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Model-free digital workflow and immediate functional loading of implant-supported monolithic glass-ceramic crowns: A case series. J Dent 2022; 125:104270. [PMID: 36002118 DOI: 10.1016/j.jdent.2022.104270] [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: 10/10/2021] [Revised: 07/29/2022] [Accepted: 08/20/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of this study is to evaluate surgical and prosthetic outcomes of immediate functional loading of implants with glass-ceramic screw-retained single crowns. METHODS A total of 22 implants were placed. Within 24 hours, functional full-contour glass ceramic crowns were delivered to patients. The amount of attached gingiva, Simplified Oral Hygiene Index Score, bleeding on probing, time after extraction, bone type, implant size, soft tissue thickness, primary stability, a general fit of the restoration, occlusal and proximal contacts were recorded. Restorations were followed-up at 1, 3, and 6 months tracking marginal bone loss (MBL), noting changes in occlusal and interproximal contacts, checking other possible complications. RESULTS One implant failed and was removed after 4 weeks (95.5 % survival rate). The rest of the implants and crowns functioned with no complications during the follow-up period of 6 months. Factors such as time after extraction, bone type, implant size, soft tissue thickness, and primary stability recorded in Ncm and implant stability quotient (ISQ) values, were not associated with MBL (p<0.05). Mean MBL was found to be 0.3 mm (standard deviation = 0.42) mesially and 0.4 mm (standard deviation = 0.66) distally. One distal and one mesial proximal contact were found to be missing at the 6-month check-up appointment. CONCLUSIONS Within the limits of this study, fully digital workflow without a 3D printed model could be successfully employed for immediate functional loading with single-unit implant-supported crowns. Further studies are needed to obtain long-term results with a larger sample of patients. CLINICAL SIGNIFICANCE Model-free digital workflow and immediate functional loading of implant-supported monolithic glass-ceramic crown might be viable option to restore a single tooth defect.
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Rutkowski R, Smeets R, Neuhöffer L, Stolzer C, Strick K, Gosau M, Sehner S, Volz KU, Henningsen A. Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading. BMC Oral Health 2022; 22:198. [PMID: 35606734 PMCID: PMC9125844 DOI: 10.1186/s12903-022-02231-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background There is limited evidence for the use of zirconium dioxide implants in immediate implant placement as well as for related immediate loading protocols. The aim of this retrospective study was to investigate the survival rate, success and patient satisfaction of immediately placed zirconia implants compared to delayed placed implants. Methods The study included 58 partially edentulous patients who were treated between 2013 and 2015 with immediate and delayed transgingival healing zirconium dioxide implants (SDS, Kreuzlingen/ Switzerland). In addition to survival and success rate, marginal bone loss was assessed using radiographs and soft tissue was evaluated using Pink Esthetic Score. Oral health-related quality of life was investigated prospectively using a modified OHIP questionnaire. Results The cumulative survival rate of all implants included was 92% with 88% classified as full success. No significant difference was found between the bone levels of immediately and delayed placed and immediately and delayed loaded implants. The mean Pink Esthetic Score after final prosthetic rehabilitation was 12.2/14 points indicating excellent esthetic clinical results. Analysis of the OHIP questionnaire showed a mean value of 0.54/100 points reflecting a high patient satisfaction. Conclusions Immediate and delayed placed as well as loaded zirconium dioxide implants showed excellent results regarding implant success and survival in this study. Zirconium dioxide implants may ensure excellent esthetic results and high patient satisfaction. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02231-0.
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Affiliation(s)
- Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Leon Neuhöffer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Carolin Stolzer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Kilian Strick
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. .,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Long-term clinical outcomes of immediate loading versus non-immediate loading in single-implant restorations: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 51:1345-1354. [DOI: 10.1016/j.ijom.2022.03.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022]
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Krautwald L, Smeets R, Stolzer C, Rutkowski R, Guo L, Reitmeier A, Gosau M, Henningsen A. Osseointegration of Zirconia Implants after UV-Light or Cold Atmospheric Plasma Surface Treatment In Vivo. MATERIALS 2022; 15:ma15020496. [PMID: 35057216 PMCID: PMC8781961 DOI: 10.3390/ma15020496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 12/04/2022]
Abstract
The influence of UV light and non-thermal plasma on the osseointegration of yttria-stabilized zirconia implants (Y-TZP) comparing the two methods is unclear. The aim of this study was to show the influence of these methods on the osseointegration of dental zirconia implants in an animal model. A total of 54 implants were either untreated, treated with UV light (UV), or non-thermal oxygen plasma for 12 min and inserted into the parietal bones of six domestic pigs. The animals were sacrificed after a healing interval of two, four, and nine weeks. The degree of osseointegration was determined using histomorphometric determination of bone-to-implant contact values (BIC) and the bone-to-implant contact values within the retentive parts of the implants (BAFO). BIC values decreased in all groups after four weeks of healing and re-increased after nine weeks in all groups. BAFO increased significantly over time in all groups. However, there were no statistically significant differences in BIC and BAFO values between the control group and the test groups and over time. Clinical studies may follow to confirm the influence of cold plasma and UV light on the healing and survival of zirconia implants.
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Affiliation(s)
- Lisa Krautwald
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Ralf Smeets
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Carolin Stolzer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Linna Guo
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Aline Reitmeier
- Department of Laboratory Animal Science, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Martin Gosau
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
| | - Anders Henningsen
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Private Practice ELBE MKG, Suelldorfer Kirchenweg 1A, 22587 Hamburg, Germany
- Correspondence:
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Cosyn J, De Lat L, Seyssens L, Doornewaard R, Deschepper E, Vervaeke S. The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:224-241. [PMID: 30624808 DOI: 10.1111/jcpe.13054] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 11/28/2022]
Abstract
AIM To compare immediate implant placement (IIP) to delayed single implant placement (DIP, ≥3 months post-extraction) in terms of implant survival (primary outcome), surgical, clinical, aesthetic, radiographic and patient-reported outcomes (secondary outcomes). MATERIALS AND METHODS Two reviewers independently performed an electronic search in PubMed, Web of Science, EMBASE and Cochrane and a hand search to identify eligible studies up to May 2018. Only randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP to DIP with at least 1 year of follow-up were selected for a qualitative analysis and meta-analysis. RESULTS The search identified 3 RCTs and 5 NRSs out of 2,589 titles providing data on 473 single implants (IIP: 233, DIP: 240) that had been in function between 12 and 96 months. One RCT showed unclear risk of bias, whereas all other studies demonstrated high risk. Meta-analysis showed significantly lower implant survival for IIP (94.9%) as compared to DIP (98.9%) (RR 0.96, 95% CI [0.93; 0.99], p = 0.02). All were early implant failures. A subgroup meta-analysis demonstrated a trend towards lower implant survival for IIP when postoperative antibiotics had not been administered (RR: 0.93, 95% CI [0.86; 1.00], p = 0.07). This was not observed among studies including the administration of postoperative antibiotics (RR: 0.98, 95% CI [0.94; 1.02], p = 0.35). Meta-analyses showed similar probing depth (WMD 0.43 mm, 95% CI [-0.47; 1.33], p = 0.35) and aesthetic outcomes as assessed by the pink aesthetic score (standardized WMD -0.03, 95% CI [-0.46; 0.39], p = 0.88) for IIP and DIP. Data on marginal bone loss were conflicting and highly biased. Soft tissue recession was underreported and available data were highly biased. Patient-reported outcomes were underreported, yet both IIP and DIP seemed well tolerated. CONCLUSION Immediate implant placement demonstrated higher risk for early implant loss than DIP. There is a need for RCTs comparing IIP to DIP with CBCT analyses at different time points and data on midfacial recession with the preoperative status as baseline. In these studies, the need for hard and soft tissue grafting should also be evaluated.
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Affiliation(s)
- Jan Cosyn
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Oral Health Research Group (ORHE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Liesa De Lat
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Ron Doornewaard
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Ellen Deschepper
- Faculty of Medicine and Health Sciences, Department of Biomedical statistics, Ghent University, Ghent, Belgium
| | - Stijn Vervaeke
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Cytocompatibility of Titanium, Zirconia and Modified PEEK after Surface Treatment Using UV Light or Non-Thermal Plasma. Int J Mol Sci 2019; 20:ijms20225596. [PMID: 31717459 PMCID: PMC6888564 DOI: 10.3390/ijms20225596] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/28/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022] Open
Abstract
A number of modifications have been developed in order to enhance surface cytocompatibility for prosthetic support of dental implants. Among them, ultraviolet (UV) light and non-thermal plasma (NTP) treatment are promising methods. The objective of this study was to compare the effects of UV light and NTP on machined titanium, zirconia and modified polyetheretherketone (PEEK, BioHPP) surfaces in vitro. Machined samples of titanium, zirconia and BioHPP were treated by UV light and NTP of argon or oxygen for 12 min each. Non-treated disks were set as controls. A mouse fibroblast and a human gingival fibroblast cell line were used for in vitro experiments. After 2, 24 and 48 h of incubation, the attachment, viability and cytotoxicity of cells on surfaces were assessed. Results: Titanium, zirconia and BioHPP surfaces treated by UV light and oxygen plasma were more favorable to the early attachment of soft-tissue cells than non-treated surfaces, and the number of cells on those treated surfaces was significantly increased after 2, 24 and 48 h of incubation (p < 0.05). However, the effects of argon plasma treatment on the cytocompatibility of soft tissue cells varied with the type of cells and the treated material. UV light and oxygen plasma treatments may improve the attachment of fibroblast cells on machined titanium, zirconia and PEEK surfaces, that are materials for prosthetic support of dental implants.
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Madani E, Smeets R, Freiwald E, Sanj MS, Jung O, Grubeanu D, Hanken H, Henningsen A. Impact of different placement depths on the crestal bone level of immediate versus delayed placed platform-switched implants. J Craniomaxillofac Surg 2018; 46:1139-1146. [PMID: 29802060 DOI: 10.1016/j.jcms.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/16/2018] [Accepted: 05/02/2018] [Indexed: 10/16/2022] Open
Abstract
PURPOSE The preservation of peri-implant bone is one requirement for long-term success of dental implants. The purpose of this study was to evaluate the impact of subcrestal placement on the crestal bone level of immediate versus delayed placed implants after loading. MATERIALS AND METHODS In this retrospective study, data of 159 patients who received 330 implants was analyzed. Implants were placed subcrestally, crestally or supracrestally into fresh sockets or healed sites. Vertical bone level height was assessed radiographically and implants were followed up annually. The influence of patient and implant related risk factors for peri-implant bone loss was evaluated using a linear mixed model. RESULTS Depth of implant placement was significantly correlated with peri-implant bone loss (P = 0.001, 95% CI). Least effective loss of crestal bone was determined when implants were placed between 1 mm and 1.99 mm subcrestally. Smoking significantly enhanced the risk of peri-implant bone loss (P = 0.04, 95% CI). Immediate implant placement was not positively correlated with peri-implant bone loss (P = 0.51, 95% CI). CONCLUSION Within the limits of this study, implant placement 1.08 mm subcrestally may be recommendable in order to avoid supracrestal expositions of platform-switched titanium implants over time.
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Affiliation(s)
- Elika Madani
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Eric Freiwald
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Maryam Setareh Sanj
- Department of Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ole Jung
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oral and Maxillofacial Surgery, German Armed Forces Hospital, Hamburg, Germany.
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Henningsen A, Smeets R, Heuberger R, Jung OT, Hanken H, Heiland M, Cacaci C, Precht C. Changes in surface characteristics of titanium and zirconia after surface treatment with ultraviolet light or non-thermal plasma. Eur J Oral Sci 2018; 126:126-134. [PMID: 29336070 DOI: 10.1111/eos.12400] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Positive effects of irradiation with ultraviolet (UV) light or treatment with non-thermal plasma on titanium and zirconia surfaces have been described in various studies. The aim of this study was to assess and compare the changes in the physicochemical surface conditions of titanium and zirconia surfaces after a short treatment with UV light or with non-thermal plasmas of argon or oxygen. Titanium and zirconia samples with moderately rough surfaces were treated for 12 min either in a UV-light oven or in a non-thermal plasma reactor that generates non-thermal plasmas of oxygen or argon. Changes in surface conditions were assessed by confocal microscopy, dynamic contact angle measurement, and X-ray photoelectron spectroscopy (XPS). No changes in roughness occurred. Ultraviolet irradiation and non-thermal plasma significantly increased the wettability of the titanium and zirconia surfaces. X-ray photoelectron spectroscopy showed an increase of oxygen and a significant decrease of carbon after treatment with either method. Thus, ultraviolet light and non-thermal plasma were found to be able to improve the chemical surface conditions of titanium and zirconia following a short exposure time. However, further in vitro and in vivo studies are needed to determine the relevance of the results.
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Affiliation(s)
- Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, German Armed Forces Hospital, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Ole T Jung
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Clarissa Precht
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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