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Ahn JH, Lim YJ, Lee J, Baek YW, Kim MJ, Kwon HB. A One-Year Randomized Controlled Clinical Trial of Three Types of Narrow-Diameter Implants for Fixed Partial Implant-Supported Prosthesis in the Mandibular Incisor Area. Bioengineering (Basel) 2024; 11:272. [PMID: 38534546 DOI: 10.3390/bioengineering11030272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Narrow-diameter implants (NDI) serve as a solution for treating limited bone volume in the anterior mandible. This study aimed to evaluate the one-year clinical outcomes of various NDIs in the mandibular incisor area after immediate loading in partially edentulous patients. This single-center, prospective, single-blinded, randomized controlled trial study included 21 patients, with 7 patients in each of the following groups: control (BLT NC SLActive®; Straumann), experimental group 1 (CMI IS-III Active® S-Narrow; Neobiotech), and experimental group 2 (CMI IS-III Active® Narrow; Neobiotech). Using full digital flow, two fixtures were placed in each patient and immediately provisionalized on the day of surgery. Evaluations encompassed periapical radiographs, implant stability quotient (ISQ), implant stability test (IST) readings, per-implant soft tissue health, patient satisfaction surveys, and esthetic score assessments. Definitive prostheses were delivered twelve weeks post-surgery (CRiS, number: KCT0007300). Following exclusions due to low stability values (n = 2), fixture failure (n = 5), and voluntary withdrawal (n = 1), the implant success rate for patients completing all clinical protocols stood at 100%. The resulting patient failure rates in the control, experimental group 1, and experimental group 2 were 50.0%, 42.9%, and 14.3%, respectively. There were no significant differences between the groups in terms of marginal bone loss, soft tissue health, patient satisfaction, and esthetic scores. Narrow implants showed superior clinical outcomes, followed by S-Narrow and Straumann implants. Calculated one-year survival rates at the implant level were 66.7% for the control group, 85.7% for experimental group 1, and 100% for experimental group 2. All three types of NDIs showed acceptable clinical and radiographic results during the year-long observation period.
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Affiliation(s)
- Ji-Ho Ahn
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea
| | - Yeon-Wha Baek
- Department of Prosthodontics, Gwanak Center, Seoul National University Dental Hospital, Seoul 08826, Republic of Korea
| | - Myung-Joo Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
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Zhang Y, Wen G, Dong W. Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:196. [PMID: 38443497 DOI: 10.1007/s00784-024-05588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. MATERIALS AND METHODS A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. RESULTS Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. CONCLUSION The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. CLINICAL RELEVANCE Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.
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Affiliation(s)
- Yan Zhang
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Guochen Wen
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Wei Dong
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China.
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Herrera-Pérez P, García-De-La-Fuente AM, Andia-Larrea E, Marichalar-Mendia X, Aguirre-Urizar JM, Aguirre-Zorzano LA. Clinical analysis of the tooth-implant papilla for two narrow-diameter titanium-zirconium implants in the anterior area: prospective controlled clinical study. BMC Oral Health 2024; 24:310. [PMID: 38443879 PMCID: PMC10916199 DOI: 10.1186/s12903-024-04075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Rehabilitation of the anterior area when the mesio-distal space is reduced is a challenge for the clinician, due to the patient's anatomical limitations and aesthetic requirements. Narrow Diameter Implants (NDI) are an option of treatment when the standard diameter implant is not possible, but the evidence is scarce. This prospective clinical study aims to analyze the formation of the tooth-implant papilla between the implant and the adjacent natural tooth in the maxillary lateral incisors and mandibular incisors. METHODS A total of 40 patients treated with NDI, of titanium-zirconium (Ti-Zr) alloy i.e., 2.9 mm Test Group (TG) and 3.3 mm Control Group (CG), were included. The mesiodistal distance between the adjacent natural teeth was used for implant selection, maintaining 1.5 mm between the fixation and the adjacent tooth. Clinical assessment was performed by a clinical examiner at 6 and 12 months after the final prosthesis. The primary variable was the Jemt Papillary Index. Also, implant survival rate (SR), complications, Implant Stability Quotient (ISQ), and patient-reported outcomes measures (PROMs) such as aesthetics, chewing, phonation, comfort, and self-esteem were analyzed. RESULTS A significant amount of papilla filling was observed concerning the baseline, with a trend towards more formation of the papilla in the TG, with a JPI score of 3. No significant differences were observed between the two groups regarding implant SR, clinical parameters, and complications. In terms of PROMs, a higher satisfaction in the TG was observed, with significant intergroup differences for aesthetics, comfort, self-esteem, and primary stability ISQ (TG: 59.05 (SD: 5.4) vs. CG: 51.55 (SD: 5.7)). CONCLUSIONS The 2.9 mm diameter Ti-Zr implants achieved a formation of papilla similar to 3.3 mm implants in the anterior region at 12 months of follow-up after the final prosthetic restoration. The use of Ti-Zr implants with a diameter of 2.9 mm to rehabilitate single teeth in areas of the anterior region, where the mesiodistal distance is limited, showed favorable clinical results and a high degree of satisfaction during 1 year of observation similar to 3.3 mm dental implants. TRIAL REGISTRATION This study was retrospectively registered in ClinicalTrials.gov with the number NCT05642520, dated 18/11/2022.
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Affiliation(s)
| | - Ana María García-De-La-Fuente
- Research Group: GIU21/042Department of StomatologyFaculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain.
| | - Eztizen Andia-Larrea
- International University of Catalunya, Barcelona, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Biscay, Spain
| | - Xabier Marichalar-Mendia
- Research Group: GIU21/042, Department of Nursery I, University of the Basque Country (UPV/EHU), Biscay, Spain
| | - José Manuel Aguirre-Urizar
- Research Group: GIU21/042Department of StomatologyFaculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
| | - Luis Antonio Aguirre-Zorzano
- Research Group: GIU21/042Department of StomatologyFaculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena S/N, 48940, Leioa, Biscay, Spain
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Anitua E, Eguia A, Staudigl C, Alkhraisat MH. Clinical performance of additively manufactured subperiosteal implants: a systematic review. Int J Implant Dent 2024; 10:4. [PMID: 38315326 PMCID: PMC10844163 DOI: 10.1186/s40729-024-00521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
PURPOSE The aim of this study was to assess implant survival and complications rate of modern subperiosteal implants (CAD designed and additively manufactured). METHODS A systematic review was conducted using three electronic databases; Medline (Pubmed), Cochrane library, and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "In patients with bone atrophy (P), do additively manufactured subperiosteal implants (I), compared to subperiosteal implants manufactured following traditional approaches (c), present satisfactory implant survival and complication rates (O)? The study was pre-registered in PROSPERO (CRD42023424211). Included articles quality was assessed using the "NIH quality assessment tools". RESULTS Thirteen articles were finally selected (5 cohort studies and 8 case series), including 227 patients (121 female / 106 male; weighted mean age 62.4 years) and 227 implants. After a weighted mean follow-up time of 21.4 months, 97.8% of implants were in function (5 failures reported), 58 implants (25.6%) presented partial exposure, 12 patients (5.3%) suffered soft tissue or persistent infection. Fracture of the interim prosthesis was reported in 8 of the155 patients (5.2%) in which the use of a provisional prosthesis was reported. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. CONCLUSIONS Within the limitations of this study, modern additively manufactured subperiosteal implants presented a good survival in the short-time, but a noticeable number of soft-tissue related complications were reported. Further studies are needed to assess the clinical behavior in the medium- and long-term.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University of the Basque Country UPV/EHU and University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Christoph Staudigl
- Department of Cranio-Maxillofacial Surgery, Kepler Universitätsklinikum, Linz, Austria
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
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Cruz RS, Fernandes E Oliveira HF, Lemos CAA, de Souza Batista VE, Capalbo da Silva R, Verri FR. Biomechanical influence of narrow-diameter implants placed at the crestal and subcrestal level in the maxillary anterior region. A 3D finite element analysis. J Prosthodont 2024; 33:180-187. [PMID: 36799260 DOI: 10.1111/jopr.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE To evaluate the tendency of movement, stress distribution, and microstrain of single-unit crowns in simulated cortical and trabecular bone, implants, and prosthetic components of narrow-diameter implants with different lengths placed at the crestal and subcrestal levels in the maxillary anterior region using 3D finite element analysis (FEA). MATERIALS AND METHODS Six 3D models were simulated using Invesalius 3.0, Rhinoceros 4.0, and SolidWorks software. Each model simulated the right anterior maxillary region including a Morse taper implant of Ø2.9 mm with different lengths (7, 10, and 13 mm) placed at the crestal and subcrestal level and supporting a cement-retained monolithic single crown in the area of tooth 12. The FEA was performed using ANSYS 19.2. The simulated applied force was 178 N at 0°, 30°, and 60°. The results were analyzed using maps of displacement, von Mises (vM) stress, maximum principal stress, and microstrain. RESULTS Models with implants at the subcrestal level showed greater displacement. vM stress increased in the implant and prosthetic components when implants were placed at the subcrestal level compared with the crestal level; the length of the implants had a low influence on the stress distribution. Higher stress and strain concentrations were observed in the cortical bone of the subcrestal placement, independent of implant length. Non-axial loading influenced the increased stress and strain in all the evaluated structures. CONCLUSIONS Narrow-diameter implants positioned at the crestal level showed a more favorable biomechanical behavior for simulated cortical bone, implants, and prosthetic components. Implant length had a smaller influence on stress or strain distribution than the other variables.
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Affiliation(s)
- Ronaldo S Cruz
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF)-Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Victor Eduardo de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, The University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Rodrigo Capalbo da Silva
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
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Hwang I, Kim TI, Cho YD. Clinical evaluation of 3.0-mm narrow-diameter implants: a retrospective study with up to 5 years of observation. J Periodontal Implant Sci 2024; 54:44-52. [PMID: 37336522 PMCID: PMC10901684 DOI: 10.5051/jpis.2300820041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE This study aimed to evaluate the clinical outcomes of a single type of narrow-diameter implant (NDI) by investigating its survival rate and peri-implant marginal bone loss (MBL). In addition, variables possibly related to implant survival and MBL were investigated to identify potential risk factors. METHODS The study was conducted as a retrospective study involving 49 patients who had received 3.0-mm diameter TSIII implants (Osstem Implant Co.) at Seoul National University Dental Hospital. In total, 64 implants were included, and dental records and radiographic data were collected from 2017 to 2022. Kaplan-Meier survival curves and a Cox proportional hazard model were used to estimate the implant survival rate and to investigate the effects of age, sex, jaw, implant location, implant length, the stage of surgery, guided bone regeneration, type of implant placement, and the surgeon's proficiency (resident or professor) on implant survival. The MBL of the NDIs was measured, and the factors influencing MBL were evaluated. RESULTS The mean observation period was 30.5 months (interquartile range, 26.75-45 months), and 6 out of 64 implants failed. The survival rate of the NDIs was 90.6%, and the multivariate Cox regression analysis showed that age was associated with implant failure (hazard ratio, 1.17; 95% confidence interval, 1.04-1.31, P=0.01). The mean MBL was 0.44±0.75 mm, and no factors showed statistically significant associations with greater MBL. CONCLUSIONS NDIs can be considered a primary alternative when standard-diameter implants are unsuitable. However, further studies are required to confirm their long-term stability.
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Affiliation(s)
- InKyung Hwang
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
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Walter C, Sagheb K, Blatt S, Klein MO, Herrmann J, Kleinheinz J, Al-Nawas B. Evaluation of the clinical safety and performance of a narrow diameter (2.9 mm) bone-level implant: a 1-year prospective single-arm multicenter study. Int J Implant Dent 2023; 9:32. [PMID: 37725234 PMCID: PMC10509112 DOI: 10.1186/s40729-023-00495-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE Narrow-diameter implants facilitate single-tooth restoration when interdental or inter-implant spaces and bone volume are inadequate for using standard diameter implants. This study reports the short-term data on the clinical safety and performance of a bone-level-tapered two-piece implant with a 2.9 mm diameter in the clinical practice setting. This study was retrospectively registered on March 1st, 2016 (NCT02699866). METHODS Implants were placed in partially healed extraction sockets of the central and lateral incisors in the mandible and lateral incisors in the maxilla for single-tooth replacement. The primary outcome was to assess implant survival at 12 months after placement. Secondary outcomes included implant success, pink esthetic score, marginal bone-level changes, and safety. RESULTS Twenty four males and 17 females with a mean age of 44.5 (± 18.3 standard deviation) received the implant. Three out of 41 implants were lost yielding a survival rate of 92.7% (95%-CI: 79.0%; 97.6%) at 1 year. One patient reported an ongoing foreign body sensation, pain, and/or dysesthesia at month 12. The average pink esthetic score at 6 months was 11.2 (95%-CI: 10.5; 11.9). The bone level was stable with a mean bone-level change of-0.3 mm (± 0.42 mm standard deviation) at 1 year after implantation. No serious adverse events or adverse device events were reported. CONCLUSIONS The use of a 2.9 mm diameter bone-level-tapered implant is a safe and reliable treatment option for narrow tooth gaps at the indicated locations. Overall performance and good survival rates support their use in cases, where wider implants are unsuitable.
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Affiliation(s)
- Christian Walter
- Oral and Maxillofacial Surgery of the Mediplus Clinic, Haifa-Allee 20, 55128, Mainz, Germany.
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
| | - Keyvan Sagheb
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Blatt
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Marcus Oliver Klein
- Oral and Maxillofacial Surgery Private Dental Office, Stresemannstraße 7-9, 40210, Düsseldorf, Germany
| | - Jan Herrmann
- Oral and Maxillofacial Surgery Private Dental Office, Lothar-Streit-Straße 10B, 08056, Zwickau, Germany
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Münster, Albert Schweitzer-Campus 1, 48149, Münster, Germany
| | - Bilal Al-Nawas
- Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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Cao R, Chen B, Xu H, Fan Z. Clinical outcomes of titanium-zirconium alloy narrow-diameter implants for single-crown restorations: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2023; 61:403-410. [PMID: 37331853 DOI: 10.1016/j.bjoms.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/26/2023] [Accepted: 05/07/2023] [Indexed: 06/20/2023]
Abstract
Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The purpose of this systematic review and meta-analysis was to evaluate clinical evidence, including survival rates, success rates, and marginal bone loss (MBL) on Ti-Zr NDIs that support single crowns. An extensive search was performed in the databases of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for studies published in English up to April 2022. Only peer-reviewed clinical studies with at least 10 patients and a follow-up time of at least 12 months were included. Risk of bias in each study was assessed and data extraction was carried out independently by two reviewers. The outcome variables were survival rates, success rates, and MBL. The search returned 779 results. Eight studies were identified for qualitative analysis and seven for quantitative synthesis. Overall, a total of 256 Ti-Zr NDIs were included. Cumulative implant survival rates and success rates were 97.5% (95% confidence interval (CI): 94.5% to 98.9%) and 97.2% (95% CI: 94.2% to 98.7%), respectively, over a maximum follow-up period of 36 months, with no difference between Ti-Zr NDIs and commercial pure titanium (cpTi) implants. Cumulative mean (SD) MBL was 0.44 (0.04) mm (95% CI: 0.36 to 0.52) after one year. Meta-analysis of MBL indicated a mean difference of 0.02 mm (95% CI: -0.23 to 0.10), with no differences between Ti-Zr NDIs and cpTi implants. Short-term results of Ti-Zr NDIs for single-crown restorations are quite promising, although the number of published studies and follow-up periods are insufficient to determine the real benefit for single crowns. Long-term, follow-up clinical studies are needed to verify the excellent clinical performance of Ti-Zr NDIs.
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Affiliation(s)
- Rongkai Cao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Beibei Chen
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Hui Xu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Zhen Fan
- Department of Oral Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
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Same-Day Digital Dentistry Restorative Workflow for Single Immediate Provisionalization of Narrow-Diameter Implants: An Exploratory Prospective Study. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after placement. At least 2 months after placement, the implant was restored with a prefabricated titanium abutment and an all-ceramic crown using a same-day dentistry protocol. Clinical outcomes, including apical bone loss, probing depths, gingival index, and surgical and prosthetic complications, were documented. There was no implant failure over the course of two years. No surgical complications were reported. Two cases lost provisional crowns. One crown needed to be remade due to esthetic concern. The cumulative two-year survival rate of the implants was 100%. Implant bone loss after two years of functional loading was −0.56 ± 0.54 mm and −0.32 ± 0.68 mm for mesial and distal crestal bone, respectively. Two prosthetic complications included recementation of a crown and remaking of a crown. This exploratory study suggests that immediate provisionalization and a same-day restorative dentistry digital workflow protocol for narrow-diameter implants appear to be predictable clinical procedures with no reported surgical complications and minimal prosthetic complications.
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10
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Thomé G, Vianna CP, Caldas W, Bernardes SR, Uhlendorf J, Cartelli CA, Trojan LC. Clinical and radiographic outcomes of maxillary lateral incisors rehabilitation using Morse taper connection extra-narrow implants at 12-month follow-up: A case report. Clin Case Rep 2022; 10:e6248. [PMID: 36034604 PMCID: PMC9400033 DOI: 10.1002/ccr3.6248] [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: 06/06/2022] [Revised: 07/19/2022] [Accepted: 07/30/2022] [Indexed: 11/26/2022] Open
Abstract
Narrow-diameter implants (≤3.5 mm) have been proposed to address the challenge of implant placement in cases of insufficient bone quantity, thin alveolar crest, and small cervical diameter teeth replacement The aim of this study is to report one-year outcomes of extra-narrow implant rehabilitation of maxillary lateral incisors, due to agenesis, in a young adult that presented sites with reduced mesiodistal and buccolingual dimensions. A 26-year-old male patient in need of fixed-implant supported prostheses due to the absence of permanent maxillary lateral incisors and with limited space, was submitted to surgery to receive two 2.9 mm hybrid Morse taper connection implants with hydrophilic surfaces. Immediate loading was applied by means of insertion of provisional prostheses, which were replaced for all-ceramic prostheses 12 months after surgery. The 1 year follow-up showed clinical and radiographic success of extra-narrow implant rehabilitation. Also, both regions presented good evolution of peri-implant esthetics, as assesses using the pink esthetic score, with improvements at 4 months follow-up and reaching high scores 12 months after surgery. Although the prosthetic rehabilitation of maxillary lateral incisors is challenging due to limited space for the insertion of implants, the clinical case suggests that the use of extra-narrow Morse Taper implants with hybrid design and hydrophilic surface is a reliable alternative, presenting good outcomes regarding hard and soft tissue and it is a versatile solution or immediate loading procedure. Further studies are needed to confirm extra-narrow implant predictability.
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Affiliation(s)
- Geninho Thomé
- Department of ImplantologyLatin American Institute for Research and Dental Education (ILAPEO)CuritibaBrazil
| | | | | | - Sergio Rocha Bernardes
- Department of ImplantologyLatin American Institute for Research and Dental Education (ILAPEO)CuritibaBrazil
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Kim JC, Lee M, Yeo ISL. Three interfaces of the dental implant system and their clinical effects on hard and soft tissues. MATERIALS HORIZONS 2022; 9:1387-1411. [PMID: 35293401 DOI: 10.1039/d1mh01621k] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Anatomically, the human tooth has structures both embedded within and forming part of the exterior surface of the human body. When a tooth is lost, it is often replaced by a dental implant, to facilitate the chewing of food and for esthetic purposes. For successful substitution of the lost tooth, hard tissue should be integrated into the implant surface. The microtopography and chemistry of the implant surface have been explored with the aim of enhancing osseointegration. Additionally, clinical implant success is dependent on ensuring that a barrier, comprising strong gingival attachment to an abutment, does not allow the infiltration of oral bacteria into the bone-integrated surface. Epithelial and connective tissue cells respond to the abutment surface, depending on its surface characteristics and the materials from which it is made. In particular, the biomechanics of the implant-abutment connection structure (i.e., the biomechanics of the interface between implant and abutment surfaces, and the screw mechanics of the implant-abutment assembly) are critical for both the soft tissue seal and hard tissue integration. Herein, we discuss the clinical importance of these three interfaces: bone-implant, gingiva-abutment, and implant-abutment.
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Affiliation(s)
- Jeong Chan Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea
| | - Min Lee
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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Burkhardt F, Harlass M, Adolfsson E, Vach K, Spies BC, Kohal RJ. A Novel Zirconia-Based Composite Presents an Aging Resistant Material for Narrow-Diameter Ceramic Implants. MATERIALS 2021; 14:ma14092151. [PMID: 33922688 PMCID: PMC8122934 DOI: 10.3390/ma14092151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/23/2023]
Abstract
A novel ceria-stabilized zirconia-alumina-aluminate composite (Ce-TZP-comp) that is not prone to aging presents a potential alternative to yttrium-stabilized zirconia for ceramic oral implants. The objective of this study was to evaluate the long-term stability of a one-piece narrow-diameter implant made of Ce-TZP-comp. Implant prototypes with a narrow (3.4 mm) and regular (4.0 mm) diameter were embedded according to ISO 14801, and subgroups (n = 8) were subsequently exposed to dynamic loading (107 cycles, 98N) and/or hydrothermal treatment (aging, 85 °C). Loading/aging was only applied as a combined protocol for the 4.0 mm diameter implants. One subgroup of each diameter remained untreated. One sample was cross-sectioned from each subgroup and evaluated with a scanning electron microscope for phase-transformation of the lattice. Finally, the remaining samples were loaded to fracture. A multivariate linear regression model was applied for statistical analyses (significance at p < 0.05). All samples withstood the different loading/aging protocols and no transformation propagation was observed. The narrow diameter implants showed the lowest fracture load after combined loading/aging (628 ± 56 N; p < 0.01), whereas all other subgroups exhibited no significantly reduced fracture resistance (between 762 ± 62 and 806 ± 73 N; p > 0.05). Therefore, fracture load values of Ce-TZP-comp implants suggest a reliable intraoral clinical application in the anterior jaw regions.
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Affiliation(s)
- Felix Burkhardt
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (F.B.); (M.H.); (B.C.S.)
| | - Markus Harlass
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (F.B.); (M.H.); (B.C.S.)
| | | | - Kirstin Vach
- Medical Center—University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany;
| | - Benedikt Christopher Spies
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (F.B.); (M.H.); (B.C.S.)
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (F.B.); (M.H.); (B.C.S.)
- Correspondence:
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