International Journal of Oral Implantology & Clinical Research

Register      Login

VOLUME 3 , ISSUE 1 ( January-April, 2012 ) > List of Articles

ORIGINAL RESEARCH

A Comparative Evaluation of Crestal Bone Levels in Mandibular Implant-Retained Overdentures using Delayed and Immediate Loading Protocols: An in vivo Study

Himanshu Gupta, AS Kaul, Manesh Lahori, Sidhartha Chandra, Rahul Nagrath

Citation Information : Gupta H, Kaul A, Lahori M, Chandra S, Nagrath R. A Comparative Evaluation of Crestal Bone Levels in Mandibular Implant-Retained Overdentures using Delayed and Immediate Loading Protocols: An in vivo Study. Int J Oral Implantol Clin Res 2012; 3 (1):1-7.

DOI: 10.5005/JP-Journals-10012-1057

License: CC BY-ND 4.0

Published Online: 00-04-2012

Copyright Statement:  Copyright © 2012; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: The purpose of the study was to evaluate the changes in peri-implant bone quality, crestal bone level and the implant stability (periotest) for mandibular implant retained overdentures with ball attachments using delayed and immediate loading protocols. Materials and methods: Two Alpha-Bio dental implants were placed in the anterior part of the mandible in ten completely edentulous patients. Five patients were loaded under immediate loading protocols and other five following delayed. Crestal bone loss and bone quality were assessed around each implant. Periotest values were recorded for each implant at 3, 6 and 12 months after loading. Results: Two implants were lost and were excluded from the study, however mean crestal bone loss around implants was 0.81 mm from the time of prosthetic loading to 12 months after prosthetic loading was seen and no significant result was found between the two groups for the crestal bone loss and the periotest values. Though the periotest value decreased (indicates increased stability) over the time period. The bone density changes were significant for both the groups at coronal level at all time intervals but at middle level significant only after 12 months of prosthetic loading, although individual variation was high. Conclusion: This study concluded that the changes in crestal bone level and periotest values were insignificant for the two groups. But, the implant stability increased over the time and the crestal bone loss was evident with decreased rate over the period of time. There was wide individual variation for the bone density changes but overall increase in the density was seen.


PDF Share
  1. Liddelow GJ, Henry PJ. A prospective study of immediately loaded single implant-retained mandibular overdentures: Preliminary one-year results. J Prosthet Dent 2007;97(6, suppl):S126-S37.
  2. Atsumi, Park, Wang. Methods used to assess implant stability: Current status. Int J Oral Maxillofac Implants 2007;22:743-54.
  3. Chiapasco M, Abati S, Romeo E, Vogel G. Implant-retained mandibular overdentures with Branemark system MKII implants: A prospective comparative study between delayed and immediate loading. 2001;16:537-46.
  4. Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998;11:491-501.
  5. Lima V, Morgano Steven M. A dual purpose stent for the implant supported prosthesis. J of Prosthet Dent 1993;69:276-80.
  6. Au-yeung, Ahuja AT, Ching AC, Metreweli. Dentascan in oral imaging. Clinical Radiology 2001;56:700-13.
  7. Zarb, Schmitt. Implant prosthodontic treatment options for the edentulous patient. Journal of Oral Rehabilitation 1995;22: 661-71.
  8. Batenburg R, Meijer H, Raghoebar G, Vissink A. Treatment concept for mandibular overdentures supported by endosseous implants. A literature review. Int J Oral Maxillofac Implants 1998;13:539-45.
  9. Roe, et al. Immediate loading of unsplinted implants in the anterior mandible for overdentures: A case series. Int J Oral Maxillofac Implants 2010;25:1028-35.
  10. Naert IE, Gizani S, Vuylsteke M, van Steenberghe D. A randomized clinical trial on the influence of splinted and unsplinted oral implants in mandibular overdenture therapy. A 3-year report. Clin Oral Investig 1997;1:81-88.
  11. Batenburg RH, Raghoebar GM, Van Oort RP, Heijdenrijk K, Boering G. Mandibular overdentures supported by two or four endosteal implants. A prospective, comparative study. Int J Oral Maxillofac Surg.
  12. Heijdenrijk K, Raghoebar GM, Meijer HJA, van der Reijden WA, van Winkelhoff AJ, Stegenga B. Two stage IMZ implants and ITI implants inserted in a single-stage procedure. Clin Oral Implants Res 2002;13:371-80.
  13. Payne AGT, Tawse-Smith A, Duncan WD, Kumara R. Conventional and early loading of unsplinted ITI implants supporting mandibular overdentures. Clin Oral Implants Res 2002;13:603-09.
  14. Rungcharassaeng K, Lozada JL, Kan JYK, Kim JS, Campagni WV, Munoz CA. Peri-implant tissue response of immediately loaded, threaded, HA-coated implants: 1-year results. J Prosthet Dent 2002;87:173-81.
  15. Ikumi N, Tsutsumi S. Assesment of correlation between computerized tomography values of the bone and cutting torque values at implant placement: A clinical study. Int J Oral Maxillofac Implants 2005;20:253-60.
  16. Di Giacomo GAP, Cury PR, de Araujo NY, Sendyk WR, Sendyk CL. Clinical application of stereolithographic surgical guides for implant placement: Preliminary results. J Periodontol 2005;76:503-07.
  17. Prestipino V, Ingber A. All-ceramic implant abutments: Esthetic indications. J Esthet Dent 1996;8:255-62.
  18. Blatz MB. Long-term clinical success of all-ceramic posterior restorations. Quintessence Int 2002,33:415-26.
  19. Linkevicius T, Apse P. Influence of abutment material on stability of peri-implant tissues: A systematic review. Int J Oral Maxillofac Implants 2008;23:449-56.
  20. Andersson B, Taylor A, Lang BR, Scheller H, Scher P, Sorenson JA, et al. Alumina ceramic implant abutments used for singletooth replacement: A prospective 1- to 3- year multicenter study. Int J Prosthodont 2001;14:432-38.
  21. Andersson B, Scharer P, Simion M, Bergstrom C. Ceramic implant abutments used for short-span fixed partial dentures: A prospective 2-year multicenter study. In J Prosthodont 1999;12:318-24.
  22. Luthardt RG, Holzhuter M, Sandkuhl O, Herold V, Schnapp JD, Kuhlisch E, et al. Reliability and properties of ground Y-TZP-Zirconia Ceramics. J Dent Res 2002;81:487.
  23. Nevins M, Mellonig JT. The advantages of localized ridge augmentation prior to implant placement: A staged event. Int J Periodontics Restorative Dent 1994;14:96-111.
  24. Gallucci GO, Doughtie CB, Hwang JW, Fiorellini JP, Weber HP. Five-year results of fixed implant-supported rehabilitations with distal cantilevers for the edentulous mandible. Clin Oral Implants Res 2009;20(6):601-07.
  25. Benic GI, Jung RE, Siegenthaler DW, Hammerle CH. Clinical and radiographic comparison of implants in regenerated or native bone: 5-year results. Clin Oral Implants Res 2009;20(5): 507-13.
  26. George K, Zafiropoulos GG, Murat Y, Hubertus S, Nisengard RJ. Clinical and microbiological status of osseointegrated implants. J Periodontol 1994;65(8):766-70.
  27. Lang NP, Wetzel AC, Stich H, Caffesse RG. Histologic probe penetration in healthy and inflamed peri-implant tissues. Clin Oral Implants Res 1994;5(4):191-201.
  28. Bragger U. Radiographic parameters: Biological significance and clinical use. Periodontol 2000, 2005;39:73-90.
  29. Watzak G, Zechner W, Busenlechner D, et al. Radiological and clinical follow-up of machined- and anodized-surface implants after mean functional loading for 33 months. Clin Oral Implants Res 2006;17(6):651-57.
  30. Simonis P, Dufour T, Tenenbaum H. Long-term implant survival and success: A 10 to 16-year follow-up of non-submerged dental implants. Clin Oral Implants Res 2010;21(7):772-77.
  31. Lindquist LW, Carlsson GE, Jemt T. Association between marginal bone loss around osseointegrated mandibular implants and smoking habits: A 10-year follow-up study. J Dent Res 1997;76(10):1667-74.
  32. Lindquist LW, Carlsson GE, Jemt T. A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss. Clin Oral Implants Res 1996;7(4):329-36.
  33. Galindo-Moreno P, Fauri M, Avila-Ortiz G, et al. Influence of alcohol and tobacco habits on peri-implant marginal bone loss: A prospective study. Clin Oral Implants Res 2005;16(5): 579-86.
  34. Ben Slama L, Hasni W, De Labrouhe C, Bado F, Bertrand JC. Osteoradionecrosis and dental implants. Rev Stomatol Chir Maxillofac 2008;109(6):387-391; discussion 391-82.
  35. Misch CE, Bidez. Occlusal considerations for implant supported prostheses: Implant protective occlusion. In: Misch CE (Ed). Dental implant prosthetics. St Louis: Mosby 2005.
  36. Berglundh T, Lindhe J. Dimension of the peri-implant mucosa. Biologic width revisited. J Clin Periodontol 1996;23:971-73.
  37. Hoshaw SJ, Brunski JB, Cochran GVB. Mechanical loading of Brànemark implants affects interfacial bone modeling and remodeling. IntJ Oral Maxillofac Implants 1994;9:345-60.
  38. Nkenke E, Lehner B, Weinzierl K, Thams U, Neugebauer J, Steveling H, Radespiel-Trager M, Neukam FW. Bone contact, growth, and density around immediately loaded implants in the mandible of mini pigs. Clin Oral Hp Res 2003;14: 312-21.
  39. Frost HM. The role of changes in mechanical usage set points in the pathogenesis of osteoporosis. J Bone Minerai Res 1992;7:253-61.
  40. Piattelli A, Ruggeri A, Trisi P, Romasco N, Franchi M. A histologic and histomorphometric study of the bone reactions to non-submerged unloaded and loaded single implants in monkeys. J Oral Implantol 1993;19:314-20.
  41. Piattelli A, Trisi P, Romasco N, Emanuelli M. Histological analysis of a screw implant retrieved from man: Influence of early loading and primary stability. J Oral Implantol 1993;19:303-06.
  42. Piattelli A, Corigliano M, Scarano A. Microscopical observations of the osseous responses in early loaded human titanium implants: A report of two cases. Biomaterials 1996;17: 1333-37.
  43. Piattelli A, Corigliano M, Scarano A, Quaranta M. Bone reactions to early occlusal loading of two -stage titanium plasmasprayed implants: A pilot study in monkeys. Int J Periodont Rest Dent 1997;17:163-69.
  44. Piattelli A, Scarano A, Paolantonio M. Immediately loaded screw implant removed for fracture after a 15-year loading period: Histological and histochemical analysis. J Oral Implantol 1997;23:75-79.
  45. Degidi M, Sca rano A, Piattelli M, Perrotti V, Piattelli A. Bone remodeling in immediately loaded and unloaded titanium dental implants: A histologic and histomorphometric study in humans. J Oral Implantol 2005;31(1)18-24.
  46. Brunski JB, Moccia AF Jr, Pollack SR, Korostoff E, Trachtenberg DI. The influence of functional use of endossous dental implants on the tissue-implant interface. Histological aspects. J Dental Res 1979;58:1953-69.
  47. Brunski JB. Influence of biomechanical factors at the bonebiomaterial interface. In: Davies JE (Ed). The Bone-Biomaterial Interface. Toronto: Toronto University Press 1991:391-405.
  48. Brunski JB. Forces on dental implants and interfacial stress transfer. In: Laney WR, Tolman DE (Eds). Tissue Integration in Oral, Orthopaedic and Maxillofacial Reconstruction. Chicago: Quintessence 1992:108-24.
  49. Brunski JB. Avoiding pitfalls in overloading and micromotions of intraosseous implants (Interview). Dent Implantol Update 1993;4(10):77-81.
  50. Tarnow D, Elian N, Fletcher P, et al. Vertical distance from the crest of bone to the height of the interproximal papilla between adjacent implants. J Periodontol 2003;74:1785-88.
  51. Ericsson J, Persson LG. Different types of implant-associated reactions in periodontal soft tissues. J Clin Periodont 1995; 22:255-61.
  52. Steinebrunner L, Wolfart S. In vitro evaluation of bacterial leakage along the implant of different implant abutment interface of different implant systems. Int J Oral Maxillofac Implants 2005;20:875-81.
  53. Engelke W, Decco OA. In vitro evaluation of horizontal implant micromovement in bone specimen with contact endoscopy. Implant Dent 2004;13:88-94.
  54. Hermann J, Buser D, Schenk RK, Schoolfield JD. Influence of the size of the microgap on crestal bone changes around titanium implants: A histometric evaluation of unloaded non-submerged implants in canine mandible. J Periodontol 2001;72:1372-83.
  55. Hermann JS, Buser D, Schenk RK, et al. Crestal bone changes around titanium implants: A histometric evaluation of unloaded non-submerged and submerged implants in the canine mandible. J Peridontol 2000;71:1412-24.
  56. Wohrle PS. Nobel perfect esthetic scalloped implant: Rationale for a new design. Clin Implant Dent Relat Res 2003;5:64-73.
  57. Nentwig GH. Ankylos implant system: Concept and clinical application. J Oral Implantol 2004;30:171-77.
  58. Gardener D. Maintaining crestal bone around dental implants: Literature review and clinical technique. Dentistry Today 2006.
  59. Tonetti MS, Sanz M. Consensus report of session B. In: Lang N, Karring T, Lindhe J. Proceedings of the 3rd European Workshop on Periodontology and Implant Dentistry. Berlin: Quintessence 1999:185-88.
  60. Huang MT, Ho CT, Wang ZY, Ferraro T, Lou YR, Stauber K, Ma W, Georgiadis C, Laskin JD, Conney AH. Inhibition of skin tumorigenesis by rosemary and its constituents carnosol and ursolic acid. Cancer Res. 1994 Feb;54(3):701-708.
  61. Bernardes WA, Lucarini R, Tozatti MG, Souza MG, Silva ML, Filho AA, Martins CH, Crotti AE, Pauletti PM, Groppo M, et al. Antimicrobial activity of tosmarinus officinalis against oral pathogens: relevance of carnosic acid and carnosol. Chem Biodivers 2010 Jul;7(7):1835-1840.
  62. Parolia A, Thomas MS, Kundabala M, Mohan M. Propolis and its potential uses in oral health. Int J Med Sci 2010 Jul;2(7): 210-215.
  63. Oncag O, Cogulu D, Uzel A, Sorkun K. Efficacy of propolis as an intracanal medicament against Enerococcus faecalis. Gen Dent 2006 Sep-Oct:54(5):319-322.
  64. Martin MP, Pileggi R. A quantitative analysis of propolis: a promising new storage media following avulsion. Dent Traumatol 2004 Apr:20(2):85-89.
  65. Carbajal D, Casaco A, Arruzazabala L, Gonzalez R, Tolon Z. Pharmacological study of Cymbopogon citratus leaves. J Ethnopharmacol 1989 Feb;25(1):103-107.
  66. Sanches NR, Cortez DAG, Schiavini MS, Nakamura CV, Filho BPD. An evaluation of antibacterial activities of Psidium guajava. Braz Arch Biol Technol 2005 May;48(3):4229-4230.
  67. Sanda KA, Grema HA, Geidam YA, Bukar-Kolo YM. Pharmacological aspects of Psidium guajava: an update. Int J Pharmacol 2011 May;7:316-324.
  68. Menezes SM, Cordeiro LN, Viana GS. Punica grantum (pomegranate) extract is active against dental plaque. J Herb Pharmacother 2006;6(2):79-92.
  69. Vasconcelos LC, Sampaio FC, Sampaio MC, Pereira Mdo S, Higino JS, Peixoto MH. Minimum inhibitory concentration of adherence of punica granatum linn (pomegranate) gel against S. mutans, S. mitis and C albicans. Braz Dent J 2006;17(3): 223-227.
  70. Prasad D, Kunnaiah R. Punica granatum: a review on its potential role in treating periodontal disease. J Indian Soc Periodontol 2014 Jul;18(4):428-432.
  71. Sauvaire Y, Petit P, Baissac Y, Ribes G. Chemistry and pharmacology of fenugreek. In: Herbs, botanicals and teas. Mazza G, Oomah BD, editors. Lancaster, Pennsylvania: Technomic Pub. Co; 2000. p. 107-129.
  72. Acharya SN, Basu SK, Thomas JE. Methods for the improvement of plant medicinal properties with particular reference to fenugreek (Trigonella foenum-graecum L.). In: Acharya SN, Thomas JE, editors. Advances in medicinal plant research. Kerala, India: Research Signpost; 2007b p. 491-412.
  73. Al-Habori M, Raman A. Pharmacological properties in fenugreek. - In: Petropoulos GA, editor. The genus trigonella. 1st ed. London and New York: Taylor and Francis 2002. p. 163-182.
  74. Saini P, Al-Shibani N, Sun J, Zhang W, Song F, Gregson KS, Windsor LJ. Effects of calendula officinalis on human gingival fibroblasts. Homeopathy 2012 Apr;101(2):92-98.
  75. Khairnar MS, Pawar B, Marawar PPA. Evaluation of calendula officinalis as an anti-plaque and anti-gingivitis agent. J Indian Soc Periodontol 2013 Nov-Dec;17(6):741-747.
  76. Chakraborthy GS. Antimicrobial activity of leaf extract of calendula officinalis Linn. J Herb Med Toxicol 2008 Jun;2(2):65–66.
  77. Zilda CG, Claudia MR, Sandra RF. Antifungal activity of the essential oil from calendula officinalis L growing in Brazil. Braz J Microbiol 2008;39(1):61-63.
  78. Bussadori SK, Castro LC, Galvão AC. Papain gel: a new chemo-mechanical caries removal agent. J Clin Pediatr Dent 2005 Winter;30(2):115-119.
  79. Bertassoni LE, Marshall GW. Papain-gel degrades intact nonmineralized type I collagen fibrils. Scanning 2009 Nov- Dec;31(6):253-258.
  80. Moon SE, Kim HY, Cha JD. Synergistic effect between clove oil and its major compounds and antibiotics against oral bacteria. Arch Oral Biol 2011 Sep;56(9):907-916.
  81. Pinto E, Vale-Silva L, Cavaleiro C, Salgueiro L. Antifungal activity of the clove essential oil from Syzygium aromaticumon, candida, aspergillus and dermatophyte species. J Med Microbiol 2009 Nov;58(Pt 11):1454-1462.
  82. Olajide OA, Makinde JM, Awe SO. Evaluation of the pharmacological properties of nutmeg oil in rats and mice. Pharma Biol 2000;38(5):385-390.
  83. Thanoon SZ, Al-Refai AS, Kamal A. Antibacterial effect and healing potential of nutmeg oil for chemically induced oral ulcerations in rabbits. Zanco J Med Sci 2013;17(2): 393-399.
  84. Mitwally MF, Casper RF. Use of an aromatase inhibitor for induction of ovulation in patients with an inadequate response to clomiphene citrate. Fertil Steril 2001;75:305-09.
  85. Sammour A, Bijan MM, Tan SL, Tulandi T. Prospective randomised trial comparing the effects of letrazole (LE) and clomiphene citrate (CC) on follicular development, endometrial thickness and pregnancy rate in patients undergoing superovulation prior to intrauterine insemination (IUI). Fertil Steril 2001;76(Suppl 1):S110.
  86. Mitwally MF, Casper RF. Single-dose administration of an aromatase inhibitor for ovarian stimulation. Fertil Steril 2005;83:229-31.
  87. Fisher SA, Reid RL, Van Vugt DA, Casper RF. A randomized double-blind comparison of the effects of clomiphene citrate and the aromatase inhibitor letrozole on ovulatory function in normal women. Fertil Steril 2002;78:280-85.
  88. Fatemi HM, Kalibianakis E, Tournaye H, Camus M, Van Steirteghem AC, Devroey P. Clomiphene citrate vs letrozole for ovarian stimulation: A pilot study. Reprod Biomed Online 2003;7:543-46.
  89. Hu Y, Cortvrindt R, Smitz J. Effects of aromatase inhibition on in vitro follicle and oocyte development analyzed by early preantral mouse follicle culture. Mol Reprod Dev 2002;61: 549-59.
  90. Shetty G, Krishnamurthy H, Krishnamurthy HN, Bhatnagar S, Moudgal NR. Effect of estrogen deprivation on the reproductive physiology of male and female primates. J Steroid Biochem Mol Biol 1997;61:157-66.
  91. Mitwally MF, Casper RF. Aromatase inhibition reduces gonadotrophin dose required for controlled ovarian stimulation in women with unexplained infertility. Hum Reprod 2003;18:1588-97.
  92. Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril 2002;77:776-80.
  93. Goswami SK, Das T, Chattopadhyay R, Sawhney V, Kumar J, Chaudhury K, Chakravarty BN, Kabir SN. A randomized single blind controlled trial of letrozole as a low-cost IVF protocol in women with poor ovarian response: A preliminary report. Hum Reprod 2004;19:2031-35.
  94. Newkirk KM, Chandler HL, Parent AE, et al. Ultraviolet radiation-induced corneal degeneration in 129 mice. Toxicol Pathol 2007;35:819-26.
  95. Pettenati MJ, Sweatt AJ, Lantz P, et al. The human cornea has a high incidence of acquired chromosome abnormalities. Hum Genet 1997;101:26-29.
  96. Snibson GR. Collagen cross-linking: A new treatment paradigm in corneal disease—a review. Clin Experiment Ophthalmol 2010;38:141-53.
  97. Spoerl E, Raiskup-Wolf F, Kuhlisch E, Pillunat LE. Cigarette smoking is negatively associated with keratoconus. J Refract Surg 2008;24:S737-40.
  98. Rabinowitz YS, Nesburn AB, McDonnell PJ. Videokeratography of the fellow eye in unilateral keratoconus. Ophthalmology 1993;100:181-86.
  99. Goodrich DW, Lee WH. The molecular genetics of retinoblastoma. Cancer Surv 1990;9:529-54.
  100. Moodaley LC, Woodward EG, Liu CS, Buckley RJ. Life expectancy in keratoconus. Br J Ophthalmol 1992;76:590-91.
  101. Honein MA, Dawson AL, Petersen EE, Jones AM, Lee EH, Yazdy MM, Ahmad N, Macdonald J, Evert N, Bingham A, et al. Birth defects among fetuses and infants of US women with evidence of possible Zika virus infection during pregnancy. JAMA 2017 Jan 3;317(1):59-68.
  102. Chervenak FA, Jeanty P, Cantraine F, Chitkara U, Venus I, Berkowitz RL, Hobbins JC. The diagnosis of fetal microcephaly. Am J Obstet Gynecol 1984 Jul 1;149(5):512-517.
  103. Papageorghiou AT, Thilaganathan B, Bilardo CM, Ngu A, Malinger G, Herrera M, Salomon LJ, Riley LE, Copel JA. ISUOG Interim Guidance on ultrasound for Zika virus infection in pregnancy: information for healthcare professionals. Ultrasound Obstet Gynecol 2016 Apr;47(4):530-532.
  104. Chibueze EC, Parsons AJ, Lopes KD, Yo T, Swa T, Nagata C, Horita N, Morisaki N, Balogun OO, Dagvadorj A, et al. Diagnostic accuracy of ultrasound scanning for prenatal microcephaly in the context of Zika virus infection: a systematic review and meta-analysis. Sci Rep 2017 May 23;7(1):2310.
  105. Cordeiro MT. Zika virus: laboratory diagnosis. In: Zika in focus. Springer International Publishing; 2017. pp. 59-62.
  106. Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, Kolenc M, Resman Rus K, Vesnaver Vipotnik T, Fabjan Vodušek V, et al. Zika virus associated with microcephaly. N Engl J Med 2016 Mar 10;374(10):951-958.
  107. Zare Mehrjardi M, Keshavarz E, Poretti A, Hazin AN. Neuroimaging findings of Zika virus infection: a review article. Jpn J Radiol 2016 Dec;34(12):765-770.
  108. Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol 2016 Jan;47(1):6-7.
  109. Araujo AQ, Silva MT, Araujo AP. Zika virus-associated neurological disorders: a review. Brain 2016;139(8):2122-2130.
  110. Brasil P, Pereira JP Jr, Moreira ME, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, Rabello RS, Valderramos SG, Halai UA, Salles TS, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med 2016 Dec 15;375(24):2321-2334.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.