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D'Amario M, Orsijena A, Franco R, Chiacchia M, Jahjah A, Capogreco M. Clinical achievements of implantology in the pterygoid region: A systematic review and meta-analysis of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101951. [PMID: 38906380 DOI: 10.1016/j.jormas.2024.101951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/21/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024]
Abstract
The purpose of the study is to evaluate the survival rate of pterygoid implants compared to implants placed in different maxilla area and to settle as an alternative solution for the rehabilitation of the posterior maxilla atrophy. Studies that were included for this systematic review were selected using different database of references: PubMed Medline, Lilacs and Cochrane Library. Other journal platforms were also used for the research. Five articles met the strict inclusion/exclusion criteria of the 180 articles founded. This systematic review was registered on Prospero (CRD42023409706) and followed PRISMA statement. A total of 768 implants placed presented 97.43 % with a peak of 100 % of survival rate. Follow-up period varies from a minimum of 1 year to a maximum of six years. Pterygoid implants could be a valid alternative in patients presenting a posterior maxilla atrophy, but results should be interpreted cautiously due to the difficulty of the surgical technique. Further studies in the future should be taken in consideration to confirm the success rate of pterygoid implants since there is only one prospective RCT, potentially incorporating modern technologies such as guided surgery or navigated surgery could be a solution for the success of pterygoid implants, minimizing the risk and less dependent on the operator.
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Affiliation(s)
- Maurizio D'Amario
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy.
| | - Alessandro Orsijena
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy
| | - Rocco Franco
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy
| | - Marianna Chiacchia
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy
| | - Ali Jahjah
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, Dental Clinic, University of L'Aquila, Via Vetoio, Delta 6, Coppito, L'Aquila 67100, Italy
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Wadde K, Kokitkar S, Venkatakrishnan L, Ranganath S, Khaire S. Comparative Evaluation of Sinus Complication and Survival Rates of Quad Zygoma versus Bizygoma in Combination with two Regular Implants in Atrophic Maxilla: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2024; 23:710-718. [PMID: 38911424 PMCID: PMC11190113 DOI: 10.1007/s12663-024-02136-1] [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: 10/16/2023] [Accepted: 01/31/2024] [Indexed: 06/25/2024] Open
Abstract
Aim To systematically review existing scientific literature to determine, compare and evaluate the sinus complication and survival rates of quad zygoma against two zygomatic implants with combination of two regular implants in atrophic maxilla in adults. Methods Review was performed in accordance with preferred reporting items for systematic reviews and meta-analysis guidelines and registered in PROSPERO-CRD42023392721 Electronic databases like PubMed, Google scholar and EBSCO host were searched from 2000 to December 2022 for studies reporting treatment of Atrophic maxilla with either quad zygoma or two zygomatic implants in combination with two regular implants. Quality assessment was evaluated using Cochrane risk of bias-2 tool for randomized controlled trials (RCT). The risk of bias summary graph and risk of bias summary applicability concern was plotted using RevMan software version 5.3. The odds ratio (OR) and standardized mean difference (SMD) were used as summary statistic measure with random effect model and p value < 0.05 as statistically significant. Results Eleven studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which only nine studies were suitable for meta-analysis. The pooled estimate through the odds ratio 0.59 signifies that the quad zygomatic implants on an average has 0.59 (0.18-1.93) times or odds of developing sinus complications while the SMD signifies that better survival rate (SR) on an average is 0.35 (- 0.61 to 1.30) times more by two zygomatic implants with combination of two regular implants as compared to quad zygomatic implants (p > 0.05). Publication bias through the funnel plot showed asymmetric distribution with systematic heterogeneity. Conclusion Two zygomatic implants in combination with two regular implants provides better survival rate and less sinus complications compared to quad zygoma in atrophic maxilla. Despite the high SR observed, there is a need to conduct more randomized controlled clinical trials to examine their efficacy in comparison with other techniques.
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Affiliation(s)
- Kavita Wadde
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India
| | - Sandhya Kokitkar
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India
| | - Lakshmi Venkatakrishnan
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India
| | - Suleka Ranganath
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India
| | - Samir Khaire
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India
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Fan X, Chen L, Chen Q, Wang F, Wu Y, Sun Y. Influence of a mesial cantilever on stress, strain, and axial force in fixed partial dentures with a distally tilted implant in the atrophic posterior maxilla. J Prosthodont Res 2024:JPR_D_23_00218. [PMID: 38616127 DOI: 10.2186/jpr.jpr_d_23_00218] [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: 04/16/2024]
Abstract
PURPOSE This study aimed to investigate whether the presence of a mesial cantilever influences the biomechanical behavior and screw loosening in fixed partial dentures (FPDs) with a distally tilted implant in the atrophic posterior maxilla and where to best place the distal implant. METHODS Two configurations of implant-supported four-unit FPDs were modelled using finite element analysis. Five interabutment distances were considered. The stress and strain distributions in the implants, abutments, and prosthetic screws were verified under occlusal loading. The development of the axial force on the abutments and screws was also examined. Two-sample t-tests were used to identify differences (P < 0.05). RESULTS The von Mises stress distributions of the components in the two configurations were similar, as were the maximum plastic strains of the distal prosthetic screws, distal implants, and 30° abutments. The difference in the maximum plastic strains of the straight abutments was statistically significant. The preload of the 30° abutment screws was significantly reduced after the initial loading. In the absence of a mesial cantilever, the axial force on the straight abutments increased. However, when a mesial cantilever was used, the preload of the straight abutments was maintained, and the axial force on the prosthetic screws fluctuated less. The axial force fluctuation of the abutments gradually decreased as the interabutment distance increased. CONCLUSIONS Mesial cantilever usage had minimal effect on stress or strain distribution in FPD implants, abutments, or prostheses. However, it helped resist screw loosening. The distal screw access hole was preferably positioned close to the prosthetic end.
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Affiliation(s)
- Xiaohui Fan
- Shanghai Key Laboratory of Advanced High Temperature Materials and Precision Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Li Chen
- Yangtze Delta Advanced Material Research Institute, Suzhou, China
| | - Qiuren Chen
- Yangtze Delta Advanced Material Research Institute, Suzhou, China
| | - Feng Wang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yuanyuan Sun
- Department of Second Dental Center, Shanghai Ninth People's Hospital, School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, Netherlands
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Nagib MA, Ibrahim AM, Abdel-Rahman FH, Hegazy SA, Habib A. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024; 25:141-147. [PMID: 38514411 DOI: 10.5005/jp-journals-10024-3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM To compare between the rehabilitation of atrophied maxilla with fixed prosthesis using two posterior zygomatic implants and two conventional anterior implants or four implants inserted according to the all-on-four concept regarding the patient quality of life and satisfaction after one year of prosthesis insertion. MATERIALS AND METHODS Thirty-six patients with atrophic edentulous maxillae were randomized into two groups: Group I (rehabilitated with fixed prostheses supported by two zygomatic and two conventional implants in the anterior region) and group II (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after the placement of the definitive prostheses, patients completed oral health impact profile-14 and satisfaction questionnaires. RESULTS All patients were satisfied regarding retention, stability, occlusion, comfort, cleaning, speaking, chewing, bolus quality, appearance, handling, prosthesis apart, and embarrassing, with no significant significance between two groups except satisfaction with surgical procedures and healing period. CONCLUSIONS Using two distally tilted zygomatic implants or all-on-four concept to rehabilitate atrophied maxilla by fixed detachable prosthesis could be considered a promising functional and esthetic treatment option regarding the patient satisfaction. CLINICAL SIGNIFICANCE Traditionally, treatment of maxillary atrophied ridges was done by bone grafting or sinus-lifting techniques; however, using all-on-four concept or zygomatic implants was a successful treatment as it has high success rates and highly satisfied by the patients. How to cite this article: Nagib MA, Ibrahim AM, Abdel-Rahman FH, et al. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(2):141-147.
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Affiliation(s)
- Mohamed A Nagib
- Department of Prosthodontics, Delta University for Science and Technology, Dakahlia, Mansoura, Egypt, e-mail:
| | - Abdullah M Ibrahim
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
| | | | - Salah A Hegazy
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Ahmed Habib
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
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Venkatachalam V, Pandiarajan R, Meyappan A, Anbukkarasu H. Evaluation of Surgical Outcomes of Zygomatic Implant-Supported Rehabilitation of Atrophic Maxillary Arches - A Prospective Study. Ann Maxillofac Surg 2024; 14:27-32. [PMID: 39184428 PMCID: PMC11340836 DOI: 10.4103/ams.ams_32_23] [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: 02/16/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Prosthetic rehabilitation with implants in the atrophic edentulous maxilla often requires a bone augmentation procedure to enable implant placement and integration. However, rigid anchorage can also be achieved using long zygomatic implants. The aim of this study was to evaluate the surgical outcomes of rehabilitation of atrophic posterior maxillary ridges with zygomatic implants using the zygomatic success code (ZSC) and derive the success grade for the procedure based on the observed results. Materials and Methods A total of eight implants were placed in an extrasinus technique based on the zygomatic anatomy-guided approach. The following were evaluated postoperatively - primary stability, maxillary sinus pathology, soft-tissue healing and prosthetic offset. The ZSC score was calculated, and success grading was given with ZSC based on Aparacio et al.,'s guidelines. Results One implant had Grade 1 mobility and partial maxillary sinus opacification, 25% (n = 2) revealed a mild recession exposing the implant head and 12.5% (n = 1) showed significant recession up to 7 mm. The prosthetic offset of zygomatic implants was scored -1 for all eight implants. Five implants were given a success code of 1/1/1/1 and a success grade of Grade I, two implants were given code 1/1/2/1 with Grade II and one implant 2/2/3/1 and grade III. The results imply that zygomatic implants can be a successful option in maxillary rehabilitation. Discussion The zygomatic implants, as a graft less and promising solution to the rehabilitation of atrophied maxillary arches, have excellent surgical outcomes with varied advantages.
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Affiliation(s)
- Vaishali Venkatachalam
- Department of Oral and Maxillofacial Surgery, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Rajesh Pandiarajan
- Department of Oral and Maxillofacial Surgery, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Alagappan Meyappan
- Department of Oral and Maxillofacial Surgery, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Harushi Anbukkarasu
- Department of Oral and Maxillofacial Surgery, A.S Dentistry, Salem, Tamil Nadu, India
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Konstantinović VS, Abd-Ul-Salam H, Jelovac D, Ivanjac F, Miličić B. Pterygoid and tuberosity implants in the atrophic posterior maxilla: A retrospective cohort study. J Prosthet Dent 2023; 130:219.e1-219.e10. [PMID: 37481400 DOI: 10.1016/j.prosdent.2023.06.007] [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: 07/16/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/24/2023]
Abstract
STATEMENT OF PROBLEM Rehabilitation of the partially or completely edentulous posterior maxilla using dental implants is a clinical challenge because of the presence of the maxillary sinus, as well as the low quality and quantity of bone in that region. In addition to bone augmentation procedures, posterior maxillary rehabilitation using implants includes their anchoring in bones such as the zygoma, pterygoid, and maxillary tuberosity, as well as in short implants. However, the performance of pterygoid and tuberosity implants in the atrophic posterior maxilla is unclear. PURPOSE The purpose of this retrospective cohort study was to evaluate the survival of tuberosity and pterygoid implants in patients with posterior maxillary atrophy. MATERIAL AND METHODS A nonprobability convenient sample of patients who had received fixed prostheses on implants placed in the maxillary tuberosity or pterygoid regions was analyzed retrospectively. Demographic variables included sex (male, female) and age. Implant-related variables included surface characteristics, site of placement, implant design, length, diameter, and anteroposterior insertion angle. Prosthetic-related variables included the type of reconstruction for rehabilitation and loading protocols. Implant survival, complications, crestal bone loss, and follow-up intervals were also documented. Collected data were analyzed at both patient and implant levels. The demographics and implant characteristics of patients receiving pterygoid or tuberosity implants were analyzed with a statistical software program (α=.05). Survival analysis was estimated by using the nonparametric Kaplan-Meier curve. RESULTS A total of 119 patients had 183 pterygoid or tuberosity implants inserted. Most implants in the pterygoid region (71.5%) were Ø4.1 mm (87.4%) and 15 mm in length (60.1%). The most common prostheses were complete maxillary reconstructions (49.2%) with late loading (74.3%). The average implant anteroposterior insertion angle was 60.8 degrees. The cumulative survival rate was 97.3% (n=178) during the mean follow-up period of 57 months (range 1 to 168 months). Among all implants placed, 2.7% failed (n=5) within 2 months of their placement. The statistically significant differences noted between tuberosity and pterygoid implants were related to design, surface characteristics, and loading. The average crestal bone loss was 1.5 mm. CONCLUSIONS The survival of the implants placed in the maxillary tuberosity and pterygoid regions was high in patients with posterior maxillary atrophy.
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Affiliation(s)
- Vitomir S Konstantinović
- Professor, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Hani Abd-Ul-Salam
- Adjunct Professor, Department of Population Oral Health, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada; and Professor, Department of Diagnostic and Oral Surgical Dental Sciences, Faculty of Dentistry, Gulf Medical University, College of Dentistry, Ajman, Ajman, United Arab Emirates.
| | - Drago Jelovac
- Associate Professor, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Filip Ivanjac
- Research Associate, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Biljana Miličić
- Professor, Department of Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Ahmad AG, Awadalkreem F, Osman M, Palka L. Does the Protrusion of Corticobasal Implants in the Maxillary Sinuses Affect Sinus Health? A Retrospective Study. J Contemp Dent Pract 2023; 24:357-363. [PMID: 37534501 DOI: 10.5005/jp-journals-10024-3521] [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: 08/04/2023]
Abstract
AIM The aim of this retrospective study is to investigate the effect of corticobasal implant penetration in the nasal and maxillary sinuses on sinus health and implant survival rate in cases of severely atrophid ridges. MATERIALS AND METHODS This retrospective study was conducted on thirty patients with 172 implants who underwent corticobasal implant treatment between 2014 and 2018. Implants were divided into two groups according to the penetration depths (Group A, <4 mm; Group B, 4 mm). Inclusion criteria for the study included: (A) patients with severe maxillary ridge resorption with an immediately loaded corticobasal implant-supported prosthesis that showed implant protrusion inside the maxillary sinus on cone-beam computed tomography (CBCT); and (B) patients with a preoperative and postoperative follow-up CBCT scan using the same standard technique and machine. (C) Patients without any history of sinusitis before implant insertion patients who fulfilled the inclusion criteria were recalled for follow-up. The presence of sinus complications was clinically assessed according to the clinical practice guidelines for adult sinusitis of the American Academy of Otolaryngology-Head and Neck Surgery and Radiologically using CBCT. Moreover, patient satisfaction was evaluated using yes-or-no questions. The result was statistically analyzed using Fisher's Exact test. RESULTS Despite the differences in implant penetration depths, no clinical signs of sinusitis were evident in any patient. One patient presented with transient epistaxis after the surgery, and 2 patients with nine implants revealed nonsignificant thickening of the sinus membrane radiologically (p = 0.055). All implants showed optimum bone-implant contact with a 100% survival rate. A significant relationship was reported between the thickness of the membrane and the patient's gender, hypertension, and smoking habits. (p = 0.001*, p = 0.002*, and p = 0.034*, respectively). CONCLUSION Penetration of corticobasal implants in the maxillary sinus did not compromise the health of the maxillary sinus or implant survival rate. CLINICAL SIGNIFICANCE Limited posterior maxillary bony support and maxillary sinus pneumatization present challenges in implant dentistry and increase the possibility of implant protrusion inside the maxillary and nasal cavities. Hence, studying the effect of this protrusion on the maxillary sinuses' health and implant survival is highly significant.
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Affiliation(s)
- Abdelnasir G Ahmad
- Department of Oral and Maxillofacial Surgery, International University of Africa, Khartoum, Sudan
| | - Fadia Awadalkreem
- Department of Prosthodontics, RAK College of Dental Sciences, Ras Al-Khaimah, United Arab Emirates, Phone: +00971508094225, e-mail:
| | - Motaz Osman
- Department of Implant, Khartoum Teaching Dental Hospital, Federal Ministry of Health, Khartoum, Sudan
| | - Lukasz Palka
- Department of Implant, Private Dental Practice, Zary, Poland
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Zhao J, Zhou YH, Zhao YQ, Gao ZR, Ouyang ZY, Ye Q, Liu Q, Chen Y, Tan L, Zhang SH, Feng Y, Hu J, Dusenge MA, Feng YZ, Guo Y. Oral cavity-derived stem cells and preclinical models of jaw-bone defects for bone tissue engineering. Stem Cell Res Ther 2023; 14:39. [PMID: 36927449 PMCID: PMC10022059 DOI: 10.1186/s13287-023-03265-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Jaw-bone defects caused by various diseases lead to aesthetic and functional complications, which can seriously affect the life quality of patients. Current treatments cannot fully meet the needs of reconstruction of jaw-bone defects. Thus, the research and application of bone tissue engineering are a "hot topic." As seed cells for engineering of jaw-bone tissue, oral cavity-derived stem cells have been explored and used widely. Models of jaw-bone defect are excellent tools for the study of bone defect repair in vivo. Different types of bone defect repair require different stem cells and bone defect models. This review aimed to better understand the research status of oral and maxillofacial bone regeneration. MAIN TEXT Data were gathered from PubMed searches and references from relevant studies using the search phrases "bone" AND ("PDLSC" OR "DPSC" OR "SCAP" OR "GMSC" OR "SHED" OR "DFSC" OR "ABMSC" OR "TGPC"); ("jaw" OR "alveolar") AND "bone defect." We screened studies that focus on "bone formation of oral cavity-derived stem cells" and "jaw bone defect models," and reviewed the advantages and disadvantages of oral cavity-derived stem cells and preclinical model of jaw-bone defect models. CONCLUSION The type of cell and animal model should be selected according to the specific research purpose and disease type. This review can provide a foundation for the selection of oral cavity-derived stem cells and defect models in tissue engineering of the jaw bone.
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Affiliation(s)
- Jie Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ying-Hui Zhou
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.,National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ya-Qing Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Zheng-Rong Gao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Ze-Yue Ouyang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Qin Ye
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Qiong Liu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Yun Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Li Tan
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Shao-Hui Zhang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Yao Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Jing Hu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Marie Aimee Dusenge
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
| | - Yue Guo
- Department of Stomatology, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, 410011, Hunan, China.
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Varghese KG, Kurian N, Gandhi N, Gandhi S, Daniel AY, Thomas HA, Sudharson NA, Wadhwa S. Three-dimensional finite element analysis of zygomatic implants for rehabilitation of patients with a severely atrophic maxilla. J Prosthet Dent 2023; 129:597.e1-597.e8. [PMID: 36775735 DOI: 10.1016/j.prosdent.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/13/2023]
Abstract
STATEMENT OF PROBLEM Stresses applied to zygomatic implants have been determined to be transferred mainly to the zygomatic bone; however, consensus regarding the stress distribution pattern in the bone surrounding zygomatic implants has not yet been reached. PURPOSE The purpose of this 3-dimensional (3D) finite element analysis (FEA) study was to visually compare the stress distribution pattern in 2 different zygomatic implant treatment modalities and evaluate the effect of masseter musculature involvement. MATERIAL AND METHODS A 3D FEA craniofacial model was constructed from the computed tomography (CT) data of a selected patient with a severely atrophic edentulous maxilla. Modeled zygomatic and conventional implants were inserted into the craniofacial model supporting a prosthesis superstructure. Two types of treatment were considered in the study: 2 zygomatic implants placed bilaterally or 2 zygomatic implants placed in conjunction with at least 2 conventional implants at the anterior maxilla. The models were loaded with a vertical force of 150 N, a lateral force of 50 N, and a distributed occlusal force of 300 N applied to the insertion area of the masseter muscle. The stresses on and deformations of the bones and implants were then observed and compared with and without the involvement of the musculature component. RESULTS The stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull; however, a difference in distribution pattern was observed when the models were loaded without applying the muscle component. The maximum deformation of bones surrounding the implants occurred in the abutment connection of the conventional anterior implant in the model with an additional conventional anterior implant. CONCLUSIONS The FEA revealed the stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull. However, the stresses in both models were concentrated in the zygomatic bone when incorporating the muscle component. Therefore, incorporating muscular force into FEA studies could affect the analysis result.
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Affiliation(s)
- Kevin George Varghese
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India.
| | - Nirmal Kurian
- Associate Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
| | - Nitasha Gandhi
- Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
| | - Sumir Gandhi
- Professor, Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India
| | - Angleena Y Daniel
- Department Head and Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
| | - Hemiya Anna Thomas
- Post-Graduate Resident, Department of Pedodontics and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - Nishanth A Sudharson
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
| | - Samiksha Wadhwa
- Post-Graduate Resident, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
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Grün P, Pfaffeneder-Mantai F, Schneider B, Bandura P, Grün AS, Turhani D. Are selective serotonin reuptake inhibitors responsible for the failure of osseointegrated titanium-zirconium and one-piece zirconia dental implants in a premenopausal Caucasian woman? - A case report. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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11
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Awadalkreem F, Khalifa N, Satti A, Suliman AM. Rehabilitation of Patients with Compromised Ridge Support Using Immediately Loaded Corticobasal Implant-supported Prostheses: A Prospective Observational Study. J Contemp Dent Pract 2022; 23:971-978. [PMID: 37073908 DOI: 10.5005/jp-journals-10024-3416] [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: 04/20/2023]
Abstract
AIM The aim of this prospective study is to evaluate the treatment outcomes and patient satisfaction following the use of fixed immediately loaded corticobasal implant-supported prostheses. MATERIALS AND METHODS One hundred and seventy-four corticobasal implants (basal cortical screw, BCS implant design) were inserted in 20 consecutive patients with compromised ridge support. Implant survival and success were assessed using the James-Misch implant health quality scale and the Albrektsson criteria for implant success. The peri-implant health was evaluated at 1 week and 3, 6, 9, 12, and 18 months postoperatively. Moreover, the radiographic and prosthetic parameters and patient satisfaction were assessed. RESULTS The implants showed optimum implant health and a 100% survival rate with none (0%) of the implants failing, mobile, lost, or fractured. Using Wilcoxon signed-rank test, significant decreases in both the modified gingival indexes and the probable pocket depth (PPD) and slight significant increases in the plaque index (PI) at 3, 9, 12, and 18 months and a nonsignificant increase at 6-month follow-up were reported with a range of 0-1. The calculus index (CI) was zero at all follow-up visits. Radiographic evaluations revealed increases in the bone-to-implant contact. Evaluation of the prostheses showed some treatable complications, and all the patients were satisfied. CONCLUSION The use of corticobasal implant-supported prosthesis meets the patient's demand for an immediate, fixed treatment modality, with high survival and success rates, optimum peri-implant soft tissue health, and high reported satisfaction. CLINICAL SIGNIFICANCE Corticobasal implants can improve the patient's esthetic, phonetic, mastication, and quality of life with the advantage of eliminating the need of bone grafting procedures.
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Affiliation(s)
- Fadia Awadalkreem
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan Phone: +00971508094225, e-mail: ,
| | - Nadia Khalifa
- Chair of the Department of Preventive and Restorative Dentistry, University of Sharjah/Faculty of Dental Medicine, Sharjah, United Arab Emirates
| | - Asim Satti
- Department of Computing and Research, Federal Ministry of Health, Khartoum Teaching Dental Hospital, Khartoum, Sudan
| | - Ahmed Mohamed Suliman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
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Comparison of the Efficacy of the Panoramic and Cone Beam Computed Tomography Imaging Methods in the Surgical Planning of the Maxillary All-On-4, M-4, and V-4. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1553340. [PMID: 35937385 PMCID: PMC9348921 DOI: 10.1155/2022/1553340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
This study is aimed at analyzing the difference between the measurements made according to certain anatomical signs of the maxillary jaw using panoramic radiography and cone beam computed tomography (CBCT) to decide whether to use all-on-4, M-4, or V-4 configuration to prevent complications caused by incorrect measurements during the presurgical planning stage of the placement of implants in the all-on-4 technique. A retrospective study was conducted with 50 patients with upper edentulous jaws suitable for the all-on-4 technique, who underwent preoperative panoramic radiography and cone beam computed tomography evaluation for dental implant surgery. The shortest vertical distances between anatomical structures were measured. Measurements were made independently by two oral and maxillofacial surgeons, one experienced and the other inexperienced. A statistically significant difference was found between the mean values according to gender (p=0.045). When the measurements made by the experienced surgeon and the inexperienced surgeon were compared, there was no significant difference between panoramic radiography and cone beam computed tomography. In situations where bone measurements are required for deciding on all-on-4 or one of its configurations (M-4 and V-4), it was found that panoramic radiography gives significantly incorrect results compared to cone beam computed tomography (p<0.05). Cone beam computed tomography is more reliable than panoramic radiography and eliminates the margin of error in the planning of all-on-4 or its variations to be made by either an experienced or an inexperienced oral surgeon.
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Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials. MATERIALS 2022; 15:ma15144953. [PMID: 35888420 PMCID: PMC9323759 DOI: 10.3390/ma15144953] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/25/2022]
Abstract
The aim of this study was to assess and compare the stress–strain pattern of zygomatic dental implants supporting different superstructures using 3D finite element analysis (FEA). A model of a tridimensional edentulous maxilla with four dental implants was designed using the computer-aided design (CAD) software. Two standard and two zygomatic implants were positioned to support the U-shaped bar superstructure. In the computer-aided engineering (CAE) software, different materials have been simulated for the superstructure: cobalt–chrome (CoCr) alloy, titanium alloy (Ti), zirconia (Zr), carbon-fiber polymers (CF) and polyetheretherketone (PEEK). An axial load of 500 N was applied in the posterior regions near the zygomatic implants. Considering the mechanical response of the bone tissue, all superstructure materials resulted in homogeneous strain and thus could reconstruct the edentulous maxilla. However, with the aim to reduce the stress in the zygomatic implants and prosthetic screws, stiffer materials, such Zr, CoCr and Ti, appeared to be a preferable option.
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Mehta SP, Sutariya PV, Pathan MR, Upadhyay HH, Patel SR, Kantharia NDG. Clinical success between tilted and axial implants in edentulous maxilla: A systematic review and meta-analysis. J Indian Prosthodont Soc 2021; 21:217-228. [PMID: 34380808 PMCID: PMC8425376 DOI: 10.4103/jips.jips_79_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: This systematic review and meta-analysis evaluated the clinical survival of axial and tilted implants in atrophic edentulous maxilla after three years of immediate loading and also the corresponding marginal bone loss. Setting and Design: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). Materials and Methods: The relevant studies were retrieved from MEDLINE(PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), Science Direct, Google Scholar databases. The search was limited to studies published in the English language with no date restrictions. A further hand search was conducted on individual journals and reference lists of studies. The risk of bias in included studies was assessed by using the Evidence Project risk of bias tool. Statistical Analysis Used: Statistical meta-analysis was conducted using RevMan 5.4 software. The assessment for the level of evidence was done using GRADEpro software. Results: Eleven studies were finalised. All were included in the meta-analysis for implant survival, while only seven studies were included in the meta-analysis of marginal bone loss. After three years, the meta-analysis results for implant survival showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (RR = 1.00 (95% CI: 0.98-1.01); P-value = 0.59). After three years, the meta-analysis results for marginal bone showed no statistical difference between axial and tilted implants, with the forest plot neither favouring axial nor tilted implants (MD = -0.02; 95% CI; -0.09-0.06; P-value = 0.69). Conclusion: In the immediately loaded rehabilitation of completely edentulous atrophic maxillae, tilting of implants did not induce any significant alteration in their survival and their corresponding marginal bone loss levels compared to conventionally placed axial implants even after three years of function.
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Affiliation(s)
- Shruti Parthiv Mehta
- Department of Prosthodontics, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Priyanka Vaibhav Sutariya
- Department of Prosthodontics, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | | | - Hemil Hitesh Upadhyay
- Department of Prosthodontics, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Surbhi Ravi Patel
- Department of Prosthodontics, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
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Low CYS, Ong DC, Freer E. Interdisciplinary management of a partially dentate adult patient with a complex malocclusion. Clin Case Rep 2021; 9:e04586. [PMID: 34457280 PMCID: PMC8380093 DOI: 10.1002/ccr3.4586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 11/10/2022] Open
Abstract
Adult patients may present with complex malocclusions requiring extensive oral rehabilitation. This case report demonstrates how carefully planned interdisciplinary management can provide pleasing outcomes despite the considerable initial clinical challenges.
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Affiliation(s)
- Chui Yi Sarah Low
- Private PracticeSingapore CitySingapore
- School of DentistryThe University of QueenslandHerstonQLDAustralia
| | - Desmond Cheer‐Vern Ong
- Private PracticeTownsvilleQLDAustralia
- Discipline of OrthodonticsThe University of QueenslandHerstonQLDAustralia
| | - Elissa Freer
- Discipline of OrthodonticsThe University of QueenslandHerstonQLDAustralia
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Factors influencing implant and prosthesis survival in zygomatic implant-supported fixed rehabilitation: a retrospective study. Odontology 2021; 109:965-972. [PMID: 34146176 DOI: 10.1007/s10266-021-00621-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this retrospective study was to evaluate mid-term implant and prosthesis survival in patients with edentulous atrophic maxillae submitted to zygomatic implant-supported fixed rehabilitation and to identify possible related risk factors. METHODS Data were collected from records of patients with edentulous atrophic maxillae, in good general health and who were rehabilitated by means of acrylic resin full-arch screw-retained prosthesis supported by at least one zygomatic implant, between the years of 2006-2017. Implant and prosthesis survival rates were calculated. The association between implant and prosthesis loss and quantitative and qualitative variables of interest was verified with t tests and Fisher's exact tests, respectively. For the significant variables in the latter, odds ratio and 95% confidence intervals were additionally calculated. RESULTS The sample comprised 66 patients in whom 171 zygomatic implants were placed to support maxillary screw-retained full-arch prostheses. Implant and prosthesis survival rates of 94.15% and 92.4%, respectively, were observed in a mean of 3.6 years of follow-up (up to 11.7 years). Implant loss was 4.33 more likely to occur when adverse events were recorded after the procedure of implant placement (P = 0.026) and 10.31 more likely to occur in implants that had their prosthesis repaired during follow-up visits (P = 0.004). Prosthesis loss was 22.00 times more likely to occur when implants were previously lost (P < 0.001). All prostheses that were considered as failures (i.e. were replaced) had been previously submitted to laboratory repair at some point during follow-up. CONCLUSIONS Zygomatic implant rehabilitation demonstrated to be a reliable method with good mid-term results. The occurrence of post-surgical adverse events and need for laboratory repair of the prosthesis were found to be significant risk factors for implant loss. Previous implant loss was significantly associated with prosthesis loss. These risk factors may be prevented by means of detailed planning of the rehabilitation to be carried out, including post-operative care of the patients, so that treatment success using zygomatic implants can be achieved.
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Zaninovich MI. Immediate rehabilitation of severely atrophic maxilla using trans-sinus nasal protocol and extended-length subcrestal angulated implants. Case series with one-year follow-up. J ORAL IMPLANTOL 2021; 48:117-124. [PMID: 34091678 DOI: 10.1563/aaid-joi-d-19-00307] [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: 11/22/2022]
Abstract
<p>Immediate fixed full arch rehabilitation of the severely atrophic maxilla eliminates the use of a tissue supported prosthesis during the healing phase and maximises patient comfort and quality of life.<o:p></o:p></p> <p>The surgical treatment options available for immediate rehabilitation of the severely atrophic maxilla are dependent on the location and availability of the residual alveolar ridge. When bone is only available in the inter canine region, a graftless approach using tilted distal implants may not provide adequate distance between implants for favourable biomechanics. Subsequently, zygomatic implants are the alternative to provide adequate posterior occlusal support. <o:p></o:p></p> <p>The use of extended length sub crestal angulated implants offers an additional implant option for the clinician to restore the severely atrophic maxilla immediately. The treatment protocol involves anchorage of the implant fixture to the lateral wall of the nasal bone. The distally tilted implant transverses an augmented sinus cavity and extends to the site of the first permanent molar. The novel implant sub crestal angulation and use of a multi-unit abutment promotes passivity of fit of a full arch fixed immediate prosthesis.<o:p></o:p></p> <p>Five clinical case reports from private practice are presented which outline the clinical value of the novel implant design in the rehabilitation the severely atrophic maxilla. In each case, the use of zygomatic implants would conventionally have been prescribed due to the absence of residual alveolar bone in the maxilla premolar and molar regions. Alternatively, the use of extended length subcrestally angulated implants with straight of angulated multi-unit abutments have successfully restored the arch immediately.<o:p></o:p></p>.
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Affiliation(s)
- MIchael Zaninovich
- Aria Dental Specialist Implant Centre Prosthodontist Prosthodontics 1002 Hay street Perth 6000 AUSTRALIA Perth western australia 6000 Aria Dental Specialist Implant Centre
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Effects of rehabilitation with complete dentures on bite force and electromyography of jaw and neck muscles and the correlation with occlusal vertical dimension. Clin Oral Investig 2021; 25:4691-4698. [PMID: 33442778 DOI: 10.1007/s00784-021-03783-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the effects of oral rehabilitation with complete dentures on bite force and electromyography of the suprahyoid and sternocleidomastoid muscles, and their correlation with occlusal vertical dimension (OVD). The research questions were "What are the effects of rehabilitation with complete dentures on bite force and electromyography of suprahyoid and sternocleidomastoid muscles, and how are they correlated with OVD?" MATERIALS AND METHODS Patients who are wearers of unsatisfactory removable complete dentures were attended in three sessions (T0, T1, and T2). At T0, while the patients still wore the old dentures, they were submitted to bite force and surface electromyographic exams of the suprahyoid and sternocleidomastoid muscles. These exams were repeated, and the OVD was measured while the patients wore their old and new prostheses, 30 days after insertion of the new prosthesis (T1). The exams were repeated 100 days after the insertion of the new prosthesis (T2). The data were submitted to the Shapiro-Wilk normality test, analysis of variance (ANOVA), and Pearson correlation and linear regression, all with 5% significance. RESULTS Fifteen patients participated in the study. No statistically significant difference was observed for bite force or electromyography in T0, T1, or T2. However, the correlation and regression tests showed important interactions between the OVD and maximum voluntary occlusal bite force, as well as the OVD and electromyography during deglutition for the suprahyoid muscles. CONCLUSION Rehabilitation did not impact bite force nor the activity of the assessed muscles (electromyography). On the other hand, OVD was shown to be an important factor for bite force, and deglutition of water after rehabilitation. CLINICAL RELEVANCE This study shows what are the influences of rehabilitation on oral functions and reinforces the importance of corrected reestablishment of OVD because it has been found to be an important factor for bite force and electromyography during deglutition.
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Ramezanzade S, Yates J, Tuminelli FJ, Keyhan SO, Yousefi P, Lopez-Lopez J. Zygomatic implants placed in atrophic maxilla: an overview of current systematic reviews and meta-analysis. Maxillofac Plast Reconstr Surg 2021; 43:1. [PMID: 33409713 PMCID: PMC7788139 DOI: 10.1186/s40902-020-00286-z] [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: 10/21/2020] [Accepted: 11/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Zygomatic implants are a treatment option for severely atrophic maxilla. MAIN TEXT This study aimed to summarize and evaluate systematic reviews assessing the clinical outcomes of zygomatic implants including survival/failure rate and complications. PubMed-MEDLINE, Google Scholar, LILACS, and the Cochrane Database were searched up to April 2020. Risk of bias assessment was conducted by the AMSTAR tool. Initial searches yielded 175 studies. These were assessed, and following title abstract and full-text evaluation, 7 studies (2 meta-analyses) were included in the final review. According to the AMSTAR tool, 1 was deemed high quality, 4 were classified as medium, and 2 as low quality. The mean AMSTAR score (±SD) was 5.28 of 9 (±2.36) ranging from 2/9 to 9/9. The reported survival rates ranged from 95.2 to 100% except for resected maxillas, which established higher failure rates up to 21.43%. Concerning the complications with the zygomatic implants, various surgical and prosthetic complications were reported with sinusitis being the most frequently observed complication. Zygomatic implants appears to offer a promising alternative to formal bone grafting techniques with lower costs, less complications, less morbidity, shorter treatment times, and comparably high survival rates. CONCLUSION Complications were rare and usually easy to manage. However, the treatment should be directed by appropriately trained clinicians with noticeable surgical experience.
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Affiliation(s)
| | - Julian Yates
- Department of Oral and Maxillofacial Surgery, University of Manchester, Manchester, UK
| | - Frank J. Tuminelli
- Department of Dental Medicine, Hofstra Northwell School of Medicine, New York, USA
| | - Seied Omid Keyhan
- Maxillofacial Surgery and Implantology Research Foundation., Tehran, Iran
- Craniomaxillofacial Research Center for Craniofacial Reconstruction, Tehran University of Medical Science, Shariati Hospital, Tehran, Iran
| | - Parisa Yousefi
- Department of Prosthodontics, Dental College, Isfahan University of Medical Science, Isfahan, Iran
| | - Jose Lopez-Lopez
- Department of Odontostomatology, School of Dentistry & Dental Hospital Barcelona University, University of Barcelona, Feixa Llarga, s/n – L’Hospitalet de Llobregat, 08907 Barcelona, Spain
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Torres-Alemany A, Fernández-Estevan L, Agustín-Panadero R, Montiel-Company JM, Labaig-Rueda C, Mañes-Ferrer JF. Clinical Behavior of Short Dental Implants: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3271. [PMID: 33053872 PMCID: PMC7599668 DOI: 10.3390/jcm9103271] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to the loss of these. The aim of this systematic review and meta-analysis was to analyze the impact of the use of short implants on their survival and on peri-implant bone loss, evaluating the influence that length, diameter, and crown-to-implant ratio (C/I) have on these parameters. This systematic review was based on guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An electronic search was conducted using terms related to the use of short implants in partially or totally edentulous patients. A total of five databases were consulted in the literature search: PubMed, Embase, Cochrane, Scopus, and Web of Science. After eliminating the duplicate articles and assessing which ones met the inclusion criteria, 15 articles were included for the qualitative analysis and 14 for the quantitative study. Through meta-analysis, the percentage of implant loss and peri-implant bone loss was estimated. Relating these parameters to length, diameter, and C/I ratio, no significant differences have been found for implant loss (values of p = 0.06, 0.10, and 0.9, respectively for length, diameter, and C/I ratio), nor for peri-implant bone loss (values of p = 0.71, 0.72, and 0.36, respectively for length, diameter, and C/I ratio). In conclusion, the use of short implants does not seem to have a significant influence on marginal bone loss or the survival rate of implants.
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Affiliation(s)
| | - Lucía Fernández-Estevan
- Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag 1, 46010 Valencia, Spain; (A.T.-A.); (R.A.-P.); (J.M.M.-C.); (C.L.-R.); (J.F.M.-F.)
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Sales PH, Gomes MV, Oliveira-Neto OB, de Lima FJ, Leão JC. Quality assessment of systematic reviews regarding the effectiveness of zygomatic implants: an overview of systematic reviews. Med Oral Patol Oral Cir Bucal 2020; 25:e541-e548. [PMID: 32520920 PMCID: PMC7338062 DOI: 10.4317/medoral.23569] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 06/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background Oral rehabilitation of atrophic maxillae features high complexity, for which there are several therapeutic modalities reported on scientific literature. Zygomatic implant placement is a viable option that features low morbidity and allows immediate prosthetic loading. The purpose of the present study was to determine the methodological quality of systematic reviews that assessed the effectiveness of zygomatic implants placed in atrophic maxillae.
Material and Methods Searches were conducted on Medline via Pubmed, LILACS, Dare Cochrane, Scopus, and Sigle via Open Grey up to June 2019.
Results Seven systematic reviews were eligible for Overview and comprised a total of 2313 patients, 4812 zygomatic implants, and a 96,72% success rate. Common surgical complications, in decreasing order, were: maxillary sinusitis, peri-implant mucositis, prosthetic fracture, and infections. Methodological quality was assessed using the AMSTAR 2 tool, which revealed that six systematic reviews showed critically low methodological quality and one review was assessed as of low methodological quality.
Conclusions Zygomatic implants seem to be an adequate option for atrophic maxilla rehabilitation, however, new studies with a higher methodological rigor are needed to provide more reliable results to professionals and patients undergoing this modality of oral rehabilitation. Key words:Zygomatic Implants, dental Implants, complications, oral rehabilitation.
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Affiliation(s)
- P-H Sales
- Av. Professor Moraes Rego, 1235 Cidade Universitária, Recife Pernambuco Brazil
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22
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Yang G, Chen L, Gao Y, Liu H, Dong H, Mou Y. Risk factors and reoperative survival rate of failed narrow‐diameter implants in the maxillary anterior region. Clin Implant Dent Relat Res 2019; 22:29-41. [PMID: 31797552 DOI: 10.1111/cid.12867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/04/2019] [Accepted: 10/23/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Guangwen Yang
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Li Chen
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Ying Gao
- The 461 Clinical Department of the 964 Hospital of People's Liberation Army Changchun Jilin China
| | - Hui Liu
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Heng Dong
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Yongbin Mou
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
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V M, Iyer S, Menon D, Nair SV, Nair MB. Evaluation of osseointegration of staged or simultaneously placed dental implants with nanocomposite fibrous scaffolds in rabbit mandibular defect. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 104:109864. [DOI: 10.1016/j.msec.2019.109864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022]
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Araujo RZ, Santiago Júnior JF, Cardoso CL, Benites Condezo AF, Moreira Júnior R, Curi MM. Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. J Craniomaxillofac Surg 2019; 47:651-660. [PMID: 30799134 DOI: 10.1016/j.jcms.2019.01.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/21/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of this systematic literature review was to analyze clinical outcomes of pterygoid implant for the treatment of patients with atrophic posterior maxillae and to provide clinical recommendations for this dental implant technique. An extensive search of electronic databases (PubMed/Medline, Science Direct, Lilacs, Embase, and Cochrane Library) was conducted, for articles published between January 1995 and January 2018, to identify literature presenting clinical outcomes of pterygoid implants in the treatment of patients with atrophic posterior maxillae. The systematic review was performed in accordance with PRISMA/PICO statement guidelines, and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk of implant failure was analyzed within a 95% confidence interval (95% CI). After screening 331 abstracts from the electronic databases, 36 full-text articles were accessed for eligibility, and a total of 6 studies were included in this systematic review (after applying the inclusion and exclusion criteria). All studies were retrospective in nature and were classified with a poor level of evidence. A total of 634 patients received 1.893 pterygoid implants, with a mean implant survival rate of 94.87%. The mean prevalence of implant failure was 0.056 with a 95% CI of 0.04-0.077. This study demonstrates that pterygoid implants can be successfully used in patients with atrophic posterior maxilla. However, the results should be interpreted with caution, given the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- Rafael Zetehaku Araujo
- Department of Oral Implantology and Dental Prosthesis, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | | | - Camila Lopes Cardoso
- Department of Oral Implantology, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | | | - Rosenvaldo Moreira Júnior
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | - Marcos Martins Curi
- Department of Oral and Maxillofacial Surgery, Hospital Santa Catarina, São Paulo, Brazil
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Özalp Ö, Tezerişener HA, Kocabalkan B, Büyükkaplan UŞ, Özarslan MM, Şimşek Kaya G, Altay MA, Sindel A. Comparing the precision of panoramic radiography and cone-beam computed tomography in avoiding anatomical structures critical to dental implant surgery: A retrospective study. Imaging Sci Dent 2019; 48:269-275. [PMID: 30607351 PMCID: PMC6305775 DOI: 10.5624/isd.2018.48.4.269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/07/2018] [Accepted: 10/19/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to evaluate the correlations between measurements made using panoramic radiography and cone-beam computed tomography (CBCT) based on certain anatomical landmarks of the jaws, with the goal of preventing complications due to inaccurate measurements in the pre-surgical planning phase of dental implant placement. Materials and Methods A total of 56 individuals who underwent panoramic radiography and a CBCT evaluation before dental implant surgery were enrolled in the study. Measurements were performed to identify the shortest vertical distance between the alveolar crest and neighboring anatomical structures, including the maxillary sinus, nasal floor, mandibular canal, and foramen mentale. The differences between the measurements on panoramic radiography and CBCT images were statistically analyzed. Results Statistically significant differences were observed between the measurements on panoramic radiography and CBCT for all anatomical structures (P<.05). The correlation coefficients (r) between the paired samples obtained from panoramic radiography and CBCT were closely correlated (P<.05), with r values varying from 0.921 and 0.979 for different anatomical regions. Conclusion The results of this study support the idea that panoramic radiography might provide sufficient information on bone height for preoperative implant planning in routine cases or when CBCT is unavailable. However, an additional CBCT evaluation might be helpful in cases where a safety margin cannot be respected due to insufficient bone height.
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Affiliation(s)
- Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | - Burak Kocabalkan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | | | - Göksel Şimşek Kaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Ewers R. The incisal foramen as a means of insertion for one of three ultra-short implants to support a prosthesis for a severely atrophic maxilla - A short-term report. Heliyon 2019; 4:e01034. [PMID: 30603683 PMCID: PMC6310776 DOI: 10.1016/j.heliyon.2018.e01034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/20/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022] Open
Abstract
As a continuation of our prospective cohort study for a total of 18 patients with 72 implants in severely atrophic maxillae corresponding to Cawood and Howell class V and VI (1988) [1] with four 4.0 × 5.0 mm ultrashort locking taper implants Ewers et al., 2018 [2], we now present a prospective cohort study with a total of 9 patients. The special feature of this newly modified study is the reduction of the number of implants to only three 4.0 × 5.0 mm or 4.5 × 6.0 mm or 5.0 × 6.0 mm calcium phosphate-coated Bicon Integra CP implants. Reducing the number of implants is possible by inserting the middle implant into the incisal foramen and the nasopalatine canal. All patients were restored with metal-free prostheses made of a glass fiber-reinforced hybrid resin material. Neither were any implants lost during the observation period, nor did any patient experience any sensory alteration due to the placement of an implant into the nasopalatine canal. Three implants were sufficient in all patients to stabilize their 12-unit prosthesis.
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Affiliation(s)
- Rolf Ewers
- Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- CMF Implant Institute Vienna, Schumanngasse 15, 1180, Vienna, Austria1
- Corresponding author.
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Hosni A, El-Beialy WR, Ezz M. Modified lateral sinus lift using disc-form silica calcium-phosphate NanoComposite and consequent implant placement. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.fdj.2018.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Öztürk Ö, Külünk T, Külünk Ş. Influence of different implant-abutment connections on stress distribution in single tilted implants and peripheral bone: A three-dimensional finite element analysis. Biomed Mater Eng 2018; 29:513-526. [PMID: 30282347 DOI: 10.3233/bme-181006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The load transfer between the implant-bone interface depends on various factors, including loading type; material properties of the implant and prosthesis; and implant geometry, length, diameter, and shape. OBJECTIVE The purpose of this study was to evaluate stress distribution in single tilted bone-level implants with different connections and peripheral bone under vertical and oblique loads using three-dimensional (3D) finite element analysis (FEA).METHOS.3D models of four different implant systems and their abutments were created from the data (computer-aided design) of original implants and abutments scanned with an optical scanner. The implants were placed in the bone block at degrees of 0°, 15°, and 30°. Then, a 3D model of the metal-ceramic crown was created and a 100-N total load was applied vertically and obliquely. RESULTS Stress analyses showed variable results depending on the connection design and tilting angle; however, the tube in tube (TIT) connection type exhibited lower stress values in most loading and tilting simulations. CONCLUSIONS Increase in tilting angle showed variable results in each connection design. The TIT connection design was found to be more successful in terms of stress distributions in the implant components and the peripheral bone.
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Affiliation(s)
- Özgür Öztürk
- Estethica Surgical Medical Center, Ataşehir, Istanbul
| | - Tolga Külünk
- Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Şafak Külünk
- Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Altay MA, Sindel A, Özalp Ö, Yildirimyan N, Kader D, Bilge U, Baur DA. Does the Intake of Selective Serotonin Reuptake Inhibitors Negatively Affect Dental Implant Osseointegration? A Retrospective Study. J ORAL IMPLANTOL 2018. [DOI: 10.1563/aaid-joi-d-17-00240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors (SSRIs) have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in patients rehabilitated with dental implants. A retrospective cohort study was conducted, including a total of 2055 osseointegrated dental implants in 631 patients (109 implants in 36 SSRI \users and 1946 in 595 nonusers). Predictor and outcome variables were SSRI intake and osseointegration failure, respectively. The data were analyzed with Mann–Whitney test or Fisher exact test accordingly. Both patient-level and implant-level models were implemented to evaluate the effect of SSRI exposure on the success of osseointegration of dental implants. Median duration of follow-up was 21.5 months (range = 4–56 months) for SSRI users and 23 months (range –60 months) for nonusers (P = .158). Two of 36 SSRI users had 1 failed implant each; thus, the failure rate was 5.6%. Eleven nonusers also had 1 failed implant each; thus, the failure rate was 1.85%. The difference between the 2 groups failed to reach statistical significance at patient and implant levels (P = .166, P = .149, respectively). The odds of implant failure were 3.123 times greater for SSRI users compared with nonusers. Patients using SSRIs were found to be 3.005 times more likely to experience early implant failure than nonusers. The results of this study suggest that SSRIs may lead to increase in the rate of osseointegration failure, although not reaching statistical significance.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nelli Yildirimyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Dinçer Kader
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Uğur Bilge
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Dale A. Baur
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio
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Malchiodi L, Giacomazzi E, Cucchi A, Ricciotti G, Caricasulo R, Bertossi D, Gherlone E. Relationship Between Crestal Bone Levels and Crown-to-Implant Ratio of Ultra-Short Implants With a Microrough Surface: A Prospective Study With 48 Months of Follow-Up. J ORAL IMPLANTOL 2018; 45:18-28. [PMID: 30040018 DOI: 10.1563/aaid-joi-d-17-00204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this cohort study was to investigate the relationship between crestal bone levels and crown-to-implant ratio of ultra-short implants, after functional loading. Sixty patients with single or partial edentulism and alveolar bone atrophy were enrolled and treated between December 2009 and January 2016. Without using bone-grafting procedures, patients were rehabilitated with ultra-short implants characterized by a microrough surface and a 6-mm length. Clinical and anatomical crown-to-implant (C/I) ratios and crestal bone levels (CBL) were measured after a follow-up period ranging from 12 to 72 months; all peri-implant and prosthetic parameters were recorded. The data collected were statistically analyzed ( P = .05). A total of 47 patients with 66 ultra-short implants were completely followed up according to described protocol. The mean follow-up was 48.5 ± 19.1 months. The mean anatomical C/I ratio was 2.2, while the mean clinical C/I ratio was 2.6 ± 0.6 at baseline and 2.8 ± 0.6 at the last follow-up appointment. Mean CBL as calculated at the baseline was 0.7 ± 0.5 mm, while at the last appointment it measured 1.0 ± 0.5 mm. The overall implant-based success rate was 96.9%, and the mean peri-implant bone loss (PBL) was 0.3 ± 0.3 mm. No statistically significant relationship was found between anatomical or clinical C/I ratio and PBL. Ultra-short implants appear to offer a predictable solution for implant-prosthetic rehabilitation in patients with edentulism and bone atrophy. A high percentage of implants were successful, with minimal crestal bone loss. The high C/I ratio did not appear to influence either peri-implant bone loss or prosthetic complication rates.
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Affiliation(s)
- Luciano Malchiodi
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | | | - Alessandro Cucchi
- 3 Department of Biomedical and Neuromotorial Science, University of Bologna, Bologna, Italy
| | - Giulia Ricciotti
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Riccardo Caricasulo
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Dario Bertossi
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Enrico Gherlone
- 4 Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
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da Rosa WLDO, da Silva TM, da Silva AF, Piva E. Bioactive treatments in bone grafts for implant-based rehabilitation: Systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:251-260. [PMID: 29105932 DOI: 10.1111/cid.12552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/08/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND The use of bioactive proteins, such as rhBMP-2, may improve bone regeneration in oral and maxillofacial surgery. PURPOSE Analyze the effect of using bioactive proteins for bone regeneration in implant-based rehabilitation. MATERIALS AND METHODS Seven databases were screened. Only clinical trials that evaluated the use of heterologous sources of bioactive proteins for bone formation prior to implant-based rehabilitation were included. Statistical analyses were carried out using a random-effects model by comparing the standardized mean difference between groups for bone formation, and risk ratio for implant survival (P ≤ .05). RESULTS Seventeen studies were included in the qualitative analysis, and 16 in the meta-analysis. For sinus floor augmentation, bone grafts showed higher amounts of residual bone graft particles than bioactive treatments (P ≤ .05). While for alveolar ridge augmentation bioactive treatments showed a higher level of bone formation than control groups (P ≤ .05). At 3 years of follow-up, no statistically significant differences were observed for implant survival (P > .05). CONCLUSIONS Bioactive proteins may improve bone formation in alveolar ridge augmentation, and reduce residual bone grafts in sinus floor augmentation. Further studies are needed to evaluate the long-term effect of using bioactive treatments for implant-based rehabilitation.
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Affiliation(s)
| | | | - Adriana Fernandes da Silva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Evandro Piva
- Department of Restorative Dentistry, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Intrasinusal locking technique: a novel use of the ring block technique at sinus perforations for simultaneous implant placement. Int J Oral Maxillofac Surg 2017; 47:499-504. [PMID: 29032854 DOI: 10.1016/j.ijom.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/08/2017] [Accepted: 09/20/2017] [Indexed: 11/24/2022]
Abstract
Ten patients who underwent sinus lift surgery with simultaneous implant placement using the intrasinusal locking technique were evaluated retrospectively. All patients were scheduled for sinus floor elevation procedures with simultaneous implant placement. Schneiderian membrane perforation occurred during the lifting procedure, and conventional methods failed to repair the perforation. Therefore, an autogenous bone ring was placed at the base of the maxillary sinus and was locked to the alveolar crest with a dental implant. Marginal resorption around the dental implants was measured on panoramic radiographs. Prosthetic rehabilitation was performed at 6 months postoperative. The overall survival rate of the implants over a mean follow-up of 24.3 months was 90%. One case failed due to resorption of the alveolar crest around the implant as a result of infection; the implant and the adjacent ring were removed at 1 month postoperative. At the time of writing, the nine implants placed using the documented technique continue to function well, without any signs of peri-implant disease. The proposed approach allows for simultaneous dental implant placement in the extremely atrophic maxilla, even if there is extensive perforation of the Schneiderian membrane.
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de Caxias FP, Dos Santos DM, Goiato MC, Bitencourt SB, da Silva EVF, Laurindo-Junior MCB, Turcio KHL. Effects of mouth rehabilitation with removable complete dentures on stimulus perception and the electromyographic activity of the orbicularis oris muscle. J Prosthet Dent 2017; 119:749-754. [PMID: 28967406 DOI: 10.1016/j.prosdent.2017.07.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/26/2017] [Accepted: 07/26/2017] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Many elderly individuals are rehabilitated with removable complete dentures, which require an initial adaptation period for both oral perception and the perioral muscles. Studies assessing the changes in stimulus perception and the electromyographic (EMG) activity of the orbicularis oris muscle shortly after conventional complete denture insertion are lacking. PURPOSE The purpose of this clinical study was to evaluate the effect of mouth rehabilitation with removable complete dentures on stimulus perception and the EMG activity of the orbicularis oris muscle. MATERIAL AND METHODS This study was approved by the Human Research Ethics Committee of the Araçatuba Dental School (São Paulo State University). Fifteen participants who had worn their removable complete dentures for at least 5 years and needed rehabilitation with new prostheses were enrolled in the study. A perception questionnaire was applied, and surface EMG examinations of the orbicularis oris muscle during rest, suction of water with a straw, and pronunciation of the syllables /bah/, /mah/, /pah/, and the word 'Mississippi' were performed before (T0) and 30 (T1) and 100 (T2) days after insertion of the new prostheses. The data were analyzed with the Cochran Q test, McNemar test, 2-way repeated measures ANOVA, and honestly significant difference (HSD) Tukey test (α=.05). RESULTS Significant improvement was reported in the perception questionnaire in terms of the oral discomfort sensation in the T2 period. EMG activity decreased during rest and suction after insertion of the new prostheses. A statistical difference between the upper and lower fascicles of the orbicularis oris muscle was detected, with a decrease of EMG activity between the T0 and T1 periods on the lower fascicle, except for when pronouncing the /pah/ syllable. CONCLUSIONS Mouth rehabilitation with removable complete dentures decreased oral discomfort and, depending on the oral function, decreased or increased EMG activity of the orbicularis oris muscle. In addition, the lower fascicle was more active than the upper fascicle during rest and most functional activities.
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Affiliation(s)
- Fernanda P de Caxias
- Postgraduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
| | - Daniela M Dos Santos
- Professor, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
| | - Marcelo C Goiato
- Professor, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil.
| | - Sandro B Bitencourt
- Postgraduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
| | - Emily V F da Silva
- Postgraduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
| | - Murilo C B Laurindo-Junior
- Postgraduate student, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
| | - Karina H L Turcio
- Professor, Department of Dental Materials and Prosthodontics, São Paulo State University, School of Dentistry, São Paulo, Brazil
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Elgali I, Omar O, Dahlin C, Thomsen P. Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 2017; 125:315-337. [PMID: 28833567 PMCID: PMC5601292 DOI: 10.1111/eos.12364] [Citation(s) in RCA: 400] [Impact Index Per Article: 57.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. The application of a membrane to exclude non‐osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Membrane materials possess a number of properties which are amenable to modification. A large number of membranes have been introduced for experimental and clinical verification. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research.
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Affiliation(s)
- Ibrahim Elgali
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Maxillofacial Surgery/ENT, NU-Hospital organisation, Trollhättan, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
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Casar-Espinosa JC, Castillo-Oyagüe R, Serrera-Figallo MÁ, Garrido-Serrano R, Lynch CD, Menéndez-Collar M, Torres-Lagares D, Gutiérrez-Pérez JL. Combination of straight and tilted implants for supporting screw-retained dental prostheses in atrophic posterior maxillae: A 2-year prospective study. J Dent 2017; 63:85-93. [PMID: 28587977 DOI: 10.1016/j.jdent.2017.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/13/2017] [Accepted: 05/30/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To evaluate the two-year survival rate (SR) and marginal bone loss (MBL) of fixed dental prostheses (FDPs) supported by straight (S) and tilted (T) implants under the influence of diverse study variables. METHODS A prospective investigation comprising 21 patients provided with a total of 27 maxillary screw-retained restorations fixed to 70 dental implants was developed. Two groups of implants were considered depending on their inclination with respect to the occlusal plane: Group 1 (S, n=37): straight/axial implants and Group 2 (T, n=33): tilted/angled fixations. Each FDP was supported by a combination of S and T implants. SR and MBL were assessed at the time of loading and two years after surgery. Patient-, surgical- and/or rehabilitation-related information was gathered. Data were statistically analysed at the α=0.05 significance level. RESULTS After 24 months, a 100% SR was achieved and the MBL of S and T implants were statistically similar. T implants located in the molar region showed lower MBL than did those replacing premolars (p=0.031). CONCLUSIONS Upright and angled fixations inserted at posterior maxillary areas resulted in comparable survival rates and peri-implant MBL after two years. The marginal bone resorption around tilted implants depended on their location. CLINICAL SIGNIFICANCE Screw-retained restorations fixed to straight and tilted implants seem to be a safe treatment option in posterior atrophic maxillae.
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Affiliation(s)
- Juan-Carlos Casar-Espinosa
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - Raquel Castillo-Oyagüe
- Department of Buccofacial Prostheses, Faculty of Dentistry, Complutense University of Madrid (U.C.M.), Pza. Ramón y Cajal, s/n, 28040, Madrid, Spain.
| | | | - Roberto Garrido-Serrano
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | | | - Manuel Menéndez-Collar
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - José-Luis Gutiérrez-Pérez
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
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Fienitz T, Moses O, Klemm C, Happe A, Ferrari D, Kreppel M, Ormianer Z, Gal M, Rothamel D. Histological and radiological evaluation of sintered and non-sintered deproteinized bovine bone substitute materials in sinus augmentation procedures. A prospective, randomized-controlled, clinical multicenter study. Clin Oral Investig 2016; 21:787-794. [DOI: 10.1007/s00784-016-1829-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 04/17/2016] [Indexed: 11/29/2022]
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Abstract
The use of dental implants for the rehabilitation of missing teeth has broadened the treatment options for patients and clinicians equally. As a result of advances in research in implant design, materials, and techniques, the use of dental implants has increased dramatically in the past two decades and is expected to expand further in the future. Success of dental implants depends largely on the quality and quantity of the available bone in the recipient site. This however may be compromised or unavailable due to tumor, trauma, periodontal disease, etc., which in turn necessitates the need for additional bone manipulation. This review outlines the various bone manipulation techniques that are used to achieve a predictable long-term success of dental implants.
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Affiliation(s)
- Yuvika Mittal
- Department of Oral and Maxillofacial Surgery, Gian Sagar Dental College and Hospital, Ramnagar, Rajpura, Punjab, India
| | - Govind Jindal
- Department of Oral and Maxillofacial Surgery, Gian Sagar Dental College and Hospital, Ramnagar, Rajpura, Punjab, India
| | - Sandeep Garg
- Department of Oral and Maxillofacial Surgery, Gian Sagar Dental College and Hospital, Ramnagar, Rajpura, Punjab, India
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