PMC8121375_01
Initial clinical images. Carious lesion on tooth 13 on the mesiobuccal (A) and palatal surfaces (B); Edema of the peri-implant mucosa in the region of 12 to 23, with dental calculus in 12 and bleeding in 12 and 11 (C and D); Screw access-hole restorations of implants in 12,11 and 21 (E); Prostheses over implants from 23 to 25, and erythema of the mucosa is observed in 25 (F); Palatal region from 24 to 26, in which erythema is observed in the mesial of 24 and, prosthetic component of the implant in the region of 26, with loss of the prosthetic crown (G and H); Buccal view of the implants and their screw access-hole restorations from 44 to 46 (I); Teeth 32 to 42 with unfinished and unpolished restorations (J); Buccal view of teeth 33 and 34 (K) and lingual (L), and 34 has prosthetic restoration
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The presence of carious lesion was verified in tooth 13, in the mesial of the buccal and palatine surfaces (Figures 1A and 1B), edematous and erythematous area in the peri-implant mucosa from 12 to 23, associated with dental calculus in 12, and bleeding in 12 and 11 (Figures 1C and 1D). In turn, the resin restorations in region of screw access-hole of implants in 12,11 and 21 were properly sealed (Figure 1E). Erythematous regions were observed in mucosa in the buccal region of the 25, and in the interproximal region of the palatal surface of prosthesis, over implants between 23 and 24 (Figures 1F and 1G). In addition, the absence of prosthetic crown associated with implant in 26 was found (Figures 1G and 1H). The lower arch, in turn, had prostheses over implants from 44 to 46 and, teeth from 34 to 43 with extensive restorations, without finishing and polishing (Figures 1I, 1J, 1K and 1L).
Initial images of wide-field optical fluorescence. Vestibular view of the region of 14 and 13 showing reddish fluorescence in the mesiobuccal region of 13 (A); Palatal view of the region of 13 to 21 showing reddish fluorescence in 13 and areas of intense green fluorescence in the region of screw access-hole restorations of implants 12, 11, and 21 (B); Vestibular view of the prostheses over implants from 12 to 22 showing reddish fluorescence in cervical, which is more intense in 12 and 11 (C and D); Palatal view with intense green fluorescence in region of the screw access-hole restorations of implants from 12 to 21 (E); Presence of reddish fluorescence in cervical of the buccal face of prostheses over implants from 23 to 25 (F); Palatal interproximal between 23, 24, cervical face and, in the access to the 26 prosthetic component screw (G and H); Intense green fluorescence of screw access-hole restorations of implants at 23 and 24 (F and G); Reddish fluorescence in cervical region of prostheses over implants from 46 to 44 (I); Cervical face of teeth from 43 to 31(I and J); Interproximal between the teeth 32 to 34 in buccal (K) and, in cervical of lingual face of the 34 (L)
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Reddish fluorescence could be seen in the region of carious lesion of the 13 in vestibular and palatal surfaces (Figures 2A and 2B) and along the cervical of the vestibular surface of prostheses over implants from 12 to 21, which was more intense in 12 and 11 (Figures 2C and 2D). Intense green fluorescence was noted in region of screw access-hole restorations of implants from 12 to 21 (Figure 2E). In turn, reddish fluorescence was observed in the cervical of the buccal surface from 23 to 26, screw access-hole of implant in 26 and, in the interproximal palatal region between 23 and 24 (Figures 2F, 2G and 2H). The lower arch showed reddish fluorescence in cervical region of the prostheses over implants from 44 to 46, cervical of the teeth from 43 to 31, interproximal between the teeth from 32 to 34 and, in cervical of the lingual face of the 34 (Figures 2I, 2J, 2K and 2L).
Initial radiographic images. Presence of prosthesis over implant in region of 12, bone loss in distal of tooth 14 and, radiolucent area in mesial of tooth 13, which was endodontically treated (A); Presence of prostheses over implants from 12 to 25, and 44 to 46, with normal bone pattern (B, C, D and E); Implant associated with its prosthetic component in region of 26, but with loss of the prosthetic crown (D); Teeth from 34 to 43, extensively restored (F, G and H), and 34 was endodontically treated and restored with prosthetic crown (H)
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Periapical radiography showed bone loss in the distal of tooth 14 and a carious lesion in the mesial of tooth 13, which was endodontically treated (Figure 3A). Dental implants were present in the region of 12, 11, 21, 23, 24, 26, 44, 45 and 46 with images within the normal bone pattern (Figures 3A to 3E). There are prostheses over implants from 12 to 25, and 46, 45 and 44, being that in 26 there was no prosthetic crown related to the implant (Figures 3A to 3E). In turn, figures 3F to 3H showed bone loss ranging from mild to moderate, related to teeth from 33 to 43, and presence of widely restored teeth from 34 to 43, and tooth 34 was endodontically treated.
Clinical and fluorescence images referring to consultations: initial, follow-up with 15 and 30 days. Reduction of edema and absence of bleeding from the peri-implant mucosa in 12 and 11, 15 days after the initial consultation (A); After 30 days of the initial consultation, the region had normal characteristics (B); Presence of reddish fluorescence in cervical of prostheses over implants from 12 to 21, which was more intense in 12 and 11 at the initial consultation (C); After 30 days of the initial consultation, the same region showed an absence of reddish fluorescence (D); Peri-implant mucosa in region of the 26 with 15 days (E); After 30 days of the initial consultation, with normal characteristics (F); Initial aspect of reddish fluorescence around the prosthetic component and in screw access-hole of implant 26 (G); After 30 days of the initial consultation, the same region, showed absence of reddish fluorescence (H); Teeth from 32 to 42 with unfinished and unpolished restorations after 15 days (I); After 30 days of the initial consultation, restorations were properly finished, polished and there was the presence of a carious cervical lesion in 41 (J); Presence in the initial consultation of reddish fluorescence in cervical from 31 to 43 and interproximal between 31 and 41 (K); After 30 days, there was reddish fluorescence only in the cervical of the 41 (L)
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The process of recovery of peri-implant mucosa health of 12 and 11 was noted by reduction of edema and absence of bleeding 15 days after the initial consultation (Figure 4A), whereas, after 30 days, peri-implant mucosa was in normal condition (Figure 4B). In this sense, in initial consultation, the cervical region of 11 and 12 showed presence of intense reddish fluorescence (Figure 4C), which, after 30 days, was absent (Figure 4D). The region of the implant corresponding to 26, in which there was no prosthetic crown, showed characteristics of normal mucosa at 15 days (Figure 4E) and 30 days (Figure 4F). In fact, in initial consultation, there was reddish fluorescence around the prosthetic component and at the screw access-hole of the 26 (Figure 4G), which, after 30 days, was absent (Figure 4H). Otherwise, initial presence of unfinished and non-polished restorations in region from 32 to 42 (Figure 4I), which, after 30 days, duly finished, polished and with biofilm removal allowed to identify carious cervical lesion in tooth 41 (Figure 4J). However, in this case, initial reddish fluorescence in cervical region of 31, 41, 42, 43 (Figure 4K) was still maintained after 30 days, only in the region of the cervical carious lesion of tooth 41 (Figure 4L).