Time PCR. A nanotopografia de Ti6Al4V foi obtida por meio de processo patenteado que inclui condicionamento químico de solução de ácido fluorídrico e oxidação controlada com peróxido de hidrogênio. Os resultados mostraram que sobre Ti Nano+PPHE, células MC3T3-E1 exibem tendência a menor espraiamento celular e maior viabilidade em períodos iniciais da cultura - 3 e 7 dias -, com potencial osteogênico expressivo e crescente de 14 a 18 dias, estatisticamente semelhante ao de culturas sobre Ti Nano em 18 dias. Culturas RAW 264.7 exibem células aderidas e espraiadas sobre Ti Nano e Ti Nano+PPHE em 3 dias, com aspectos semelhantes entre si de variabilidade morfológica e de viabilidade celular, e com maior expressão de iNOS, Arg1, TNF-α e GMCSF sobre Ti Nano+PPHE em 5 dias. Em conclusão, a funcionalização de PPHE sobre nanotopografia de Ti exerce efeitos biológicos sobre células osteoblásticas e macrofágicas in vitro potencialmente moduladores do processo de reparo ósseo na interface com implantes metálicos osseointegráveis. The functionalization of nanostructured surfaces of metallic implants with organic molecules has been highlighted as an important strategy for the control of biological events that occur in the interfacial region during bone repair. The aim of the present study was to evaluate, in vitro, key aspects of the interaction of osteoblastic and macrophagic cells with a nanostructured titanium alloy surface rich in hydroxyl groups (Ti Nano), functionalized with polyphenols from grape pomace extract at the concentration of 5 mg/mL (PPHE). Pre-osteoblastic MC3T3-E1 cells were evaluated in terms of cell morphology and cell viability, in situ alkaline phosphatase activity and mineralized matrix formation, whereas the macrophagic RAW 264.7 cell line were evaluated in terms of cell morphology and cell viability, and expression of macrophage markers by Real Time PCR. The Ti6Al4V nanotopography was obtained by means of a patented process consisting of chemical etching with hydrofluoric acid solution and controlled oxidation with hydrogen peroxide. The results showed that on Ti Nano+PPHE, MC3T3-E1 cells show a tendency towards reduced cell spreading and significantly higher cell viability at days 3 and 7 of culture, with increasing osteogenic potential from 14 to 18 days of culture, similarly to that of cultures on Ti Nano at day 18 of culture. RAW 264.7 cells attached and spread on Ti Nano and Ti Nano+PPHE, exhibiting similar aspects of morphological variability and unaltered cell viability at day 3 of culture, and higher mRNA expression of iNOS, Arg1, TNF-α and GMCSF on Ti Nano+PPHE at day 5 of culture. In conclusion, the functionalization of PPHE on Ti Nano exerts biological effects on both osteoblastic and macrophagic cells in vitro that potentially modulate the bone repair process at the interface with osseointegrated metallic implants.

Devido ao crescente uso da tomografia computadorizada tipo feixe cônico (TCFC), aumentou-se a busca por softwares para arquivos DICOM que permitem a avaliação e a mensuração da área craniofacial. O objetivo deste trabalho foi comparar a medida do volume do espaço aéreo e a menor área axial da via aérea em pacientes com fissura labiopalatina por meio de 5 diferentes softwares de imagem: Dolphin3D, InVivo Dental, ITK Snap, InVesalius e NemoFAB, para análise tridimensional da via aérea, através de imagens de TCFC. Inicialmente, um examinador selecionou através de randomização 100 TCFC de um arquivo de 450 TCFC, sendo coletado seu arquivo DICOM. As segmentações da orofaringe foram realizadas de acordo com as referências do fabricante, com duas técnicas para segmentação: intervalo de limiar interativo e intervalo de limiar fixo. Os resultados foram submetidos a um teste de análise de variância (ANOVA) sendo adotado um nível de significância de 5% para todos os testes estatísticos. Os resultados encontrados tanto para análise da área seccional mínima quanto o volume total mostraram que os valores medianos entre os grupos de tratamento são maiores do que seria esperado e quando houve comparação entre cada grupo existiu diferença estatisticamente significante (P =

Despite the successful clinical application of titanium (Ti) as a biomaterial, the exact cellular and molecular mechanisms responsible for Ti osseointegration remain unclear. Indeed, specific knowledge still lacks on what elements are present at biomaterial/host interface and how these factors can trigger inflammatory pathways involved in the subsequent osseointegration process. In this context, we hypothesize that the surgical trauma inherent to the biomaterial grafting results in the release of DAMPs (damage-associated molecular patterns), endogenous proteins that act as triggers of immune inflammatory response upon cellular/tissue stress and/or damage. HMGB1 comprises the prototypic DAMP, which triggers host response via its cognate receptor RAGE, present at leucocytes and somatic cells surfaces. In this context, the aim of this thesis is to study the influence of DAMPs on the biomaterial/host interface and its role in mediating a constructive inflammatory process along tissue repair and osseointegration outcome. Methods and Results: In the article 1, we first characterized an oral osseointegration model in C57Bl/6 mice. This model of oral osseointegration was performed by using Ti screws (6AL-4V, Ø0.6mm, length of 1.5 mm) implanted in the edentulous alveolar crest of mice maxilla. The peri-implant sites were evaluated by microCT, as well histological and molecular assessments. In the article 2, we confirm the presence of DAMPs (HMGB1, HSP60, HSP70, S100A, Byglican, and Fibronectin) at Ti/host interface, analyzing Ti discs (6AL-4V, Ø6mm, 2mm of thick) implanted in the subcutaneous tissue of C57Bl/6 mice. Subsequently, the impact of HMGB1 and RAGE on the tissue repair around Ti discs was investigated by using HMGB1 (GZA 200mg/Kg) or RAGE (RAP, 4m/Kg/day) pharmacological inhibitors. The HMGB1/RAGE axis actively influences the inflammatory response post biomaterial implantation and the blocking of both molecules can negatively affect the subcutaneous tissue repair surrounding Ti disc in mice. In the article 3, Ti screws were implanted in the maxillary edentulous alveolar crest of C57Bl/6 mice, treated or untreated with GZA and RAP and the osseointegration process was evaluated by microscopic and molecular analysis (such as characterized in the article 1). The failure of osseointegration process was observed in mice treated with RAP or GZA, which present a disruption of the inflammatory process followed by foreign body reaction. In conclusion, HMGB1 and RAGE actively influence the tissue repair and osseointegration process in response to Ti-devices grafting, influencing the genesis and regulation of inflammatory immune response, which include the modulation of macrophages polarization state, MSC migration and differentiation in bone cells and consequent bone deposition. Apesar do sucesso clínico do Titânio (Ti) como biomaterial, os exatos mecanismos celulares e moleculares que levam à sua osseointegração permanecem incertos. De fato, ainda há uma lacuna de conhecimento sobre quais elementos estão presentes na interface hospedeiro/biomaterial e como esses fatores poder deflagrar as vias inflamatórias envolvidas no subseqüente processo de osseointegração. Neste contexto, sugere-se que o trauma cirúrgico inerente à implantação do biomaterial resulta na liberação de DAMPs (do inglês damage-associated molecular patterns), os quais são proteínas endógenas que agem como ativadoras da resposta imune/inflamatória sob um estresse ou dano celular e tecidual. HMGB1 constitui um DAMP prototípico, o qual ativa a resposta do hospedeiro via seu receptor cognato RAGE, que por sua vez está presente na superfície de leucócitos e células somáticas. Neste contexto, o objetivo da presente tese é estudar a influencia de DAMPs na interface hospedeiro/biomaterial e seu papel na modulação de um processo inflamatório construtivo ao longo do reparo tecidual e da osseointegração. Material e Métodos: No artigo 1, caracterizou-se um modelo de osseointegração oral em camundongos C57Bl/6 . Tal modelo foi desenvolvido utilizando parafusos de Ti (6AL-4V, Ø0,6mm, 1.5 de comprimento) implantados no rebordo alveolar edentulo da maxila de camundongos, cujos tecidos peri-implatares foram avaliados por meio de microCT, bem como análises histológicas e moleculares. No artigo 2, inicialmente confirmou-se a presença de DAMPs (HMGB1, HSP60, HSP70, S100A, Biglicana e Fibronectina) na interface Ti/hospedeiro, analisando amostras com discos de Ti (6AL-4V, Ø6mm x 2mm de espessura) implantados no tecido subcutâneo de camundongos C57Bl/6. Posteriormente, o impacto de HMGB1 e RAGE no reparo tecidual ao redor dos discos de Ti foi analisado por meio de uso de inibidores farmacológicos de HMGB1 (GZA 200mg/Kg/dia) e RAGE (RAP, 4m/Kg/dia). O eixo HMGB1/RAGE influencia ativamente a resposta inflamatória pós implantação do biomaterial, e o bloqueio de ambas as moléculas pode afetar negativamente o reparo tecidual subcutâneo ao redor de discos de Ti em camundongos. No artigo 3, parafuso de Ti foram implantados no rebordo edentulo da maxila de camundongos C57Bl/6, tratados e não tratados com GZA e RAP; e o processo de osseointegração foi avaliado por meio de análises microscópicas e moleculares (tal como caracterizado no artigo 1). A falha da osseointegração foi observada em camundongos tratados com RAP ou GZA, os quais apresentaram alterações importantes no processo inflamatório seguidas por uma reação de corpo estranho nos perídos mais tardios. Em suma, conclui-se que HMGB1 e RAGE influenciam ativamente o processo de reparo tecidual e de osseointegração frente à implantação de dispositivos de Ti, influenciando a geração e a regulação da resposta imune inflamatória, a qual inclui a modulação da polarização de macrófagos, a migração de MSCs e a diferenciação de células ósseas para subsequente deposição óssea.

Um sistema mais adequado de fixação interna no tratamento de fraturas mandibulares é essencial para um bom resultado. Foi realizado um estudo comparativo da utilização do sistema de fixação 2.0-mm locking com sistemas convencionais no tratamento de fraturas mandibulares. Para este estudo, 87 pacientes consecutivos com 134 fraturas mandibulares foram divididos aleatoriamente para receber placas 2.0-mm locking (n = 45) ou convencionais 2.0-mm ou 2.4-mm (n = 42) e tiveram um seguimento mínimo de 6 meses. Foram obtidos dados pessoais, presença de doenças sistêmicas, abuso de substâncias, etiologia, politraumatismo e as localizações. As fraturas foram classificadas com base no grau de deslocamento e de complexidade. Foi mensurada a amplitude da abertura bucal. Análises estatísticas foram feitas na comparação entre grupos (p

Esta pesquisa avaliou o sucesso de implantes utilizados como pilares de próteses inferiores implantossuportada do tipo protocolo, empregando dois sistemas reabilitadores, sob carga imediata, após 7 anos. Foram pesquisados os seguintes aspectos: índices de placa e de sangramento, estabilidade dos implantes por frequência de ressonância (FR) e perda óssea marginal. Foram avaliados 76 implantes, em 19 pacientes, divididos em 2 grupos: A (n=12, All-on-four® - Nobel Biocare®) e B (n=7, Neopronto® - Neodent®). Os pacientes foram acompanhados nos momento da instalação dos implantes (inicial), 6 meses, 1, 2 e 7 anos após a instalação. Os resultados mostraram uma taxa de sucesso de 100% para os implantes do grupo A e de 90% para o grupo B. Os índices de placa não apresentaram diferenças estatisticamente significativas e foram, no grupo A, de 71,87%, 63,54% e 47,92%, e, no grupo B de 26,78%, 41,07% e 37,50%, para as avaliações de 1, 2 e 7 anos, respectivamente. O índice de sangramento para o grupo A foi de 43,75%, 42,71% e 43,75% e para o grupo B foi de 53,57%, 51,79% e 48,21%, nos tempos de avaliação de 1, 2 e 7 anos, respectivamente, sem diferenças estatísticas. Não foi observado supuração em nenhum tempo de avaliação. Os resultados de FR não diferiram estatísticamente entre os dois grupos, entretanto, diminuíram entre a avaliação inical (grupo A = 69,27ISQ e grupo B = 68,29ISQ) e de 6 meses (grupo A = 64,65ISQ e grupo B = 66,50ISQ), e aumentaram nos anos seguintes para os 2 grupos, sendo para o grupo A de 66,17ISQ, 66,05ISQ e 69,87ISQ e para o grupo B de 67,78ISQ, 68,13ISQ e 73,61ISQ para os tempos de 1, 2 e 7 anos, respectivamente. Em relação a perda óssea, existiu diferença significativa entre grupos e foi de 0,49mm e 0,67mm após 1 ano e de 1,03mm e 1,27mm, após 7 anos, para os grupos A e B, respectivamente. Em relação à posição dos implantes, o grupo B apresentou diferença estatística entre os implantes centrais e distais nas avaliações de FR e perda óssea. Concluiu-se que 1- a taxa de sucesso foi de 100% para o grupo A e de 90% para o grupo B; 2- os índices de placa e de sangramento diminuíram ao longo dos anos de avaliação; 3- a FR foi semelhante entre os grupos, mas com diferença significativa no grupo A para o critério tempo e, no grupo B para os critérios tempos de avaliação e posição dos implantes; 4- perda da altura da crista óssea foi diferente significativamente entre os grupos, sendo maior no grupo B. This study evaluated the success of implants used to support mandibular complete full-arch fixed prosthesis employing two rehabilitation systems with immediate loading after 7 years. The following aspects were investigated: plaque and bleeding index, implant stability by resonance frequency analysis and marginal bone loss. The 76 implants were evaluated in 19 patients divided in 2 groups: A (n=12, All-on-four® - Nobel Biocare®) and B (n=7, Neopronto® - Neodent®). The follow-up visits were at the time of implant placement (initial), 6 months, 1, 2 and 7 years after surgery. The results showed a success rate of 100% for implants in group A and 90% for group B. The plaque index did not differ statistically signifcant and were in group A, 71.87%, 63.54% and 47.92%, and in group B 26.78%, 41.07% and 37, 50% for 1, 2 and 7 years of follow-up, respectively. The bleeding index for group A was 43.75%, 42.71% and 43.75% and for group B was 53.57%, 51.79% and 48.21%, for 1, 2 and 7 years of follow-up, respectively, no statistical differences. Suppuration was not observed at any time of evaluation. The results of FR did not differ significantly between groups, however, decreased between initial (group A = 69,27ISQ and group B = 68,29 ISQ) and 6 months (group A = 64,65ISQ and group B = 66,50ISQ), and increased in the following evaluations for both groups, in group A was 66,17ISQ, 66,05ISQ and 69,87ISQ and group B was 67,78ISQ, 68,13ISQ and 73,61ISQ for 1, 2 and 7 years of follow-up, respectively. In relation to bone loss, a significant difference existed between groups and was 0,49mm and 0,67 mm after 1 year and 1,03mm and 1,27mm after 7 years, for groups A and B, respectively. Regarding the position of the implants, group B showed statistical difference between the central and distal implants for FR and bone loss. It was concluded that 1- Success rate was 100% for group A and 90% for group B; 2 - Plaque and bleeding index decreased over the follow-up; 3- FR was similar between groups, but with a significant difference in group A for thw criterion time, and in group B for the criteria evaluation times and position of the implants, 4- bone loss was significantly different between groups, and higher in group B.