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Suzuki A, Nakano T, Inoue M, Isigaki S. Multivariate analysis of the effect of keratinized mucosa on peri-implant tissues with platform switching: A retrospective study. Clin Implant Dent Relat Res 2024; 26:592-603. [PMID: 38500194 DOI: 10.1111/cid.13318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND In recent years, platform switching implant treatment has been increasing, which is believed to minimize bone loss around the implant after placement. However, there have been no reports on the relationship between keratinized mucosa width (KMW) and bone loss and soft tissue recession in platform switching implants. OBJECTIVE We evaluated the effect of the KMW on the amount of bone loss and soft tissue recession around a platform switching implant retrospectively using multivariate analysis. MATERIALS AND METHODS This one-year retrospective study included 91 implants in 48 patients. Age, sex, a history of periodontitis, implant location, oral hygiene status, and the KMW were included as explanatory variables to evaluate bone loss (BL) and buccal gingival height (GH). Generalized estimating equations (GEEs) were used to evaluate the effect of the KMW on platform switching peri-implant tissues. RESULTS The mean bone loss on the mesial (ΔBLm), distal (ΔBLd), and buccal (ΔBLb) sides of the implant were 0.16 ± 0.27 mm, 0.19 ± 0.34 mm, and 0.24 ± 0.50 mm, respectively, at 1 year after superstructure placement. The mean amount of change of GH (ΔGH) on the buccal side was 0.30 ± 0.47 mm. After correcting for confounders using GEEs, the results suggested that KMW <1.5 mm was a significant factor (P < 0.001) for bone loss over time in ΔBLm, ΔBLd, and ΔBLb. In addition, for soft tissues on the buccal side, KMW <1.5 mm was a significant factor for ΔGH reduction over time (P < 0.001). CONCLUSIONS Keratinized mucosa width ≥1.5 mm was associated with a higher probability less hard and soft tissue recession around the platform switching implant after 1 year from superstructure placement.
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Affiliation(s)
- Azusa Suzuki
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaki Inoue
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shoichi Isigaki
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
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Mahmoud IA, ElTannir AM, Eissa SM, ElBasty RS. Assessment of crestal bone loss and periodontal parameters of polymer infiltrated ceramic network versus lithium disilicate implant hybrid abutment crowns in the esthetic zone (A randomized clinical trial). Clin Implant Dent Relat Res 2024; 26:333-342. [PMID: 37984494 DOI: 10.1111/cid.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Lithium disilicate can be reliable when restoring implants in the esthetic zone. However, it has a high elastic modulus. This might increase the amount of forces transmitted to the crestal bone. AIM OF THE STUDY To evaluate the crestal bone loss and peri-implant periodontal parameters of polymer infiltrated ceramic network compared to lithium disilicate implant-supported hybrid abutment crowns after 12 months of follow-up. METHODOLOGY 44 patients were enrolled. They were randomly assigned into two groups (n = 22). The first group received 22 implants restored with polymer-infiltrated ceramic network (Vitaenamic) hybrid abutment crowns. The second group received 22 implants restored with lithium disilicate (e.max) hybrid abutment crowns over immediately placed implants in the esthetic zone. Periapical radiographs were taken immediately after prosthetic placement and 1 year later utilizing a parallel technique, to assess crestal bone loss. Periodontal parameters were assessed after 1 year. RESULTS Regarding crestal bone loss, a comparison between group I (Vitaenamic) and group II (e.max) was made by using an Independent t-test, which showed an insignificant difference between them (p > 0.05). A comparison between groups I and II revealed insignificant differences regarding periodontal parameters (probing depth, bleeding on probing, visible plaque, and suppuration). CONCLUSIONS Regarding bone stability and periodontal parameters, polymer infiltrated ceramic network and lithium disilicate hybrid abutment crowns showed comparable results. Both materials showed clinically acceptable hard and soft tissue responses.
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Affiliation(s)
- Inas Adel Mahmoud
- Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Adel Mohamed ElTannir
- Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sherihan Mohamed Eissa
- Fixed and Removable Prosthodontics Department, Oral and Dental Research Institute, National Research Centre, Cairo, Egypt
| | - Reham Said ElBasty
- Fixed Prosthodontics Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Jervøe-Storm PM, Marder M, Hagner M, Menn I, Menn P, Jepsen S. Prevalence of Peri-Implant Disease in Patients with Stage III or IV Periodontitis: Results of a Long-Term Follow-Up from a Specialized Periodontal Practice. J Clin Med 2023; 12:5547. [PMID: 37685613 PMCID: PMC10488241 DOI: 10.3390/jcm12175547] [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: 07/18/2023] [Revised: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of this study was to examine the conditions of implants that had been in function for 5-17 years in stage III/IV periodontitis patients of a specialized periodontal practice. There were 83 patients (43 female/40 male, mean age 64.4 (9.69) years), with a total of 213 implants, who participated in the study. Assessments included periodontal and peri-implant probing depths, bleeding and plaque scores, and a radiographic examination. Smoking habits, participation in a supportive care program (SCP), and the Implant Disease Risk Assessment (IDRA) scores were recorded. A total of 44 patients presented with stage III periodontitis, and 39 with stage IV. In all, 85% of patients had adhered to regular SCP. On an implant/patient level, peri-implant health was found in 37.1.7% (79 implants)/24.1% (20 patients), peri-implant mucositis in 58.7% (125 implants)/66.3% (55 patients), and peri-implantitis in 4.2% (9 implants)/9.6% (8 patients). IDRA scores showed 30.5% of implants at moderate and 69.5% at high risk. The present long-term analysis shows a high prevalence of peri-implant disease in patients treated for advanced periodontitis. These findings underline the challenges involved in the long-term maintenance of oral health in stage III/IV periodontitis patients restored with dental implants.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
| | - Martin Hagner
- Practice for Interdisciplinary Dentistry, Im Mühlenbach 2b, 53127 Bonn, Germany;
| | - Ina Menn
- Practice for Interdisciplinary Dentistry Dr. Menn, Dammstraße 4, 57271 Hilchenbach, Germany; (I.M.); (P.M.)
| | - Philipp Menn
- Practice for Interdisciplinary Dentistry Dr. Menn, Dammstraße 4, 57271 Hilchenbach, Germany; (I.M.); (P.M.)
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Welschnonnenstrasse 17, 53111 Bonn, Germany;
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Sbricoli L, Bazzi E, Stellini E, Bacci C. Systemic Diseases and Biological Dental Implant Complications: A Narrative Review. Dent J (Basel) 2022; 11:dj11010010. [PMID: 36661547 PMCID: PMC9857470 DOI: 10.3390/dj11010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
The relationship between periodontitis and such systemic disorders as diabetes, cardiovascular disease and obesity has been extensively investigated. There is less scientific evidence available, however, regarding the influence of systemic diseases on the risk of late failure of dental implant rehabilitation due to peri-implantitis. The aim of the present study was to review the literature on the role of several common systemic disorders (diabetes, obesity, cardiovascular disease, hypertension and osteoporosis) in the onset of peri-implantitis. A database search initially yielded 2787 studies of potential interest published up to 1 March 2022 (993 in PubMed; 908 in Web of Science; and 886 in Scopus). After removing 1190 duplicate articles and checking the titles, abstracts and full texts for relevance, 70 articles were selected for the present analysis. Only cohort, case-control studies and clinical case series were considered. Most of the literature concludes for no association between diabetes, cardiovascular disease, hypertension or osteoporosis and the risk of peri-implantitis. On the other hand, almost all the studies that investigated obesity as a risk factor for implant rehabilitation found a positive association between the two. Further longitudinal studies are needed to better understand the effects of systemic diseases on rehabilitation with dental implants.
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An Y, Xie L, Liu Y, Wu P, Li H, Jiang J, Zhang Z, Yang S. Research on skull trauma biomechanical stress distribution in case of dental implants existence. Technol Health Care 2022; 31:821-829. [PMID: 36442219 DOI: 10.3233/thc-220148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND: When the jaw bone is subjected to an external force, the stress is transmitted from the force point along the alveolar bone to the skull and skull base. In the case of a dental implant, the stress distribution is mainly dependent on the implant position, type, and mechanical properties. OBJECTIVE: To investigate the dental implant position influence on the stress distribution and transmission in case of facial frontal trauma. Furthermore, the correlation between facial trauma and skull trauma in the case of a dental implant exists. METHODS: In this study, a Finite Element Method (FEM) model was constructed based on a real skull shape, size, and anatomy. Dental implants were modeled based on imported CAD Data. Five cases were investigated including no dental implant and the replacement of teeth no. 18, 19 20 and 21. Facial trauma was mimicked by applying an external load on the lower frontal jaw. Finally, the stress distribution based on the bone geometry and implant position were evaluated and compared. RESULTS: Results suggested that a dental implant could significantly influence the stress distribution in the skull in case of facial trauma. In addition, the dental position greatly affects stress transmission from the mandible to the skull bones through the zygomatic arch. CONCLUSION: The position of the dental implant could have a significant role in stress transmission and distribution in case of facial or even brain trauma. Thus, increasing the possibility of a correlation between facial and brain trauma.
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Affiliation(s)
- Yang An
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ling Xie
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Yu Liu
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Po Wu
- Department of Stomatology, People’s Hospital of Tianfu New District, Chengdu, Sichuan, China
| | - Hao Li
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Ji Jiang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Zhengrui Zhang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
| | - Shuyong Yang
- General Hospital of the Western War Zone of the Chinese People’s Liberation Army, Chengdu, Sichuan, China
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Kikuchi T, Wada M, Mameno T, Hasegawa D, Serino G, Ikebe K. Longitudinal study on the effect of keratinized mucosal augmentation surrounding dental implants in preventing peri-implant bone loss. PeerJ 2022; 10:e13598. [PMID: 35782095 PMCID: PMC9248778 DOI: 10.7717/peerj.13598] [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: 03/23/2022] [Accepted: 05/25/2022] [Indexed: 01/17/2023] Open
Abstract
Background Dental implant therapy is a well-established method of prosthetic rehabilitation of missing teeth. To maintain the health of the surrounding tissue, management of risk factors/indicators and daily maintenance are important. It still remains controversial whether a certain amount of keratinized mucosal width is essential for maintaining the health of peri-implant tissue. The purpose of this multicenter retrospective study was to assess the correlation between bone loss around dental implant and the amount of keratinized tissue width. Methods A total of 1,644 implants were evaluated. Data was collected about participants' general and dental history, as well as implant details. Bone resorption around implant was calculated from intra-oral radiographs taken after 1 year and more than 3 years of function. Implants were classified into three groups; received free gingival graft or apically repositioned flap surgery for increasing the keratinized mucosa ≥2 mm width (group A), keratinized mucosa width ≥2 mm (group B), and keratinized mucosa width <2 mm (group C). These data were analyzed by propensity score analysis and a generalized linear regression analysis was performed to compare the bone resorption among groups. Results Mean functional time was 55.8 months (SD = 20.5) in group A, 67.6 months (SD = 28.1) in group B, and 74.5 months (SD = 32.9) in group C. Mean bone resorption of groups A, B, and C were 0.08 mm (SD = 0.40), 0.18 mm (SD = 0.66), and 0.44 mm (SD = 0.40). Groups A and B had significantly lower bone resorption than group C. Conclusion The results in this study show the importance of keratinized mucosa in maintaining the peri-implant bone. Our findings also suggest that mucosal transplantation is useful, as opposed to narrowing of the keratinized mucosa.
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Affiliation(s)
- Takeshi Kikuchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya City, Aichi, Japan
| | - Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Daisuke Hasegawa
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Giovanni Serino
- Department of Periodontology, Södra Älvsborg Hospital, Brämhultsvägen, Borås, Sweden
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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Polymeri A, Loos BG, Aronovich S, Steigmann L, Inglehart MR. Risk factors, diagnosis and treatment of peri-implantitis: A cross-cultural comparison of U.S. and European periodontists' considerations. J Periodontol 2021; 93:481-492. [PMID: 34390497 PMCID: PMC10138758 DOI: 10.1002/jper.21-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 07/14/2021] [Accepted: 08/11/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. vs. European periodontists' considerations of risk factors, diagnostic criteria, and management of PI. MATERIALS AND METHODS 393 periodontists from the U.S. and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail. RESULTS Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs. 13.90;p = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated >4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs. 4.45;p = 0.005) and history of periodontitis (4.36 vs. 4.10;p = 0.006) as more important and implant surface (2.91 vs. 3.18;p = 0.023), occlusion (2.80 vs. 3.75;p<0.001) and presence of keratinized tissue (3.27 vs. 3.77;p<0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs. 3.54;p = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs. 3.07;p<0.001), lasers (2.11 vs. 1.68;p = 0.005), allograft (3.39 vs. 2.14;p<0.001) and regenerative approaches (3.57 vs. 2.56;p<0.001), but less likely to use resective surgery (3.09 vs. 3.53;p<0.001) than European periodontists. CONCLUSIONS U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Angeliki Polymeri
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Bruno G Loos
- Department of Periodontology, University of Amsterdam and Vrije Universiteit, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Sharon Aronovich
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI
| | - Larissa Steigmann
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
| | - Marita R Inglehart
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI
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Wada M, Mameno T, Otsuki M, Kani M, Tsujioka Y, Ikebe K. Prevalence and risk indicators for peri-implant diseases: A literature review. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:78-84. [PMID: 34158874 PMCID: PMC8203834 DOI: 10.1016/j.jdsr.2021.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 03/18/2021] [Accepted: 05/23/2021] [Indexed: 02/08/2023] Open
Abstract
Peri-implant diseases are known as undesirable conditions that can occur after implant therapy. Although several risk indicators are becoming clear, the causes of peri-implant diseases have not been completely investigated. The purpose of this review was to summarize the prevalence and risk indicators for peri-implant diseases by referring to current papers from various angles. Many studies have reported the varied prevalence of peri-implant mucositis (23.9%-88.0% at the patient level and 9.7%-81.0% at the implant level) and peri-implantitis (8.9%-45% at the patient level and 4.8%-23.0% at the implant level). Additionally, several studies concluded that poor oral hygiene and lack of regular maintenance were strongly correlated with the development of both peri-implant mucositis and peri-implantitis. Diabetes and a history of periodontitis were revealed as risk indicators for peri-implantitis. However, there was no definitive conclusion about the correlations between peri-implant diseases and other factors such as smoking, the shape of the implant superstructure, and the condition of the keratinized mucosa. Further studies useful for evidence-based decision-making are needed for predictable implant therapy in the long term.
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Affiliation(s)
- Masahiro Wada
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Tomoaki Mameno
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Motohiro Otsuki
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan.,Private Dental Office, Japan
| | - Misako Kani
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Yoshitaka Tsujioka
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
| | - Kazunori Ikebe
- Osaka University, Graduate School of Dentistry Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Japan
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Park WB, Han JY, Kang KL. Long-Term Comparison of Survival and Marginal Bone of Implants with and without Sinus Augmentation in Maxillary Molars within the Same Patients: A 5.8- to 22-Year Retrospective Study. J Clin Med 2021; 10:jcm10071360. [PMID: 33806214 PMCID: PMC8036778 DOI: 10.3390/jcm10071360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/13/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022] Open
Abstract
Maxillary sinus floor augmentation (MSFA) is widely used and considered a predictable procedure for implant placement. However, the influence of MSFA on implant survival and marginal bone loss (MBL) is still inconclusive. The purpose of this retrospective observational study is to evaluate the long-term genuine influence of MSFA on the survival and MBL of implants by comparing those with and without MSFA only in maxillary molars within the same patients. Thirty-eight patients (28 male and 10 female), with a total of 119 implants, received implants with and without MSFA, and were followed up for 5.8 to 22 years. Patient- and implant-related factors were assessed with a frailty model for implant survival and with generalized estimation equations (GEE) for MBL around the implant. No variables showed a statistical significance for implant failure in the frailty model. In GEE analysis for MBL, MSFA did not show any statistical significance. In conclusion, MSFA demonstrated no significant influence on implant failure and MBL in posterior maxilla in this study.
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Affiliation(s)
- Won-Bae Park
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 05278, Korea;
| | - Ji-Young Han
- Department of Periodontology, Division of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Kyung-Lhi Kang
- Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul 05278, Korea;
- Correspondence: ; Tel.: +82-2-440-7515; Fax: +82-2-440-7549
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