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Zhang J, Hou H, Chen P, Sun B, Hu F, Yu Y, Song L. Mechanical and modal analysis of different implant strategies for loss of three teeth with bone atrophy in the maxillary posterior region. Comput Methods Biomech Biomed Engin 2024:1-10. [PMID: 38829324 DOI: 10.1080/10255842.2024.2358363] [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: 03/07/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE This study aimed to evaluate the stress distribution and secondary stability involved in five implant strategies, including implant-supported prostheses (ISP) and tooth-implant-supported prostheses (TISP), used for bone atrophy in the maxillary posterior region with teeth loss using finite element analysis, and to explore the more desirable implant methods. METHODS Five implant strategies were made to analyze and compare: M1, implant-supported prosthesis consisting of a short implant with a regular implant; M2, implant-supported prosthesis consisting of a tilted implant with a regular implant; M3, cantilever structure; M4, tooth-implant-supported prosthesis consisting of a short implant with a regular implant; M5, tooth-implant-supported prosthesis consisting of a regular implant, and M6, with only the natural teeth as a control group. Dynamic loading of the above models was performed in finite element analysis software to assess the stress distribution of the bone tissue and implants using the von Mise criterion. Finally, the secondary stability of different models was evaluated by modal analysis. RESULTS The maximum stress distribution in the cortical bone in M1(60 MPa) was smaller than that in M2(97 MPa) and M3(101 MPa), The first principal strain minimum was obtained in M2 (2271μ ε ). M4 (33 MPa, 10085 Hz) with the best mechanical properties and highest resonance frequency. But increased the loading on the natural teeth. CONCLUSIONS Short implants and tilted implants are both preferred implant strategies, if cantilever construction is necessary, a tooth-implant-supported prosthesis consisting of a short implant and a regular implant is recommended.
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Affiliation(s)
- Jianguo Zhang
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai, China
| | - Hu Hou
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai, China
| | - Peng Chen
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai, China
| | - Benhao Sun
- School of Mechanical Engineering, Shanghai Institute of Technology, Shanghai, China
| | - Fengling Hu
- Department of Stomatology, Shanghai Geriatric Medical Center, Shanghai, China
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Youcheng Yu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liang Song
- Department of Stomatology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
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He J, Liu Y, Lin Z, Li Y, Li C, Zhou L. Feasibility of implant placement in healed mandibular molar sites: A retrospective cone beam computed tomography study. J Prosthet Dent 2024; 131:904.e1-904.e10. [PMID: 38472073 DOI: 10.1016/j.prosdent.2024.02.002] [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: 09/02/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/14/2024]
Abstract
STATEMENT OF PROBLEM Implant placement in the mandibular molar sites plays a crucial role in the restoration of edentulous mandibles. However, the evaluation of bone quantity before implant surgery using cone beam computed tomography (CBCT) is lacking. PURPOSE The purpose of this clinical study was to evaluate CBCT images of edentulous patients to analyze the feasibility of implant placement in healed mandibular molar sites. MATERIAL AND METHODS The CBCT data of 138 patients were analyzed in the sagittal plane for measurements of mandibular bone height (MBH), superior bone height (SBH), inferior bone height (IBH), buccal bone width (BBW), lingual bone width (LBW), and alveolar bone widths (ABWs). The edentulous sites were categorized according to the bone quantity and complexity of the implant surgery. Multivariate analysis of variance (MANOVA) was used to analyze the site, sex, and age-related variations. An independent t test was used to compare the difference of bone dimension in different sites and between sexes. One-way ANOVA followed by post hoc tests were used to analyze the difference between different age groups. Categorical variables were presented as number of events and percentages. The chi-squared test was used to compare categorical variables (α=.05). RESULTS A total of 534 sites of interest were recorded, including 274 hemimandibles. A significant difference in BBW was found between the first and second molar sites. Men had higher MBH, SBH, IBH, and BBW than women. The distribution of implant surgical complexity in the conventional group was 63.5%, while the buccolingual tilted implant group accounted for 17.0%, and the complicated group accounted for 19.5%. Of the 274 hemimandibles, an implant could be placed directly at molar sites in 88% of situations. CONCLUSIONS The BBW at the mandibular second molar site was greater than that at the first molar site. The amount of available bone in the SBH and BBW was greater in men than in women at the healed molar sites. Age did not significantly affect the complexity of the implant surgery. Implants can be placed directly in healed mandibular molar sites in most patients who require a complete arch mandibular implant-supported restoration.
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Affiliation(s)
- Jianfeng He
- Master's student, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China
| | - Yudong Liu
- Resident, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China
| | - Zhiyan Lin
- Master's student, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China
| | - Yongqi Li
- Master's student, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China
| | - Chengwei Li
- Master's student, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China
| | - Libin Zhou
- Associate Professor, Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, PR China.
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Malchiodi L, Fiorino A, Merlino L, Cucchi A, Zotti F, Nocini PF. Analysis of ultra-short implants with different angulations: a retrospective case-control study with 2 to 9 years of follow-up. Clin Oral Investig 2024; 28:79. [PMID: 38183469 DOI: 10.1007/s00784-023-05460-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: 10/08/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Does the angulation of ultrashort implants influence the stability of the peri-implant bone? The present study aimed to evaluate the effectiveness of non-axial ultrashort implants after 2 to 9 years of follow-up in resorbed alveolar ridges. MATERIALS AND METHODS All partially edentulous patients with ultrashort implants (< 6 mm) used in the posterior region of an atrophic mandible or maxilla, to support partial dentures in conjunction with standard implants, were included in this study. Peri-implant bone loss, success and survival rates, crestal bone levels, crown-to-implant ratio and implant angulation were measured for each implant. Implants were divided into two groups: straight implants with angulation < 17° (control group) and tilted implants with angulation > 17° (test group). Statistical analysis was used to find any significant differences between the two study groups and to investigate significant linear correlations among all the variables (p = 0.05). RESULTS A total of 42 ultrashort implants with a mean of 4 years of follow-up were included: 20 ultrashort axially loaded implants and 22 tilted implants. Mean crestal bone levels from baseline loading to maximum follow-up did not reveal statistical differences in regard to PBL; mean success and survival rates were 100% in all groups. CONCLUSIONS PBL, success and survival rates of axial ultrashort implants and tilted ultrashort implants are comparable to those of conventional implants. CLINICAL RELEVANCE This retrospective study revealed that ultrashort implants, even when placed with an angulation > 17°, can safely be used to support partial fixed prostheses. Further prospective clinical studies with larger samples and prospective design are needed to confirm these findings.
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Affiliation(s)
- Luciano Malchiodi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Antonino Fiorino
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Via S. Pansini 5, 80131, Naples, Italy.
| | | | | | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
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Qin S, Gao Z. Comparative evaluation of short or standard implants with different prosthetic designs in the posterior mandibular region: a three-dimensional finite element analysis study. Comput Methods Biomech Biomed Engin 2023; 26:1499-1509. [PMID: 36125258 DOI: 10.1080/10255842.2022.2124859] [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: 06/05/2022] [Revised: 08/29/2022] [Accepted: 09/11/2022] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to evaluate the stress distribution of splinted or nonsplinted restorations supported by 2 short or 2 standard dental implants in the mandibular molar region using three-dimensional finite element analysis. Two standard implants (4.8 × 10mm) were placed in the mandibular molar area. Two short implants (4.8 × 6 mm) were located in the mandibular molar atrophied area. Implant-supported prostheses were simulated with splinted or nonsplinted crowns design. Vertical load of 200 N and oblique load of 100 N were applied on the central fossa and the buccal cusps. Evaluation of stress distribution in implants and peri-implant cortical bone using the finite element analysis software (Ansys, Version 2020, R2), a multipurpose computer design program. The maximum principal stress of cortical bone around the implants was higher in nonsplinted crowns when compared to splinted crowns. The stress concentration of cortical bone surrounding implants increased as the implant length decreased either splinted crowns or nonsplinted crowns. The short implants with nonsplinted crowns showed lower stresses when compared to standard implants with nonsplinted crowns. The results suggest that the nonsplinted prostheses supported by short dental implants might be considered in the molar area of the atrophic mandible.
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Affiliation(s)
- Siqi Qin
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi Gao
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Sáenz-Ravello G, Ossandón-Zúñiga B, Muñoz-Meza V, Mora-Ferraro D, Baeza M, Fan S, Sagheb K, Schiegnitz E, Díaz L. Short implants compared to regular dental implants after bone augmentation in the atrophic posterior mandible: umbrella review and meta-analysis of success outcomes. Int J Implant Dent 2023; 9:18. [PMID: 37400739 DOI: 10.1186/s40729-023-00476-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/28/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE To assess the body of evidence of short versus regular implants after bone augmentation (BA) in the atrophic posterior mandible in the context of implant treatment success outcomes. METHODS Seven databases, two registries, and reference lists were searched for systematic reviews and meta-analysis (SR/MA), randomized controlled trials (RCTs) and longitudinal studies published in English, Spanish or German since 2012. Confidence in the SR/MA methodology was evaluated using AMSTAR-2 and the risk of bias of primary studies using Cochrane's RoB 2.0 and ROBINS-I. A random-effects meta-analysis and a meta-regression were performed for continuous and dichotomous outcomes. GRADE approach was used to assess the certainty of the evidence. RESULTS Eighteen SRs/MAs, most of them "critically low" and "low" confidence with substantial overlap, included 14 relevant RCTs with a high risk of bias. A cohort study with moderate risk of bias was added. Quantitative synthesis of 595 implants and 281 hemiarches/patients indicates that the use of short implants (< 10 mm) compared to regular implants and BA may reduce implant failure at 1-year follow-up, and marginal bone loss (MBL) at 3-, 5-, and 8-year follow-up; is likely to reduce the risk of biological complications at 1-, 3-, 5-, and 8-year follow-up; and may be the patient's preferred alternative. There is a correlation between bone height, MBL and biological complications. CONCLUSIONS The available evidence partially suggests that the use of short implants could decrease implant failure, MBL, and biological complications, and increase patient satisfaction. However, given the need for further RCTs and real-world evidence to fully evaluate short- and long-term outcomes, it would be prudent for clinicians to carefully consider the individual needs and circumstances of the patients before deciding whether to use short implants. Trial registration PROSPERO CRD42022333526.
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Affiliation(s)
- Gustavo Sáenz-Ravello
- Faculty of Dentistry, Center for Epidemiology and Surveillance of Oral Diseases, University of Chile, Santiago, Chile
| | | | | | | | - Mauricio Baeza
- Faculty of Dentistry, Center for Epidemiology and Surveillance of Oral Diseases, University of Chile, Santiago, Chile
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Leonardo Díaz
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile.
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany.
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Guida L, Esposito U, Sirignano M, Torrisi P, Annunziata M, Cecchinato D. 6 mm short versus 11 mm long inter-foraminal implants in the full-arch rehabilitation of edentulous non-atrophic mandibles: 5-year results from a multicenter randomized controlled trial. Clin Oral Implants Res 2023; 34:127-136. [PMID: 36461704 DOI: 10.1111/clr.14024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/09/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE The aim of this multicenter parallel-group randomized controlled trial is to compare, in the same clinical scenario, 6 mm short with 11 mm long implants for the rehabilitation of completely edentulous non-atrophic mandibles. MATERIALS AND METHODS Thirty patients in three study centers received a fixed full-arch mandibular rehabilitation supported by five inter-foraminal implants, with no need for bone augmentation procedures. Patients were randomly allocated (1:1 ratio), at the time of surgery, to test (6 mm implants) or control group (11 mm implants). After 3 months, a screw-retained full-arch prosthesis was positioned (baseline). Peri-implant marginal bone level change (MBLc, primary outcome) together with implant and prosthesis survival rate, and biological/technical complications (secondary outcomes) were evaluated up to 5 years. RESULTS Twenty seven patients were controlled at 5 years (3 drop-outs). No implant or prosthesis loss occurred. No significant intergroup difference for biological/technical complications (p > .05, Fisher's exact test) and no significant intragroup and intergroup difference in the MBLc values were registered (test -0.03 ± 0.17 mm and control -0.13 ± 0.32 mm at 5-years; p > .025, one-sided Mann-Whitney U-test). CONCLUSIONS When used in comparable anatomic, surgical, and prosthetic conditions, no difference in the clinical and radiographic outcomes between 6-mm and 11-mm implants was observed at 5 years of follow-up. Short implants showed to be a reliable option for the rehabilitation of completely edentulous non-atrophic mandibles. There is growing clinical evidence supporting the use of short implants, even in the case of non-atrophic sites.
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Affiliation(s)
- Luigi Guida
- Multidisciplinary Department of Medical- Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Dentistry, Orthopaedics and Rehabilitation, University Hospital "Luigi Vanvitelli", Naples, Italy
| | | | | | | | - Marco Annunziata
- Multidisciplinary Department of Medical- Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Dentistry, Orthopaedics and Rehabilitation, University Hospital "Luigi Vanvitelli", Naples, Italy
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7
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Al Qahtani WMS. Effect of Short Dental Implant Material on Bone Stress: An In Vitro Finite Element Analysis. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aim: Using finite element analysis, determine the influence of short dental implant material on surrounding bone stresses. Material and Methods: One simplified model was created for a short implant of 4.8×4.8×4 mm placed vertically in simplified bone geometry
to support dummy crown fixed by 50micron resin cement layer. Three materials were tested as an implant material, Zirconia, Titanium, and 30% CFR-PEEK. Components of the 3D model were prepared on engineering CAD/CAM software accumulated under ANSYS modeling for finite element analysis. The
model was subjected to two loading cases as; 100 N compressive load and 50 N Oblique (45°), both at the central fossa. Results: Under the applied loads, all values of total deformations and Von Mises stresses that developed during the current investigation were within physiological
limits. Under both loading cases, changing the implant material from Zirconia to titanium to Polyether ether ketone (PEEK) decreased Von Mises stress values in the implant, cortical, and cancellous bone. The cement layer, abutment, and connecting screws all showed signs of growth. Conclusion:
Zirconia and Titanium can replace each other as short implant material. In addition, 30% CFR-PEEK can also be used as short implant material with minor acceptable stress differences.
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Affiliation(s)
- Waleed M. S. Al Qahtani
- Department of Prosthetic Dentistry, King Khalid University College of Dentistry Abha, 62529, Saudi Arabia
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8
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Guida L, Bressan E, Cecoro G, Volpe AD, Del Fabbro M, Annunziata M. Short versus Longer Implants in Sites without the Need for Bone Augmentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3138. [PMID: 35591482 PMCID: PMC9099984 DOI: 10.3390/ma15093138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The present systematic review and meta-analysis aims to analyse the clinical performance of short compared to longer implants inserted in sites without the need for bone augmentation. METHODS The protocol of the present PRISMA-driven meta-analysis was registered on PROSPERO (CRD42021264781). Electronic and manual searches were performed up to January 2022. All Randomized Controlled Trials (RCTs) comparing short (≤6 mm) to longer (≥8.5 mm) implants placed in non-atrophic and non-augmented sites were included. The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized clinical trials (RoB 2) and the quality of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. A meta-analysis was performed on implant survival rate, marginal bone level change (MBLc), and technical and biological complications at the available follow-up time points. The power of the meta-analytic findings was determined by trial sequential analysis (TSA). RESULTS From 1485 initial records, 13 articles were finally included. No significant difference was found in the survival rate between short and long implant at any follow-up (moderate quality of evidence). Significantly more bone loss for long implants at 1 and 5 years from implant placement and more technical complications with short implants at 10 years were found. No other significant inter-group differences in terms of MBLc and biological complications were detected. CONCLUSIONS Moderate evidence exists suggesting that short implants perform as well as longer ones in the rehabilitation of edentulous sites without the need for bone augmentation. Further long-term, well-designed RCTs, however, are still needed to provide specific evidence-based clinical recommendations for an extended use of short implants in non-atrophic sites.
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Affiliation(s)
- Luigi Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.D.V.); (M.A.)
| | - Eriberto Bressan
- Department of Neurosciences, School of Dentistry, University of Padova, Via Giustiniani 2, 35100 Padova, Italy;
| | - Gennaro Cecoro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.D.V.); (M.A.)
| | - Armando Davide Volpe
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.D.V.); (M.A.)
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
- IRCCS Galeazzi Orthopedic Institute, 20161 Milan, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.D.V.); (M.A.)
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Bitinas D, Bardijevskytė G. Short implants without bone augmentation vs. long implants with bone augmentation: systematic review and meta-analysis. Aust Dent J 2021; 66 Suppl 1:S71-S81. [PMID: 34037243 DOI: 10.1111/adj.12859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/19/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Anatomical limits such as the location of the lower alveolar nerve, the maxillary sinus in atrophied jaws might extend implant surgery treatment. The purpose of this systematic literature review is to review the literature and determine whether short implants can be an effective alternative to standard-length implants after bone augmentation. MATERIALS AND METHODS A systematic search was performed on PRISMA wizard. Searched for clinical trials 2010-2020 in the Medline database. The keywords chosen are "short versus long implants, augmented bone, clinical trial", and their various variations. RESULTS Meta-analyses of the studies of implant loss after 1, 3 and 5 years showed a statistically insignificant difference between groups. The number of complications after 1 year was statistically significantly higher in the control group. Meta-analyses with follow-up periods of 3 and 5 years showed a statistically insignificant difference; Meta-analyses of studies of marginal bone loss after 1, 3 and 5 years showed a statistically insignificant difference between the groups. CONCLUSIONS Short dental implants may be a suitable alternative to standard length dental implants after bone augmentation. The risk of their complications is possibly lower because of the lack of need for bone augmentation.
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Affiliation(s)
- Donatas Bitinas
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Gailė Bardijevskytė
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
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10
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Merli M, Nieri M, Mariotti G, Merli M, Franchi L, Quiroga Souki B. The fence technique: Autogenous bone graft versus 50% deproteinized bovine bone matrix / 50% autogenous bone graft-A clinical double-blind randomized controlled trial. Clin Oral Implants Res 2020; 31:1223-1231. [PMID: 32979877 DOI: 10.1111/clr.13670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/29/2020] [Accepted: 09/08/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this short-term double-blind, parallel, randomized clinical trial was to compare bone augmentation grafting with 100% autogenous bone (AB) or 50% deproteinized bovine bone matrix (DBBM)/ 50% autogenous bone (BOAB) using a guided bone regeneration procedure, the fence technique, in a two-stage implant placement. MATERIAL AND METHODS Partially edentulous patients with extensive three-dimensional osseous defects were included in this study. The main outcome measure was the differences in bone volume from pre-surgery (T1) to 6 months post-surgery (T2). Bone height, chair-time, pain, functional limitation, and complications were also assessed. RESULTS Fifteen patients were allocated to the AB group and 15 patients to the BOAB group. The difference in bone volume from T1 to T2 was 648 mm3 for the AB group and 869mm3 for the BOAB group (difference between groups 221 mm3 , 95% CI from -363 to 804, p = .442). The surgery pain VAS was 1.6 for the AB group and 2.3 for the BOAB group (difference between groups 0.8, 95% CI from 0.0 to 1.5, p = .045 favoring the AB group). The height difference in bone from T1 to T2 was 2.2 mm for the AB group and 3.7 mm for the BOAB group (difference between groups 1.5mm, 95% CI from 0.1 to 2.9, p = .038 favoring the BOAB group). For complications, chair-time, post-surgery pain, and functional limitation, there were no differences between AB and BOAB. CONCLUSIONS No significant differences, except for surgery pain VAS and difference in bone height, were observed in this trial comparing grafting with AB or BOAB.
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Affiliation(s)
- Mauro Merli
- Clinica Merli, Rimini, Italy.,Politecnico delle Marche, Ancona, Italy
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Lorenzo Franchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Bernardo Quiroga Souki
- Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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11
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Sandwich osteotomy of the atrophic posterior mandible with interpositional autogenous bone block graft compared with bone substitute material: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2020; 58:e237-e247. [PMID: 32811722 DOI: 10.1016/j.bjoms.2020.07.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 07/29/2020] [Indexed: 11/23/2022]
Abstract
The objective of the present systematic review was to test the hypothesis that there were no differences in outcome of implant treatment after sandwich osteotomy in the atrophic posterior mandible with interpositional autogenous bone block graft, compared with bone substitute material. A MEDLINE/PubMed, Embase and Cochrane Library search in combination with hand-search of selected journals was conducted. Two short-term randomised controlled trials with a split-mouth study design and low risk of bias fulfilled the inclusion criteria. High survival rate of suprastructures and implants was disclosed with no significant difference between interpositional autogenous bone block graft compared with bone substitute material. Meta-analysis revealed patient-based implant survival risk ratio of 1.05 (95% CI: 0.88 to 1.25) and peri-implant marginal bone loss of 0.31mm (95% CI: -0.29 to 0.90) indicating no significant differences between the two treatments. High implant stability values, gain in vertical alveolar ridge height, bone formation, and few complications were reported with both treatments. Sandwich osteotomy with interpositional grafting material appears to be a predictable surgical technique for enhancement of the vertical alveolar ridge height in the atrophic posterior mandible prior to implant placement.
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12
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Batas L, Anagnostou E, Vouros I. Evaluation of a Double Layer Technique to Enhance Bone Formation in Atrophic Alveolar Ridge: Histologic Results of a Pilot Study. J Oral Maxillofac Surg 2020; 78:2195-2207. [PMID: 32853544 DOI: 10.1016/j.joms.2020.07.209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
The atrophic alveolar ridge has been a challenge in implant dentistry; various techniques using the principle of guided bone regeneration (GBR) have been applied in the past 2 decades.The aim of this study was to introduce and evaluate-clinically, histologically, and radiographically-a novel technique of regenerating a new bone in the atrophic alveolar ridge, which is based on the GBR principles, the double layer technique (DLT). Six patients with partially edentulous jaws with a residual bone width less than or equal to 4 mm in the maxilla were subjected to GBR. The sites were grafted using a DLT. At first, sites were grafted with allogenic bone and then a second layer of deproteinized bovine bone was placed. Next, grafted sites were covered with a resorbable membrane tucked with 2 titanium pins. Cone-beam computed tomography scans were obtained before and 5 months after DLT. In the latter case and during implant site preparation, trephine biopsies were obtained and processed for histologic and histomorphometric evaluation. In all cases, implants were successfully installed and primary stability was established. Implant diameter ranged from 3.8 to 4.1 mm. In all cases, radiographic findings showed increased alveolar ridge width before and after surgery. The new tissues consisted mostly of a variable amount of new trabecular bone, some loose connective tissue, blood vessels, and occasional inflammatory cells. All 15 implants placed had 100% survival rate after a 5-year follow-up. On the basis of these preliminary results, it seems that the double layer GBR technique may achieve satisfactory results from a clinical, radiographic, and histologic perspective favoring placement of dental implants in the atrophic maxillary alveolar ridge.
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Affiliation(s)
- Leonidas Batas
- Private Practitioner and Research Associate, Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Eleftherios Anagnostou
- Histopathologist Scientific Coordinator, Department of Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Vouros
- Professor and Department Head, Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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The sandwich osteotomy technique to treat vertical alveolar bone defects prior to implant placement: a systematic review. Clin Oral Investig 2020; 24:1073-1089. [DOI: 10.1007/s00784-019-03183-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/23/2019] [Indexed: 01/06/2023]
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14
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Guida L, Annunziata M, Esposito U, Sirignano M, Torrisi P, Cecchinato D. 6‐mm‐short and 11‐mm‐long implants compared in the full‐arch rehabilitation of the edentulous mandible: A 3‐year multicenter randomized controlled trial. Clin Oral Implants Res 2019; 31:64-73. [DOI: 10.1111/clr.13547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/01/2019] [Accepted: 09/19/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Luigi Guida
- Multidisciplinary Department of Medical‐Surgical and Dental Specialties University of Campania “Luigi Vanvitelli” Naples Italy
- Department of Dentistry, Orthopedics and Rehabilitation University Hospital “Luigi Vanvitelli” Naples Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical‐Surgical and Dental Specialties University of Campania “Luigi Vanvitelli” Naples Italy
- Department of Dentistry, Orthopedics and Rehabilitation University Hospital “Luigi Vanvitelli” Naples Italy
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15
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Evaluation of the Cortical Deformation Induced by Distal Cantilevers Supported by Extra-Short Implants: A Finite Elements Analysis Study. Symmetry (Basel) 2018. [DOI: 10.3390/sym10120762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of the study was to analyze the distribution of stresses caused by an axial force in a three-dimensional model with the finite element method in the implant-supported fixed partial denture with distal overhang (PPFIVD) on short dental implants in the posterior edentulous maxilla. Methods: geometrical models of the maxilla with a bone remnant of 9 and 5 mm were created. Straumann SP® (Base, Switzerland) implants were placed in the premolar area. Two groups with subgroups were designed. Group A (GA): PPFIVD on two implants (GA1: 4.1 × 8 mm and GA2: 4.1 × 4 mm); Group B (GB): PPFIVD on the single implant (GB1: 4.1 × 8 mm and GB2: 4.1 × 4 mm). It was applied to a static force of 100 N to 30°. Results: PPFIVD on two implants reached the maximum tension in GA2 with respect to GA1; the difference was not significant in implants. In the maxilla GA2 was lower in relation to GA1; the difference was not significant. In PPFIVD over an implant, the stress was greater in GB2 with respect to GB1; the difference was significant in maxilla and implants. Peri-implant bone micro deformations and prosthesis-implant displacements were observed. Conclusions: PPFIVD over short splinted implants could be viable in the maxilla with reduced bone height, being an option when lifting the floor of the maxillary sinus. The rehabilitation with unitary implant (4 mm) did not provide adequate results. The dominant tensions evidenced bone micro-distortions with a displacement of the prosthesis-implant set. The real statement of this paper was to define that short splinted implants can be used in soft bone with high success rate in reducing bending forces.
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Starch-Jensen T, Nielsen HB. Prosthetic Rehabilitation of the Partially Edentulous Atrophic Posterior Mandible with Short Implants (≤ 8 mm) Compared with the Sandwich Osteotomy and Delayed Placement of Standard Length Implants (> 8 mm): a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2018; 9:e2. [PMID: 30116514 PMCID: PMC6090250 DOI: 10.5037/jomr.2018.9202] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 01/26/2023]
Abstract
Objectives Test the hypothesis of no difference in prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) compared with the sandwich osteotomy and delayed placement of standard lengths implants (> 8 mm). Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search was conducted by including studies published in English. No year of publication restriction was applied. Results Six randomized controlled trials characterized by low or moderate risk of bias fulfilled the inclusion criteria. There were no statistically significant differences (P > 0.05) in the survival rate of suprastructures and implants between the two treatment modalities after one year. Sandwich osteotomy and delayed implant placement demonstrated statistically significant higher long-term peri-implant marginal bone loss as well as biological and technical complications compared with short implants (P < 0.0001). Moreover, patients significantly favoured prosthetic rehabilitation with short implants (P < 0.0001). Conclusions Short implants and the sandwich osteotomy with delayed placement of standard length implants appear to result in predictable outcomes in terms of high survival rate of suprastructures and implants after prosthetic rehabilitation of the partially edentulous atrophic posterior mandible. However, further long-term randomized controlled trials assessing donor site morbidity, an economic perspective, professional and patient-related outcome measures with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of short implants for prosthetic rehabilitation of the partially edentulous atrophic posterior mandible compared with the sandwich osteotomy and delayed placement of standard length implants.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
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