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Biomedical subjects

Roberto Uribe

Publications and source records attributed to Roberto Uribe.

4 recordsLinked to original sources

Immediate loading in oral implants. Present situation.

The earliest antecedents of immediate loading were introduced by Ledermann in 1979. He placed overdenture in four interforaminal implants on the same day the surgery was carried out. In the original implantological protocol of Brånemark the immediate loading did not appear indicated, currently, it is being presented as a predictable alternative in several studies. We revised different articles on immediate loading from 1997 to 2002. We analysed different variables and concluded that immediate loading produces a success rate in posterior maxilla similar to the differed loading (90-100%). The characteristics of the implant, favourable to immediate loading, are: screw-shaped, with a rough surface, sand blasted and acid etching processed and a minimum length of 10 mm. The initial stability and a micro movement of the implant, inferior to 150 microm and a marginal to the insertion equal or superior to 32 N/cm are defined as a proper osseous. The bruxism stands out as an adverse factor according to several authors.

Crowns↗

Marginal peri-implantitis due to occlusal overload. A case report.

The etiology of marginal peri-implantitis describes an infectious factor and a biomechanical factor resulting from occlusal overload. Clinical and experimental articles oriented to the biomechanical factor are scarce, so as the studies about the histology associated to periimplantitis. We present a case of marginal peri-implantitis on an implant in the mandibular molar zone caused by occlusal overload, which led to an osseous defect on the marginal crest. The treatment was composed of occlusal adjustment, removal of contaminated surgical tissue, and autogenous bone graft, which varies from the common treatment of infectious peri-implantitis. Histologic analysis of peri-implantitis tissue reveals a juxtaepithelial lympho-plasmocytorious infiltrate and a central zone of dense fibro-connective tissue with scanty inflammatory cells, which differs from the chronic inflammatory tissue associated with infectious peri-implantitis. Clinical and radiographic followup control after 12 months evidenced the remission of the symptoms and bone regeneration on the marginal crest. We consider that in the treatment of marginal peri-implantitis, it is necessary to continue the studies on the histological differences between the infectious types and those that are caused by occlusal overload.

Bite Force↗

Immediate implants after extraction. A review of the current situation.

Immediate implants are positioned in the course of surgical extraction of the tooth to be replaced. The percentage success of such procedures varies among authors from 92.7-98.0%. The main indication of immediate implantation is the replacement of teeth with pathologies not amenable to treatment. Its advantages with respect to delayed implantation include reduced post-extraction alveolar bone resorption, a shortening of the rehabilitation treatment time, and the avoidance of a second surgical intervention. The inconveniences in turn comprise a general requirement for membrane-guided bone regeneration techniques, with the associated risk of exposure and infection, and the need for mucogingival grafts to seal the socket space and/or cover the membranes. The surgical requirements for immediate implantation include extraction with the least trauma possible, preservation of the extraction socket walls and thorough alveolar curettage to eliminate all pathological material. Primary stability is an essential requirement, and is achieved with an implant exceeding the alveolar apex by 3-5 mm, or by placing an implant of greater diameter than the remnant alveolus. Esthetic emergence in the anterior zone is achieved by 1-3 mm sub-crest implantation. Regarding guided regeneration of the alveolar bone, the literature lacks consensus on the use of membranes and the type of filler material required. While primary wound closure is desirable, some authors do not consider it to be of great relevance.

Animals↗

Zygomatic implants using the sinus slot technique: clinical report of a patient series.

PURPOSE: The management of 5 patients with extreme maxillary atrophy and treatment consisting of maxillary fixed prostheses supported by conventional implants and zygomatic fixations positioned according to the sinus slot technique is reported. MATERIALS AND METHODS: A total of 16 conventional implants were placed, together with 2 pterygoid implants and 10 zygomatic fixations. In 2 cases zygomatic fixation could not be performed on the alveolar ridge, thus requiring palatal displacement. One patient presented nasogenian ecchymosis. The fixed rehabilitations were either screwed or cemented after 5 to 6 months. RESULTS: Follow-up from implantation lasted 12 to 18 months, during which the prostheses and implants remained stable and in function. DISCUSSION: The placement of zygomatic fixations based on the sinus slot technique offers advantages over the conventional technique, though extreme atrophy of the alveolar processes does not allow fixation at the supracrestal level, and complications may develop. CONCLUSION: While zygomatic fixation is a valid alternative for treating the atrophic jaw, long-term studies are required to confirm its efficacy.

Adult↗