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Sharon E, Engel I. The Effect of Prosthetic Factors on the Long-Term Survival of Dental Implants: A Narrative Review. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00060-8. [PMID: 39261213 DOI: 10.1016/j.coms.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
The success of implants depends on the biological and mechanical factors of the implant, as well as on the chosen prosthesis, which has different characteristics that can affect the survival of the implant and its marginal bone levels. Therefore, when choosing the type of prosthesis, it is necessary to understand and consider each of these variables and tailor them to the relevant clinical situation. In this narrative review, we will assess the types of prostheses, their different characteristics, timing, and their impact on implant survival and marginal bone levels, as accepted in today's literature.
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Affiliation(s)
- Esi Sharon
- Department of Prosthodontics, Hadassah Medical Center, Jerusalem, Israel; Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel.
| | - Ilana Engel
- Department of Prosthodontics, Hadassah Medical Center, Jerusalem, Israel; Faculty of Dental Medicine, Hebrew University of Jerusalem, Israel
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Ribeiro MCDO, Vargas-Moreno VF, Gomes RS, Faot F, Del Bel Cury AA, Marcello-Machado RM. Implant-supported crowns with locking taper implant-abutment connection: A systematic review and meta-analysis. J Prosthet Dent 2024; 132:369-380. [PMID: 35864024 DOI: 10.1016/j.prosdent.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported single crowns are more prone to screw loosening than splinted prostheses. Therefore, the locking taper system, which has a screwless abutment, may perform better when associated with this type of rehabilitation. However, systematic reviews on this system are lacking. PURPOSE The purpose of this systematic review was to evaluate the clinical performance and complications of single crowns retained by the locking taper system. MATERIAL AND METHODS This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42020189921. An electronic search was made in 5 databases and 3 other sources up to February 2021 to select prospective clinical studies evaluating the performance of single crowns retained by the locking taper system by using the outcomes implant survival, success rate, complications, marginal bone loss (MBL), and prosthesis success rate. Four meta-analyses grouped according to the follow-up intervals were performed. The risk of bias of the selected studies was evaluated by using the RoB 2 checklist for randomized controlled trials (RCTs) and Downs and Black for uncontrolled studies. RESULTS Twelve studies were included: 9 prospective cohort studies and 3 RCTs. A survival rate of 99% (98% to 99%) and a success rate of 97% (92% to 99%) after 5 years were found. Of the total, 2.6% biological and 2.9% prosthetic complications were described. The prosthesis success rate was 97% (96% to 98%) after 5 years. An average of -0.73 mm (-0.93 to -0.52) was found for the MBL after 5 years. The risk-of-bias assessment showed 2 RCTs with high risk and 1 RCT with low risk of bias. Among uncontrolled studies, 2 were classified as poor and 7 as fair. CONCLUSIONS Single crowns retained by locking taper implants can be safely indicated based on the high survival and success rates achieved in the long term, the maintenance of bone level stability over time, and the low incidence of complications.
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Affiliation(s)
| | - Vanessa Felipe Vargas-Moreno
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Rafael Soares Gomes
- Professor, Department of Prosthodontics, Faculty of Technology and Sciences (UniFTC), Salvador, Bahia, Brazil
| | - Fernanda Faot
- Professor, Department of Restorative Dentistry, Federal University of Pelotas, Pelotas (UFPel), RS, Brazil
| | - Altair Antoninha Del Bel Cury
- Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Raissa Micaella Marcello-Machado
- Postdoctoral Research Fellow, Department of Prosthodontics and Periodontology, Piracicaba Dental School (UNICAMP), Piracicaba, São Paulo, Brazil.
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Aung YT, Eo MY, Sodnom-Ish B, Kim MJ, Kim SM. Long-term survival rates of tapered self-tapping bone-level implants after immediate placement: a positional effective rationale. Maxillofac Plast Reconstr Surg 2024; 46:17. [PMID: 38727979 PMCID: PMC11087388 DOI: 10.1186/s40902-024-00428-7] [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: 02/03/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Immediate implant placement has gained popularity due to its several advantages. However, immediate placement has its challenges, including concerns about primary stability and bone formation around the implant. The aim of the present study is to evaluate the clinical outcomes of tapered, sand-blasted, and acid-etched internal submerged dental implants in various regions of the jaw bones and to provide a positional rationale for immediate implant placement. METHODS Between 2009 and 2018, a single surgeon at Seoul National University Dental Hospital in Seoul, Korea, immediately inserted 49 dental implants with tapered bone-level design after extraction, in a total of 34 patients. The clinical outcomes were collected and evaluated, focusing on location of implant placement and marginal bone loss (MBL), with consideration of other parameters such as implant diameter and length. RESULTS Of 49 immediately installed Luna® (Shinhung Co., Seoul, Korea) dental implants, 23 were placed in the mandible, and 26 were set in the maxilla. The mean age of patients at the time of installation was 65.91 years, ranging from 40 to 86 years. The average follow-up period was 7.43 years, with a range of 5 to 14 years. After a 5-year retrospective evaluation of tapered, sand-blasted, and acid-etched internal submerged dental implants for immediate implant placement, the cumulative survival rate was 93.88%, with 100% survival rate in the mandible and premolar region of both the maxilla and mandible. CONCLUSIONS After a 5-year evaluation, tapered, sand-blasted, and acid-etched internal submerged dental implants demonstrated good efficacy for immediate placement in various locations within the dental arches, exhibiting effective clinical performance.
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Affiliation(s)
- Yoon Thu Aung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, Republic of Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, Republic of Korea
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, Republic of Korea
| | - Myung Joo Kim
- Department of Prosthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongno-Gu, 03080, Seoul, Republic of Korea.
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Vinhas AS, Salazar F, Mendes JM, Silva AS, Ríos-Carrasco B, Ríos-Santos JV, Gil J, Herrero-Climent M, Aroso C. SEM Analysis and Micro-CT Evaluation of Four Dental Implants after Three Different Mechanical Requests-In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2024; 17:434. [PMID: 38255602 PMCID: PMC10820107 DOI: 10.3390/ma17020434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/24/2023] [Accepted: 01/07/2024] [Indexed: 01/24/2024]
Abstract
STATEMENT OF PROBLEM Implant-supported rehabilitations are an increasingly frequent practice to replace lost teeth. Before clinical application, all implant components should demonstrate suitable durability in laboratory studies, through fatigue tests. OBJECTIVE The purpose of this in vitro study was to evaluate the integrity and wear of implant components using SEM, and to assess the axial displacement of the implant-abutment assembly by Micro-CT, in different implant connections, after three distinct mechanical requests. MATERIALS AND METHODS Four KLOCKNER implants (external connection SK2 and KL; and internal connection VEGA and ESSENTIAL) were submitted to three different mechanical requests: single tightening, multiple tightening, and multiple tightening and cyclic loading (500 N × 100 cycles). A total of 16 samples were evaluated by SEM, by the X-ray Bragg-Brentano method to obtain residual stresses, and scratch tests were realized for each surface and Micro-CT (4 control samples; 4 single tightening; 4 multiple tightening; 4 multiple tightening and cyclic loading). All dental implants were fabricated with commercially pure titanium (grade 3 titanium). Surface topography and axial displacement of abutment into the implant, from each group, were evaluated by SEM and Micro-CT. RESULTS In the manufacturing state, implants and abutments revealed minor structural changes and minimal damage from the machining process. The application of the tightening torque and loading was decisive in the appearance and increase in contact marks on the faces of the hexagon of the abutment and the implant. Vega has the maximum compressive residual stress and, as a consequence, higher scratch force. The abutment-implant distances in SK2 and KL samples did not show statistically significant differences, for any of the mechanical demands analyzed. In contrast, statistically significant differences were observed in abutment-implant distance in the internal connection implants Vega and Essential. CONCLUSIONS The application of mechanical compression loads caused deformation and contact marks in all models tested. Only internal connection implants revealed an axial displacement of the abutment into the implant, but at a general level, a clear intrusion of the abutment into the implant could only be confirmed in the Essential model, which obtained its maximal axial displacement with cyclic loading.
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Affiliation(s)
- Ana Sofia Vinhas
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, Rua Central de Gandra, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (J.M.M.); (A.S.S.); (C.A.)
| | - Filomena Salazar
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, Rua Central de Gandra, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (J.M.M.); (A.S.S.); (C.A.)
| | - José Manuel Mendes
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, Rua Central de Gandra, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (J.M.M.); (A.S.S.); (C.A.)
| | - António Sérgio Silva
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, Rua Central de Gandra, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (J.M.M.); (A.S.S.); (C.A.)
| | - Blanca Ríos-Carrasco
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain;
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain;
| | - Javier Gil
- Bioengineering Institute of Technology, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Sant Cugat-Barcelona, Spain;
| | | | - Carlos Aroso
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS), CESPU, Rua Central de Gandra, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (J.M.M.); (A.S.S.); (C.A.)
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Shen L, Dong C, Chen J, Bai X, Yang F, Wang L. The mechanical and clinical influences of prosthetic index structure in Morse taper implant-abutment connection: a scoping review. BMC Oral Health 2023; 23:775. [PMID: 37865734 PMCID: PMC10590505 DOI: 10.1186/s12903-023-03545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023] Open
Abstract
AIM The implant-abutment connection is a crucial factor in determining the long-term stability of dental implants. The use of a prosthetic index structure in the Morse taper implant-abutment connection has been proposed as a potential solution to improve the accuracy of this connection. This study aimed to provide a scoping review of the mechanical and clinical effects of the prosthetic index structure in the Morse taper implant-abutment connection. METHODS A systematic scoping review of articles related to "dental implants," "Morse taper," and "index" was conducted using PubMed/MEDLINE, Web of Science, Cochrane, and Scopus databases, as well as a comprehensive literature search by two independent reviewers. Relevant articles were selected for analysis and discussion, with a specific focus on investigating the impact of prosthetic index structure on the mechanical and clinical aspects of Morse taper implant-abutment connections. RESULTS Finally, a total of 16 articles that met the inclusion criteria were included for data extraction and review. In vitro studies have demonstrated that the use of a prosthetic index structure in the Morse taper implant-abutment connection can affect stress distribution, biomechanical stability, and reverse torque values, which may reduce stress within cancellous bone and help limit crestal bone resorption. However, retrospective clinical studies have shown that this structure is also associated with a higher risk of mechanical complications, such as abutment fracture and abutment screw loosening. CONCLUSIONS Therefore, the clinical trade-off between preventing crestal bone resorption and mechanical complications must be carefully considered when selecting appropriate abutments. The findings suggest that this structure can improve the accuracy and stability of the implant-abutment connection, but its use should be carefully evaluated in clinical practice.
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Affiliation(s)
- Liheng Shen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Chengzhi Dong
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xiaolei Bai
- Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Verma V, Hazari P, Verma P. Biomechanical efficiency of different implant-abutment connection: a systematic review of studies using photoelastic stress analysis. Evid Based Dent 2023; 24:92. [PMID: 37188921 DOI: 10.1038/s41432-023-00884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 03/22/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE The present review aimed to comparatively evaluate the biomechanical efficiency of different implant-abutment connections studied by photoelastic stress analysis. MATERIALS AND METHODS A comprehensive online literature search was conducted on Medline (Pubmed), Web of Science, and Google Scholar from 2000(Jan) to 2023(Jan). Keywords used initially to carry out the search included implant-abutment connection & photoelastic stress analysis, and stress distribution in different implant-abutment connections. 34 photoelastic stress analysis studies were screened and 30 studies were excluded after the screening of the title, abstract and full article. Finally, 4 studies were included for complete review. RESULT The result of this systematic review showed that the internal connection was more efficient then the external connection as there was less marginal bone loss and favorable distribution of stress in internal connection. CONCLUSION Crestal bone loss is more in external connection when compared to internal connection. In Internal connection, there is more intimate contact between the abutment's outer surface and implant which renders a more stable interface, which favoring uniform stress distribution and protects the retention screw.
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Affiliation(s)
- Varsha Verma
- Department of Prosthodontics and Crown & Bridge, People's Dental Academy, Bhopal, Madhya Pradesh, India.
| | - Puja Hazari
- Department of Prosthodontics and Crown & Bridge, Peoples Dental Academy, Bhopal, Madhya Pradesh, India
| | - Puja Verma
- School of Humanities and Engineering Sciences, MIT Academy of Engineering, Alandi, Pune, Maharashtra, India
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Mendes TA, Vilhena L, Portugal J, Caramês J, Ramalho AL, Lopes LP. Wear of Titanium Implant Platforms with Different Abutment Connections and Abutment Materials: A Pilot Study. J Funct Biomater 2023; 14:jfb14040178. [PMID: 37103268 PMCID: PMC10146395 DOI: 10.3390/jfb14040178] [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: 02/15/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
The most commonly used material in dental implants and their abutments is titanium. Zirconia is a more aesthetic alternative to titanium abutments; however, it is much harder. There are concerns that zirconia could damage the surface of the implant over time, especially in less stable connections. The aim was to evaluate the wear of implants with different platforms connected to titanium and zirconia abutments. A total of six implants were evaluated, two of each connection type: external hexagon, tri-channel, and conical connections (n = 2). Half of the implants were connected to zirconia abutments, and the other half to titanium abutments (n = 3). The implants were then cyclically loaded. The implant platforms were evaluated by digital superimposing micro CT files and calculating the area of the loss surface (wear). In all the implants, a statistically significant loss of the surface area (p = 0.028) was observed when comparing the area before and after cyclic loading. The average lost surface area was 0.38 mm2 with titanium abutments and 0.41 mm2 with zirconia abutments. The average lost surface area was 0.41 mm2 with the external hexagon, 0.38 mm2 with the tri-channel, and 0.40 mm2 with the conical connection. In conclusion, the cyclic loads induced implant wear. However, neither the type of abutment (p = 0.700) nor the connection (p = 0.718) influenced the amount of surface area lost.
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Affiliation(s)
- Teresa A Mendes
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Luis Vilhena
- Department of Mechanical Engineering, Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), University of Coimbra, 3004-516 Coimbra, Portugal
| | - Jaime Portugal
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - João Caramês
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- Laboratório de Instrumentação, Engenharia Biomédica e Física da Radiação (LIBPhys), 1600-277 Lisbon, Portugal
| | - Amilcar L Ramalho
- Department of Mechanical Engineering, Centre for Mechanical Engineering, Materials and Processes (CEMMPRE), University of Coimbra, 3004-516 Coimbra, Portugal
| | - Luis P Lopes
- Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisbon, Portugal
- Laboratório de Instrumentação, Engenharia Biomédica e Física da Radiação (LIBPhys), 1600-277 Lisbon, Portugal
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Hariharan AS, Sivaswamy V, Subhashini R. Implant-Abutment Connections: A Structured Review. J Long Term Eff Med Implants 2022; 33:47-56. [PMID: 36382704 DOI: 10.1615/jlongtermeffmedimplants.2022042610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The aim of the study was to carry out a structured review of studies that dealt with types of implant abutment connections, the concept of platform switching and its influence on hard and soft oral tissues. Electronic search was conducted over PubMed, Google Scholar, Medline, Embase to find articles dealing with Implant abutment connection and platform switching. We came across a total of 248 articles, which were filtered to a cumulative 19 articles after cross matching with predetermined inclusion and exclusion criteria. Most of the available literature gravitates in favor of an internal connection with the incorporation of platform switching to attain satisfactory hard and soft tissue outcomes.
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Affiliation(s)
| | - Vinay Sivaswamy
- Department of Prosthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
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Bacterial infiltration and detorque at the implant abutment morse taper interface after masticatory simulation. Sci Rep 2022; 12:17103. [PMID: 36224228 PMCID: PMC9556662 DOI: 10.1038/s41598-022-20915-z] [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: 03/07/2022] [Accepted: 09/20/2022] [Indexed: 01/04/2023] Open
Abstract
This study evaluated the bacterial infiltration and the detorque of indexed and non-indexed abutments of Morse taper implants (MTI) after mechanical cycling (MC). 40 MTI were distributed into four groups: IIA (indexed implant abutments); NIIA (non-indexed implant abutments); IIAMC (indexed implant abutments submitted to MC); NIIAMC (non-indexed implant abutments submitted to MC), which were carried out under one million 5 Hz frequency and 3 Bar pressure. After mechanical cycling, all groups were immersed in a bacterial solution in Brain Heart Infusion Agar. After detorque, the bacteria infiltration was evaluated by counting the colony-forming units. For the bacterial infiltration, analysis was applied to the Kruskal-Wallis test (p = 0.0176) followed by Dunn's test. For the detorque analysis, the two-way repeated-measures ANOVA was applied, followed by the Tukey's test (p < 0.0001). Bacteria infiltration was highly observed in NIIA (p = 0.0027) and were absent in IIAMC and NIIAMC. The detorque values for IIA (19.96Ncm ± 0.19Ncm), NIIA (19.90Ncm ± 0.83Ncm), and NIIAMC (19.51Ncm ± 0,69Ncm) were similar and remained close to the initial value, while IIAMC (55.2Ncm ± 2.36Ncm) showed an extremely significant torque value increase (p < 0.0001). The mechanical cycling resulted in mechanical sealing of the implant-abutment interface, preventing bacterial infiltration in the indexed and non-indexed specimens, and increasing the detorque strength in the group of indexed abutments.
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Marginal Bone Loss in Internal Conical Connection Implants Placed at the Crestal and Subcrestal Levels before Prosthetic Loading: A Randomized Clinical Study. MATERIALS 2022; 15:ma15103729. [PMID: 35629754 PMCID: PMC9145780 DOI: 10.3390/ma15103729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/04/2022]
Abstract
The vertical position concerning the bone in which the implants are placed has been related as one of the factors causing marginal bone loss. The objective of this study was to evaluate the bone loss that occurs before prosthetic loading around tapered internal connection (CIC) implants placed at the crestal (C) and subcrestal (S) levels. Method: A randomized clinical trial (RCT) was carried out, with a sample size of 62 implants placed in 27 patients who underwent radiological controls on the day of placement, at one month, and at 4 months, and stability was measured by resonance frequency analysis (RFA) on three occasions. Results: Bone loss in implants C and S from the time of placement (T0) and the month after (T1) was not significant (p = 0.54) (C = 0.19 mm and S = 0.15 mm). The difference between one month (T1) and four months (T2) (C = 0.17 mm and S = 0.22 mm) was not significant either (p = 0.26). The difference between the day of placement (T0) and the third and last measurement (T2) was almost null (p = 0.94) (C = 0.35 mm and S = 0.36). The overall success rate of the implants was 97.8%. The stability of the implants measured with RFA went from 70.60 (T0) to 73.16 (T1) and 74.52 (T2). Conclusions: No significant differences were found in the bone loss for implants placed at the C and S levels. The millimeters of bone loss detected in both vertical positions did not have a significant impact on the stability of the implants.
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In Vitro Study of Preload Loss in Different Implant Abutment Connection Designs. MATERIALS 2022; 15:ma15041392. [PMID: 35207933 PMCID: PMC8879145 DOI: 10.3390/ma15041392] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
The stability and integrity of the abutment-implant connection, by means of a screw, is fallible from the moment the prosthetic elements are joined and is dependent on the applied preload, wear of the components and function. One of the main causes of screw loosening is the loss of preload. The loosening of the screw-abutment can cause complications such as screw fracture, marginal gap, peri-implantitis, bacterial microleakage, loosening of the crown and discomfort of the patient. It is also reported that loosening of the screw/abutment may lead to a failure of osseointegration. It is necessary to evaluate and quantify, with in vitro studies, the torque loss before and after loading in the different connections. Aim: evaluate the influence of implant- abutment connection design in torque maintenance after single tightening, multiple tightening and multiple tightening followed by mechanical cycling. Materials and Methods: 180 Klockner implants divided in 4 groups: 15 SK2 external connection, 25 Ncm tightening torque; 15 KL external connection, 30 Ncm tightening torque; 15 Vega internal connection, 25 Ncm tightening torque; 15 Essential internal connection, 30 Ncm tightening torque. In each group removal torque values (RTV) were evaluated with a digital torque meter, in 3 distinct phases: after one single tightening, 10 multiple tightenings and 10 multiple tightenings and cyclic loading (500 N × 1000 cycles). Results: After one single tightening, and for all connections, RTV were lower than those of insertion, but only for Essential and Vega internal connections this result was statistically significant. After multiple tightening, RTV were significantly lower in all connections. After repeated tightening followed by cyclic loading, mean RTV were significantly lower, when compared to insertion torque. The multiple tightening technique resulted in higher RTV than the single tightening technique, except for Vega implant. The multiple tightening followed by cyclic load, compared to the other phases, was the one that generated the lowest RTV, for all connections. Conclusions: The connection design, in our study, did not seem to influence the maintenance of preload. Loading influenced the loss of preload, in the sense that significantly decreased the removal torque values. The multiple re-tightening technique resulted in higher removal torque values than the single tightening technique. Clinically, our results recommend to retighten retaining screws, a few minutes after insertion.
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Shah AH, Patel P, Trivedi A, Shah A, Desai N, Talati M. A comparison of marginal bone loss, survival rate, and prosthetic complications in implant-supported splinted and nonsplinted restorations: A systematic review and meta-analysis. J Indian Prosthodont Soc 2022; 22:111-121. [PMID: 36511022 PMCID: PMC9132503 DOI: 10.4103/jips.jips_365_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim To compare marginal bone loss (MBL), implant survival rate and prosthetic complications of implant-supported splinted and non-splinted restorations (NSR). Settings and Design This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The PROSPERO registry, which keeps track of prospective systematic reviews, also received this paper (CRD42021229477). Material and Methods An electronic search was done in PubMed, the Cochrane Central Trials Register, Scopus, Science Direct, and Google Scholar searches were carried out. The search was limited to articles published in English and covered the period from January 2010 to August 2020. Statistical Analysis Used To conduct the meta analysis, researchers employed methodologies such as continuous measurement and odds ratios. Results For both qualitative and quantitative analysis, 19 scientific studies were chosen. 3682 implants were placed in 2099 patients with a mean age of 59 years (splinted, 2529; non-splinted, 1153); the mean age was not provided in 5 trials. For splinted restorations, there were statistically significant differences in MBL, indicating the former has less MBL than for NSR. Splinted restorations had much greater survival rates than NSR, according to a qualitative study. Rest prosthesis complications with or without splinting were essentially the same. Conclusions Splinted implant restorations lost less bone than non-splinted implant restorations, according to this meta analysis. This was particularly true for posterior restorations. Lower implant failure was associated with splinted restorations. Restorations with and without splinting had the same level of prosthetic problems.
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Affiliation(s)
- Aesha Harsh Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India,Address for correspondence: Dr. Aesha Harsh Shah, Department of Prosthodontics, Goenka Research Institute of Dental Science, Pethapur - Mahudi Road, Gandhinagar District, Near G.G.S, Piplaj, Ahmedabad, Gujarat - 382 610, India. E-mail:
| | - Pankaj Patel
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Aumkar Trivedi
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Adit Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Nikki Desai
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Mitangi Talati
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
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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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Bittencourt ABBC, Neto CLDMM, Penitente PA, Pellizzer EP, Dos Santos DM, Goiato MC. Comparison of the Morse Cone Connection with the Internal Hexagon and External Hexagon Connections Based on Microleakage - Review. Prague Med Rep 2021; 122:181-190. [PMID: 34606430 DOI: 10.14712/23362936.2021.15] [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] [Indexed: 10/20/2022] Open
Abstract
The gap formed at the abutment-implant interface brings about a bacterial colonization. In addition, a bacterial reservoir can be established within the implant. The build-up of microorganisms around the implant can cause soft tissue infections and bone loss around the implant, which can lead to implant failure. Our literature review aimed to evaluate the infiltration at the implant-abutment interface, comparing the Morse cone connection with the external hexagon and internal hexagon connections. A literature search using the PubMed database was performed on March 24, 2021. The search terms were combinations of "Morse cone" or "Morse taper" with each of the following terms (individually): "microleakage", "leakage", "infiltration", and "penetration". The inclusion criterion was in vitro studies comparing the Morse cone with the external hexagon and/or internal hexagon, based on infiltration at the implant-abutment interface. The exclusion criterion was the evaluation of microleakage at the implant-abutment interface after applying a sealant over this region. The search was expanded as needed. There was no limit on the year of publication, and only articles written in English were included. In addition, references cited in included articles were also included in this review when they were appropriate. This literature review concluded that, in most cases, the microleakage in the Morse cone connection was lower when compared with the external hexagon and internal hexagon connections.
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Affiliation(s)
| | | | - Paulo Augusto Penitente
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - Daniela Micheline Dos Santos
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
| | - Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil.
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15
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Asbi T, Hussein HA, Horwitz J, Gabay E, Machtei EE, Giladi HZ. A single application of chlorhexidine gel reduces gingival inflammation and interleukin 1-β following one-stage implant placement: A randomized controlled study. Clin Implant Dent Relat Res 2021; 23:726-734. [PMID: 34378862 DOI: 10.1111/cid.13041] [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] [Received: 05/24/2021] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Chlorhexidine (CHX) is a broad-spectrum antimicrobial agent commonly used in medicine. Application of (CHX) during abutment connection reduced the bacterial load at the implant-abutment interface. We hypothesize this treatment may consequently reduce peri-implant soft tissue inflammation and marginal bone loss. PURPOSE To evaluate the effect of a single application of CHX gel inside the dental implant internal hexagon on peri-implant tissue. METHODS Forty patients were recruited to this randomized, double-blinded, clinical trial. At the time of implant installation, a 4-mm healing abutment was connected to the implant. In the test group, chlorhexidine gel 1% was applied inside the implant hex, whereas control implants did not receive any gel. Clinical and radiographic measurements included soft tissue recession (REC), plaque index (PI), gingival index (GI), plaque index (PI), keratinized mucosa width (KM), probing depth (PD), and a peri-apical parallel x-ray. Peri-implant crevicular fluid (PICF) was collected for cytokine analysis. t-Test was used to compare changes from baseline to 3 months. Mann-Whitney U test and t test were used to compare test and control groups. RESULTS Twenty patients in the test group and 17 in the control group completed the study. One implant in the control group failed to osteointegrate. There were no significant differences between the control and test groups for REC changes, bone loss, and PD. GI was significantly lower in the test group after 1 week (1.79 ± 0.24 vs 0.75 ± 0.18, respectively) and 3 months (1.18 ± 0.21 vs 0.25 ± 0.12, respectively) although PI was equal. At 3 months, interleukin 1-β (IL1-β) was higher in the control group (p < 0.01) and a positive correlation was found between GI and IL1-β (rs = 0.60424, p = 0.00032). CONCLUSIONS Application of chlorhexidine gel reduced inflammation and IL1-β levels in the peri-implant soft tissue.
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Affiliation(s)
- Thabet Asbi
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel
| | - Hiba Abu Hussein
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Eran Gabay
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Eli E Machtei
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Hadar Zigdon Giladi
- Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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16
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Moergel M, Rocha S, Messias A, Nicolau P, Guerra F, Wagner W. Clinical and radiographic performance of self-locking conical connection implants in the posterior mandible: Five-year results of a two-centre prospective study. Clin Oral Implants Res 2021; 32:998-1007. [PMID: 34115893 PMCID: PMC8457113 DOI: 10.1111/clr.13794] [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: 09/25/2020] [Revised: 05/09/2021] [Accepted: 05/23/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This prospective study aims to assess the 5-year clinical performance of implants with internal conical connection and platform-switched abutments in the posterior mandible. MATERIAL AND METHODS Healthy adults missing at least two teeth in the posterior mandible and with a natural tooth mesial to the implant site received two or three adjacent implants. After a transmucosal healing period single crown restorations were cemented on platform-switched abutments. Changes in marginal bone levels were investigated in standardized periapical radiographs from surgery and loading (baseline) to 60-months post-loading. RESULTS Twenty-four patients received 52 implants. Bone remodelling took place between surgery and loading (mean:-0.5, SD:±0.4 mm). From loading to 60 months, there was a mean bone change of 0.27 (SD:±0.47 mm) which stabilized 24 months after prosthesis delivery (mean:0.2, SD:±0.46 mm). 71.7% of all implants presented bone preservation at 60 months irrespective of the initial insertion depth. Two implants were lost after 5 years and the success rate was 95.1%. Patient enquiry revealed high satisfaction. CONCLUSION Internal conical connection implants with platform-switched abutments presented a high success rate and preservation of marginal bone levels at the implant shoulder after 5 years of loading.
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Affiliation(s)
- Maximilian Moergel
- Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University Medical Centre, Mainz, Germany
| | - Salomão Rocha
- Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Messias
- Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Pedro Nicolau
- Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Fernando Guerra
- Department of Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery, Johannes Gutenberg-University Medical Centre, Mainz, Germany
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Tokgöz SE, Bilhan H. The influence of the implant-abutment complex on marginal bone and peri-implant conditions: A retrospective study. J Adv Prosthodont 2021; 13:46-54. [PMID: 33747394 PMCID: PMC7943754 DOI: 10.4047/jap.2021.13.1.46] [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: 10/26/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. MATERIALS AND METHODS A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. RESULTS The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P =.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P =.000). The position of the crown-abutment border showed a statisticallysignificant influence (P =.019) and a negative correlation (r=−0.395) on MBL. BoP was found significantly higher in PM implants (P =.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P =.523). The relation between PPD and connection type revealed no statistically significant influence (P >.05). CONCLUSION Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.
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Affiliation(s)
- Selen Ergin Tokgöz
- Private Dental Practice, Prosthodontist, Dentaglobal Oral Health Centre, Bayraklı/İzmir, Turkey
| | - Hakan Bilhan
- Department of Periodontology, School of Dentistry, Faculty of Health Witten/Herdecke University, Alfred-Herrhausen Str. 45, Witten, Germany
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18
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D’Addazio G, Sinjari B, Arcuri L, Femminella B, Murmura G, Santilli M, Caputi S. Mechanical Pull-Out Test of a New Hybrid Fixture-Abutment Connection: An In Vitro Study. MATERIALS 2021; 14:ma14061555. [PMID: 33810040 PMCID: PMC8004755 DOI: 10.3390/ma14061555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/06/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022]
Abstract
Implant abutment connection was described among the main causes of peri-implant bone resorption. The aim of this in vitro study was to test the coupling capacity, the surface modification of a new hybrid connection and the influence of repeated connection activations caused during the main clinical and laboratory phases. A total of 40 implant-abutment screw retained systems with 10°-conical and internal hexagon connection were tested. The connection was screwed, fixed to the universal test machine, removed the screw and a pull-out test was performed. Test was repeated five times in succession. Also Scanning Electron Microscopy (SEM) was used to detect microscopically surface modification. Analysis of variance and Tukey tests were used for the statistical analysis. Pull-out test reveals a mean value of 131.35 ± 16.52 Newton Centimeter (N·cm). For each single activation, results from first to fifth were: 113.9 ± 13.02, 126.1 ± 12.81, 138.11 ± 15.15, 138.8 ± 11.90 and 140 ± 12.99 N·cm. A statistically significant difference between the measurements and an increase in the removal force was shown. The collected data supports the use of this new type of connection, resulting in a very strong interface between implant and abutment. Also, repeated activation of connection can promote a better coupling of the implant-abutment interface.
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Affiliation(s)
- Gianmaria D’Addazio
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
- Correspondence: ; Tel.: +393-922-7471479; Fax: +390-8713-554070
| | - Lorenzo Arcuri
- Department of Oral and Maxillo-Facial Sciences, “Sapienza”, University of Rome, 00185 Rome, Italy;
| | - Beatrice Femminella
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
| | - Manlio Santilli
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
| | - Sergio Caputi
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (G.D.); (B.F.); (G.M.); (M.S.); (S.C.)
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Cytotoxic effects of submicron- and nano-scale titanium debris released from dental implants: an integrative review. Clin Oral Investig 2021; 25:1627-1640. [PMID: 33616805 DOI: 10.1007/s00784-021-03785-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This integrative review aimed to report the toxic effect of submicron and nano-scale commercially pure titanium (cp Ti) debris on cells of peri-implant tissues. MATERIALS AND METHODS A systematic search was carried out on the PubMed electronic platform using the following key terms: Ti "OR" titanium "AND" dental implants "AND" nanoparticles "OR" nano-scale debris "OR" nanometric debris "AND" osteoblasts "OR "cytotoxicity" OR "macrophage" OR "mutagenic" OR "peri-implantitis". The inclusion criteria involved articles published in the English language, until December 26, 2020, reporting the effect of nano-scale titanium particles as released from dental implants on the toxicity and damage of osteoblasts. RESULTS Of 258 articles identified, 14 articles were selected for this integrative review. Submicron and nano-scale cp Ti particles altered the behavior of cells in culture medium. An inflammatory response was triggered by macrophages, fibroblasts, osteoblasts, mesenchymal cells, and odontoblasts as indicated by the detection of several inflammatory mediators such as IL-6, IL-1β, TNF-α, and PGE2. The formation of a bioactive complex composed of calcium and phosphorus on titanium nanoparticles allowed their binding to proteins leading to the cell internalization phenomenon. The nanoparticles induced mutagenic and carcinogenic effects into the cells. CONCLUSIONS The cytotoxic effect of debris released from dental implants depends on the size, concentration, and chemical composition of the particles. A high concentration of particles on nanometric scale intensifies the inflammatory responses with mutagenic potential of the surrounding cells. CLINICAL RELEVANCE Titanium ions and debris have been detected in peri-implant tissues with different size, concentration, and forms. The presence of metallic debris at peri-implant tissues also stimulates the migration of immune cells and inflammatory reactions. Cp Ti and TiO2 micro- and nano-scale particles can reach the bloodstream, accumulating in lungs, liver, spleen, and bone marrow.
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Montero J. A Review of the Major Prosthetic Factors Influencing the Prognosis of Implant Prosthodontics. J Clin Med 2021; 10:jcm10040816. [PMID: 33671394 PMCID: PMC7921991 DOI: 10.3390/jcm10040816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The treatment plan of prosthetic restorations supported by dental implants requires comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS * OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%), or prospective evaluations of prosthesis with various kinds of events (18%). However, narrative reviews of literature (14%) and in vitro/animal studies (16%) were also found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.
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Affiliation(s)
- Javier Montero
- Department of Surgery, University of Salamanca, 37007 Salamanca, Spain
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21
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Sicilia A, Gallego L, Sicilia P, Mallo C, Cuesta S, Sanz M. Crestal bone loss associated with different implant surfaces in the posterior mandible in patients with a history of periodontitis. A retrospective study. Clin Oral Implants Res 2021; 32:88-99. [PMID: 33210774 DOI: 10.1111/clr.13682] [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] [Received: 05/03/2020] [Revised: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To retrospectively assess the interproximal bone loss (CBL) in external hexagon implants (EHI), with different surface micro-topography, placed in the posterior mandible in patients with a history of periodontitis undergoing supportive periodontal care. MATERIAL AND METHODS 268 consecutive patients received 755 EHI implants in the mandibular molar region between 2007 and 2015 with the following surface characteristics: 72 turned, 145 hybrids (double acid-etched/turned), and 538 anodized. CBL was yearly evaluated by analysing calibrated digital periapical radiographs, with a follow-up of 1-6 years. Data on implant survival were also calculated. RESULTS At 6 years (53 patients), the mean CBL was 1.34/1.42 mm at patient/implant level, respectively (range: 0-5.2 mm). Significantly higher CBL was detected in anodized implants than in turned and hybrid implants (1.92/1.46/1.02 mm) (p < .01). The maximum CBL values were found in 2 anodized implants at 4 years (6.3 and 8.1 mm). CBL ≥2 mm was detected in 18% of implants at 3 years and 35% at 6 (p < 2.2 × 10-16 ), this prevalence being 2.6 times higher in the anodized than in the hybrid and turned group (40%/15.6%, p < .0094). At 6 years, 25 anodized implants presented CBL ≥3 mm (18%). 6 anodized implants (5 patients) were removed between 4 and 5 years. CONCLUSION A significant higher CBL was observed in anodized, compared to hybrid and turned implants, when placed in the mandibular molar region of periodontal patients, with a follow-up of 1 to 6 years.
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Affiliation(s)
- Alberto Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Luis Gallego
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Pelayo Sicilia
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Carmen Mallo
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Susana Cuesta
- Section of Periodontology, Faculty of Health Sciences, University Clinic of Odontology, University of Oviedo, Oviedo, Spain
| | - Mariano Sanz
- Faculty of Odontology, ETEP Research Group, University Complutense of Madrid, Madrid, Spain
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Yu P, Zhi Li, Tan X, Yu H. Effect of sealing gel on the microleakage resistance and mechanical behavior during dynamic loading of 3 implant systems. J Prosthet Dent 2020; 127:308-317. [PMID: 33246561 DOI: 10.1016/j.prosdent.2020.05.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM Sealing products have been produced to reduce microleakage at the implant abutment interface. However, little is known about their effectiveness and any alterations in mechanical behavior of implant systems with their application. PURPOSE The purpose of this in vitro study was to evaluate the effect of a silicone sealing gel on implant abutment interface microleakage, abutment screw torque loss, and thread wear of implant systems in a simulated oral environment. MATERIAL AND METHODS Five specimens each of 3 implants systems (Nobel, Straumann, and WEGO) that included sealed and unsealed groups were analyzed (N=30). Before assembling the components, toluidine blue solution was injected to the implant intaglio cavity to evaluate implant abutment interface microleakage. After tightening to the recommended torque, 20 to 200 N of 30-degree off-axis dynamic force was applied at 2 Hz for 48 hours. The toluidine blue solution was extracted to test optical density values at 1, 3, 9, 24, 33, and 48 hours. Detorque values were measured before and after cycling loading, and torque loss rates were calculated. The abutment screw morphologies were observed by using scanning electron microscopy. The coefficient of friction tendency of applying sealing gel was explored with a ball-on-flat configuration. One-way ANOVA and Student t test were used for statistical analysis (α=.05). RESULTS The optical density value increased with the loading time, especially for Straumann group. The sealing gel decreased the implant abutment interface microleakage of Straumann assemblies after cyclic loading of 9 hours (P=.044), whereas no statistical difference was found for Nobel (P=.140) or WEGO groups (P=.402) at 6 time points. Torque loss occurred during tightening and further increased after dynamic cyclic load in each group. Among the 3 implant systems, Straumann implants reported the best antiloosening property (P<.001). The application of sealing gel reduced the initial (P=.048) and final (P=.032) torque loss rate in all the 3 systems. Scanning electron microscopy observations revealed the bottom thread tended to have more abrasion than the first thread. After applying sealing gel, less thread abrasion was found in Nobel and WEGO assemblies, whereas the protective effect was not evident for the Straumann group. The coefficient of friction of sealed group (0.17 ±0.026) was significantly (P=.012) lower than that of unsealed group (0.24 ±0.044). CONCLUSIONS The silicone sealing gel improved the immediate fastening and long-term antiloosening performances of 3 implant systems, decreased the implant abutment interface microleakage of Straumann system, and reduced abutment screw thread abrasion of the Nobel and WEGO systems.
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Affiliation(s)
- Ping Yu
- Doctoral candidate, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Zhi Li
- Resident Doctor, Aerospace Center Hospital, Beijing, PR China
| | - Xin Tan
- Doctoral candidate, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Haiyang Yu
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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Vinhas AS, Aroso C, Salazar F, López-Jarana P, Ríos-Santos JV, Herrero-Climent M. Review of the Mechanical Behavior of Different Implant-Abutment Connections. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228685. [PMID: 33238476 PMCID: PMC7700386 DOI: 10.3390/ijerph17228685] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022]
Abstract
Introduction: Different implant-abutment connections have been developed to reduce mechanical and biological failure. The most frequent complications are loss of preload, screw loosening, abutment or implant fracture, deformations at the different interfaces, and bacterial microleakage. Aim: To review the evidence indicating whether the implant-abutment connection type is significant regarding the following issues: (1) maintenance of the preload in static and dynamic in vitro studies; (2) assessment of possible deformations at the implant-abutment interfaces, after repeated application of the tightening torque; (3) evaluation of the sealing capability of different implant connections against microleakage. Materials and Methods: In June 2020, an electronic literature search was performed in Medline, EBSCO host, and PubMed databases. The search was focused on the ability of different implant connections to maintain preload, resist deformation after tightening and retightening, and prevent microleakage. The related titles and abstracts available in English were screened, and the articles that fulfilled the inclusion criteria were selected for full-text reading. Results: The literature search conducted for this review initially resulted in 68 articles, among which 19 articles and 1 systematic review fulfilled the criteria for inclusion. The studies were divided according to the three proposed objectives, with some studies falling into more than one category (maintenance of preload, surface abutment-implant deformation, and resistance to microleakage). Conclusions: Conical abutment appears to result in fewer mechanical complications, such as screw loosening or fractures, and higher torque preservation. After SEM evaluation, damage was observed in the threads of the abutment screws, before and after loading in internal and external connections. Internal hexagon implants and predominantly internal conical (Morse taper) implants showed less microleakage in dynamic loading conditions. We suggest further studies to guarantee excellence in methodological quality.
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Affiliation(s)
- Ana Sofia Vinhas
- Department of Periodontology, Instituto Universitário de Ciências da Saúde, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (P.L.-J.)
| | - Carlos Aroso
- Department of Prosthodontics, Instituto Universitário de Ciências da Saúde, 4585-116 Gandra, Portugal;
| | - Filomena Salazar
- Department of Periodontology, Instituto Universitário de Ciências da Saúde, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (P.L.-J.)
| | - Paula López-Jarana
- Department of Periodontology, Instituto Universitário de Ciências da Saúde, 4585-116 Gandra, Portugal; (A.S.V.); (F.S.); (P.L.-J.)
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain
- Correspondence: ; Tel.: +34-954-481-121; Fax: +34-954-481-157
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Marginal Bone Loss in Implants with External Connection versus Internal Conical Connection Prior to Prosthetic Loading. A Randomized Clinical Study. COATINGS 2020. [DOI: 10.3390/coatings10111044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The prosthetic connection of implants has been related to the loss of marginal bone. The aim of this study was to evaluate bone loss around external connection (EC) and internal conical connection (ICC) implants prior to prosthetic loading. Material and methods: A randomized clinical trial (RCT) was carried out, with a sample size of 93 implants (31 EC and 62 ICC) placed in 27 patients. Radiological controls were performed and stability was measured by resonance frequency analysis (RFA) on the day of placement, at 1 month and at 4 months after the placement. Results: Bone loss in EC implants was not statistically different than in ICC implants between the time of placement (T0) and the subsequent month (T1): (EC = 0.18 mm and ICC = 0.17 mm). Between one month (T1) and four months (T2): (EC = 0.39 mm and ICC = 0.19 mm) this difference was highly significant (p = 0.00). Bone loss between T0 and T2 was significantly lower in the ICC (EC = 0.57 mm and ICC = 0.36 mm), (p = 0.01). The overall success rate of the implants was 97.8%. The stability of the implants increased from 70.69 (T0) to 73.91 (T1) and 75.32 (T2). Conclusions: ICC showed less bone loss up to the time of prosthesis placement. Such bone loss did not have a significant impact on bone stability. Long term RCTs are needed to demonstrate whether this bone loss, which is more pronounced at the beginning in EC, tends to stabilize and equate to ICC.
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Al-Sawaf O, Tuna T, Rittich A, Kern T, Wolfart S. Randomized clinical trial evaluating the effect of splinting crowns on short implants in the mandible 3 years after loading. Clin Oral Implants Res 2020; 31:1061-1071. [PMID: 33463774 DOI: 10.1111/clr.13652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To compare the radiographic marginal bone loss and clinical parameters of splinted and non-splinted fixed dental prostheses on short implants in the posterior region of the lower jaw 3 years after loading. MATERIAL AND METHODS Twenty patients, 15 female and five males, with uni- or bilateral free-end situations in the mandible participated in the study. Two short implants (7 mm) in the posterior mandible were placed and patients were randomized to receive splinted (n = 11) or non-splinted (n = 13) cemented crowns. Marginal bone loss (MBL) was assessed on radiographs taken with customized positioning jigs at baseline, 1 and 3 years after loading. Plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were measured. (ClinicalTrials.gov; identifier: NCT03558347). RESULTS After 3-year survival rate of altogether 48 implants was 100% for both groups. Success rate (according to Papaspyridakos, Chen, Singh, Weber, & Gallucci, 2012) was 84.6% for non-splinted and 86.4% for splinted implants. At restoration level survival rate was 100% for both groups. Marginal bone level changes showed mean gain of 0.3 ± 0.8 mm for non-splinted and 0.1 ± 0.5 mm for splinted implants 3 years after loading. Statistical analysis showed no significant difference in PI, GI, PD, BOP, and marginal bone loss between both groups (p > .05). CONCLUSION Within the limitations of this study it can be concluded that splinting crowns on short implants neither seems to affect the amount of marginal bone loss nor peri-implant health 3 years after loading.
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Affiliation(s)
- Omar Al-Sawaf
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Thomas Kern
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
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Farronato D, Pasini PM, Orsina AA, Manfredini M, Azzi L, Farronato M. Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study. MATERIALS 2020; 13:ma13030511. [PMID: 31973195 PMCID: PMC7040578 DOI: 10.3390/ma13030511] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/14/2020] [Accepted: 01/19/2020] [Indexed: 02/07/2023]
Abstract
Background: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue maturation during three years of follow-up. Methods: Seventy-eight implants were enrolled in the present study. The BBT was assessed at the surgical stage and each case assigned to Group 1 (BBT values ≤0.5 mm), Group 2 (BBT values >0.5 and <1.5 mm), or Group 3 (BBT values ≥1.5 mm). Only native bone and healed sites were included. The tooth height (TH), based on the distance between the buccal free gingival margin at the zenith level and the crown incisal edge, according to the main axis of the tooth, was monitored at one, two, and three years from the final prosthodontic rehabilitation to determine any occurrence of recession or coronal repositioning of the gums over time. A Pearson Two-Tailed test was applied and the significance level set at p ≤ 0.05. Results: For BBT values ≤0.5 mm, the buccal gum at three years showed an average recession of 1.22 ± 0.41 mm. For BBT values >0.5 and <1.5 mm, the buccal gum also showed recession of 0.64 ± 0.29 mm. In contrast, for BBT values ≥1.5 mm, the buccal gum showed coronal growth of 0.77 ± 0.22 mm. The differences between the groups were significant (p ≤ 0.01) at all times. Conclusion: The BBT at the time of implant placement was found to affect the buccal gingival margin stability over three years of observation.
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Affiliation(s)
- Davide Farronato
- School of Dentistry, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (P.M.P.); (A.A.O.)
| | - Pietro Mario Pasini
- School of Dentistry, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (P.M.P.); (A.A.O.)
| | - Andrea Alain Orsina
- School of Dentistry, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy; (D.F.); (P.M.P.); (A.A.O.)
| | | | - Lorenzo Azzi
- Department of Medicine and Surgery, University of Insubria, Unit of Oral Pathology, Dental Clinic, ASST dei Sette Laghi, 21100 Varese, Italy;
| | - Marco Farronato
- IRCCS Fondazione Cà Granda, University of Milan, Via Francesco Sforza 28, 20122 Milan, Italy;
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Meijndert CM, Raghoebar GM, Santing HJ, Vissink A, Meijer HJA. Performance of bone-level implants with conical connections in the anterior maxilla: A 5-year prospective cohort study. Clin Oral Implants Res 2019; 31:173-180. [PMID: 31677294 DOI: 10.1111/clr.13553] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 10/16/2019] [Accepted: 10/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess clinical, radiographic and aesthetic outcomes, and satisfaction of patients treated with single implant restorations in the maxillary aesthetic region 5 years after final restoration. MATERIAL AND METHODS Sixty patients (29 male/31 female, mean age 37 years) with a missing anterior tooth in the maxilla (39 central incisors/10 lateral incisors/5 cuspids/6 first premolars) received a bone-level implant with conical connection. In 29 patients, a bone augmentation procedure was necessary before implant placement (autogenous bone grafts mixed with spongiosa granules). All implants (12 with 3.3 mm diameter/ 48 with 4.1 mm diameter) were loaded after 3 months of submerged healing. The restoration consisted of an individually designed full-zirconia abutment veneered with porcelain. Follow-up with clinical and radiographic assessment was conducted until 60 months after the final restoration. Aesthetic outcome of the restoration was determined with the Pink Esthetic Score-White Esthetic Score (PES-WES). Patient satisfaction was assessed with a VAS scale and satisfaction questionnaire. RESULTS Fifty patients completed the 5-year follow-up. Implant survival was 100%, restoration survival 98%. Mean bone-level change was -0.13 ± 0.66 mm with a median (IQR) pocket probing depth of 2.75 [2.25; 3.25]. The mean PES and WES scores were 6.6 ± 1.7 and 7.8 ± 1.5, respectively. Patient satisfaction was high (92.1 ± 7.8 on 100 mm VAS scale). There were no differences between patients with or without a bone augmentation procedure. CONCLUSION Bone-level implants with a conical connection are a reliable treatment option in single-tooth replacements in the maxillary aesthetic zone.
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Affiliation(s)
- Caroliene M Meijndert
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Gerry M Raghoebar
- Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Hendrik J Santing
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Arjan Vissink
- Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Jung WK, Lee WS, Kwon HB. Effects of abutment screw preload in two implant connection systems: A 3D finite element study. J Prosthet Dent 2019; 122:474.e1-474.e8. [DOI: 10.1016/j.prosdent.2019.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 10/25/2022]
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External Connection versus Internal Connection in Dental Implantology. A Mechanical in vitro Study. METALS 2019. [DOI: 10.3390/met9101106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Background: In today's dentistry, implantology has become a therapeutic resource of choice in certain clinical situations. The design of implants has evolved in several aspects since their inception. Dental implants were initially designed with an external hex connection, although due to force transmission and security in the adjustment of the prosthesis, later implants featured an internal hex connection. This study aims to analyse the mechanical properties of two types of implants (an internal connection and an external connection) from the same manufacturer and their different prosthetic components (union screw between implant and prosthetic abutment, and the abutment itself) when subjected to different types of load. (2) Materials and methods: Intraosseous dental implants of similar shape, design and size, although different in type of connection (external vs. internal), were studied. The specifications of the UNI EN ISO 14801 test standard were used, with all determinations being carried out three times. Finally, the dimensional characterisation of the samples analysed after the dynamic load study was carried out, and the values of both study groups were compared by means of the non-parametric Mann–Whitney U test to find statistically significant differences (p < 0.05). (3) Results: For the static characterisation test, we found between 610.9 N and 986.1 N for the external connection and between 1263.6 N and 1324 N for the internal connection (p = 0.011). All of the dynamic load tests were positive and there was no failure in any of the components studied. (4) Conclusions: After the analysis of the samples studied in vitro, satisfactory results were obtained, demonstrating that both connections can support considerable mechanical loads according to international standards (UNI EN ISO 14801).
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do Nascimento C, Nogueira Fernandes FHC, Teixeira W, Pedrazzi V. Iodoform and silver-coated abutments preventing bacterial leakage through the implant-abutment interfaces: In vitro analysis using molecular-based method. Arch Oral Biol 2019; 105:65-71. [PMID: 31276940 DOI: 10.1016/j.archoralbio.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/06/2019] [Accepted: 06/26/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the effectiveness of an iodoform paste and silver-coated abutments in preventing the microbial colonization and leakage through the implant-abutment interface of morse taper and internal hexagon implants. MATERIAL AND METHODS Seventy-two implants with morse taper (n = 36) or internal hexagon connections (n = 36) were investigated. Implants were treated with iodoform paste (n = 12), silver-coated abutments (n = 12), or control (n = 12). After saliva incubation, Checkerboard DNA-DNA hybridization was used to identify and quantify up to 43 microbial species colonizing the inner parts of the implants. ANOVA-Type and Wald-Type analyses of variance were used to investigate the relative effects and their interaction. Friedman- Conover test adjusted by Benjamini-Hockberg FDR were performed for pairwise multiple comparisons. Significance was set as p < 0.05. RESULTS Analyses of variance indicate a significant interaction between connections, antimicrobial treatments, and species. The frequency of contamination was reduced in the implants submitted to the antimicrobial treatments. Iodoform and silver-coated abutments significantly reduced the total microbial counts in the internal hexagon implants. The lower microbial counts were recorded for morse taper implants with silver-coated abutments. CONCLUSIONS Iodoform paste and silver-coated abutments have influenced the microbial leakage through the implant-abutment interface, by reducing both frequency of contamination and microbial levels. Treatments were not effective in reducing the counts of the target species.
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Affiliation(s)
- Cássio do Nascimento
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | - Wendel Teixeira
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
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He Y, Fok A, Aparicio C, Teng W. Contact analysis of gap formation at dental implant-abutment interface under oblique loading: A numerical-experimental study. Clin Implant Dent Relat Res 2019; 21:741-752. [PMID: 31087510 DOI: 10.1111/cid.12792] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/25/2019] [Accepted: 04/23/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To develop numerical and experimental methods for investigating the formation of micro-gaps and the change in contact area at the implant-abutment interface of two different connector designs under oblique cyclic loading. MATERIALS AND METHODS Samples (n = 10 per group) of two-piece implant systems with the conical connection (group A) and the external hexagonal connection (group B) were subjected to cyclic loading with increasing load amplitudes up to 220 N. After loading, the samples were scanned using micro-CT, with silver nitrate as a high-contrast penetrant, and the level of leakage was assessed using a discrete scoring system. Three-dimensional finite element (FE) analyses of the two implant systems were also conducted to reveal the micro-gap formation process, especially bridging of the internal abutment screw space. The experimental and numerical results for the bridging load were then compared. RESULTS 90% of the samples in group A showed leakage into the internal implant space at a load of around 100 N; while over 80% of those in group B did so at a load of around 40 N. This agreed with the FE analysis, which showed bridging of the internal implant space at loads similar to those measured for the two implant systems. Residual gaps of less than 1.49 μm were predicted for group A only after unloading. CONCLUSIONS The FE-predicted loads for bridging agreed well with those found experimentally for leakage to occur. The conical connection showed more resistance against formation of micro-gaps at the implant-abutment interface than the external hexagonal connection. Although the minimum load required to bridge the internal implant space was within the range of human biting force, the relation between bacterial invasion and micro-gaps needs further research.
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Affiliation(s)
- Yiting He
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People's Republic of China
| | - Alex Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Conrado Aparicio
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Wei Teng
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People's Republic of China
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Lee DW, Kim NH, Lee Y, Oh YA, Lee JH, You HK. Implant fracture failure rate and potential associated risk indicators: An up to 12-year retrospective study of implants in 5,124 patients. Clin Oral Implants Res 2019; 30:206-217. [PMID: 30672029 DOI: 10.1111/clr.13407] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study investigated fracture rates and risk indicators for fractures in internal connection dental implants. MATERIAL AND METHODS We performed a retrospective analysis of 19,006 internal connection implants used in fixed restoration in 5,124 patients (4,570 males, 554 females) at the Dental Hospital of Veterans Health Service Medical Center between 2006 and 2015. Patients were followed through June 2018 (0.03-12.39 years post-installation). Clinical factors (age, sex, implant diameter, implant length, placement site, bone graft, fixture material, cervical feature, abutment connection, microthread, and platform switching) were recorded. Kaplan-Meier survival analysis identified risk indicators associated with an implant fracture. Cox regression models elucidated potential fracture risks. RESULTS One hundred and seventy-four implants fractured in 135 patients, for an incidence rate of 0.92% after an average of 4.95 ± 2.14 years of use. Kaplan-Meier estimates showed that the 3-, 5-, and 10-year survival rates of implants were 99.8%, 99.2%, and 97.7%, respectively. In the multivariable Cox regression model, the diameter, location, history of bone graft, and microthread presence were significantly correlated with implant fractures. Wide-diameter implants had a reduced fracture risk within 90 months, after which the diameter did not correlate with fractures. Implants placed in the anterior mandible had a lower fracture risk within 90 months; mandibular premolar implants corresponded with a lower risk after 90 months. Implants without a history of bone graft or microthreads were more likely to fracture throughout the follow-up time. CONCLUSIONS These results elucidate risk indicators for implant fractures and facilitate their reduction in clinical practice.
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Affiliation(s)
- Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Na-Hong Kim
- Department of Prosthodontics, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Young Lee
- Research Institute of Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Yeon-Ah Oh
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
| | - Hyung-Keun You
- Department of Periodontology, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
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Wachtel A, Zimmermann T, Sütel M, Adali U, Abou-Emara M, Müller WD, Mühlemann S, Schwitalla AD. Bacterial leakage and bending moments of screw-retained, composite-veneered PEEK implant crowns. J Mech Behav Biomed Mater 2018; 91:32-37. [PMID: 30529984 DOI: 10.1016/j.jmbbm.2018.11.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
Due to its elastic modulus close to bone, the high-performance material PEEK (polyetheretherketone) represents an interesting material for implant-supported dental prostheses. Besides a damping effect of masticatory forces, it might have a sealing effect against bacterial leakage of the implant-abutment interface (IAI). So far, PEEK has only been used for provisional implant crowns. Therefore, the aim of the study was the evaluation of the bacterial tightness of screw-retained PEEK crowns on titanium implants with conical IAI during masticatory simulation and subsequent bending moment testing. Ten screw-retained implant crowns in the shape of an upper central incisor consisting of a PEEK crown framework veneered with composite were connected to NobelActive RP titanium implants (4.3 × 11.5 mm, Nobel Biocare AB, Göteborg, Sweden) with a tightening torque of 15 Ncm. Prior to tightening, the interior of the implant was inoculated with a bacterial suspension of Enterococcus faecium. The specimens were overmolded with indicating agar (Kanamycin-Aesculin-Azid-Agar (KAAA), Oxoid Limited, Basingstoke United Kingdom), that turns black in contact with E. faecium. The specimens were subjected to a cyclic masticatory simulation whereby a force of 50 N cm was applied at an angle of 30° to the implant axis for 1.2 million cycles. Afterwards, the specimens were subjected to a static loading test according to ISO 14801:2007 to determine the bending moment. During masticatory simulation neither a loosening of the implant screws nor any damage to the veneer or the PEEK framework occurred. Furthermore, no bacterial leakage could be observed in any of the specimens. The average maximum bending moment was measured at 352.13 ± 48.96 N cm. Regarding masticatory forces, PEEK implant crowns seem to be applicable as definitive implant-supported restorations. Furthermore, the bacterial tightness of the IAI of screw-retained one-piece PEEK implant crowns is advantageous compared to superstructures of conventional materials. Further studies are necessary to substantiate the clinical significance of these findings.
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Affiliation(s)
- Andreas Wachtel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Tycho Zimmermann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Mona Sütel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Ufuk Adali
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Mohamad Abou-Emara
- Beuth University of Applied Sciences, Luxemburger Str. 10, 13353 Berlin, Germany
| | - Wolf-Dieter Müller
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Sven Mühlemann
- University of Zurich, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Plattenstrasse 11, 8032 Zürich, Switzerland
| | - Andreas Dominik Schwitalla
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
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BASTOS JMC, BORDIN D, VASCONCELLOS AAD, MIRANDA ME. Influence of cantilever position and implant connection in a zirconia custom implant-supported fixed partial prosthesis: in silico analysis. REVISTA DE ODONTOLOGIA DA UNESP 2018. [DOI: 10.1590/1807-2577.06718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction A better tension distribution on implants and abutments in implant-supported fixed partial prosthesis is essential in the rehabilitation of posterior mandible area. Objective: To evaluate the influence of cantilever position and implant connection in a zircônia custom implant-supported fixed partial prosthesis using the 3-D finite element method. Material and method: Four models were made based on tomographic slices of the posterior mandible with a zirconia custom three-fixed screw-retained partial prosthesis. The investigated factors of the in silico study were: cantilever position (mesial or distal) and implant connection (external hexagon or morse taper). 100 N vertical load to premolar and 300 N to molar were used to simulate the occlusal force in each model to evaluate the distribution of stresses in implants, abutments, screws and cortical and cancellous bone. Result: The external hexagon (EH) connection showed higher cortical compression stress when compared to the morse taper (MT). For both connections, the molar cantilever position had the highest cortical compression. The maximum stress peak concentration was located at the cervical bone in contact with the threads of the first implant. The prosthetic and abutment screws associated with the molar cantilevers showed the highest stress concentration, especially with the EH connection. Conclusion: Morse taper implant connetions associated with a mesial cantilever showed a more favorable treatment option for posterior mandible rehabilitation.
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de Souza Batista VE, Verri FR, Lemos CAA, Cruz RS, Oliveira HFF, Gomes JML, Pellizzer EP. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2018; 121:41-51. [PMID: 29961632 DOI: 10.1016/j.prosdent.2018.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 10/28/2022]
Abstract
STATEMENT OF PROBLEM The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. MATERIAL AND METHODS This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was "Should the restoration of adjacent implants be splinted or nonsplinted?" The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. RESULTS Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. CONCLUSIONS Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure.
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Affiliation(s)
- Victor E de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil.
| | - Fellippo R Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ronaldo S Cruz
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Hiskell F F Oliveira
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica M L Gomes
- Graduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo P Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
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Kim DH, Kim HJ, Kim S, Koo KT, Kim TI, Seol YJ, Lee YM, Ku Y, Rhyu IC. Comparison of marginal bone loss between internal- and external-connection dental implants in posterior areas without periodontal or peri-implant disease. J Periodontal Implant Sci 2018; 48:103-113. [PMID: 29770239 PMCID: PMC5944221 DOI: 10.5051/jpis.2018.48.2.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 04/22/2018] [Indexed: 11/08/2022] Open
Abstract
Purpose The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. Methods This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. Results A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P<0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. Conclusions IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.
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Affiliation(s)
- Dae-Hyun Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Hyun Ju Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Gallego L, Sicilia A, Sicilia P, Mallo C, Cuesta S, Sanz M. A retrospective study on the crestal bone loss associated with different implant surfaces in chronic periodontitis patients under maintenance. Clin Oral Implants Res 2018; 29:557-567. [DOI: 10.1111/clr.13153] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Luis Gallego
- Section of Periodontology; Faculty of Medicine and Health Sciences; University Clinic of Odontology; University of Oviedo; Oviedo Spain
| | - Alberto Sicilia
- Section of Periodontology; Faculty of Medicine and Health Sciences; University Clinic of Odontology; University of Oviedo; Oviedo Spain
| | - Pelayo Sicilia
- International University of Cataluña (UIC); Barcelona Spain
| | - Carmen Mallo
- Section of Periodontology; Faculty of Medicine and Health Sciences; University Clinic of Odontology; University of Oviedo; Oviedo Spain
| | - Susana Cuesta
- Section of Periodontology; Faculty of Medicine and Health Sciences; University Clinic of Odontology; University of Oviedo; Oviedo Spain
| | - Mariano Sanz
- Periodontology; Faculty of Odontology; University Complutense of Madrid; Madrid Spain
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Schwitalla AD, Zimmermann T, Spintig T, Abou-Emara M, Lackmann J, Müller WD, Houshmand A. Maximum insertion torque of a novel implant-abutment-interface design for PEEK dental implants. J Mech Behav Biomed Mater 2017; 77:85-89. [PMID: 28898725 DOI: 10.1016/j.jmbbm.2017.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 11/25/2022]
Abstract
Frequent reports attest to the various advantages of tapered implant/abutment interfaces (IAIs) compared to other types of interfaces. For this reason, a conical IAI was designed as part of the development of a PEEK (polyetheretherketone)-based dental implant. This IAI is equipped with an apically displaced anti-rotation lock with minimal space requirements in the form of an internal spline. The objective of this study was the determination of the average insertion torque (IT) at failure of this design, so as to determine its suitability for immediate loading, which requires a minimum IT of 32Ncm. 10 implants each made of unfilled PEEK, carbon fiber reinforced ("CFR") PEEK (> 50vol% continuous axially parallel fibers) as well as of titanium were produced and tested in a torque test bench. The average IT values at failure of the unfilled PEEK implants were measured at 22.6 ± 0.5Ncm and were significantly higher than those of the CFR-Implants (20.2 ± 2.5Ncm). The average IT values at failure of the titanium specimens were significantly higher (92.6 ± 2.3Ncm) than those of the two PEEK variants. PEEK- and CFR-PEEK-implants in the present form cannot adequately withstand the insertion force needed to achieve primary stability for immediate loading. Nevertheless, the achievable torque resilience of the two PEEK-variants may be sufficient for a two-stage implantation procedure. To improve the torque resistance of the PEEK implant material the development of a new manufacturing procedure is necessary which reinforces the PEEK base with continuous multi-directional carbon fibers as opposed to the axially parallel fibers of the tested PEEK compound.
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Affiliation(s)
- Andreas Dominik Schwitalla
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Tycho Zimmermann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Tobias Spintig
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Mohamed Abou-Emara
- Beuth University of Applied Sciences, Luxemburger Str. 10, 13353 Berlin, Germany
| | - Justus Lackmann
- Beuth University of Applied Sciences, Luxemburger Str. 10, 13353 Berlin, Germany
| | - Wolf-Dieter Müller
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
| | - Alireza Houshmand
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
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Apaza-Bedoya K, Tarce M, Benfatti CAM, Henriques B, Mathew MT, Teughels W, Souza JCM. Synergistic interactions between corrosion and wear at titanium-based dental implant connections: A scoping review. J Periodontal Res 2017; 52:946-954. [DOI: 10.1111/jre.12469] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 01/15/2023]
Affiliation(s)
- K. Apaza-Bedoya
- Center for Research on Dental Implants (CEPID); Post-Graduate Program in Dentistry (PPGO); School of Dentistry (ODT); Federal University of Santa Catarina (UFSC); Florianopolis Brazil
| | - M. Tarce
- Department of Oral Health Sciences; University Hospitals Leuven; Katholieke Universiteit Leuven; Leuven Belgium
| | - C. A. M. Benfatti
- Center for Research on Dental Implants (CEPID); Post-Graduate Program in Dentistry (PPGO); School of Dentistry (ODT); Federal University of Santa Catarina (UFSC); Florianopolis Brazil
| | - B. Henriques
- Center for Research on Dental Implants (CEPID); Post-Graduate Program in Dentistry (PPGO); School of Dentistry (ODT); Federal University of Santa Catarina (UFSC); Florianopolis Brazil
- Center for Microelectromechanical Systems (CMEMS); University of Minho; Guimarães Portugal
| | - M. T. Mathew
- Department of Biomedical Science; University of Illinois (UIC) School of Medicine; Rockford IL USA
- Department of Restorative Dentistry; University of Illinois (UIC) College of Dentistry; Chicago IL USA
| | - W. Teughels
- Department of Oral Health Sciences; University Hospitals Leuven; Katholieke Universiteit Leuven; Leuven Belgium
| | - J. C. M. Souza
- Center for Research on Dental Implants (CEPID); Post-Graduate Program in Dentistry (PPGO); School of Dentistry (ODT); Federal University of Santa Catarina (UFSC); Florianopolis Brazil
- Center for Microelectromechanical Systems (CMEMS); University of Minho; Guimarães Portugal
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Minatel L, Verri FR, Kudo GAH, de Faria Almeida DA, de Souza Batista VE, Lemos CAA, Pellizzer EP, Santiago JF. Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 71:35-42. [DOI: 10.1016/j.msec.2016.09.062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 09/17/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
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Are intra-articular injections of hyaluronic acid effective for the treatment of temporomandibular disorders? A systematic review. Int J Oral Maxillofac Surg 2016; 45:1531-1537. [DOI: 10.1016/j.ijom.2016.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/14/2016] [Accepted: 06/06/2016] [Indexed: 11/19/2022]
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Santiago JF, Verri FR, Almeida DADF, de Souza Batista VE, Lemos CAA, Pellizzer EP. Finite element analysis on influence of implant surface treatments, connection and bone types. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 63:292-300. [DOI: 10.1016/j.msec.2016.02.061] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/02/2016] [Accepted: 02/19/2016] [Indexed: 11/27/2022]
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Peruzetto WM, Martinez EF, Peruzzo DC, Joly JC, Napimoga MH. Microbiological Seal of Two Types of Tapered Implant Connections. Braz Dent J 2016; 27:273-7. [PMID: 27224559 DOI: 10.1590/0103-6440201600604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/04/2016] [Indexed: 11/22/2022] Open
Abstract
Tapered implant connections have gained wide popularity for being more resistant to fatigue and for promoting a better seal against bacterial infiltration than conventional connections. The aim of this study was to evaluate the bacterial seal at the implant-abutment interface using two Morse taper implant models, by in vitro microbiological analysis. Eleven non-indexed and 11 indexed abutments were selected and connected to their respective implants with a 20 N torque, according to manufacturer's recommendation. Microbiological analysis was carried out using colonies of Escherichia coli transported directly from a culture dish to the prosthetic component. For control, one non-contaminated abutment-implant set from each group (negative control) and one contaminated implant with no abutment (positive control) were used. The specimens were immersed in BHI broth and maintained in an incubator at 37 °C for 14 days to assess the development of bacterial contamination. The results revealed that 36.4% (n=4) of the indexed components and 90.9% (n=10) of the non-indexed components allowed bacterial leakage, with significant difference between groups (p=0.0237). In conclusion, both tapered components failed to provide adequate sealing to bacterial leakage, although the indexed type components showed a superior seal compared with non-indexed components.
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Affiliation(s)
- Wheslley M Peruzetto
- Laboratory of Immunology and Molecular Biology, SLMANDIC - São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil, Faculdade de Odontologia São Leopoldo Mandic, Laboratory of Immunology and Molecular Biology, São Leopoldo Mandic Institute and Research Center, Campinas SP , Brazil
| | - Elizabeth F Martinez
- Laboratory of Oral Pathology, SLMANDIC - São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil, Faculdade de Odontologia São Leopoldo Mandic, Laboratory of Oral Pathology, São Leopoldo Mandic Institute and Research Center, Campinas SP , Brazil
| | - Daiane C Peruzzo
- Laboratory of Immunology and Molecular Biology, SLMANDIC - São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil, Faculdade de Odontologia São Leopoldo Mandic, Laboratory of Immunology and Molecular Biology, São Leopoldo Mandic Institute and Research Center, Campinas SP , Brazil
| | - Júlio Cesar Joly
- Laboratory of Immunology and Molecular Biology, SLMANDIC - São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil, Faculdade de Odontologia São Leopoldo Mandic, Laboratory of Immunology and Molecular Biology, São Leopoldo Mandic Institute and Research Center, Campinas SP , Brazil
| | - Marcelo H Napimoga
- Laboratory of Immunology and Molecular Biology, SLMANDIC - São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil, Faculdade de Odontologia São Leopoldo Mandic, Laboratory of Immunology and Molecular Biology, São Leopoldo Mandic Institute and Research Center, Campinas SP , Brazil
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In Vitro Evaluation of Bacterial Leakage at Implant-Abutment Connection: An 11-Degree Morse Taper Compared to a Butt Joint Connection. Int J Biomater 2016; 2016:8527849. [PMID: 27242903 PMCID: PMC4868898 DOI: 10.1155/2016/8527849] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 03/12/2016] [Accepted: 04/13/2016] [Indexed: 11/21/2022] Open
Abstract
Background and Aim. The geometry of implant-abutment interface (IAI) affects the risk of bacterial leakage and invasion into the internal parts of the implant. The aim of this study was to compare the bacterial leakage of an 11-degree Morse taper IAI with that of a butt joint connection. Materials and Methods. Two implants systems were tested (n = 10 per group): CSM (submerged) and TBR (connect). The deepest inner parts of the implants were inoculated with 2 μL of Streptococcus mutans suspension with a concentration of 108 CFU/mL. The abutments were tightened on the implants. The specimens were stored in the incubator at a temperature of 37°C for 14 days and the penetration of the bacterium in the surrounding area was determined by the observation of the solution turbidity and comparison with control specimens. Kaplan-Meier survival curve was traced for the estimation of bacterial leakage and the results between two groups of implants were statistically analyzed by chi-square test. Results. No case of the implant system with the internal conical connection design revealed bacterial leakage in 14 days and no turbidity of the solution was reported for it. In the system with butt joint implant-abutment connection, 1 case showed leakage on the third day, 1 case on the eighth day, and 5 cases on the 13th day. In total, 7 (70%) cases showed bacterial leakage in this system. Significant differences were found between the two groups of implants based on the incidence of bacterial leakage (p < 0.05). Conclusion. The 11-degree Morse taper demonstrated better resistance to microbial leakage than butt joint connection.
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