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Leles CR, Curado TFF, Nascimento LN, Silva JR, de Paula MS, McKenna G, Schimmel M. Changes in masticatory performance and bite force after treatment with mandibular overdentures retained by four titanium-zirconium mini implants: One-year randomised clinical trial. J Oral Rehabil 2024; 51:1459-1467. [PMID: 38685704 DOI: 10.1111/joor.13722] [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: 03/06/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This prospective study is part of a randomised clinical trial and reports the changes in masticatory performance (MP) and bite force, and explores their influential factors, 1 year after the provision of mandibular overdentures retained by four titanium-zirconium mini implants. METHODS Edentulous patients received conventional complete dentures, followed by placement of four mini implants (Straumann® Mini Implant System) in the anterior mandible and converting the conventional prosthesis into a mandibular overdenture. Treatment protocols were randomised using a 2×2 factorial design combining different surgical (flapped vs. flapless) and loading (immediate vs. delayed) protocols. MP was assessed using a two-colour mixing ability test and a colorimetric analysis to measure the level of colour mixing (Variance of Hue-VoH). Maximum voluntary bite force (MBF) was measured by a digital gnathodynamometer in the posterior and anterior regions. Sex, age, surgical and loading protocols and ridge morphology were tested as independent variables. MP and MBF tests were performed at baseline (pre-treatment) and the 3-, 6- and 12-month after implant loading. Descriptive statistics, independent t-test, and linear mixed-effect model (LMM) regression were used for data analysis. RESULTS Seventy-four participants were assessed and 73 completed the 1-year follow-up. Statistically significant improvements in functional parameters were observed in all follow-up periods compared to baseline (p < .001). The flapless protocol was associated with higher improvement in MP at the 3-month follow-up (p = .004), while less resorbed ridges were associated with better MP (p = .038) and higher MBF (p < .001). CONCLUSION The mandibular overdenture protocol using four titanium-zirconium mini implants was effective in improving MP and MBF of edentulous patients, compared to pre-treatment values. The findings also suggest that improvements in chewing function and bite force are impacted by clinical factors since better outcomes were observed for flapless surgeries and less resorbed edentulous ridges. CLINICAL TRIAL REGISTRATION ClinicalTrials.Gov ID NCT04760457.
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Affiliation(s)
- Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
| | | | | | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry, School of Dental Medicine of the University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Silva JR, Curado TFF, Srinivasan M, Schimmel M, McKenna G, Leles CR. Mandibular overdenture retained by four one-piece titanium-zirconium mini implants: A 2-year follow-up on prosthodontic outcomes. J Dent 2024; 149:105266. [PMID: 39067651 DOI: 10.1016/j.jdent.2024.105266] [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: 06/10/2024] [Revised: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE This 2-year prospective study reports the incidence of prosthetic complications and maintenance events after treatment with mandibular overdenture retained by four mini implants opposed to a maxillary denture. METHODS Implant intervention included flapless or flapped surgery combined with immediate or delayed loading, as part of a randomized clinical trial. Four one-piece titanium-zirconium mini-implants (Straumann Mini Implant System) were inserted, and the retentive PEEK elements (Optiloc) were incorporated into the overdenture using chairside procedures. Prosthodontic complications and maintenance events were recorded over a 2-year follow-up, and the final outcome was defined according to standardized criteria. Data analysis included descriptive statistics, incidence and incidence density rates, and Kaplan-Meier survival. RESULTS 73 out of 74 patients (64.9 % female), mean age of 64 (SD=8.2) years, completed the study follow-up (one withdrew after 9 months). Implant survival was 100 %. A total of 163 prosthodontic events occurred in 53 patients (72.6 %), and 20 patients had no clinical complaints or maintenance needs. The most common procedures were adjustment/repair of the overdenture base (47.0 %), replacement of retentive inserts (19.8 %), and laboratory relining (12.9 %). A high prosthodontic success rate was achieved (93.2 %), and all patients presented serviceable overdentures and continuous use after the resolution of prosthodontic complications. The incidences of matrix replacement and laboratory relines were low in the first year, while denture base adjustments were common within the first year, especially in the first 6 months. CONCLUSION The mini implant system showed high prosthodontic success rates. Minor adjustments/repairs during the initial follow-up were common. Relines and matrix replacements tend to occur after one year of overdenture use, and matrix replacements may occur as a consequence of the need for relining.
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Affiliation(s)
| | | | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry, Division of Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gerald McKenna
- Oral Health Services and Gerodontology, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil; Clinic of General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry, Division of Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland.
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de Oliveira Rigotti RL, Tardelli JDC, Dos Reis AC, da Valente MLC. Influence of dental implant/mini-implant design on stress distribution in overdentures: a systematic review. Oral Maxillofac Surg 2024; 28:515-527. [PMID: 37665393 DOI: 10.1007/s10006-023-01177-z] [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: 05/13/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?". METHODS This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters. RESULTS Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction). CONCLUSION It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration.
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Affiliation(s)
- Renan Leonardi de Oliveira Rigotti
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Mariana Lima Costa da Valente
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil.
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Schenk N, Bukvic H, Schimmel M, Abou-Ayash S, Enkling N. One-Piece Mini Dental Implant-Retained Mandibular Overdentures: 10-Year Clinical and Radiological Outcomes of a Non-Comparative Longitudinal Observational Study. J Funct Biomater 2024; 15:99. [PMID: 38667556 PMCID: PMC11051283 DOI: 10.3390/jfb15040099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
This study presents the first 10-year follow-up investigation of the implant survival and peri-implant outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone level alterations (ΔMBLs), clinical peri-implant parameters, and complications. Twenty participants with horizontally atrophied mandibles received complete dentures and four MDIs (diameter 1.8 mm) at baseline. The dentures were converted into IODs with O-ring attachments. The 10-year follow-up comprised a radiological assessment of ΔMBLs, peri-implant parameters, as well as biological and technical complications. Results from a 10-year follow-up of 14 participants showed a 100% implant survival rate for all 56 implants. The mean ΔMBL after 10 years was -1.12 ± 0.80 mm, with 49 implants classified as successful (ΔMBL < 2 mm) and 7 implants with satisfactory survival (ΔMBL 2-4 mm). Time after implant placement significantly influenced ΔMBL, with stable MBLs after 5 years. The prosthetic survival rate after 10 years was 93%. ΔMBLs were not influenced by implant position or gender but were significantly smaller in subjects older than 65 years. Conclusively, one-piece MDIs with O-ring attachments offer a reliable treatment option for horizontally atrophied mandibles after 10 years, with high implant and prosthetic survival rates, potentially benefiting from advanced age regarding peri-implant bone stability.
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Affiliation(s)
- Nicole Schenk
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Hristina Bukvic
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, 1205 Geneva, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland; (N.S.); (H.B.); (M.S.); (N.E.)
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Medical Faculty, University of Bonn, 53113 Bonn, Germany
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Celebic A, Kovacic I, Petricevic N, Alhajj MN, Topic J, Junakovic L, Persic-Kirsic S. Clinical Outcomes of Three versus Four Mini-Implants Retaining Mandibular Overdenture: A 5-Year Randomized Clinical Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:17. [PMID: 38276051 PMCID: PMC10820318 DOI: 10.3390/medicina60010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Due to a lack of long-term clinical studies that would clarify whether the insertion of three mini-implants (MDIs) can be as successful treatment as the insertion of four MDIs for the retention of mandibular overdentures (ODs), this 5-year prospective cohort study was set up. Materials and Methods: Participants (n = 83) randomly received either four or three MDIs and a mandibular OD. Clinical examinations were performed at the baseline, as well as after one, three, and five years, respectively. A total of 73 participants (38 in the four-MDI and 35 in the three-MDI groups) partook in the study. The marginal bone level change, success and survival rates, and prosthodontic maintenance were assessed. Results: Repeated measures showed that the mean peri-implant bone loss increased progressively at a small amount over five years in both groups (four-MDI group = -0.36 ± 0.74; three-MDI group = -0.33 ± 0.27 mm; p < 0.05). However, an ANCOVA revealed no significant effects of the group (no significant difference between the three- and the four-MDI groups; F = 0.085; p = 0.771), gender (F = 0.023; p = 0.88), or covariate age (F = 1.95; p = 0.167) on the dependent variable: the 5-year MBL change. The success rate (together with successful survival) was 93.8% in the four-MDI group and 91.7% in the three-MDI group. The log-rank (Mantel-Cox) test revealed no significant differences between them (X2 = 0.373; p = 0.541). Conclusions: In patients with narrow ridges, the insertion of three MDIs in the mandible for overdenture retention can be equally as successful as the insertion of four MDIs.
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Affiliation(s)
- Asja Celebic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Ines Kovacic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Nikola Petricevic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
| | - Mohammed Nasser Alhajj
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Thamar 87246, Yemen;
| | - Jolanda Topic
- Private Dental Office, 21300 Makarska, Croatia;
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Junakovic
- Mag. Math., Libertas International University, 10000 Zagreb, Croatia;
| | - Sanja Persic-Kirsic
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (N.P.); (S.P.-K.)
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Curado TFF, Silva JR, Nascimento LN, Leles JLR, McKenna G, Schimmel M, Leles CR. Implant survival/success and peri-implant outcomes of titanium-zirconium mini implants for mandibular overdentures: Results from a 1-year randomized clinical trial. Clin Oral Implants Res 2023; 34:769-782. [PMID: 37254798 DOI: 10.1111/clr.14102] [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: 01/31/2023] [Revised: 04/15/2023] [Accepted: 05/18/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To report the 1-year implant survival/success and peri-implant outcomes of mandibular overdentures retained by four titanium-zirconium mini implants (Straumann® Mini Implant System), and to assess how surgery and loading protocols influence these outcomes. MATERIALS AND METHODS A 2 × 2 factorial randomized clinical trial (RCT) tested the combined effects of two loading protocols (immediate or delayed) and two surgical approaches (flapless or flapped) on the success/survival of the mini implants, and peri-implant parameters (plaque, bleeding, sulcus depth, gingival position, and marginal bone loss). Outcomes were assessed up to 1-year after loading, and generalized estimating equations (GEEs) were used to analyze longitudinal and within-patient clustered data. RESULTS Two hundred and ninety-six implants were placed in 74 patients. The implant survival/success rates after 1 year were 100%, and no major biological complications were observed. After 1-year, descriptive data suggest no noticeable changes in plaque scores, whilst a reduction in bleeding scores at the 6-month and 1-year follow-ups compared to baseline. Good longitudinal stability was observed for the probing depth and gingival margin height measures. Overall mean marginal bone loss was 0.68 (±0.68) mm after 3 months and 0.89 (±0.75) mm after 1-year. The flapless protocol showed better results on soft tissue stability and health but a slightly higher risk for marginal bone loss. CONCLUSION The results of this RCT suggest that mandibular overdentures retained by this novel mini implant system represent a safe and predictable treatment option as confirmed by implant survival/success and peri-implant outcomes, even when flapless surgery and immediate loading protocols are adopted.
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Affiliation(s)
| | | | | | | | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Martin Schimmel
- Department of Reconstructive Dentistry, Division of Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Cláudio Rodrigues Leles
- School of Dentistry, Federal University of Goias, Goiania, Brazil
- Department of Reconstructive Dentistry, Division of Gerodontology, School of Dental Medicine of the University of Bern, Bern, Switzerland
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Güzelce S E. Biomechanical comparison of different framework materials in mandibular overdenture prosthesis supported with implants of different sizes: a finite element analysis. BMC Oral Health 2023; 23:450. [PMID: 37408011 DOI: 10.1186/s12903-023-03080-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND The aim of this study is to evaluate the stresses on the supporting bone, implants, and framework materials under masticatory forces in mandibular overdenture prostheses modeled with different framework materials and different implant types, using the Finite Element Analysis (FEA). METHODS For the finite element modeling, two identical mandibular jaw models were created; one with two standard (diameter:4.1 mm/12 mm length) and the other with two mini-implants (diameter:2.4 mm/12 mm length) were placed in the canine teeth area. The polymethylmethacrylate (PMMA) denture was modeled upon them, supported by Cobalt Chromium alloy (CoCr), Poly-ether ether ketone (PEEK), and Zantex materials with framework. No framework was added as a control model; only PMMA overdenture prosthesis was modeled. RESULTS Regardless of the framework materials of the overdenture prostheses, the stress values on mini-implants in all models yielded approximately two times higher results comparing to standard implants. More stress transmission was observed in the supporting bone and implants in the control prostheses and overdenture prostheses supported with respectively PEEK, Zantex, CoCr alloy frameworks, respectively. In the framework materials, more stress occurred on CoCr, Zantex and PEEK in that order. CONCLUSION In the light of this study, the use of mini-implants as an alternative to standard implants is not promising in terms of distribution and transmission of chewing stresses. As a framework material, standard rigid metal alloys were found to be more advantageous than polymer materials in terms of stress distribution.
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Affiliation(s)
- Elifnur Güzelce S
- Department of Prosthodontics, University of Health Sciences Turkey, Hamidiye Campus (Istanbul) Selimiye Mah. Tıbbiye Cad. No:38, Üsküdar/Istanbul, 34668, Türkiye.
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Mini-Implants Retaining Removable Partial Dentures in Subjects without Posterior Teeth: A 5-Year Prospective Study Comparing the Maxilla and the Mandible. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020237. [PMID: 36837439 PMCID: PMC9959138 DOI: 10.3390/medicina59020237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023]
Abstract
Background and objectives: Long-term studies of clinical outcomes of mini-implants (MDIs) in the first premolar/canine sites retaining a bilateral free-ending removable partial dentures (RPD) in Kennedy class I subjects have not been well documented. The aim was to assess clinical outcomes in a prospective 5-year cohort study comparing the mandible and maxilla. Material and Methods: Participants (n = 92) who received two MDIs each and a new RPD were reviewed after one, three and five years. A total of 71 participants (82 mini-implants in the mandible; 58 in the maxilla) completed the study. Marginal bone level change, success, survival rates, Modified Plaque (MPI) and Bleeding Indices (MBI) were assessed. Results: The five-year success rate was 93.3% and 93.4% (p > 0.05), in the mandible and the maxilla, respectively. Mean peri-implant bone loss (MBL) increased significantly over five years (p < 0.01) to 0.50 mm in the mandible and 0.52 mm in the maxilla. Age had a significant effect on the MBL (higher rates in younger participants), while jaw of insertion, gender, and antagonistic jaw status did not. MPI and MBI were not significantly correlated with MBL. Conclusions: The insertion of two MDIs in previous first premolar/canine sites for retention of a free-end saddle RPD can be a successful treatment modality in subjects with narrow alveolar ridges.
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Leles CR, Leles JLR, Curado TFF, Silva JR, Nascimento LN, de Paula MS, Maniewicz S, Schimmel M, McKenna G. Mandibular bone characteristics, drilling protocols, and final insertion torque for titanium-zirconium mini-implants for overdentures: A cross-sectional analysis. Clin Implant Dent Relat Res 2023; 25:426-434. [PMID: 36623506 DOI: 10.1111/cid.13181] [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: 10/17/2022] [Revised: 12/29/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to assess the final insertion torque values achieved using site-specific drilling protocols for a novel mini implant system for removable complete overdentures. Anatomical and technical factors influencing final insertion torque were recorded and analyzed. MATERIAL AND METHODS Participants were randomized to two surgical protocol groups (flapped or flapless) and all received four mini implants (Straumann® mini implant system; Straumann AG) in the anterior mandible, using a 1.6 mm needle drill and a 2.2 mm pilot drill for the implant bed site preparation. The final insertion torque was recorded as the main outcome variable during surgery. Bone type, radiographical bone density, ridge form, implant length, and the drilling protocol were considered as independent variables. Descriptive statistics, generalized estimating equations (GEE) regression, and heatmap charts were used for data analyses. RESULTS A total of 296 mini implants were placed in 74 patients (mean age = 64.1 ± 8.0; 64.9% female) using flapless (n = 37) or flapped (n = 37) surgeries. Mean final insertion torque was 55.8 ± 18.4 Ncm (10.5% > 35 Ncm, 48.9% between 35 and 65 Ncm, and 40.6% > 65 Ncm). The needle drill was used in only 43.9% of the implant bed sites. Higher final torque values were observed for higher bone densities (bone type I > II > III, and D1-D2 > D3-D4), highly resorbed ridge forms (5-6 > 3-4), flapped surgeries, and male patients. However, regression models showed that the likelihood of achieving optimal insertion torque (≥35 and ≤65 Ncm) was higher for females (OR = 2.14; 95%CI = 1.14-4.01; p = 0.018), ridge forms 3-4 (OR = 2.87; 95%CI = 1.05-7.85; p = 0.040), and flapless surgeries (OR = 1.96; 95%CI = 1.09-3.51; p = 0.024). CONCLUSIONS Sufficient primary stability for immediate loading was achieved for the majority of the mini implants placed. Surgical implant bed preparation should be site-specific to achieve optimal primary stability for immediate loading while avoiding excessive insertion torque.
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Affiliation(s)
| | | | | | | | | | | | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gerald McKenna
- Consultant in Restorative Dentistry, Centre for Public Health, Queen's University Belfast, Belfast, UK
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Survival and stability of strategic mini-implants with immediate or delayed loading under removable partial dentures: a 3-year randomized controlled clinical trial. Clin Oral Investig 2022; 27:1767-1779. [PMID: 36472683 PMCID: PMC10102135 DOI: 10.1007/s00784-022-04805-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
Abstract
Objectives
Stability values of mini-implants (MIs) are ambiguous. Survival data for MIs as supplementary abutments in reduced dentitions are not available. The aim of this explorative research was to estimate the 3-year stability and survival of strategic MIs after immediate and delayed loading by existing removable partial dentures (RPDs).
Material and methods
In a university and three dental practices, patients with unfavorable tooth distributions received supplementary MIs with diameters of 1.8, 2.1, and 2.4 mm. The participants were randomly allocated to group A (if the insertion torque ≥ 35 Ncm: immediate loading by housings; otherwise, immediate loading by RPD soft relining was performed) or delayed loading group B. Periotest values (PTVs) and resonance frequency analysis (RFA) values were longitudinally compared using mixed models.
Results
A total of 112 maxillary and 120 mandibular MIs were placed under 79 RPDs (31 maxillae). The 1st and 3rd quartile of the PTVs ranged between 1.7 and 7.8, and the RFA values ranged between 30 and 46 with nonrelevant group differences. The 3-year survival rates were 92% in group A versus 95% in group B and 99% in the mandible (one failure) versus 87% in the maxilla (eleven failures among four participants).
Conclusions
Within the limitations of explorative analyses, there were no relevant differences between immediate and delayed loading regarding survival or stability of strategic MIs.
Clinical relevance
The stability values for MIs are lower than for conventional implants. The MI failure rate in the maxilla is higher than in the mandible with cluster failure participants.
Clinical trial registration
German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS-ID: DRKS00007589, www.germanctr.de), January 15, 2015.
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Teodorescu C, Preoteasa E, Preoteasa CT, Murariu-Măgureanu C, Teodorescu IM. The Biomechanical Impact of Loss of an Implant in the Treatment with Mandibular Overdentures on Four Nonsplinted Mini Dental Implants: A Finite Element Analysis. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8662. [PMID: 36500160 PMCID: PMC9739263 DOI: 10.3390/ma15238662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
The aim of this study was to evaluate the biomechanical impact, in terms of stress and displacement, at the level of a mandibular overdenture, on four mini dental implants (MDIs) after the loss of an implant. A three-dimensional virtual model was obtained by scanning the overdenture, and a biomechanical analysis was carried out, using the finite element method (FEM). The displacements of the overdenture and the equivalent von Mises stresses were evaluated using logarithmic scales. In the case of a mandibular overdenture on four MDIs inserted in the interforaminal area, the frontal loading generated the lowest values for the von Mises stresses, and the bilateral loading generated the least displacement when two implants were inserted in the canine area and two in the molar area. The highest von Mises stress was observed during frontal loading in the situation of the mandibular overdenture on four MDIs, two of which were inserted in the canine area and two in the molar area, following the loss of an implant in the canine area. The largest displacement was noted in the mandibular overdenture on four interforaminal MDIs during unilateral loading, following the loss of a distally inserted implant. The FEM analysis showed aspects that correlated with clinical observations, with predictive value. The concentration of von Mises stresses, and the occurrence of some displacements of the prosthodontic restoration, can explain the emergence of some complications in the overdenture's biodynamics, and the increased risk of fracture. Complications can be prevented by choosing a certain number of implants and a topographical distribution correlated with biomechanical aspects, and by proposing a correct occlusal scheme with optimal functional loading.
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Affiliation(s)
- Cristian Teodorescu
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Elena Preoteasa
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cristina Teodora Preoteasa
- Department of Scientific Research Methods-Ergonomics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cătălina Murariu-Măgureanu
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ioana Monica Teodorescu
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Liu Y, Fang M, Zhao R, Liu H, Li K, Tian M, Niu L, Xie R, Bai S. Clinical Applications of Polyetheretherketone in Removable Dental Prostheses: Accuracy, Characteristics, and Performance. Polymers (Basel) 2022; 14:polym14214615. [PMID: 36365609 PMCID: PMC9654455 DOI: 10.3390/polym14214615] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
The high-performance thermoplastic polyetheretherketone (PEEK) has excellent mechanical properties, biocompatibility, chemical stability, and radiolucency. The present article comprehensively reviews various applications of PEEK in removable dental prostheses, including in removable partial dentures (RPDs) (frameworks and clasps), double-crown RPDs, and obturators. The clinical performance of PEEK in removable dental prostheses is shown to be satisfactory and promising based on the short-term clinical evidence and technical complications are scarce. Moreover, the accuracy of RPDs is a vital factor for their long-term success rate. PEEK in removable dental prostheses is fabricated using the conventional lost-wax technique and CAD/CAM milling, which produces a good fit. Furthermore, fused deposition modeling is considered to be one of the most practical additive techniques. PEEK in removable prostheses produced by this technique exhibits good results in terms of the framework fit. However, in light of the paucity of evidence regarding other additive techniques, these manufacturers cannot yet be endorsed. Surface roughness, bacterial retention, color stability, and wear resistance should also be considered when attempting to increase the survival rates of PEEK removable prostheses. In addition, pastes represent an effective method for PEEK polishing to obtain a reduced surface roughness, which facilitates lower bacterial retention. As compared to other composite materials, PEEK is less likely to become discolored or deteriorate due to wear abrasion.
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Affiliation(s)
- Yuchen Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Ming Fang
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
| | - Ruifeng Zhao
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Hengyan Liu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Kangjie Li
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Min Tian
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Lina Niu
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Rui Xie
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
| | - Shizhu Bai
- State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- National Clinical Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Shaanxi Key Laboratory of Stomatology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, China
- Correspondence: (M.F.); (S.B.)
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Ćorić A, Kovačić I, Kiršić SP, Čelebić A. Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study. J Oral Maxillofac Surg 2022; 80:1811-1826. [PMID: 36049532 DOI: 10.1016/j.joms.2022.07.145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5 mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. MATERIALS AND METHODS In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5 years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. RESULTS From 44 participants (mean age 56.02 ± 5.72 years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean MBL change in both groups was small; however, it increased over time (-0.22 ± 0.38 mm after 1 year; -0.54 ± 0.56 mm after 5 years; P < .05). After 5 years mean MBL change was -0.59 ± 0.71 mm in the unsplinted and -0.50 ± 0.41 mm in the splinted group (P > .05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P > .05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P > .05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5 years (P > .05). Modified plaque index significantly increased over time, correlating with the MBL loss. CONCLUSION MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.
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Affiliation(s)
- Anka Ćorić
- Health Care Center Mostar, Mostar, Bosnia and Herzegovina & Assistant, Department of Prosthodontics, School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Ines Kovačić
- Assistant, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Sanja Peršić Kiršić
- Associate Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Professor, Department of Prosthodontics, School of Dental Medicine University of Zagreb, Zagreb, Croatia
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14
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Chatrattanarak W, Aunmeungtong W, Khongkhunthian P. Comparative clinical study of conventional dental implant and mini dental implant-retained mandibular overdenture: A 5- to 8-Year prospective clinical outcomes in a previous randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:475-487. [PMID: 35675561 DOI: 10.1111/cid.13098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022]
Abstract
AIM To compare the long-term prospective clinical outcomes in a previous randomized controlled clinical trial (RCT) of 2 Mini Dental Implant (2MDI), 4 Mini Dental Implant (4MDI), and 2 Conventional Dental Implant (2CDI)-retained mandibular overdenture with follow-up between 5 to 8 years. MATERIALS AND METHODS Thirty-seven patients formerly participated in the Comparative Clinical Study of CDI and MDI for Mandibular Overdenture were requested for examination of clinical outcomes. A total of 104 implants were placed with mean follow-up periods 6.64 ± 0.60 years. In Group 1 (2MDI) and Group 2 (4MDI), implants were placed and immediately loaded with Equator® attachments to retained mandibular overdenture. In Group 3 (2CDI), implants were placed and delayed 3 months for denture loading with ball attachment. The success rate, survival rate, clinical implant performance scale (CIP scale), peri-implant tissue status, prosthetic complication, implant stability quotient (ISQ), marginal bone level change (MBLC), and patient satisfactions were analyzed. RESULTS After 5 to 8 years follow-up, the success rate in Groups 1, 2, and 3 were 90.91%, 93.33%, and 54.55%, respectively. The success rate in Group 3 was significantly lesser than Group 1 (p = 0.016) and Group 2 (p < 0.001). The survival rate in Groups 1, 2, and 3 was 100%, 96.67%, and 90.91%, respectively, and showed no significant differences. Mean ISQ reported no significant differences between groups. Mean MBLC were 0.57 ± 1.19 mm, 0.68 ± 0.90 mm, and 1.55 ± 1.60 mm in Groups 1, 2, and 3, respectively. Group 3 reported significantly greater mean MBLC than Group 1 (p = 0.016) and Group 2 (p = 0.011), but Groups 1 and 2 were not significantly differences. The overall patient satisfactions were reported as not significant differences between groups. CONCLUDE Two MDI-retained mandibular overdentures with immediate loaded protocol performed had favorable clinical outcomes, cost effectiveness, and overall patient satisfactions after 5 to 8 years follow-up.
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Affiliation(s)
- Wipawan Chatrattanarak
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Weerapan Aunmeungtong
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pathawee Khongkhunthian
- Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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15
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Ganesh T, Scully J, Walker MP, Petrie CS. Biomechanical Evaluation of Mandibular Overdentures Supported by Mini-Implants: A Finite Element Analysis. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422500543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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Silva RCS, Agrelli A, Andrade AN, Mendes-Marques CL, Arruda IRS, Santos LRL, Vasconcelos NF, Machado G. Titanium Dental Implants: An Overview of Applied Nanobiotechnology to Improve Biocompatibility and Prevent Infections. MATERIALS (BASEL, SWITZERLAND) 2022; 15:3150. [PMID: 35591484 PMCID: PMC9104688 DOI: 10.3390/ma15093150] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023]
Abstract
This review addresses the different aspects of the use of titanium and its alloys in the production of dental implants, the most common causes of implant failures and the development of improved surfaces capable of stimulating osseointegration and guaranteeing the long-term success of dental implants. Titanium is the main material for the development of dental implants; despite this, different surface modifications are studied aiming to improve the osseointegration process. Nanoscale modifications and the bioactivation of surfaces with biological molecules can promote faster healing when compared to smooth surfaces. Recent studies have also pointed out that gradual changes in the implant, based on the microenvironment of insertion, are factors that may improve the integration of the implant with soft and bone tissues, preventing infections and osseointegration failures. In this context, the understanding that nanobiotechnological surface modifications in titanium dental implants improve the osseointegration process arouses interest in the development of new strategies, which is a highly relevant factor in the production of improved dental materials.
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Affiliation(s)
| | | | | | | | | | | | | | - Giovanna Machado
- Centro de Tecnologias Estratégicas do Nordeste-Cetene, Av. Prof. Luiz Freire, 01, Cidade Universitária, Recife CEP 50740-545, PE, Brazil; (R.C.S.S.); (A.A.); (A.N.A.); (C.L.M.-M.); (I.R.S.A.); (L.R.L.S.); (N.F.V.)
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17
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Ramos EU, Bizelli VF, Pereira Baggio AM, Ferriolli SC, Silva Prado GA, Farnezi Bassi AP. DO THE NEW PROTOCOLS OF PRF CENTRIFUGATION ALLOW BETTER CONTROL OF POSTOPERATIVE COMPLICATIONS AND HEALING AFTER SURGERY OF IMPACTED LOWER THIRD MOLAR? A SYSTEMATIC REVIEW AND META-ANALYSIS. J Oral Maxillofac Surg 2022; 80:1238-1253. [DOI: 10.1016/j.joms.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
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18
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Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res 2022; 8:294-312. [PMID: 35014207 PMCID: PMC8874059 DOI: 10.1002/cre2.521] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs. MATERIAL AND METHODS An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model. RESULTS Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I2 = 65%, p = .85; I2 = 75%, p = .88). CONCLUSIONS ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
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Affiliation(s)
| | | | - Assem Soueidan
- Department of Periodontology, Rmes U1229University of NantesNantesFrance
| | | | - Moctar Gueye
- Department of Odontology, Clinic of Fixed and Removable ProsthodonticsUniversity of DakarDakarSenegal
| | - Elhadj B. Mbodj
- Department of Odontology, Clinic of Fixed and Removable ProsthodonticsUniversity of DakarDakarSenegal
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of DentistryUniversity of NantesNantesFrance
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Duraisamy R, Ganapathy D, Rajeshkumar S, v A. Mini implants in dentistry – A review. J Long Term Eff Med Implants 2022; 32:29-37. [DOI: 10.1615/jlongtermeffmedimplants.2022041814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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20
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da Silva GG, Shimano MVW, Macedo AP, da Costa Valente ML, Dos Reis AC. In vitro assessment of polyetheretherketone for an attachment component for an implant-retained overdenture. J Prosthet Dent 2021; 127:319.e1-319.e8. [PMID: 34857392 DOI: 10.1016/j.prosdent.2021.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Frequent maintenance because of the limited lifetime of overdenture attachments with O-rings has led to the development of materials that might improve their functionality and longevity. However, testing of newly developed attachment materials is lacking. PURPOSE The purpose of this in vitro study was to evaluate a newly developed attachment made of polyetheretherketone (PEEK) for an implant-retained overdenture. MATERIAL AND METHODS Specimens of PEEK, polyacetal, and Teflon O-ring materials were prepared for analysis of roughness, surface hardness, and compressive strength. For the fatigue resistance test, new specimens based on acrylic resin were subjected to 2880 insertion and removal cycles. Compression and roughness data were compared with the Kruskal-Wallis and Dunn post hoc test; hardness data with ANOVA and t test; and fatigue and stereomicroscopy with ANOVA with repeated measures, t test, and Bonferroni adjustment (α=.05). RESULTS Polyacetal had the lowest surface roughness (P=.038). There was a significant difference in hardness among the materials (P<.05). PEEK presented the highest compressive strength among the materials (P<.001). For the fatigue resistance, only polyacetal showed a difference between the initial time-point (P<.05) and subsequent time-points. Polyacetal had a higher fatigue resistance than Teflon (P<.001) and PEEK (P<.05). Regarding the internal deformation of the attachments, a significant difference was observed among the materials (P<.05). CONCLUSIONS PEEK showed promising results regarding the physicomechanical properties necessary for use as an overdenture attachment when compared with other evaluated materials. In addition, the PEEK attachment showed results comparable to those in the control group (O-rings) in terms of retention.
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Affiliation(s)
- Geyson Galo da Silva
- Doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Marcos Vinicius Wada Shimano
- Graduate student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Ana Paula Macedo
- Research Laboratory Specialist, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Mariana Lima da Costa Valente
- Doctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Andréa Cândido Dos Reis
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil.
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21
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Abstract
Mini dental implants can be used to support crowns and partial and complete dentures in compromised edentulous sites. Lack of bone width or site length may be treated with mini implants. Mini implants have less percutaneous exposure and displacement that may reduce complications. Nonetheless, mini implants transmit about twice the load to the supporting bone, and thus, control of occlusal loading is important. In fixed prosthetics, rounded flat cusps, splinting, implant protective occlusal schemes, and placement only in dense bone sites are features of successful mini implant treatment. With removable prosthetics, multiple mini implants may be needed for appropriate retention and load resistance. Maxillary lateral incisor and mandibular incisor sites may be best suited for mini implant treatment. However, past research on dental implants has been directed at standard sized implants. While mini implants are indeed dental implants, they behave somewhat differently under functional load, and the clinician should be circumspect and very judicious in their use. This article is a mini review and not a systematic review. The topics covered are not pervasive because each would require a monograph or textbook for a complete discussion.
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22
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Bielemann AM, Schuster AJ, Possebon APDR, Schinestsck AR, Chagas-Junior OL, Faot F. Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2021; 33:21-32. [PMID: 34551146 DOI: 10.1111/clr.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year. MATERIALS AND METHODS In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates. RESULTS The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants. CONCLUSION Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.
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Affiliation(s)
- Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Otacílio Luiz Chagas-Junior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Kämmerer PW, Wolf JM, Buttchereit I, Frerich B, Ottl P. Prospective clinical implementation of optional implant treatment into pregraduate dental education-mini implants for retention and support of mandibular overdentures. Int J Implant Dent 2021; 7:87. [PMID: 34505196 PMCID: PMC8429539 DOI: 10.1186/s40729-021-00371-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The primary aim of the study was to evaluate mini implant (MDI) survival, prosthodontic maintenance, and patient-reported outcome measures after conducting an optional pregraduate academic course on patients with mandibular edentulism including fabrication of overdentures and MDI planning and placement as well as chair-side incorporation of the respective restauration. In a prospective clinical study, 20 patients received 80 MDIs that were restored with mandibular overdentures. All treatment steps including placement of 40 MDIs were conducted by undergraduate students under strict guidance of a consultant. Next to students’ perceptions after participation, survival of MDIs, and prosthodontic maintenance, patients’ perceptions as well as peri-implant parameters were assessed after 4 weeks and 3 and 12 months. Results Three MDIs fractured (two during insertion and one after 3 months; total survival 96.25%). Two overdentures fractured and a total of 23 cases of minor prosthodontic maintenance were required. Over time, patients’ satisfaction significantly increased. Besides, questionnaires showed a high rate of students’ positive perception and high self-confidence to include MDI therapy into own practice. Conclusions The results are in accordance to those reported by postgraduate dentists. In accordance, therapy with MDI-retained mandibular overdentures seems to be feasible and successful at pregraduate level if the students receive guidance.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131, Mainz, Germany. .,Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany.
| | - Jens M Wolf
- Department of Prosthodontics and Materials Science, University Medical Centre Rostock, Strempelstraße 13, 18057, Rostock, Germany
| | - Ingo Buttchereit
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Bernhard Frerich
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Peter Ottl
- Department of Prosthodontics and Materials Science, University Medical Centre Rostock, Strempelstraße 13, 18057, Rostock, Germany.,Department Life, Light & Matter, University of Rostock, 18051, Rostock, Germany
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24
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Wimmer L, Petrakakis P, El-Mahdy K, Herrmann S, Nolte D. Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design-retrospective analysis after a mean follow-up of 5 years. Int J Implant Dent 2021; 7:71. [PMID: 34318379 PMCID: PMC8316513 DOI: 10.1186/s40729-021-00353-8] [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: 01/24/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. RESULTS Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = - 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. CONCLUSIONS Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.
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Affiliation(s)
- Lukas Wimmer
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany.,Private Dental Practice, St. Johann, Salzburg, Austria
| | | | - Karim El-Mahdy
- Department of Restorative Dentistry & Periodontology, Dental School, Ludwig Maximilian University, Munich, Germany
| | - Surian Herrmann
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany
| | - Dirk Nolte
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany. .,Ruhr University Bochum, Bochum, Germany.
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25
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Lemos CAA, Nunes RG, Santiago-Júnior JF, Marcela de Luna Gomes J, Oliveira Limirio JPJ, Rosa CDDRD, Verri FR, Pellizzer EP. Are implant-supported removable partial dentures a suitable treatment for partially edentulous patients? A systematic review and meta-analysis. J Prosthet Dent 2021; 129:538-546. [PMID: 34330529 DOI: 10.1016/j.prosdent.2021.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/30/2022]
Abstract
STATEMENT OF PROBLEM A consensus on the clinical performance of implant-supported removable partial dentures (ISRPDs) is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the clinical performance of ISRPDs in terms of the implant survival rates, marginal bone loss, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS Four electronic databases (MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane Library) were independently searched by 2 reviewers for articles published up to December 2020. A single-arm meta-analysis was performed to evaluate the implant survival rates and marginal bone loss by using the R program. The Cochrane collaboration tool was used to evaluate the risk of bias of randomized controlled trials (RCTs), and the Newcastle-Ottawa scale for non-RCT studies. RESULTS Sixteen studies were included, with a total of 334 participants and a mean age of 58 years. The participants received a total of 581 dental implants, 475 conventional and 106 mini-implants. All included studies reported implant survival rate above 90% (range: 92% to 100%). Meta-analysis indicated a high proportion of implant survival rates of 3% (95% confidence interval [CI]: 2% to 5%) and a low mean raw score of marginal bone loss 0.98 mm (CI: 0.61 to 1.36 mm). Compared with conventional RPDs, improved patient quality of life and satisfaction were reported by studies that evaluated ISRPDs. RCT studies exhibited a low risk of bias for most domains, while most non-RCT studies were classified as good quality. CONCLUSIONS ISRPDs exhibited high implant survival rates and acceptable bone loss with improvement in the quality of life and satisfaction of patients when compared with conventional RPDs. Therefore, they can be considered suitable for the rehabilitation of partially edentulous patients.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF), Campus Avançado de Governador Valadares, School of Dentistry, Governador Valadares, State of Minas Gerais, Brazil.
| | - Rafaela Gaião Nunes
- Graduate, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Jéssica Marcela de Luna Gomes
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - João Pedro Justino Oliveira Limirio
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Cléber Davi Del Rei Daltro Rosa
- Postgraduate Student, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Fellippo Ramos Verri
- Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | - Eduardo Piza Pellizzer
- Full Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
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26
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Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [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] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
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Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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27
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Van den Borre C, Rinaldi M, De Neef B, Loomans NAJ, Nout E, Van Doorne L, Naert I, Politis C, Schouten H, Klomp G, Beckers L, Freilich MM, Mommaerts MY. Patient- and clinician-reported outcomes for the additively manufactured sub-periosteal jaw implant (AMSJI) in the maxilla: a prospective multicentre one-year follow-up study. Int J Oral Maxillofac Surg 2021; 51:243-250. [PMID: 34074574 DOI: 10.1016/j.ijom.2021.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
The clinical outcomes of maxillary rehabilitation with the additively manufactured sub-periosteal jaw implant (AMSJI; CADskills BV) were evaluated in edentulous patients with a Cawood-Howell atrophy classification ≥5 in all regions of the maxilla. Fifteen consecutive patients were included in the study and followed up for 1 year. They were interviewed using a survey protocol and were examined clinically and radiographically preoperatively (T0) and at 1 (T1), 6 (T2), and 12 (T3) months after permanent upper prosthesis placement. The patients reported an increased oral health-related quality of life. The overall mean Oral Health Impact Profile-14 score at T0 was 17.20 (standard deviation (SD) 6.42). When results at T0 were compared to those at T1 (mean 8.93, SD 5.30), a statistically significant difference was seen (P = 0.001). At T3, the mean value was 5.80 (SD 4.18). Compared to T0, there was also a statistically significant difference at T3 (P = 0.001). General satisfaction based on the numerical rating scale was a mean 49.93 at T1, which was less than patient expectation prior to treatment at T0 (52.13). A higher overall value was seen at T3 (53.20) when compared to T0. Within the constraints of the short follow-up, the AMSJI appears to be a promising tool for patients with extreme jaw atrophy. The high patient expectations were met without complications.
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Affiliation(s)
- C Van den Borre
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.
| | | | - B De Neef
- Department of Oro-Maxillo-Facial Surgery, General Hospital Oudenaarde, Oudenaarde, Belgium
| | - N A J Loomans
- Private Clinic Face Ahead Antwerp, Antwerp, Belgium; Division of Oro-Maxillo-Facial Surgery, GZA Hospitals, Antwerp, Belgium
| | - E Nout
- Oral and Maxillofacial Surgery, ETZ Hospitals, Tilburg, The Netherlands
| | - L Van Doorne
- Oral and Maxillofacial Surgery Cosmipolis Clinic Brugge, Ghent University Hospital, AZ Zeno, Knokke-Blankenberge, Belgium
| | - I Naert
- Department of Prosthetic Dentistry, KU Leuven, Leuven, Belgium
| | - C Politis
- OMFS-IMPATH Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - H Schouten
- Department of Oral and Maxillofacial Surgery, Rode Kruis Ziekenhuis Beverwijk, Beverwijk, The Netherlands
| | - G Klomp
- Oral and Maxillofacial Surgery, ETZ Hospitals, Tilburg, The Netherlands
| | | | - M M Freilich
- Private Practice, Toronto, Canada; OMFS, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Humber River Hospital, Toronto, Canada
| | - M Y Mommaerts
- Private Clinic Orthoface Ghent, Ghent, Belgium; European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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28
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Vi S, Pham D, Du YYM, Arora H, Tadakamadla SK. Mini-Implant-Retained Overdentures for the Rehabilitation of Completely Edentulous Maxillae: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084377. [PMID: 33924167 PMCID: PMC8074399 DOI: 10.3390/ijerph18084377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022]
Abstract
Purpose: Mini-dental implants (MDIs) have been used to support and retain overdentures, providing patients with a less invasive placement procedure. Although lucrative, the use of MDIs to retain a maxillary overdenture is still not an established treatment modality. This systematic review aims to answer the question: Do mini-implant-retained maxillary overdentures provide a satisfactory treatment outcome for complete edentulism? Methods: A systematic search for relevant articles was conducted to include articles published until April 2021 in the following electronic databases: CINAHL, Cochrane, EMBASE, PubMed, and Web of Science. All empirical studies evaluating the biological, survival, or patient-reported outcomes after placing mini-implant-retained overdentures in maxilla were considered for inclusion. The risk of bias was assessed by utilizing the Joanna Briggs Institute critical appraisal checklist. Study screening and data extraction were conducted by three reviewers independently. Results: The electronic search retrieved 1276 titles after omitting duplicates. Twenty articles were considered for full-text review, of which six studies were included in this systematic review. The included studies evaluated a total of 173 participants with a mean age of 66.3 years. The overall mini-implant survival rate was 77.1% (95% CI: 64.7–89.5%) with a mean follow-up time of 1.79 years (range: 6 months to 3 years). Implant survival differed significantly when comparing complete and partial palatal coverage overdentures. Those with complete palatal coverage exhibited less bone loss overall compared to partial coverage overdentures. Participants of all studies reported an increase in the quality of life and in satisfaction after rehabilitation treatment with MDIs. Conclusions: The survival rate of mini-implants retaining an overdenture in the maxilla was observed to be lower than the values reported for traditional implants in the literature. Improvements were observed in all aspects in terms of patient satisfaction, quality of life, oromyofunction, and articulation after the treatment.
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Affiliation(s)
- Serena Vi
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Damon Pham
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Yu Yian Marina Du
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
| | - Himanshu Arora
- School of Dentistry, The University of Queensland, Brisbane 4006, Australia
- Correspondence:
| | - Santosh Kumar Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast 4222, Australia; (S.V.); (D.P.); (Y.Y.M.D.); (S.K.T.)
- Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia
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29
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da Costa Valente ML, Macedo AP, Reis A. Stress distribution analysis of novel dental mini-implant designs to support overdenture prosthesis. J ORAL IMPLANTOL 2021; 48:79-83. [PMID: 33690819 DOI: 10.1563/aaid-joi-d-19-00354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to test and compare two novel dental mini-implant designs to support overdentures with a commercial model, regarding the stress distribution, by photoelastic analysis. Three different mini-implant designs (Ø 2.0 mm × 10 mm) were tested: G1-experimental threaded (design with threads and 3 longitudinal and equidistant self-cutting chamfers), G2-experimental helical (design with 2 long self-cutting chamfers in the helical arrangement), and G3-Intra-Lock® System. After including the mini-implants in a photoelastic resin, they were subjected to a static load of 100 N under two situations: axial and inclined model (30°). The fringe orders (n), that represents the intensity of stresses were analyzed around the mini-implants body and quantified using Tardy's method that calculates the maximum shear stress (τ) value in each point selected. In axial models, less stress was observed in the cervical third mini-implants, mainly in G1 and G2. In inclined models (30°), higher stresses were generated on the opposite side of the load application, mainly in the cervical third of G2 and G3. All mini-implant models presented lower tensions in the cervical third compared with the middle and apical third. The new mini-implants tested (G1 and G2) showed lower stresses than the G3 in the cervical third under axial load, while loading in the inclined model generated greater stresses in the cervical of G2.
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Affiliation(s)
| | - Ana Paula Macedo
- PhD, Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Av. do Café, s/n, 14040-904, Ribeirão Preto - SP, Brazil. E-mail:
| | - Andréa Reis
- University of São Paulo Prosthesis and dental materials Av. Café, s/n° BRAZIL Ribeirão Preto São Paulo 14040-904 55 36024044 University of São Paulo
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30
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Valente MLC, Bolfarini C, de Oliveira DP, Dos Reis AC. Dental mini-implant designs to support overdentures: Development, biomechanical evaluation, and 3D digital image correlation. J Prosthet Dent 2021; 128:754-763. [PMID: 33640085 DOI: 10.1016/j.prosdent.2020.06.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Custom mini-implants are needed for edentulous patients with extensive mandibular deficiencies where endosteal placement is not possible. However, the best design for these mini-implants is unclear. PURPOSE The purpose of this in vitro study was to develop 2 dental mini-implant designs to support mandibular overdentures and evaluate the effect of their geometries on primary stability and stress distribution. MATERIAL AND METHODS Two mini-implant designs were developed with changes in the shape, size, and arrangement of threads and chamfers. The experimental mini-implants were made of Grade V titanium alloy (Ti-6Al-4V), (Ø2.0×10 mm) and submitted to a nanoscale surface treatment. Thirty mini-implants (n=10) were placed into fresh swine bones: experimental-threaded, experimental-helical, and a commercially available product model (Intra-Lock System) as the control. The biomechanical evaluations of the experimental mini-implants were compared with those of the control in terms of primary stability, through insertion torque (IT), and with the pullout test. The analysis of stress distribution was performed by using the method of 3D digital image correlation under 250-N axial load and 100-N oblique (30-degree angled model) load. The data were analyzed by ANOVA and the Tukey HSD test (α=.05). RESULTS The IT and pullout test presented a statistically significant difference for all mini-implants (P<.05), with higher IT for the experimental-threaded and maximum pullout force for the control, followed by threaded (P=.001) and helical (P=.001). Regarding the 3D digital image correlation, a lower incidence of stress was found in the cervical third for all mini-implants. No statistically significant differences were found between the designs evaluated (P>.05). CONCLUSIONS Comparing the experimental mini-implants with the commercially available control, the experimental-threaded model presented greater primary stability, and all mini-implants showed less stress in the cervical third.
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Affiliation(s)
- Mariana L C Valente
- Posdoctoral student, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, (USP), Ribeirão Preto, São Paulo, Brazil
| | - Claudemiro Bolfarini
- Full Professor, Department of Materials Engineering, Federal University of São Carlos, (UFScar), São Carlos, São Paulo, Brazil
| | - Diego P de Oliveira
- Post-doctor, Department of Materials Engineering, Federal University of São Carlos, (UFScar), São Carlos, São Paulo, Brazil
| | - Andréa C Dos Reis
- Associate Professor, Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, (USP), Ribeirão Preto, São Paulo, Brazil.
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31
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Considerations for the Prosthetic Dental Treatment of Geriatric Patients in Germany. J Clin Med 2021; 10:jcm10020304. [PMID: 33467579 PMCID: PMC7830366 DOI: 10.3390/jcm10020304] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 12/14/2022] Open
Abstract
Demographic changes in the industrialized countries require that dentists adapt to the growing and heterogeneous group of elderly patients and develop concepts for the dental care of fit, frail, and dependent old and very old people. In general, dental care for old and very old people should be based on their individual everyday life. As a result of demographic changes, improved oral hygiene at home, and the establishment of professional teeth and denture cleaning, tooth loss occurs increasingly in higher ages, which implies that first extensive prosthetic rehabilitation with fixed or/and removable dental prostheses is shifting to a higher average age than ever before. This phenomenon requires that the individual diseases, potential multimorbidity and polypharmacy, and associated limitations are taken into consideration. Against this background, the current survey aims to summarize epidemiological trends associated with tooth loss, using Germany as a highly representative country for demographic changes as an example. Furthermore, the current narrative summary outlines general principles that should be followed in dental care, treatment of geriatric patients, and outlines current therapeutic options in prosthetic dentistry.
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32
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Van Doorne L, Fonteyne E, Matthys C, Bronkhorst E, Meijer G, De Bruyn H. "Longitudinal Oral Health-Related Quality of Life in maxillary mini dental implant overdentures after 3 years in function". Clin Oral Implants Res 2020; 32:23-36. [PMID: 33043547 DOI: 10.1111/clr.13677] [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: 01/21/2020] [Revised: 08/17/2020] [Accepted: 09/28/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Longitudinal evaluation of Oral Health-Related Quality of Life (OHRQoL) during treatment of flaplessly placed, one-piece mini-dental-implants (MDIs) for maxillary overdentures is rarely investigated, nor is the impact of MDI failures. MATERIAL AND METHODS This multicenter prospective cohort study evaluated the 3-year outcome of 5-6 MDIs in the edentulous maxilla in patients above 50 years with dentate mandible. Provisional dentures were provided before final prosthetic connection was established at 6 months. Postoperative discomfort was assessed using a visual analogue score (VAS). OHRQoL was investigated using the Oral Health Impact Profile (OHIP)-14 at baseline (preoperatively), postoperatively, post-prosthetic connection and after 3 years in function. RESULTS 164 (78.4%) of the 204 placed MDIs were still in situ after 3 years, in 29/31 patients. Two patients lost 5/6 MDIs resulting in two prosthetic failures (6.45%). With regard to pain, a score of 4.1/10 (SD 2.8) was recorded on day 1, and 1.1/10 (SD 1.7) on day 7. A decrease in total OHIP-14 scores was observed postoperatively (15.6; SD 12.8) as compared to baseline (21.3; SD 13.1), with improvement of OHRQoL. Furthermore, this was statistically significant at connection of the final prosthesis (7.3; SD 6.7) (p = .006). The OHIP-14 improved less (p = .011) when experiencing one or more implant losses (9.5; SD: 9.85), in comparison with no implant loss (20.7; SD: 13.97). A failure of one MDI did not affect OHIP-14 score (p = .658); however, multiple failures did (p = .007). CONCLUSION Maxillary MDI overdenture treatment yields significant OHRQoL improvement when at least 5 MDIs survive, preserving functional comfort.
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Affiliation(s)
- Luc Van Doorne
- Cosmipolis Clinic, Brugge, Belgium.,Ghent University Hospital, Gent, Belgium
| | | | | | - Ewald Bronkhorst
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Gert Meijer
- Department of Dentistry-Implantology and Periodontology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Hugo De Bruyn
- Department of Dentistry-Implantology and Periodontology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
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Three-Dimensional Radiographic Outcome of Free-Handed Flaplessly Placed Mini Dental Implants in Edentulous Maxillae after 2-Years Function. J Clin Med 2020; 9:jcm9072120. [PMID: 32635649 PMCID: PMC7408764 DOI: 10.3390/jcm9072120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Free-handed, flaplessly placed mini dental implants (MDIs) are a valuable, more affordable and minimally invasive treatment to support overdentures in fully edentulous jaws, especially for medically compromised patients. However, critical 3D radiographic evaluation is lacking. This multicenter prospective case series assessed clinical outcome and carried out 3D- cone-beam computerized tomography (CBCT) analysis of free-handed flaplessly placed one-piece maxillary MDIs by an experienced maxillofacial surgeon. Methods: Thirty-one patients suffering from an ill-fitting maxillary denture relating to compromised bone volume (as confirmed on CBCT), with a dentate mandible, were selected. They received 5–6 MDIs free-hand flaplessly placed and mentally guided with preoperative CBCT. Final connection and attachment activation took place six months later. After two years each implant was individually assessed with CBCT for perforations on eight sites. Implant survival, prosthetic failure, clinical stability and sinus/nasal complaints were registered after three years. Results: 32/185 (17.3%) MDIs failed during the provisional loading with non-activated attachments; 17 replacements in 10 patients were performed. Of the 170 actively loaded 170 MDIs, 82.3% survived and 27/31 prostheses (87%) were fully functional. In total 98/170 MDIs showed no perforation. Based on 1360 CBCT observations, 231 perforations (16.9%) were registered. Of most perforations 37 (25%) were observed at the apical tip and 37 were positioned (21%) into the sinus/nasal cavity, although without clinical complaints. Conclusions: Given the compromised population, the minimally invasive procedure and the low treatment cost involved, a failure rate of 17% is substantial, however clinically acceptable given the critical bone condition. However, even in experienced surgical hands, freehanded and flapless placement yield a high risk for implant perforation, although this did not necessarily lead to complications.
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Wirz H, Teufelhart S, McBeth C, Gyurko R, Dibart S, Sauer‐Budge A. Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss. Clin Exp Dent Res 2020; 6:336-344. [PMID: 32558317 PMCID: PMC7301390 DOI: 10.1002/cre2.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Bone augmentation delays implant placement and increases risks due to additional surgeries. Implant systems compatible with reduced alveolar bone volume are required. To design, manufacture, and test a non-cylindrical dental implant system using piezotomes and custom-designed matching titanium mini-implants to address the needs of patients with missing teeth and narrow jawbone. MATERIALS AND METHODS Tapered mini-implants with a rectangular cross-section (4.6 mm × 2.1 mm) were machined with dimensions that could accommodate narrow alveolar ridges. The performance of the implants were tested in both static and fatigue cycle 30° compression tests. Tapered, rectangular cutting tools that matched the overall trapezoidal morphology of the implant were also designed. These novel tools were engineered to be compatible with commercially available piezoelectric osteotomes. Tools were optimized using finite element analysis and were manufactured accordingly and were used by a periodontal surgery team in a pork rib bone model to monitor utility of the device and ease of use. RESULTS The rectangular design of the implant allows for a full occlusal load due to the larger implant flexural rigidity compared to a similar diameter mini-implant with a standard cylindrical design. During 30° compression fatigue tests, the implant tested at 340 N did not fail after 5M cycles as shown in Kaplan-Meier survival curves. Finite element analysis allowed for functional optimization of the roughing and finishing tools. In the pork rib model, these tools successfully cut trapezoidal holes that matched the dimensions of the implant. CONCLUSIONS The implant system here demonstrates the feasibility of a mini-implant system that has superior flexural rigidity and potentially circumvents the need for patient bone augmentation.
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Affiliation(s)
- Holger Wirz
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
| | - Stefan Teufelhart
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Project Group for Resource‐Efficient Mechatronic Processing Machines (RMV)Fraunhofer Institute for Machine Tools and Forming Technologies (IWU)AugsburgGermany
| | - Christine McBeth
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Department of Biomedical EngineeringBoston UniversityBostonMassachusetts
| | - Robert Gyurko
- Department of PeriodontologyBoston UniversityBostonMassachusetts
- Department of Periodontology, Tufts University School of Dental MedicineBostonMassachusetts
| | - Serge Dibart
- Department of PeriodontologyBoston UniversityBostonMassachusetts
| | - Alexis Sauer‐Budge
- Fraunhofer USA Center for Manufacturing InnovationBrooklineMassachusetts
- Exponent IncNatickMassachusetts
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Pontes M, Gomes J, Lemos C, Leão RS, Moraes S, Vasconcelos B, Pellizzer EP. Effect of Bleaching Gel Concentration on Tooth Color and Sensitivity: A Systematic Review and Meta-analysis. Oper Dent 2020; 45:265-275. [PMID: 32396502 DOI: 10.2341/17-376-l] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis was to evaluate a high concentration of hydrogen peroxide (35%) regarding tooth sensitivity and color change in tooth bleaching in comparison to low concentrations (6% to 20%). METHODS AND MATERIALS This review was conducted using the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and is registered on the Prospective Register of Systematic Reviews (CRD42017064493). The PICO question was "Does a concentration of hydrogen peroxide ≥35% using in-office bleaching procedure contribute to greater tooth sensitivity?" A search was made in PubMed/MEDLINE, Scopus, and the Cochrane Library. RESULTS Fourteen studies were selected for the qualitative analysis and seven for quantitative analysis. A total of 649 patients were evaluated (mean age: 36.32 years; range: 13.9 to 31 years), and the follow-up period ranged from one week to 12 months. The meta-analysis demonstrated that tooth sensitivity was higher in the patients submitted to treatment involving a high concentration of hydrogen peroxide (0.67; 95% confidence interval [CI]: 0.44 to 1.03; p=0.04; I 2 : 56%), and a significant difference was found regarding objective color ΔE (1.53; 95% CI: 2.99 to 0.08; p<0.0001; I 2 : 82%) but no significant difference was found regarding subjective color ΔSGU (0.24; CI: 0.75 to 1.23; p<0.00001; I 2 : 89%). CONCLUSIONS This study indicated that a lower concentration of hydrogen peroxide causes less tooth sensitivity and better effectiveness in objective color change (ΔE); however, there is no difference between them related to subjective color (ΔSGU).
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Van Doorne L, De Kock L, De Moor A, Shtino R, Bronkhorst E, Meijer G, De Bruyn H. Flaplessly placed 2.4-mm mini-implants for maxillary overdentures: a prospective multicentre clinical cohort study. Int J Oral Maxillofac Surg 2020; 49:384-391. [DOI: 10.1016/j.ijom.2019.08.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/31/2019] [Accepted: 08/21/2019] [Indexed: 11/26/2022]
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Comparison between flapless and open-flap implant placement: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 49:1220-1231. [PMID: 29685387 DOI: 10.1016/j.ijom.2018.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 02/18/2018] [Accepted: 04/08/2018] [Indexed: 12/16/2022]
Abstract
No consensus has been reached regarding the influence of the flapless and open-flap surgical techniques on the placement of dental implants. This systematic review compared the effects of flapless implant placement and implant placement with elevation of the mucoperiosteal flap in terms of marginal bone loss, implant survival rate and complications rates. This review followed PRISMA guidelines and was registered in PROSPERO with the registration number CRD42017071475. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until December 2017. The search identified 559 references. After a detailed review, 24 studies were assessed for eligibility. A total of 1025 patients who had received a total of 1873 dental implants were included. There were no significant differences between the flapless and open-flap surgical techniques in terms of implant survival rates (P=0.34; risk ratio (RR): 1.36; confidence interval (CI): 0.72-2.56), marginal bone loss (P=0.23; MD: -0.20; CI: -0.52-0.13), or complication rates (P=0.67; RR: 1.10; CI: 0.70-1.73). The current meta-analysis showed that the implant survival rate, marginal bone levels, and complications of flapless surgery were similar to those of open-flap surgery over a mean follow-up period of 21.62 months.
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Wang B, Ho KS, Neo TK, Cheng AC. Mini-dental implants for definitive prosthesis retention - A synopsis of the current evidence. SINGAPORE DENTAL JOURNAL 2019; 39:1-9. [PMID: 31672092 DOI: 10.1142/s2214607519300015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: This narrative review provides an evidence-based overview of the comparison between mini-dental implants (MDI) and conventional dental implants for definitive prosthesis retention. In addition, recommendations are made on whether the use of reduced diameter dental implants is more appropriate. Method: A literature review was conducted via electronic search addressing the following topics: (1) osseointegration, (2) peri-implant soft tissue characteristics, (3) biomechanics, (4) implant survival and (5) implant success. Conclusion: The procedure for dental implant prosthetic rehabilitation should preferentially include conventional dental implants (i.e. [Formula: see text][Formula: see text]mm fixture diameter). Small (3-3.25[Formula: see text]mm) and narrow (3.3-3.5[Formula: see text]mm) dental implants should primarily be used in non-load-bearing regions. MDI ([Formula: see text][Formula: see text]mm) should be considered to retain definitive prosthesis, only for reasons of anatomy or patient-centred preferences and as a last resort. If MDI are to be used, patients should be made aware of the lack of long-term, high-quality evidence as a part of the informed consent process and that most of the prospective data available pertain to MDI retaining complete dentures.
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Affiliation(s)
- Ben Wang
- Specialist Dental Group, Mount Elizabeth Medical Centre, 3 Mount Elizabeth #08-03, 228510, Singapore
| | - Kok Sen Ho
- Specialist Dental Group, Mount Elizabeth Medical Centre, 3 Mount Elizabeth #08-03, 228510, Singapore
| | - Tee Khin Neo
- Specialist Dental Group, Mount Elizabeth Medical Centre, 3 Mount Elizabeth #08-03, 228510, Singapore
| | - Ansgar C Cheng
- Specialist Dental Group, Mount Elizabeth Medical Centre, 3 Mount Elizabeth #08-03, 228510, Singapore
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Gomes JMDL, Moraes SLDD, Lemos CAA, Cruz RS, Oliveira HFFE, Pellizzer EP. Systematic review and meta-analysis of welding procedures in one-piece cast implant-supported frameworks. Braz Oral Res 2019; 33:e110. [PMID: 31778474 DOI: 10.1590/1807-3107bor-2019.vol33.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/10/2019] [Indexed: 11/21/2022] Open
Abstract
The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was "Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?" Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.
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Affiliation(s)
- Jéssica Marcela de Luna Gomes
- Universidade Estadual Paulista - Unesp, Araçatuba Dental School, Department of Dental Materials and Prosthodontics, Araçatuba, SP, Brazil
| | | | - Cleidiel Aparecido Araujo Lemos
- Universidade Estadual Paulista - Unesp, Araçatuba Dental School, Department of Dental Materials and Prosthodontics, Araçatuba, SP, Brazil
| | - Ronaldo Silva Cruz
- Universidade Estadual Paulista - Unesp, Araçatuba Dental School, Department of Dental Materials and Prosthodontics, Araçatuba, SP, Brazil
| | | | - Eduardo Piza Pellizzer
- Universidade Estadual Paulista - Unesp, Araçatuba Dental School, Department of Dental Materials and Prosthodontics, Araçatuba, SP, Brazil
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Kovačić I, Peršić S, Kranjčić J, Čelebić A. A cohort study on short mini-implants for mandibular overdentures compared to those of standard length. Clin Oral Implants Res 2019; 31:121-132. [PMID: 31541517 DOI: 10.1111/clr.13542] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To assess peri-implant bone level, survival and success rates of short (6 or 8 mm long) one-piece mini-implants (MDIs) in edentulous patients with extremely resorbed alveolar ridge (interforaminal height <10 mm) rehabilitated with mandibular implant overdentures and to compare them with patients having standard length MDIs in 1-year prospective clinical study. MATERIAL AND METHODS The Short MDI group consisted of 28 participants with interforaminal height ≤10 mm. Implants being, both, short and slim (short MDIs: 6 or 8 mm long, 2 or 2.5 mm wide) were inserted. The Standard-MDI group included 35 participants (interforaminal height >13 mm) who received standard length MDIs (10-14 mm long, 2 or 2.5 mm wide). Primary outcomes were assessments of MDI peri-implant bone level, survival and success rates; secondary outcomes were assessments of peri-implant tissue, oral hygiene, and prosthodontic maintenance. RESULTS The Short MDI group had mean marginal bone loss (MBL) of 0.26 ± 0.35 mm, 6.4% of failure, and 92.6% of, both, success and survival rates. The Standard-MDI group had mean MBL of 0.34 ± 0.40 mm, 5% of failure, 95% of survival, and 94.3% success. There were no significant differences in MBL (p = .420), survival (p = .414), and success (p = .571) between the groups. The Short MDI group had significantly less plaque (p = .001) and bleeding on probing (p < .001). CONCLUSION Within the limitations of this study, short MDIs (6 or 8 mm long) in extremely atrophied mandibles (interforaminal height <10 mm) showed good clinical results in the first year of function.
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Affiliation(s)
- Ines Kovačić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Sanja Peršić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Josip Kranjčić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Asja Čelebić
- Department of Prosthodontics, School of Dental Medicine & Clinical Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
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Fonteyne E, Van Doorne L, Becue L, Matthys C, Bronckhorst E, De Bruyn H. Speech evaluation during maxillary mini-dental implant overdenture treatment: A prospective study. J Oral Rehabil 2019; 46:1151-1160. [PMID: 31271663 PMCID: PMC6899632 DOI: 10.1111/joor.12852] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 12/27/2022]
Abstract
Large proportions of patients are edentulous and wear removable dentures leading to reduced functional comfort and less oral health‐related quality of life. Satisfaction with the oral situation after implantation depends on the outcome in eating comfort, speech comfort and aesthetics. Modification in form and location of the teeth may affect speech. The aim of this study is to determine speech, oromyofunctional behaviour, satisfaction with the treatment and the impact on quality of life of the horse‐shoe overdenture retained by mini‐dental implants (MDIs) in the maxilla. This prospective multicentre cohort study included 32 patients for treatment. 5 to 6 implants were placed, traumatically piercing the mucosa. Patients were evaluated three times during treatment (pre‐operatively with conventional prosthesis including full palatal coverage (CD), post‐operatively with provisionally relined CD and with horse‐shoe overdenture on MDI). The assessment included a phonetic evaluation, examination of oromyofunctional behaviour, evaluation of the impact on quality of life (OHIP‐14) and a rating of satisfaction with the treatment and speech on a visual analogue scale. Several speech sounds are found to be disturbed before treatment. In the next two stages of the treatment, the number of speech issues decreases. In the final stage, ten people show minor speech problems, especially with the /s/ sound. In this stage, seven people still present with oromyofunctional problems, especially whistling problems. In this last stage, people are very satisfied with the treatment (83%) and with speech (84%). The impact on quality of life is low (8.23/56).
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Affiliation(s)
- Ester Fonteyne
- Department of Oral Health Sciences, Section Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Luc Van Doorne
- Department of Oral Health Sciences, Section Maxillo-Facial Surgery, Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | | | - Carine Matthys
- Clinic for Removable Prosthodontics, Faculty of Medicine and Health Sciences, Dental School, Ghent University, Ghent, Belgium
| | - Ewald Bronckhorst
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hugo De Bruyn
- Department of Dentistry, Periodontology Dental School Ghent, Radboud University Medical Center, Nijmegen, The Netherlands
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Retention force and deformation of an innovative attachment model for mini-implant–retained overdentures. J Prosthet Dent 2019; 121:129-134. [DOI: 10.1016/j.prosdent.2018.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 11/18/2022]
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de Luna Gomes JM, Lemos CAA, Santiago Junior JF, de Moraes SLD, Goiato MC, Pellizzer EP. Optimal number of implants for complete-arch implant-supported prostheses with a follow-up of at least 5 years: A systematic review and meta-analysis. J Prosthet Dent 2018; 121:766-774.e3. [PMID: 30527569 DOI: 10.1016/j.prosdent.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 06/03/2018] [Accepted: 06/04/2018] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM Consensus is lacking regarding the optimal number of implants for supporting complete-arch prostheses with good survival rates and lower prosthetic complications and marginal bone loss. PURPOSE The purpose of this systematic review was to evaluate the influence of the number of implants used for complete-arch prostheses with at least 5 years of follow-up. MATERIAL AND METHODS A search was performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and was registered in The International Prospective Register of Systematic Reviews (CRD42016048468). The following was the population, intervention, comparison, outcome (PICO) question: Does the number of implants influence the longevity of complete-arch prostheses? RESULTS Nineteen studies including 1006 patients with a mean age of 61.44 years were selected for evaluation. The number of implants per jaw ranged between 2 and 9 in the maxilla, mandible, or both jaws. For implant survival rate in complete-arch prostheses with fewer than 5 implants per jaw, the pooled weighted event rate was 1.4% (I2=25.26%; P=.211) and 4.2% (I2=81.35%; P<.001) for complete arches with more than 4 implants per jaw. For the prosthesis survival rate, the pooled weighted event rate for a complete-arch with fewer than 5 implants per jaw was 1.5% (I2=0%; P=.677) and 9% (I2=17.33%; P=.304) for complete arches with more than 4 implants per jaw. For prosthesis complications for complete arches with fewer than 5 implants per jaw, the pooled weighted event rate was 19.9% (I2=93.5%; P<.001) and 24.5% (I2=88.89; P<.001) for complete arches with more than 4 implants per jaw. The mean marginal bone loss for complete arches with fewer than 5 implants per jaw was 1.22 ±0.49 mm (I2=99.46; P<.001) and 1.46 ±0.46 mm (I2=99.6; P <.001) for more than 4 implants per jaw. CONCLUSIONS The current systematic review indicated no relationship of the number of implants used to support a complete-arch prosthesis with implant survival rate, prosthesis survival rate, prosthesis complications, or marginal bone loss in studies with follow-up periods of between 5 and 15 years.
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Affiliation(s)
- Jéssica Marcela de Luna Gomes
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.
| | - Cleidiel Aparecido Araújo Lemos
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Joel Ferreira Santiago Junior
- Assistant Professor, Pró-Reitoria de Pesquisa e Pós-graduação (PRPPG), Universidade do Sagrado Coração (USC), Bauru, Brazil
| | | | - Marcelo Coelho Goiato
- Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
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Bielemann AM, Marcello‐Machado RM, Schuster AJ, Chagas Júnior OL, Del Bel Cury AA, Faot F. Healing differences in narrow diameter implants submitted to immediate and conventional loading in mandibular overdentures: A randomized clinical trial. J Periodontal Res 2018; 54:241-250. [DOI: 10.1111/jre.12624] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/25/2018] [Accepted: 09/30/2018] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | - Otacílio Luiz Chagas Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial ProsthodonticsSchool of DentistryFederal University of Pelotas Pelotas Brazil
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and PeriodontologyPiracicaba Dental SchoolState University of Campinas Piracicaba Brazil
| | - Fernanda Faot
- Department of Restorative DentistrySchool of DentistryFederal University of Pelotas Pelotas Brazil
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Schiegnitz E, Al‐Nawas B. Narrow‐diameter implants: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:21-40. [DOI: 10.1111/clr.13272] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
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47
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Can Genetic Factors Compromise the Success of Dental Implants? A Systematic Review and Meta-Analysis. Genes (Basel) 2018; 9:genes9090444. [PMID: 30200629 PMCID: PMC6162655 DOI: 10.3390/genes9090444] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/28/2018] [Accepted: 08/31/2018] [Indexed: 02/06/2023] Open
Abstract
Dental implants provide a predictable treatment option for partial and complete edentulism via the placement of a fixed permanent artificial root to support prosthetic dental crowns. Despite the high survival rates, long-term dental implant failures are still reported, leading to implant removals and additional financial and health burdens. While extrinsic factors that improve the success rate of implants have been well explored, the impact of genetic factors on this matter is poorly understood. A systematic review and meta-analysis study was conducted to determine whether genetic factors contribute to an increased risk of dental implant failures. A comprehensive search for peer-reviewed articles on dental implants and genetic factors was performed using various literature database libraries. The study design was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the obtained records were registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. According to the exclusion/inclusion criteria, 13 studies were eligible for this study out of 809 articles. The meta-analysis of the combined association studies of DNA variations and dental implants did not indicate an increased risk for implant failure due to DNA variations in IL-1B, IL-10 and TNF-α. This study emphasizes the need for larger randomized controlled clinical trials to inform clinicians and patients about the role of genetic factors on dental implant survival and the success rate in healthy and compromised patients.
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48
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Pisani MX, Presotto AGC, Mesquita MF, Barão VAR, Kemmoku DT, Del Bel Cury AA. Biomechanical behavior of 2-implant– and single-implant–retained mandibular overdentures with conventional or mini implants. J Prosthet Dent 2018; 120:421-430. [DOI: 10.1016/j.prosdent.2017.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/06/2017] [Accepted: 12/06/2017] [Indexed: 11/30/2022]
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49
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de Souza Batista VE, Verri FR, Lemos CAA, Cruz RS, Oliveira HFF, Gomes JML, Pellizzer EP. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2018; 121:41-51. [PMID: 29961632 DOI: 10.1016/j.prosdent.2018.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 10/28/2022]
Abstract
STATEMENT OF PROBLEM The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. MATERIAL AND METHODS This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was "Should the restoration of adjacent implants be splinted or nonsplinted?" The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. RESULTS Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. CONCLUSIONS Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure.
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Affiliation(s)
- Victor E de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil.
| | - Fellippo R Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ronaldo S Cruz
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Hiskell F F Oliveira
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica M L Gomes
- Graduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo P Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
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50
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Survival of dental implants placed in HIV-positive patients: a systematic review. Int J Oral Maxillofac Surg 2018; 47:1336-1342. [PMID: 29555240 DOI: 10.1016/j.ijom.2018.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 01/08/2023]
Abstract
No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017. Six studies were selected for review. In total, 821 implants were placed: 493 in 169 HIV-positive patients, and 328 in 135 HIV-negative patients. The mean duration of follow-up was 47.9 months. Weighted mean survival rate, success rate, and marginal bone loss values were calculated for the HIV-positive patients. Mean survival and success rates at the patient level (according to the number of patients) were 94.76% and 93.81%, respectively; when calculated at the implant level (according to the number of implants), these rates were 94.53% and 90.37%, respectively. Mean marginal bone loss was 0.83mm at the patient level and 0.99mm at the implant level. Thus, dental implants are suitable for the rehabilitation of HIV-positive patients with controlled risk factors and normal CD4+ cell counts.
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