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Friedmann A, Winkler M, Diehl D, Yildiz MS, Bilhan H. One-year performance of posterior narrow diameter implants in hyperglycemic and normo-glycemic patients-a pilot study. Clin Oral Investig 2021; 25:6707-6715. [PMID: 33939006 PMCID: PMC8602141 DOI: 10.1007/s00784-021-03957-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of the study was to compare the performance of narrow diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals during the first 12 months after implant loading. MATERIAL AND METHODS In 16 T2DM patients with HbA1C > 6.5% (test group) and 16 normo-glycemic patients (HbA1C < 6.0%; control group), one to two narrow diameter tissue level implants were placed in the posterior maxilla or mandible. After 3-month lasting integration period, implants were loaded by fixed dentures. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession and papilla bleeding index (PBI) were assessed manually at loading and after 12 months of function. The paired digital periapical radiographs were analyzed with regard to the change in marginal bone level (MBL) from baseline to 12 months' control. The mean values calculated for both patient groups were statistically analyzed. The technical complications were recorded. RESULTS The T2DM group accounted 13 patients due to 3 dropouts. The overall implant survival rate after 12 months was 100%. The differences in means for the clinical parameters and the MBL were statistically non-significant between the T2DM and normo-glycemic patients for the short period of loaded function reported here. No technical complications were recorded. CONCLUSIONS The study demonstrated an encouraging clinical outcome with narrow diameter implants in patients with uncontrolled T2DM compared to non-diabetics after 12 months post loading. For the short observation period, no biological and technical complications were reported regardless the glycemic status. CLINICAL RELEVANCE Patients with HbA1C > 6.5% may benefit from the treatment with narrow diameter implants by avoiding complex surgical interventions with augmentation procedures. TRIAL REGISTRATION Clinicaltrials.gov : NCT04630691.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Marianna Winkler
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
| | - Daniel Diehl
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Stockumer Straße 10, 58453 Witten, Germany
| | - Mehmet Selim Yildiz
- Department of Periodontology, Faculty of Dentistry, Altınbaş University, Zuhuratbaba, İncirli Cd. No:11-A, 34147 Bakırköy, Istanbul, Turkey
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 45, 58455 Witten, Germany
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Immediate Restoration of Single-Piece Zirconia Implants: A Prospective Case Series-Long-Term Results after 11 Years of Clinical Function. MATERIALS 2021; 14:ma14226738. [PMID: 34832139 PMCID: PMC8621133 DOI: 10.3390/ma14226738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this prospective case series was to evaluate single-piece zirconia implants restored with lithium disilicate CAD/CAM crowns through a long-term follow-up. METHODS In this trial, 20 one-piece zirconia implants were placed in 20 patients. Implants were restored (i) immediately with lithium disilicate CAD/CAM provisionals, and (ii) permanently four months after surgery. Patients were followed for 11 years. Clinical parameters and radiological measurements of the zirconia implants were assessed. For the statistical analysis, paired t-test was applied. RESULTS Four implants were counted as implant failure due to the loss of implant stability, resulting in a Kaplan-Meier survival rate of 80% up to 11 years. The mean bleeding on probing values were 19.1% (SD ± 13.1) and 18.2% (SD ± 17.6) 96 and 11 years after implant placement, respectively. The plaque index revealed a significant decrease over time (p < 0.001) with a value between 25.9% (SD ± 5.7) and 12.6% (SD ± 10.0) at baseline and 11-years follow-up respectively. The marginal bone level revealed a significant decrease 4, 8, and 11 years after implant insertion (p = 0.001, p = 0.019, and p = 0.027, respectively). CONCLUSIONS Immediately loaded zirconia single-piece implants showed a suitable success rate in clinical and radiographic outcomes.
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Comparing Masticatory Performance of Maxillary Mini Dental Implant Overdentures, Complete Removable Dentures and Dentate Subjects. J Clin Med 2021; 10:jcm10215006. [PMID: 34768527 PMCID: PMC8584742 DOI: 10.3390/jcm10215006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p > 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.
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Implant survival after graftless sinus floor augmentation in highly atrophic maxillae: a randomized controlled trial in a split mouth study. Int J Implant Dent 2021; 7:107. [PMID: 34661774 PMCID: PMC8523734 DOI: 10.1186/s40729-021-00387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The success rate of dental implants after graftless sinus augmentation versus conventional sinus augmentation surgery in atrophic maxillae in edentulous patients was investigated. METHODS This randomized study was performed in ten edentulous patients with marked maxillary atrophy. On the graftless side, the sinus membrane was lifted by a resorbable membrane. The control side was augmented with a mixture of autografts and xenografts. Implant placement followed 6 months postoperatively. Outcomes were implant survival, success of prosthetic rehabilitation and stability of vertical bone gain. RESULTS Ten patients were included. Postoperative radiology showed sufficient bone gain on both maxillary sides. Follow-up varied from 57 to 88 months. The conventional side showed significant (p = 0.041) more bone gain than the experimental side (respectively, 9.69 mm and 6.20 mm). A total of 59 implants were placed: 30 after conventional, 29 after graftless augmentation. One implant was lost on the conventional side and four on the experimental side. The implant survival was significantly higher on the conventional side (96.7% vs. 86.2%, p < 0.001, RR = 4.14). Prosthetic restoration was functionally successful in all cases. CONCLUSION Bone gain and implant survival were significantly lower in the non-grafted side versus the grafted side. Prosthetic rehabilitation was possible in all ten patients. The non-grafted technique may have some potential for clinical use, although it showed poorer results. Trial registration The Netherlands Trialregister. NTR NL3541 (NTR3696). Registered 20 January 2013, https://www.trialregister.nl/trial/3541 .
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Abstract
Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.
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Lin IP, Lai EHH, Chen SH, Sun TC, Chang JZC, Sun JS. Restoration of a wide edentulous posterior site with two small-diameter implants: Biologically-driven alternative treatment. J Formos Med Assoc 2021; 121:1295-1301. [PMID: 34593273 DOI: 10.1016/j.jfma.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Crestal bone stability, implant rigidity and occlusal loading are issues with small-diameter implants. This article demonstrates the use of two small-diameter implants replacing a missing wide edentulous site and discusses factors that may affect bone changes. METHODS Patients who wanted to restore an edentulous space measuring from 12 to 14 mm wide in the posterior region were offered an alternative treatment option, using two narrow or regular-diameter implants instead of one wide implant. In the study, the crestal bone stability of 12 implants in 6 edentulous sites was assessed by cone beam CTs and periapical radiographs in follow-up visits for up to 4 years. RESULTS The bone level of all the implants was stable at buccal, lingual, mesial and distal sites, with mean values < 1 mm. The average buccal bone thickness was 1.15 ± 1.07 mm and lingual was 1.86 ± 0.89 mm, meaning that implants were surrounded by a sufficient amount of bone. The good treatment outcome may be attributed to the capability of fabricating better emergence profiles, angles (Mean: 20.67 ± 7.82° at the mesial and 20.25 ± 8.23° at the distal site) and cleansable embrasures of prostheses which are key to maintaining good oral hygiene and implant health. CONCLUSION Using two narrow or regular-diameter implants to replace a single edentulous site measured around 12-14 mm wide in posterior region seemed to be a feasible treatment option. It is especially suitable for sites with ridge atrophy and/or patients suffering from systemic diseases.
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Affiliation(s)
- I-Ping Lin
- Division of Periodontology, Department of Dentistry, National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Eddie Hsiang-Hua Lai
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Szu-Han Chen
- Division of Prosthodontics, Department of Dentistry, National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Teresa Chanting Sun
- Department of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | | | - Jui-Sheng Sun
- Department of Orthopedics, China Medical University Hospital, Taichung City, Taiwan
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Bielemann AM, Schuster AJ, Possebon APDR, Schinestsck AR, Chagas-Junior OL, Faot F. Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2021; 33:21-32. [PMID: 34551146 DOI: 10.1111/clr.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year. MATERIALS AND METHODS In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates. RESULTS The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants. CONCLUSION Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.
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Affiliation(s)
- Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Otacílio Luiz Chagas-Junior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Clinical long-term and patient-reported outcomes of dental implants in oral cancer patients. Int J Implant Dent 2021; 7:93. [PMID: 34255187 PMCID: PMC8276905 DOI: 10.1186/s40729-021-00373-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/25/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND PURPOSE The aim of this clinical study was to investigate the clinical long-term and patient-reported outcome of dental implants in patients with oral cancer. In addition, analysis of the influence of radiation therapy, timing of implant insertion, and augmentation procedures on implant survival was performed. MATERIAL AND METHODS This retrospective study investigated the clinical outcome of 711 dental implants in 164 oral cancer patients, inserted by experienced surgeons of the Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Germany. Oral health-related quality of life (OHRQoL) was evaluated. RESULTS Cumulative 5-year and 10-year implant survival rates for all included implants were 87.3% and 80.0%. Implants placed straight after ablative surgery (primary implant placement) and implants placed after completing the oncologic treatment (secondary implant placement) showed a comparable implant survival (92.5% vs. 89.5%; p = 0.635). Irradiation therapy had no significant influence on implant survival of secondary placed implants (p = 0.929). However, regarding implant site (native bone vs. augmented bone) and radiation therapy (non-irradiated bone vs. irradiated bone), implants inserted in irradiated bone that received augmentation procedures showed a statistically significant lower implant survival (p < 0.001). Patients reported a distinct improvement in OHRQoL. CONCLUSIONS Promising long-term survival rates of dental implants in patients after treatment of oral cancer were seen. In addition, patients benefit in form of an improved OHRQoL. However, bone augmentation procedures in irradiated bone may result in an impaired implants' prognosis.
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Schiegnitz E, Kämmerer PW, Hellwich P, König J, Sagheb K, Al-Nawas B. Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone. Clin Oral Implants Res 2021; 32:1159-1167. [PMID: 34224171 DOI: 10.1111/clr.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/12/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare clinical and radiological outcomes of narrow-diameter implants (NDI) placed in pristine bone to standard-diameter implants placed in combination with horizontal bone augmentation procedures (SDI+A) for horizontally deficient alveolar ridges. MATERIAL AND METHODS For this retrospective study, the outcome of 597 NDI (∅ 3.3 mm, 272 patients), inserted in pristine bone, were compared with 180 SDI (∅ 4.1 mm, 83 patients), inserted in combination with horizontal augmentation procedures. Oral health-related quality of life was assessed in patients available for recall. RESULTS After a mean follow-up of 37.6 ± 40 months for the NDI and of 42.4 ± 49 months for the SDI+A, survival rates were 96.1% for NDI and 95.6% for SDI+A. Cumulative 5-year and 10-year implant survival rates were 94.3% and 92.2% for the NDI group and 97.0% and 88.3% for the SDI+A group, indicating no significant difference (p = .89). According to the criteria of Buser et al., an implant success rate of 84.3% was obtained for the NDI and an implant success rate of 81.3% for the SDI+A (p = .79). Regarding oral health-related quality of life, a similar and high patient satisfaction could be observed in both groups. CONCLUSIONS NDI without augmentation procedures showed a similar clinical outcome as SDI in combination with augmentation procedures after a follow-up of more than 3 years. Therefore, NDI might be a reasonable alternative in cases of horizontal bone atrophy (no clinical trial registration as patient inclusion started 2003).
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Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Philipp Hellwich
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
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In-Vitro Investigation of Fatigue and Fracture Behavior of Transmucosal versus Submerged Bone Level Implants Used in Fixed Prosthesis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11136186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: The present in vitro study aimed to investigate the fatigue performance of different dental fixtures in two different emergence profiles. Biological failures are frequently reported because the problem canonly be solved by replacing a failing implant with a new one. Clinicians addressed minor mechanical failures, such as bending, loosening or the fracture of screws, abutment, or the entire prosthesis, by simply replacing or fixing them. Methods: Transmucosal and submerged bone-level dental implants underwent fatigue strength tests (statical and dynamical performance) by a standardized test: UNI EN ISO 14801:2016. Two types of emergence profiles (Premium sub-crestal straight implant with a cylindrical-shaped coronal emergence or Prama one-piece cylindrical-shape implant with transmucosal convergent neck and hyperbolic geometry) were tested, and dynamic fatigue were run to failure. Data was analyzed by a suitable statistical tool. Results: The Wöhler curve of 0.38 cm Premium group c2, appeared to be significantly different from that of the 0.38 cm Prama group c3 (nonparametric one-way ANOVA χ2 = 6; degree of freedom = 1; probability = 0.0043) but not from that of the 0.33 cm Premium group c1 (nonparametric one-way ANOVA χ2 = 0.62; degree of freedom = 1; probability = 0.4328). Fatigue performance of configuration 2 was one and a half times better than that of configuration 3. Group c3 had a better ultimate failure load (421.6 ± 12.5 N) than the other two settings i.e., c1 (324.5 ± 5.5 N) and c2 (396.3 ± 5.6) reaching almost a nonsignificant level. Conclusions: It was observed that a transmucosal implant design could provide the highest resistance to static fracture. On the other hand, an equicrestal implant design could increase dynamic endurance.
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González-Valls G, Roca-Millan E, Céspedes-Sánchez JM, González-Navarro B, Torrejon-Moya A, López-López J. Narrow Diameter Dental Implants as an Alternative Treatment for Atrophic Alveolar Ridges. Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14123234. [PMID: 34208369 PMCID: PMC8231146 DOI: 10.3390/ma14123234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 01/10/2023]
Abstract
To determine the marginal bone loss and the survival, success and failure rates of narrow dental implants, a systematic literature search was carried out in the MEDLINE (Pubmed), Cochrane, Scopus, and Scielo databases for articles published between 2010 and 2021. The exclusion criteria were: systematic reviews, case reports, expert opinions; animal studies; samples of less than 10 subjects; follow-up periods of less than 36 months; smokers of minimum 10 cigarettes/day; and articles about mini-implants for orthodontic anchorage. Meta-analyses were performed to assess marginal bone loss and implant survival, success, and failure rates. Fifteen studies were included: 7 clinical trials, 3 randomized clinical trials, 3 cohort studies, and 2 case series. The total number of subjects was 773, in whom 1245 implants were placed. The survival rate for the narrow diameter implants was 97%, the success rate 96.8%, and the failure rate 3%. Marginal bone loss was 0.821 mm. All these data were evaluated at 36 months. Based on the literature, it can be considered that there is sufficient evidence to consider small diameter implants a predictable treatment option. These show favorable survival and success rates and marginal bone loss. All of them are comparable to those of standard diameter dental implants.
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Affiliation(s)
- Georgina González-Valls
- Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (G.G.-V.); (E.R.-M.); (J.M.C.-S.); (B.G.-N.); (A.T.-M.)
| | - Elisabet Roca-Millan
- Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (G.G.-V.); (E.R.-M.); (J.M.C.-S.); (B.G.-N.); (A.T.-M.)
| | - Juan Manuel Céspedes-Sánchez
- Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (G.G.-V.); (E.R.-M.); (J.M.C.-S.); (B.G.-N.); (A.T.-M.)
| | - Beatriz González-Navarro
- Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (G.G.-V.); (E.R.-M.); (J.M.C.-S.); (B.G.-N.); (A.T.-M.)
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona//Oral Health and Masticatory System Group-IDIBELL (Bellvitge Biomedical Research Institute), University of Barcelona, 08907 Barcelona, Spain
| | - Aina Torrejon-Moya
- Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona, 08907 Barcelona, Spain; (G.G.-V.); (E.R.-M.); (J.M.C.-S.); (B.G.-N.); (A.T.-M.)
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona//Oral Health and Masticatory System Group-IDIBELL (Bellvitge Biomedical Research Institute), University of Barcelona, 08907 Barcelona, Spain
- Medical Director and Head of Service of the Surgical Medical Area, Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain
- Correspondence:
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Bergamo ETP, Zahoui A, Barrera RB, Huwais S, Coelho PG, Karateew ED, Bonfante EA. Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:317-328. [PMID: 34047046 PMCID: PMC8362055 DOI: 10.1111/cid.13007] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
Background Osseodensification (OD) has shown to improve implant stability; however, the influences of implant design, dimensions, and surgical site characteristics are unknown. Purpose To compare the insertion torque (IT) and temporal implant stability quotients (ISQ) of implants placed via OD or subtractive drilling (SD). Materials and Methods This multicenter controlled clinical trial enrolled 56 patients, whom were in need of at least 2 implants (n = 150 implants). Patients were treated with narrow, regular, or wide implants and short, regular, or long implants in the anterior or posterior region of the maxilla or in the posterior region of the mandible. Osteotomies were performed following manufacturers recommendation. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery, 3 and 6 weeks. Results Data complied as a function of osteotomy indicated significantly higher IT for OD relative to SD. OD outperformed conventional SD for all pairwise comparisons of arches (maxilla and mandible) and areas operated (anterior and posterior), diameters and lengths of the implants, except for short implants. Overall, ISQ data also demonstrated significantly higher values for OD compared to SD regardless of the healing period. Relative to immediate readings, ISQ values significantly decreased at 3 weeks, returning to immediate levels at 6 weeks; however, ISQ values strictly remained above 68 throughout healing time for OD. Data as a function of arch operated and osteotomy, area operated and osteotomy, implant dimensions and osteotomy, also exhibited higher ISQ values for OD relative to SD on pairwise comparisons, except for short implants. Conclusions OD demonstrated higher IT and temporal ISQ values relative to SD, irrespective of arch and area operated as well as implant design and dimension, with an exception for short implants. Future studies should focus on biomechanical parameters and bone level change evaluation after loading.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Raúl Bravo Barrera
- Implantology Postgraduate Program, San Sebastian University, Santiago, Chile
| | - Salah Huwais
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Paulo G Coelho
- Department of Biomimetics and Biomaterials, NYU College of Dentistry, New York City, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, New York City, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York City, New York, USA
| | - Edward Dwayne Karateew
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
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Knobloch LA, Larsen P, McGlumphy E, Kim DG, Gohel A, Messner R, Fogarty KJ, Fogarty MT. Prospective cohort study to evaluate narrow diameter implants for restoration of a missing lateral incisor in patients with a cleft palate: One-year results. J Prosthet Dent 2021; 128:1265-1274. [PMID: 34034898 DOI: 10.1016/j.prosdent.2021.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Patients diagnosed with a cleft palate often have a congenitally missing maxillary lateral incisor. The congenital cleft presents the practitioner with challenges including the quantity and quality of bone, a surgically managed cleft correction, and limited clinical space. PURPOSE The purpose of the present prospective investigation was to report preliminary results at the 1-year follow-up for this planned 5-year investigation of narrow diameter implants used to restore a missing lateral incisor in patients with a cleft palate. MATERIAL AND METHODS Fourteen study participants with a cleft palate and a missing maxillary lateral incisor were enrolled based on established criteria. Narrow diameter implants (AstraTech OsseoSpeed TX 3.0S and 3.5 mm) were placed by using a 2-stage protocol and restored. All study participants received an Atlantis abutment and a cement-retained crown. Four probing depth measurements and bleeding on probing were measured at baseline and at 1 year. Probing depth measurements were evaluated using a 2-way repeated measures ANOVA with Tukey-Kramer multiple comparisons tests. Radiographic marginal bone loss was measured at 1-year by using a digital subtraction technique and evaluated by using a repeated measures ANOVA. Pretreatment cone beam computed tomography (CBCT) images were used to measure a mean gray level that was proportional to bone mineral density (BMD) in the implant site. One-way mixed ANOVA was used to compare the mean gray level and average implant stability quotient (ISQ) loading. A Pearson correlation was also tested between those parameters (α=.05) for each statistical analysis. RESULTS The mean marginal bone loss at 1 year was 0.601 ±0.48 mm. Regarding probing depth measurements, a 2-way repeated measures ANOVA found both the location (P=.012) and time (P=.009) were significant. The Tukey-Kramer multiple comparisons test showed a significant difference between the buccal and distal site (P=.006) from baseline to 1-year follow-up. CONCLUSIONS Narrow diameter implants are a reliable treatment for replacing a missing lateral incisor in patients with a cleft palate at 1 year, with an implant survival rate of 100% and implant success rate of 94% using the established criteria. A negative association was found between the bone mineral density and the implant stability in the alveolar cleft site of a patient with a cleft palate. The peri-implant soft tissue probe depths exhibited significant change during the first year.
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Affiliation(s)
- Lisa A Knobloch
- Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio.
| | - Peter Larsen
- Professor, Division of Oral and Maxillofacial Surgery, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Edwin McGlumphy
- Professor Emeritus, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio; Private practice, Columbus, Ohio
| | - Do-Gyoon Kim
- Professor, Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Anita Gohel
- Clinical Professor, Division of Oral and Maxillofacial Radiology, University of Florida College of Dentistry, Gainesville, Fla
| | - Robin Messner
- Implant Patient Care Coordinator, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Kyle J Fogarty
- Student, College of Arts and Sciences, The Ohio State University, Columbus, Ohio
| | - Matthew T Fogarty
- Student, Fisher College of Business, The Ohio State University, Columbus, Ohio
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Chen K, Li Z, Liu X, Liu Q, Chen Z, Sun Y, Chen Z, Huang B. Immediate Implant Placement with Buccal Bone Augmentation in the Anterior Maxilla with Thin Buccal Plate: A One-Year Follow-Up Case Series. J Prosthodont 2021; 30:473-480. [PMID: 33639017 DOI: 10.1111/jopr.13350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the buccal bone thickness of immediate implant placement with buccal bone augmentation in patients with a thin buccal plate in the esthetic zone. MATERIALS AND METHODS Eighteen consecutive patients requiring a single tooth replacement in the anterior maxillary zone with a thin plate (<1 mm) were included and received immediate implant placement with narrow-diameter implants. Patients received buccal bone augmentation (both internal and external socket bone grafting) with deproteinized bovine bone mineral (DBBM) and an absorbable membrane. The final restoration was delivered after 8 months. Cone-beam CT scans were performed before surgery (CBCT0), immediately after surgery (CBCT1), at final restoration delivery (CBCT2), and at 1-year follow-up after the final restoration (CBCT3) to evaluate the buccal bone thickness and ridge width. A repeated measures ANOVA and Bonferroni correction for multiple comparisons were applied for statistical analysis of changes within different time points (α = 0.05). RESULTS Fifteen of the 18 enrolled patients were available for analysis at the 1-year follow-up after final restoration. The mean buccal bone thickness at 2 mm apical to the implant-abutment junction (IAJ-2) were 3.59 mm (range: 3.04-4.58 mm), 2.79 mm (range: 2.25-3.78 mm), and 2.52 mm (range: 1.72-3.36 mm), respectively, at CBCT1, CBCT2, and CBCT3. A statistical significance was observed for buccal bone thickness change between CBCT1 and CBCT2 at IAJ-2 (F = 17.948, p = 0.001). The net gains of the ridge width from CBCT0 to CBCT1, CBCT1 to CBCT2, and CBCT2 to CBCT3 were 1.08 mm, -0.94 mm and -0.04 mm at 4 mm apical to the cementum-enamel junction, respectively. No statistical significance was observed for the change in ridge width from CBCT0 to CBCT3 (F = 10.518, p = 1.000). CONCLUSIONS Simultaneous buccal bone augmentation may maintain a predictable buccal bone thickness for immediate implant placement in the maxillary anterior sites with a thin buccal plate (<1 mm) at 1-year follow-up after final restoration.
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Affiliation(s)
- Kaidi Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Zhipeng Li
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Xin Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Quan Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Zetao Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Yue Sun
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Zhuofan Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Baoxin Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
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Roccuzzo A, Imber JC, Jensen SS. Need for lateral bone augmentation at two narrow-diameter implants: A prospective, controlled, clinical study. Clin Oral Implants Res 2021; 32:511-520. [PMID: 33548077 DOI: 10.1111/clr.13721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To detect the potential influence of implant diameter and anatomic factors on the need for bone augmentation procedures (BAPs) when replacing congenitally missing lateral incisors (MLIs). MATERIALS AND METHODS Patients with congenitally missing MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3 mm received a Ø2.9 mm implant while Ø3.3 mm implants were placed when the distance was 6.4-7.1 mm. The following linear measurements were recorded using a calliper: width of the alveolar process (WAP), width of the bony alveolar ridge (WAR) and thickness of the facial bone after implant osteotomy (TFB). Guided bone regeneration was performed in case of fenestration- or dehiscence-type defects or a thin TFB (<1.7 mm). RESULTS Fifty Ø2.9 mm and 50 Ø3.3 mm were included in 100 patients. WAP and WAR did not differ between the groups (p > .05). TFB was statistically significant larger in the Ø2.9 group (1.75 ± 0.59 mm) compared to the Ø3.3 group (1.5 ± 0.63 mm) (p = .041). Fenestration-type defects (p = .005) and a thin facial bone wall (p = .045) was observed more frequently in the Ø3.3 compared to the Ø2.9 group. Correspondingly, BAP was indicated more frequently in the Ø3.3 compared to the Ø2.9 group (p = .017). WAP, MD and WAR were statistically significant correlated to the need for BAP (p < .001). As independent variable, only WAR influenced the probability of BAP (p < .001). CONCLUSION The use of 2.9 diameter implants was correlated to a reduced frequency of BAP compared to 3.3 mm implants, without reaching a statistically significant difference. Measurement of the WAP provides the clinician useful information to predict BAP.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Mainz, Germany
| | - Simon Storgård Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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66
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Khadembaschi D, Borgna SC, Beech N, Batstone MD. Outcomes of osseointegrated implants in patients with benign and malignant pathologies of the head and neck: a 10-year single-centre study. Int J Oral Maxillofac Surg 2021; 50:1375-1382. [PMID: 33642153 DOI: 10.1016/j.ijom.2021.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022]
Abstract
The surgical management of head and neck pathologies involving the maxilla and mandible results in significant functional and aesthetic deficits, and ultimately reduced quality of life. Composite free flaps used for reconstruction address many of these deficits and create a foundation for the use of osseointegrated implants to support prosthetic replacement of the dentition. There are few comparative studies examining outcomes of implants in native and reconstructed bone in head and neck cancer patients. The aim of this retrospective cohort study was to compare survival rates and the effects of risk factors between implants placed in native and reconstructed bone. The Kaplan-Meier method estimated cumulative 1- and 5-year implant survival rates of 99.5% and 95% for native bone and 96% and 88% for reconstructed bone. Multivariate Cox regression found an increased risk of implant failure in reconstructed bone (hazard ratio (HR) 9.9, 95% confidence interval (CI) 3.4-29.7, P<0.001). Subgroup analysis of the cohorts found an increased risk of failure in the reconstructed group associated with radiotherapy (HR 6.4, 95% CI 1.8-22.3, P=0.004), current smoking (HR 23.2, 95% CI 2.7-198.6, P=0.004), and previous smoking (HR 9.0, 95% CI 1.1-71.9, P=0.038). There was no effect in the native bone group. Implants placed into reconstructed bone had higher rates of failure, and smoking status and radiotherapy increased the risk of implant failure.
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Affiliation(s)
- D Khadembaschi
- School of Medicine, University of Queensland, Herston, Queensland, Australia.
| | - S C Borgna
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - N Beech
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - M D Batstone
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Comparative analysis of stress distribution in one-piece and two-piece implants with narrow and extra-narrow diameters: A finite element study. PLoS One 2021; 16:e0245800. [PMID: 33539392 PMCID: PMC7861395 DOI: 10.1371/journal.pone.0245800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the stress distribution on three implant models with narrow and extra-narrow diameters using the finite element method (FEA). MATERIALS AND METHODS Dental implants of extra-narrow diameter of 2.5 mm for a one-piece implant (group G1), a narrow diameter of 3.0 mm for a one-piece implant (group G2) and a narrow diameter of 3.5 mm for a two-piece implant with a Morse taper connection (group G3). A three-dimensional model was designed with cortical and cancellous bone, a crown and an implant/abutment set of each group. Axial and angled (30°) loads of 150 N was applied. The equivalent von Mises stress was used for the implants and peri-implant bone plus the Mohr-Coulomb analysis to confirm the data of the peri-implant bone. RESULTS In the axial load, the maximum stress value of the cortical bone for the group G1 was 22.35% higher than that the group G2 and 321.23% than the group G3. Whereas in angled load, the groups G1 and G2 showing a similar value (# 3.5%) and a highest difference for the group G3 (391.8%). In the implant structure, the group G1 showed a value of 2188MPa, 93.6% higher than the limit. CONCLUSIONS The results of this study show that the extra-narrow one-piece implant should be used with great caution, especially in areas of non-axial loads, whereas the one- and two-piece narrow-diameter implants show adequate behavior in both directions of the applied load.
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Dynamic Navigation for Zygomatic Implants: A Case Report about a Protocol with Intraoral Anchored Reference Tool and an Up-To-Date Review of the Available Protocols. Methods Protoc 2020; 3:mps3040075. [PMID: 33167345 PMCID: PMC7711909 DOI: 10.3390/mps3040075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023] Open
Abstract
Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning. The support of this technology to the zygoma implant placement aims to reduce the risks and the errors associated with this complex surgical and prosthetic treatment. Various navigation systems are available to clinicians currently, distinguished by handling, reliability, and the associated economic and biological benefits and disadvantages. The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology. An innovative and minimally invasive dynamic navigation system, with the use of an intraoral anchored trust marker plate and a patient reference tool, has been adopted to support the accurate insertion of four zygomatic implants, which rapidly resolved maxillary atrophy from a 75-year-old male system. This approach provided an optimal implant placement accuracy reducing surgical invasiveness.
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Wedge-Shaped Implants for Minimally Invasive Treatment of Narrow Ridges: A Multicenter Prospective Cohort Study. J Clin Med 2020; 9:jcm9103301. [PMID: 33066588 PMCID: PMC7602171 DOI: 10.3390/jcm9103301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
The present study aims to investigate clinical and patient-centered outcomes after the implant-supported rehabilitation of narrow ridges using a novel wedge-shaped implant. Forty-four patients were treated with the insertion of 59 tissue-level wedge implants (1.8 mm bucco-lingual width) in horizontally atrophic ridges (mean bone width 3.8 ± 0.4 mm). The main outcome measures were: implant stability quotient (ISQ), marginal bone loss (MBL) and patient morbidity. Fifty-eight implants were functioning satisfactorily after one year of loading (98.3% survival rate). ISQ values measured in the mesio-distal direction resulted significantly higher than those in the bucco-lingual direction at all time points (p < 0.001). Both mesio-distal and bucco-lingual ISQ values at 6-month follow-up resulted significantly higher than at 4-month follow-up (p < 0.001 for both). Mean MBL was 0.38 ± 0.48 mm at prosthesis delivery (6 months after implant insertion) and 0.60 ± 0.52 mm after one year of functional loading. The majority of patients reported slight discomfort related to the surgical procedure. Postoperative pain score was classified as mild pain on the day of surgery and the first postoperative day and no pain over the following five days. Within the limitations of the present study, the device investigated showed low morbidity and positive short-term clinical results in narrow ridges treatment.
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Alshahrani A, Al Deeb M, Alresayes S, Mokeem SA, Al-Hamoudi N, Alghamdi O, Vohra F, Abduljabbar T. Comparison of peri-implant soft tissue and crestal bone status of dental implants placed in prediabetic, type 2 diabetic, and non-diabetic individuals: a retrospective cohort study. Int J Implant Dent 2020; 6:56. [PMID: 33015750 PMCID: PMC7533277 DOI: 10.1186/s40729-020-00255-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022] Open
Abstract
Background Clinicoradiographic status of narrow-diameter implants (NDIs) among patients with prediabetes and type 2 diabetes mellitus (DM) is scarce. The aim was to address the clinicoradiographic status of NDIs placed prediabetic, type 2 diabetic, and non-diabetic individuals. In this retrospective cohort study, patients having undergone oral rehabilitation with NDI were included. The participants were divided into the following: (a) patients with prediabetes; (b) patients with poorly controlled type 2 DM; (c) patients with well-controlled type 2 DM; and (d) normoglycemic individuals. Demographic data was collected. In all groups, peri-implant plaque index (PI), gingival index (GI), probing depth (PD), and mesiodistal CBL were measured in all groups. Information related to implant dimensions, surface characteristics, insertion torque, implant geometry, duration of NDI in function, and jaw location of NDI was also recorded. Data normality was assessed and group comparisons were performed. A probability value under 0.01 was considered statistically significant. Results Eighty-three patients (20 patients had prediabetes, 22 with poorly controlled type 2 DM, 20 with well-controlled type 2 DM, and 20 self-reported non-diabetic individuals) were included. The mean HbA1c levels were significantly higher among patients with prediabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with pre-diabetes (P < 0.01) and poorly controlled type 2 DM (P < 0.01) than patients with well-controlled type 2 DM and non-diabetic controls. Peri-implant PI, GI, PD, and mesiodistal CBL levels were significantly higher among patients with poorly controlled type 2 DM (P < 0.01) than patients with prediabetes. Conclusion Chronic hyperglycemia increases the risk of peri-implant diseases around NDIs.
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Affiliation(s)
- Abdullah Alshahrani
- Department of Prosthetic Dental Science, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Modhi Al Deeb
- Department of Prosthetic Dental Science, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alresayes
- Department of Prosthetic Dental Science, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sameer A Mokeem
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Osama Alghamdi
- Department of Oral and Maxillofacial Surgery, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College Of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Failure Modes and Survival of Anterior Crowns Supported by Narrow Implant Systems. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1057846. [PMID: 32964016 PMCID: PMC7495162 DOI: 10.1155/2020/1057846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Abstract
The reduced hardware design of narrow implants increases the risk of fracture not only of the implant itself but also of the prosthetic constituents. Hence, the current study is aimed at estimating the probability of survival of anterior crowns supported by different narrow implant systems. Three different narrow implant systems of internal conical connections were evaluated (Ø3.5 × 10 mm): (i) Active (Nobel Biocare), (ii) Epikut (S.I.N. Implant System), and (iii) BLX (Straumann). Abutments were torqued to the implants, and standardized maxillary incisor crowns were cemented. The assemblies were subjected to step-stress accelerated life testing (SSALT) in water through load application of 30 degrees off-axis lingually at the incisal edge of the crowns using a flat tungsten carbide indenter until fracture or suspension. The use level probability Weibull curves and reliability for completion of a mission of 100,000 cycles at 80 N and 120 N were calculated and plotted. Weibull modulus and characteristic strength were also calculated and plotted. Fractured samples were analyzed in a stereomicroscope. The beta (β) values were 1.6 (0.9-3.1) and 1.4 (0.9-2.2) for BLX and Active implants, respectively, and 0.5 (0.3-0.8) for the Epikut implant, indicating that failures were mainly associated with fatigue damage accumulation in the formers, but more likely associated with material strength in the latter. All narrow implant systems showed high probability of survival (≥95%, CI: 85-100%) at 80 and 120 N, without significant difference between them. Weibull modulus ranged from 6 to 14. The characteristic strength of Active, Epikut, and BLX was 271 (260-282) N, 216 (205-228) N, and 275 (264-285) N, respectively. The failure mode predominantly involved abutment and/or abutment screw fracture, whereas no narrow implant was fractured. Therefore, all narrow implant systems exhibited a high probability of survival for anterior physiologic masticatory forces, and failures were restricted to abutment and abutment screw.
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Schuster AJ, Marcello-Machado RM, Bielemann AM, Possebon APDR, Chagas Júnior OL, Faot F. Immediate vs conventional loading of Facility-Equator system in mandibular overdenture wearers: 1-year RCT with clinical, biological, and functional evaluation. Clin Implant Dent Relat Res 2020; 22:270-280. [PMID: 32363765 DOI: 10.1111/cid.12902] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/20/2020] [Accepted: 03/10/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The use of immediate loading (IML) is still poorly explored in elderly patients and implant-retained mandibular overdenture (IMO) wearers. For this reason, more comparisons to conventional loading (CL) are required. PURPOSE To evaluate the clinical, biological, functional, and oral health-related quality of life (OHRQOL) influence of CL and IML loading on elders wearing IMO retained by the Facility-Equator system up to 1 year after implant installation. MATERIAL AND METHODS Twenty edentulous patients received two narrow diameter implants in the mandible; the loading type (CL or IML) was randomized. The clinical parameters were monitored along with prosthetic events, marginal bone loss (MBL) and bone level change (BLC), implant stability quotients (ISQ), masticatory performance outcomes, and Interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in the peri-implant crevicular fluid during the first year of loading. The OHRQoL was assessed via the Oral Health Impact Profile-EDENT questionnaire. Data were analyzed by the Mann-Whitney, χ2 , Wilcoxon paired, and McNemar tests. RESULTS After 1 year, MBL, BLC and ISQ were statistically identical (P > .05) in the CL and IML groups. The probing depth at 12 months in the CL group (2.19 mm) was higher than in the IML group (1.29 mm; P ≤ .0001). TNF-α was 33.6% higher in the CL group at 6 months (P = .043), while IL-1β was significantly higher in the IML group up to 6 months. The survival rate was 90% in the CL group and 85% in the IML group; 33 prosthetic events occurred in CL group and 23 in IML group. CONCLUSIONS After 12 months, both loading protocols are viable and result in similar clinical, biological, functional, and OHRQOL outcomes. However, IML generates better adaptation of the peri-implant tissues, faster improvement in OHRQoL and fewer prosthetic intercurrences than CL.
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Affiliation(s)
- Alessandra J Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Raissa M Marcello-Machado
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Amália M Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Anna Paula da Rosa Possebon
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Otacílio L Chagas Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Wirz H, Teufelhart S, McBeth C, Gyurko R, Dibart S, Sauer‐Budge A. Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss. Clin Exp Dent Res 2020; 6:336-344. [PMID: 32558317 PMCID: PMC7301390 DOI: 10.1002/cre2.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Bone augmentation delays implant placement and increases risks due to additional surgeries. Implant systems compatible with reduced alveolar bone volume are required. To design, manufacture, and test a non-cylindrical dental implant system using piezotomes and custom-designed matching titanium mini-implants to address the needs of patients with missing teeth and narrow jawbone. MATERIALS AND METHODS Tapered mini-implants with a rectangular cross-section (4.6 mm × 2.1 mm) were machined with dimensions that could accommodate narrow alveolar ridges. The performance of the implants were tested in both static and fatigue cycle 30° compression tests. Tapered, rectangular cutting tools that matched the overall trapezoidal morphology of the implant were also designed. These novel tools were engineered to be compatible with commercially available piezoelectric osteotomes. Tools were optimized using finite element analysis and were manufactured accordingly and were used by a periodontal surgery team in a pork rib bone model to monitor utility of the device and ease of use. RESULTS The rectangular design of the implant allows for a full occlusal load due to the larger implant flexural rigidity compared to a similar diameter mini-implant with a standard cylindrical design. During 30° compression fatigue tests, the implant tested at 340 N did not fail after 5M cycles as shown in Kaplan-Meier survival curves. Finite element analysis allowed for functional optimization of the roughing and finishing tools. In the pork rib model, these tools successfully cut trapezoidal holes that matched the dimensions of the implant. CONCLUSIONS The implant system here demonstrates the feasibility of a mini-implant system that has superior flexural rigidity and potentially circumvents the need for patient bone augmentation.
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Affiliation(s)
- Holger Wirz
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
| | - Stefan Teufelhart
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Project Group for Resource‐Efficient Mechatronic Processing Machines (RMV)Fraunhofer Institute for Machine Tools and Forming Technologies (IWU)AugsburgGermany
| | - Christine McBeth
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Department of Biomedical EngineeringBoston UniversityBostonMassachusetts
| | - Robert Gyurko
- Department of PeriodontologyBoston UniversityBostonMassachusetts
- Department of Periodontology, Tufts University School of Dental MedicineBostonMassachusetts
| | - Serge Dibart
- Department of PeriodontologyBoston UniversityBostonMassachusetts
| | - Alexis Sauer‐Budge
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Exponent IncNatickMassachusetts
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Alghamdi O, Alrabiah M, Al-Hamoudi N, AlKindi M, Vohra F, Abduljabbar T. Peri-implant soft tissue status and crestal bone loss around immediately-loaded narrow-diameter implants placed in cigarette-smokers: 6-year follow-up results. Clin Implant Dent Relat Res 2020; 22:220-225. [PMID: 32157803 DOI: 10.1111/cid.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND It is hypothesized that in the long-term, soft tissue inflammation (reflected by increased scores of peri-implant probing-depth [PD]) and crestal bone loss (CBL) is higher in cigarette-smoker than nonsmokers with narrow diameter implants (NDIs). PURPOSE The aim of the present 6-years' follow-up clinical observational study was to compare the peri-implant soft tissue inflammatory parameters (plaque index [PI], gingival index [GI], and PD) and CBL around immediately-loaded NDIs placed in cigarette-smokers and nonsmokers. MATERIALS AND METHODS In all groups, peri-implant GI, PI and PD were measured on six sites (distolingual/palatal, mesiolingual/palatal mesiobuccal, distobuccal, midlingual/palatal, and midbuccal) per implant. The CBL was gauged on digital bitewing x-rays, which were standardized using the long cone paralleling technique. CBL was demarcated as the vertical distance from 2 mm below the implant-abutment connection to the most crestally-positioned alveolar bone. RESULTS All study-participants were male. Twenty-six cigarette smokers and twenty-five nonsmokers were included. The mean age of cigarette-smokers and nonsmokers was 45.5 ± 10.3 and 47.4 ± 9.4 years, respectively. Cigarette-smokers had a smoking history of 10.6 ± 0.4 pack years. Family history of tobacco usage was more often reported by cigarette-smokers (57.7%) than nonsmokers (20%). All cigarette-smokers and nonsmokers were aware that smoking is a risk-factor of loss of implant. Three (11.5%) of cigarette-smokers reported that they have attempted to quit smoking and 76.9% of cigarette-smokers (n = 20) reported that they had no intention to quit smoking in the future. The peri-implant P-I (P < .01), PD (P < .01) and mesial (P < .01), and distal (P < .01) CBL were significantly high in cigarette-smokers compared with nonsmokers. There was no statistically significant difference in GI among the groups. CONCLUSION Cigarette-smoking enhances peri-implant soft tissue inflammation and increases CBL around immediately-loaded NDIs.
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Affiliation(s)
- Osama Alghamdi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alrabiah
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed AlKindi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, Saudi Arabia
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75
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Enkling N, Moazzin R, Geers G, Kokoschka S, Abou-Ayash S, Schimmel M. Clinical outcomes and bone-level alterations around one-piece mini dental implants retaining mandibular overdentures: 5-year follow-up of a prospective cohort study. Clin Oral Implants Res 2020; 31:549-556. [PMID: 32096255 DOI: 10.1111/clr.13591] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/11/2020] [Accepted: 02/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To report on the clinical outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone-level alterations (ΔMBLs), clinical peri-implant parameters, and technical- and biological complications during a 5-year follow-up. The null hypothesis was that ΔMBLs would be equal in subjects older than 65 years relative to younger subjects. MATERIALS AND METHODS Four 1.8-mm diameter one-piece MDIs with ball attachments were placed in the interforaminal region of 20 edentulous subjects. The existing complete dentures were converted to IODs. Standardized radiographs of each implant were taken at implant placement (baseline) and during the five-year follow-up. ΔMBLs and potential influencing factors were evaluated, and peri-implant parameters, and biological and technical complications were recorded. RESULTS The implant and prosthetic survival rates were both 100%. IODs fractured in seven participants. The overall mean ΔMBL after 5 years was -1.18 mm (standard deviation: 0.79 mm). ΔMBLs per month were most pronounced within the first 3 months after implant placement. ΔMBLs were not influenced by the implant location, the presence of keratinized mucosa, or gender. However, ΔMBLs were significantly smaller in subjects older than 65 years (p = .007). CONCLUSIONS One-piece MDIs retaining mandibular IODs with O-ring attachments are a predictable treatment option, providing stable peri-implant bone and soft tissue conditions over a mid-term follow-up. Incorporating a metal reinforcement can prevent denture fracturing when converting a complete denture into an IOD. The presence of keratinized mucosa does not necessarily lead to decreased bone-level changes. Advanced age might be beneficial in terms of peri-implant bone stability.
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Affiliation(s)
- Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Switzerland
| | - Rim Moazzin
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Gregor Geers
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Stephanie Kokoschka
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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Van Doorne L, De Kock L, De Moor A, Shtino R, Bronkhorst E, Meijer G, De Bruyn H. Flaplessly placed 2.4-mm mini-implants for maxillary overdentures: a prospective multicentre clinical cohort study. Int J Oral Maxillofac Surg 2020; 49:384-391. [DOI: 10.1016/j.ijom.2019.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/31/2019] [Accepted: 08/21/2019] [Indexed: 11/26/2022]
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Alrabiah M, Al Deeb M, Alsahhaf A, AlFawaz YF, Al-Aali KA, Vohra F, Abduljabbar T. Clinical and radiographic assessment of narrow-diameter and regular-diameter implants in the anterior and posterior jaw: 2 to 6 years of follow-up. J Periodontal Implant Sci 2020; 50:97-105. [PMID: 32395388 PMCID: PMC7192825 DOI: 10.5051/jpis.2020.50.2.97] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/06/2019] [Accepted: 12/15/2019] [Indexed: 01/01/2023] Open
Abstract
Purpose The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions NDIs in the anterior and posterior jaws functioned equally well in terms of peri-implant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.
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Affiliation(s)
- Mohammed Alrabiah
- Department of Prosthetic Dental Science, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Modhi Al Deeb
- Department of Prosthetic Dental Science, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Abdulaziz Alsahhaf
- Department of Prosthetic Dental Science, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Yasser F AlFawaz
- Department of Restorative Dental Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Khulud Abdulrahman Al-Aali
- Department of Clinical Dental Sciences, Princess Nourah Bint Abdulrahman University College of Dentistry, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, King Saud University College of Dentistry, Riyadh, Saudi Arabia.,Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, Saudi Arabia
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Manea A, Bran S, Dinu C, Rotaru H, Barbur I, Crisan B, Armencea G, Onisor F, Lazar M, Ostas D, Baciut M, Vacaras S, Mitre I, Crisan L, Muresan O, Roman R, Baciut G. Principles of biomechanics in oral implantology. Med Pharm Rep 2019; 92:S14-S19. [PMID: 31989104 PMCID: PMC6978931 DOI: 10.15386/mpr-1512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/02/2019] [Indexed: 01/04/2023] Open
Abstract
Background and aims The principles of biomechanics comprise all the interactions between the body (tissues) and the forces acting upon it (directly or via different medical devices). Besides the mechanical aspects, the tissues response is also studied. Understanding and applying these principles is vital for the researchers in the field of oral implantology, but they must be equally known by the practitioners. From the planning stages to the final prosthetic restoration, they are involved in each and every aspect. Ignoring them inevitably leads to failure. Methods The first part of this paper includes a review of our current research in oral implantology (mechanical, digital and biological testing), while the second part includes a review of the available literature on certain biomechanical aspects and their implications in everyday practice. Results Our research opens new study directions and provides increased chances of success for dental implant therapy. The practical aspects of our findings, combined with the available literature (from the basic principles described more than 40 years ago to the most recent studies and technologies) can serve as a guide to practitioners for increasing their success rate. Conclusion While no therapy is without failure risk, a good understanding of the biomechanics involved in oral implantology can lead to higher success rates in implant supported prosthetic restorations.
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Affiliation(s)
- Avram Manea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotaru
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Barbur
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdan Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Lazar
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Ostas
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Vacaras
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Mitre
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liana Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ovidiu Muresan
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rares Roman
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Longevity and marginal bone loss of narrow-diameter implants supporting single crowns: A systematic review. PLoS One 2019; 14:e0225046. [PMID: 31710656 PMCID: PMC6844460 DOI: 10.1371/journal.pone.0225046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/28/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To compare the longevity and marginal bone loss of narrow-diameter (≤3.3-mm) versus standard-diameter implants supporting single crowns. MATERIAL AND METHODS The MEDLINE (via PubMed), Scopus, and SciELO databases were searched for relevant publications. In addition, the scientific references provided by each of the implant companies that appeared in the search were reviewed. Intervention studies comparing longevity and bone loss between narrow-diameter and standard-diameter implants were included. RESULTS The search was limited to in vivo studies in humans. The query returned 1931 results, of which 4 met the inclusion criteria. The implant success rate ranged from 93.8% to 100% over a maximum follow-up of 3 years, with no difference between narrow- and standard-diameter implants. Meta-analysis of all included studies showed greater bone loss in narrow-diameter implants as compared with standard ones; however, when analysis was restricted to randomized trials, no such difference was present. CONCLUSION The meta-analysis showed no difference in longevity between narrow implants and standard implants when supporting single crowns. However, narrow-diameter implants may be associated with greater marginal bone loss. These findings should be regarded cautiously due to the short follow-up duration and methodological heterogeneity of the primary studies.
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80
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Kovačić I, Peršić S, Kranjčić J, Čelebić A. A cohort study on short mini-implants for mandibular overdentures compared to those of standard length. Clin Oral Implants Res 2019; 31:121-132. [PMID: 31541517 DOI: 10.1111/clr.13542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess peri-implant bone level, survival and success rates of short (6 or 8 mm long) one-piece mini-implants (MDIs) in edentulous patients with extremely resorbed alveolar ridge (interforaminal height <10 mm) rehabilitated with mandibular implant overdentures and to compare them with patients having standard length MDIs in 1-year prospective clinical study. MATERIAL AND METHODS The Short MDI group consisted of 28 participants with interforaminal height ≤10 mm. Implants being, both, short and slim (short MDIs: 6 or 8 mm long, 2 or 2.5 mm wide) were inserted. The Standard-MDI group included 35 participants (interforaminal height >13 mm) who received standard length MDIs (10-14 mm long, 2 or 2.5 mm wide). Primary outcomes were assessments of MDI peri-implant bone level, survival and success rates; secondary outcomes were assessments of peri-implant tissue, oral hygiene, and prosthodontic maintenance. RESULTS The Short MDI group had mean marginal bone loss (MBL) of 0.26 ± 0.35 mm, 6.4% of failure, and 92.6% of, both, success and survival rates. The Standard-MDI group had mean MBL of 0.34 ± 0.40 mm, 5% of failure, 95% of survival, and 94.3% success. There were no significant differences in MBL (p = .420), survival (p = .414), and success (p = .571) between the groups. The Short MDI group had significantly less plaque (p = .001) and bleeding on probing (p < .001). CONCLUSION Within the limitations of this study, short MDIs (6 or 8 mm long) in extremely atrophied mandibles (interforaminal height <10 mm) showed good clinical results in the first year of function.
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Affiliation(s)
- Ines Kovačić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Sanja Peršić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Josip Kranjčić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Department of Prosthodontics, School of Dental Medicine & Clinical Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
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81
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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Abou-Ayash S, Enkling N, Srinivasan M, Haueter M, Worni A, Schimmel M. Evolution of in vivo assessed retention forces in one-piece mini dental implant-retained mandibular overdentures: 5-Year follow-up of a prospective clinical trial. Clin Implant Dent Relat Res 2019; 21:968-976. [PMID: 31313455 DOI: 10.1111/cid.12816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/19/2019] [Accepted: 06/20/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND The evolution of retention forces in one-piece mini dental implants (MDIs) retaining implant overdentures (IODs) is of major importance, as the male parts cannot be exchanged, due to the implant design. PURPOSE To report the evolution of retention forces of one-piece MDIs, retaining mandibular IODs with ball/ O-ring attachments during 5 years assessed in vivo. MATERIALS AND METHODS Four MDIs were installed in the interforaminal region and immediately loaded using the existing mandibular complete denture. Directly post-op, at the 1-year and the 5-year follow-up, the retention forces were assessed with a validated strain gauge at each implant site separately. RESULTS At the male part, changes could only be observed at implant site 34: During the first year, there was a statistically significant increase, whereas the retention forces were decreased at the 5-year follow-up. At the female part, retention forces decreased significantly over time. Baseline values could be reestablished by exchanging the O-rings. The changes of the retention forces were more obvious in the posterior, compared to the anterior implants. CONCLUSIONS Retention forces at the female part decrease significantly over time, when retaining mandibular IODs by MDIs with ball/ O-ring attachments. Baseline values can be reestablished by exchanging the O-rings. At the male part, changes of retention forces depend on the implant location.
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Affiliation(s)
- Samir Abou-Ayash
- Section for Digital Implant- and Reconstructive Dentistry (DIRecD), Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Department of Prosthodontics, University of Bonn, Bonn, Germany
| | - Murali Srinivasan
- Clinic for General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marius Haueter
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | | | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA. Mapping of inflammatory biomarkers in the peri-implant crevicular fluid before and after the occlusal loading of narrow diameter implants. Clin Oral Investig 2019; 24:1311-1320. [PMID: 31312971 DOI: 10.1007/s00784-019-03010-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To monitor the cytokine release patterns in the peri-implant crevicular fluid (PICF) and to investigate which factors affect the success rate of narrow diameter implants (NDI) during the first year. MATERIAL AND METHODS Mandibular implant overdentures (IOD) retained by 2 NDI were installed in 16 clinically atrophic edentulous patients. The following parameters were monitored during the first year: (i) peri-implant health parameters (plaque index (PI), calculus presence (CP), gingival index (GI), probing depth (PD) and bleeding on probing (BoP); (ii) cytokine concentrations in the PICF (TNF-α, IL-1β, IL-6, IL-10); (iii) implant stability quotient (ISQ); (iv) marginal bone level (MBL) and bone level change (BLC); (v) implant success. The insertion torque, bone type, mandibular atrophy, time since edentulism, and smoking habits were also recorded. All data were analyzed using multivariable multilevel mixed-effects regression models. RESULTS The variability in the TNF-α release patterns temporarily reduced at weeks (w) 8-12, while the IL-1β concentrations remained low until they peaked at w48 [p < 0.05; + 177.55 pg/μl (+ 96.13 - + 258.97)]. Conversely, IL-10 release decreased significantly at w48 [p < 0.05; - 456.24 pg/μl (- 644.41 - - 268.07)]. The PD and ISQ decreased significantly (p < 0.05) over the follow-up period, while the MBL was stable after w48 with a BLC of 0.12 ± 0.71 mm. The overall success rate was 81.3%, and was influenced by TNF-α, IL-1β, IL-10, PI, GI, PD, smoking, and time since edentulism. CONCLUSION Pro- and anti-inflammatory cytokine release was balanced during the first 24 weeks. The GI, smoking, and time since edentulism are the most important factors determining the implant success. CLINICAL RELEVANCE The study contributes to the understanding of the osseointegration process in a clinically atrophic population rehabilitated with IOD, and highlights the importance of monitoring clinical peri-implant health-related parameters, smoking habit, and time since edentulism to predict implant success rates.
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Affiliation(s)
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves St., 457, Center, Pelotas, RS, Brazil.
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
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84
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Enkling N, Haueter M, Worni A, Müller F, Leles CR, Schimmel M. A prospective cohort study on survival and success of one-piece mini-implants with associated changes in oral function: Five-year outcomes. Clin Oral Implants Res 2019; 30:570-577. [PMID: 31021481 DOI: 10.1111/clr.13444] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/11/2019] [Accepted: 04/02/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate in a prospective cohort study the 5-year post-loading survival and success of one-piece mini dental implants (MDIs) in edentulous subjects with mandibular implant overdentures (IODs) and to report the associated changes of oral function with respect to patient age. MATERIALS AND METHODS Independently living edentulous patients were recruited and provided with new complete dentures. After an adaptation period, four one-piece MDIs (diameter 1.8 mm) were installed in the interforaminal region and immediately loaded. At baseline pre-operative (BL), as well as at 1-year and 5-year follow-up examinations, chewing efficiency was assessed with a validated color-mixing ability test and maximum voluntary bite force (MBF) was recorded with a digital force gauge. Implant survival and success were evaluated at 5-year follow-up. Non-parametric tests served to analyze the differences between time points. RESULTS Twenty patients participated in the study (5 men and 15 women; age at BL: n = 10 ≤ 65 years and n = 10 > 65 years). All patients were available for a 5-year follow-up (n = 2 in their long-term care facility; n = 1 only by telephone). The survival and success rates were both 100% after 61 ± 5.7 months. Chewing efficiency did not change over the first year (p = 0.167), but was improved at 5 year fup (n = 19) compared to baseline (p = 0.033) and to 1 year (p < 0.001). The MBF (n = 19 at 5-year follow-up) increased continuously over time (p < 0.001), but was less pronounced in the older cohort (p = 0.009). CONCLUSIONS Mini dental implants seem to be a successful treatment option for edentulous elderly patients with very high survival and success rates, and serve to improve long-term oral function.
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Affiliation(s)
- Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Bonn, Germany
| | - Marius Haueter
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | | | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Cláudio Rodrigues Leles
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiás, Brazil
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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85
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Romanos GE, Bastardi DJ, Moore R, Kakar A, Herin Y, Delgado-Ruiz RA. In Vitro Effect of Drilling Speed on the Primary Stability of Narrow Diameter Implants with Varying Thread Designs Placed in Different Qualities of Simulated Bone. MATERIALS 2019; 12:ma12081350. [PMID: 31027206 PMCID: PMC6515434 DOI: 10.3390/ma12081350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/16/2019] [Accepted: 04/19/2019] [Indexed: 01/08/2023]
Abstract
It is hypothesized that there is no statistically significant impact of drilling speed (DS) on the primary stability (PS) of narrow-diameter implants (NDIs) with varying thread designs placed in dense and soft simulated bone. The aim of this in vitro study was to evaluate the impact of DS on the PS of NDIs with varying thread designs placed in dense and soft simulated bone. Two hundred and forty osteotomies for placement of various implant macro-designs were divided into three groups (80 implants per group): Group A (NobelActive, 3.0/11.5 mm); Group B (Astra OsseoSpeed-EV, 3.0/11 mm); and Group C (Eztetic-Zimmer, 3.1/11.5 mm) implants. These implants were placed in artificial dense and soft simulated bone using DSs of 800 and 2000 revolutions per minute (RPM). Resonance frequency analysis (RFA) and implant stability quotient (ISQ) were assessed. Group comparisons were performed using the one-way analysis of variance with Tukey’s post hoc tests. Level of significance was set at P < 0.05. In groups A and B, there was no difference in the ISQ for NDIs inserted in dense bone at 800 and 2000 RPM. In Group C, ISQ was significantly higher for NDIs placed in dense bone at 800 PRM compared to 2000 RPM (P < 0.05). In Group A, ISQ values were significantly higher for NDIs inserted in soft bone at 2000 RPM as compared to those inserted at 800 RPM (P < 0.05). For NDIs, a lower drilling speed in dense artificial simulated bone and a higher drilling speed in soft artificial simulated bone is associated with high primary stability.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
| | - Daniel J Bastardi
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
| | - Rachel Moore
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
| | - Apoorv Kakar
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
| | - Yaro Herin
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
| | - Rafael A Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA.
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86
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Al-Aali KA, ArRejaie AS, Alrahlah A, AlFawaz YF, Abduljabbar T, Vohra F. Clinical and radiographic peri-implant health status around narrow diameter implant-supported single and splinted crowns. Clin Implant Dent Relat Res 2019; 21:386-390. [PMID: 30767366 DOI: 10.1111/cid.12718] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/24/2018] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Studies assessing and comparing clinical and radiographic peri-implant status around narrow diameter implant-supported single crowns (NDISCs) and splinted crowns (NDISPs) are scarce. OBJECTIVE The aim of this retrospective study was to estimate and compare complication rates, patient satisfaction, peri-implant status and peri-implant bone loss (PBL) of NDISCs and NDISPs. MATERIALS AND METHODS Patients receiving narrow diameter implants (NDIs) in the posterior mandible were assessed. Technical complication and patient satisfaction were recorded. Clinical peri-implant plaque index (PI), bleeding on probing (BoP), probing depth (PD) and PBL were assessed. Technical complications and patient satisfaction were recorded. Log-rank test was computed to evaluate the influence of prostheses type and NDIs location on technical complications. P-value less than 0.05 was regarded as significant. RESULTS Seventy-eight patients (43 male and 35 females) agreed to follow up. The mean follow-up duration of the patients was 3.6 years. A total of 102 (43 NDISCs and 59 NDISPs) NDIs with moderately rough surfaces were included. No significant differences in PI, BoP, or PD were observed between NDISCs and NDISPs. The average PBL score was 1.17 (range: 0.03-4.15) at implant level and 1.14 (range: 0.03-4.14) at patient level. Seven implants and three patients showed peri-implantitis. The rates of technical complication of single crowns were significantly higher than those of splinted crowns (P = 0.036). PBL was significantly higher in molar sites than those in premolar sites (P = 0.041). A total of 67 patients (85.9%) were satisfied with the esthetics of the crowns, while a total of 59 patients (75.6%) were satisfied with the function of the crowns. CONCLUSION NDISCs and NDISPs offer high patient satisfaction and tolerable complication rates. Peri-implant conditions and peri-implant bone levels were comparable around NDISCs and NDISPs. However, bone loss of implants was higher in molar sites than those implants in premolar sites.
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Affiliation(s)
- Khulud Abdulrahman Al-Aali
- Department of Prosthodontics, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Aws S ArRejaie
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ali Alrahlah
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yasser F AlFawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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