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Lops D, Palazzolo A, Calza S, Proietto L, Sordillo A, Mensi M, Romeo E. Guided versus freehand single implant placement: A 3-year parallel randomized clinical trial. J Dent 2024; 149:105317. [PMID: 39181431 DOI: 10.1016/j.jdent.2024.105317] [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: 02/21/2024] [Revised: 07/31/2024] [Accepted: 08/18/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVES The present parallel randomized clinical trial aimed to assess, after a 3-year follow-up period, whether the choice of surgical technique-either manual or guided-and of the operator - non-expert operator or skilled - can affect the stability of peri‑implant marginal bone levels in implants placed 1 mm sub-crestal. MATERIALS AND METHODS Patients received platform-switched implants (Anyridge, MegaGen Implant Co., Gyeongbuk, South Korea) featuring a 5-degree internal conical connection and supporting single screw-retained fixed crowns. The implants were randomly assigned to be placed through a digitally static guided surgery procedure (Test group - GS) or a freehand surgical technique (Control Group - FH). A non-expert operator (fewer than 20 implants placed in his professional activity) was selected to perform procedures for the GS Group, while a skilled operator (with over 1000 implants placed in his professional activity) was chosen for the FH Group. Marginal bone level (MBL) was measured at prosthesis installation (t0) and at 1 (t1), 2 (t2) and 3 years (t3) of follow-up. Changes in MBL from t0 to t3 were analyzed through periapical radiographs. Moreover, MBL changes at all time points were correlated to different supra-crestal soft tissue heights (STH): less than 3 and ≥ 3 mm, respectively. RESULTS 60 implants in 18 patients were examined, with 30 implants allocated to the GS group and 30 to the FH group. The difference in MBL change between the two groups was 0.11 ± 0.22 mm, which was not statistically significant (p = 0.61). At the time of prosthetic loading, the mean MBL for implants with STH less than 3 mm was 0.33 mm higher than implants with STH ≥ 3 mm, though this difference was not statistically significant (P = 0.065). CONCLUSIONS Digitally static guided implant placement, performed by a non-expert operator, does not limit marginal bone remodeling, when compared to a freehand procedure performed by an experienced operator. CLINICAL SIGNIFICANCE After correct and careful planning, early marginal bone levels (MBL) around conical connection, platform-switched implants placed sub-crestally may be stable in time. Digital planning and surgery have the potential to assist non-expert clinicians in achieving implant placements with comparable outcomes to those performed by experts.
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Affiliation(s)
- Diego Lops
- Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, Italy.
| | - Antonino Palazzolo
- Department of Oral Surgery, Dental Clinic, School of Dentistry, University of Milan, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Luca Proietto
- Department of Oral Surgery, Dental Clinic, School of Dentistry, University of Milan, Italy
| | - Annamaria Sordillo
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Italy
| | - Magda Mensi
- Department of Surgical Specialties, Dental Clinic, School of Dentistry, University of Brescia, Italy
| | - Eugenio Romeo
- Professor and Chairman, Department of Prosthodontics, Dental Clinic, School of Dentistry, University of Milan, Italy
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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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Manfredini M, Poli PP, Giboli L, Beretta M, Maiorana C, Pellegrini M. Clinical Factors on Dental Implant Fractures: A Systematic Review. Dent J (Basel) 2024; 12:200. [PMID: 39056987 PMCID: PMC11276356 DOI: 10.3390/dj12070200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/06/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case-control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case-control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Luca Giboli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Matteo Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Lee JH, Kim YT, Lee JB. Identification of dental implant systems from low-quality and distorted dental radiographs using AI trained on a large multi-center dataset. Sci Rep 2024; 14:12606. [PMID: 38824187 PMCID: PMC11144187 DOI: 10.1038/s41598-024-63422-z] [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: 10/31/2023] [Accepted: 05/28/2024] [Indexed: 06/03/2024] Open
Abstract
Most artificial intelligence (AI) studies have attempted to identify dental implant systems (DISs) while excluding low-quality and distorted dental radiographs, limiting their actual clinical use. This study aimed to evaluate the effectiveness of an AI model, trained on a large and multi-center dataset, in identifying different types of DIS in low-quality and distorted dental radiographs. Based on the fine-tuned pre-trained ResNet-50 algorithm, 156,965 panoramic and periapical radiological images were used as training and validation datasets, and 530 low-quality and distorted images of four types (including those not perpendicular to the axis of the fixture, radiation overexposure, cut off the apex of the fixture, and containing foreign bodies) were used as test datasets. Moreover, the accuracy performance of low-quality and distorted DIS classification was compared using AI and five periodontists. Based on a test dataset, the performance evaluation of the AI model achieved accuracy, precision, recall, and F1 score metrics of 95.05%, 95.91%, 92.49%, and 94.17%, respectively. However, five periodontists performed the classification of nine types of DISs based on four different types of low-quality and distorted radiographs, achieving a mean overall accuracy of 37.2 ± 29.0%. Within the limitations of this study, AI demonstrated superior accuracy in identifying DIS from low-quality or distorted radiographs, outperforming dental professionals in classification tasks. However, for actual clinical application of AI, extensive standardization research on low-quality and distorted radiographic images is essential.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, Jeonbuk National University College of Dentistry, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
| | - Young-Taek Kim
- Department of Periodontology, Ilsan Hospital, National Health Insurance Service, Goyang, Korea
| | - Jong-Bin Lee
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung, Korea
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Liang W, Zhou C, Zhang H, Bai J, Long H, Jiang B, Liu L, Xia L, Jiang C, Zhang H, Zhao J. Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices. Front Bioeng Biotechnol 2024; 12:1389071. [PMID: 38860139 PMCID: PMC11163052 DOI: 10.3389/fbioe.2024.1389071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.
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Affiliation(s)
- Wenqing Liang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Chao Zhou
- Department of Orthopedics, Zhoushan Guanghua Hospital, Zhoushan, Zhejiang, China
| | - Hongwei Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Juqin Bai
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Hengguo Long
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Bo Jiang
- Rehabilitation Department, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Lu Liu
- Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Linying Xia
- Medical Research Center, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Chanyi Jiang
- Department of Pharmacy, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, Zhejiang, China
| | - Hengjian Zhang
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
| | - Jiayi Zhao
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Zhoushan, China
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Beltrán-Guijarro M, Pérez-Pevida E, Chávarri-Prado D, Estrada-Martínez A, Diéguez-Pereira M, Sánchez-Lasheras F, Brizuela-Velasco A. Biomechanical Effects of Ti-Base Abutment Height on the Dental Implant System: A Finite Element Analysis. J Funct Biomater 2024; 15:101. [PMID: 38667558 PMCID: PMC11051524 DOI: 10.3390/jfb15040101] [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: 02/21/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.
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Affiliation(s)
- Miguel Beltrán-Guijarro
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Department of Surgery, Faculty of Sports and Health Sciences, University of Zaragoza, 22006 Huesca, Spain
| | - Esteban Pérez-Pevida
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - David Chávarri-Prado
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Alejandro Estrada-Martínez
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Markel Diéguez-Pereira
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Fernando Sánchez-Lasheras
- Department of Mathematics, University Institute of Space Sciences and Technologies of Asturias (ICTEA), University of Oviedo, 33006 Oviedo, Spain;
| | - Aritza Brizuela-Velasco
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
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Shen YW, Huang HL, Hsu JT, Fuh LJ. Effects of diameters of implant and abutment screw on stress distribution within dental implant and alveolar bone: A three-dimensional finite element analysis. J Dent Sci 2024; 19:1126-1134. [PMID: 38618121 PMCID: PMC11010681 DOI: 10.1016/j.jds.2023.12.020] [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: 09/19/2023] [Revised: 12/23/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Few studies have investigated the effects of abutment screw diameter in the stress of dental implants and alveolar bones under occlusal forces. In this study, we investigated how variations in implant diameter, abutment screw diameter, and bone condition affect stresses in the abutment screw, implant, and surrounding bone. Materials and methods Three-dimensional finite element (FE) models were fabricated for dental implants with external hex-type abutments measuring 4 and 5 mm in diameter. The models also included abutment screws measuring 2.0 and 2.5 mm in diameter. Each implant model was integrated with the mandibular bone comprising the cortical bone and four types of cancellous bone. In total, 12 finite element models were generated, subjected to three different occlusal forces, and analyzed using FE software to investigate the stress distribution of dental implant and alveolar bone. Results Wider implants demonstrated lower stresses in implant and bone compared with standard-diameter implants. The quality of cancellous bone has a minimal impact on the stress values of the implant, abutment screw, and cortical bone. Regardless of occlusal arrangement or quality of cancellous bone, a consistent pattern emerged: larger abutment screw diameters led to increased stress levels on the screws, while the stress levels in both cortical and cancellous bone showed comparatively minor fluctuations. Conclusion Wider implants tend to have better stress distribution than standard-diameter implants. The potential advantage of augmenting the abutment screw diameter is unfavorable. It may result in elevated stresses in the implant system.
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Affiliation(s)
- Yen-Wen Shen
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University. Taichung, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
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Parekar D, Selvaganesh S, Nesappan T. Comparative Evaluation of Accuracy of Adjacent Parallel Implant Placements Between Dynamic Navigation and Static Guide: A Prospective Study. Cureus 2024; 16:e57331. [PMID: 38694417 PMCID: PMC11061662 DOI: 10.7759/cureus.57331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/31/2024] [Indexed: 05/04/2024] Open
Abstract
Aim The study aims to compare the accuracy of dynamic navigation (DN) and static guides (SGs) for simultaneous adjacent parallel placement of implants, the time taken for the surgery, and the ease of handling the instruments. Materials and methods This prospective trial was carried out at the Department of Implantology of Saveetha Dental College from October 2022 to February 2023. A total of 20 patients who needed simultaneous adjacent dental implants were allocated randomly into two groups: Group 1 SG surgery and Group 2 DN surgery. Forty implants were placed, 20 under DN and 20 under SG. Bucco-lingual displacement, apico-coronal displacement, mesiodistal displacement, and mesiodistal angulation were compared between the two groups. The patients' data in both groups were evaluated by operating surgeons along with the surgical time taken and the ease of handling of instruments. Results The 20 patients who underwent implant placement in the DN and SG groups all had adjacent missing teeth in posterior sites, including lower posteriors (70%) and upper posteriors (30%). There was improved precision in relation to the mesiodistal displacement and angulation of the anterior implant of the adjacent parallel implants. The mesiodistal displacement in Group 1 (SG) was 5.61 + 3.1 mm, which was higher than Group 2 (DN), which was 0.55 + 0.56 mm. The mesiodistal angulation was 3.1 + 2.9 degrees in Group 2 and 0.42 + 0.5 degrees in Group 1. The second implant had a significant difference (p < 0.005) in mesiodistal displacement, mesiodistal angulation, and bucco-lingual displacement. The difference between the intergroup surgical time (mean + SD) in Group 1 was 30 + 4.5 mins and in Group 2 was 60.7 + 10.1 mins, with p < 0.05 statistically significant. The comfort of the operator was better in the SG group. Conclusion Any digitally aided implant placement technique can improve placement accuracy but each has its downfalls. Achieving the highest levels of precision and long-lasting prosthetic results hinges on both the suitability of the chosen case and the expertise of the surgeon performing the implant placement.
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Affiliation(s)
- Dnyaneshwar Parekar
- Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Sahana Selvaganesh
- Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Thiyaneswaran Nesappan
- Prosthodontics and Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Lyu W, Zou J, Li L. A dental technique to reseat an angled nonhexagon multiunit abutment in a complete arch fixed prosthesis. J Prosthet Dent 2024:S0022-3913(23)00835-1. [PMID: 38195254 DOI: 10.1016/j.prosdent.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
When an angled abutment lacking an antirotation structure within a complete arch implant- supported fixed prosthesis becomes loose, the conventional approach typically involves replacing the entire prosthesis because of the difficulty of reseating the abutment at its original angle. To address this predicament, this technique article describes a novel solution in the form of a resin verification guide that replicates the maxillary prosthesis. The modified cylinder enables tightening of the abutment screw of the reseated multiunit abutment in place, eliminating the need for replacing the prosthesis and reducing treatment costs and duration.
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Affiliation(s)
- Wenhui Lyu
- Graduate student, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Jiaxing Zou
- Graduate student, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lei Li
- Associate Professor, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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10
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Chandran K R S, Goyal M, Mittal N, George JS. Accuracy of freehand versus guided immediate implant placement: A randomized controlled trial. J Dent 2023; 136:104620. [PMID: 37454788 DOI: 10.1016/j.jdent.2023.104620] [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: 05/24/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
PURPOSE This randomized controlled trial (RCT) aimed to compare the accuracy of immediate implant placement with freehand and static guided surgery. METHODS An RCT was conducted on 61 subjects who received a total of 80 dental implants. The enrolled patients were randomly allocated to two groups: freehand surgery (control group, n = 40 implants) and static guided surgery with R2Gate® (Megagen, Gyeongbuk, South Korea, test group, n = 40 implants). Crestal and apical deviations in both mesiodistal and buccolingual dimensions, as well as depth and angular deviations, were calculated by comparing the three-dimensional (3D) position of the implant in the planning software with the final implant position, revealed by an intraoral scan of the fixture after placement. The Mann-Whitney test was used for comparative assessment. RESULTS In the freehand group (control), crestal deviations of 1.13 ± 0.89 mm and 1.00 ± 0.76 mm were found in the mesiodistal and buccolingual directions, respectively, versus 0.34 ± 0.26 mm (p<0.001) and 0.37 ± 0.24 mm (p = 0.03) in the static guided surgery group (test). Apical deviation was also higher in the freehand group (control) than in the static guided surgery group (test) in the mesiodistal (4.04 ± 1.90 mm vs. 0.97 ± 0.55 mm, p = 0.04) and buccolingual directions (3.46 ± 1.82 mm vs. 0.94 ± 0.67 mm, p = 0.02). Freehand surgery had greater angular deviation (6.09° ± 3.23) compared to guided surgery (0.83° ± 0.53, p = 0.02). However, depth deviation was similar in the freehand surgery group (2.24 ± 1.58 mm) and static guided surgery group (0.66 ± 0.43, p = 0.09). CONCLUSIONS Immediate implant placement with static guided surgery demonstrated better accuracy than freehand surgery. STATEMENT OF CLINICAL RELEVANCE Guided implant surgery showed fewer deviations compared to freehand surgery in fresh extraction sockets; therefore, the use of static guides should be given preference over the freehand modality.
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Affiliation(s)
- Segin Chandran K R
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India.
| | - Manoj Goyal
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Neeti Mittal
- Santosh University, No.1, Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Jensy Sara George
- The Tamil Nadu Dr MGR Medical University 69, Anna Salai, Rd, Guindy, Chennai, Tamil Nadu 600032, India
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Kosewski P, De Angelis F, Sorrentino E, Mielczarek A, Buonvivere M, D’Arcangelo C. Effect of the Abutment Rigidity on the Wear Resistance of a Lithium Disilicate Glass Ceramic: An In Vitro Study. J Funct Biomater 2023; 14:395. [PMID: 37623640 PMCID: PMC10455685 DOI: 10.3390/jfb14080395] [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: 06/29/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Lithium disilicate (LDS) glass ceramics are among the most common biomaterials in conservative dentistry and prosthodontics, and their wear behavior is of paramount clinical interest. An innovative in vitro model is presented, which employs CAD/CAM technology to simulate the periodontal ligament and alveolar bone. The model aims to evaluate the effect of the abutment rigidity on the wear resistance of the LDS glass ceramic. Two experimental groups (LDS restorations supported by dental implants, named LDS-on-Implant, or by hybrid ceramic tooth replicas with artificial periodontal ligament, named LDS-on-Tooth-Replica) and a control group (LDS-Cylinders) were compared. Fifteen samples (n = 15) were fabricated for each group and subjected to testing, with LDS antagonistic cusps opposing them over 120,000 cycles using a dual axis chewing simulator. Wear resistance was analyzed by measuring the vertical wear depth (mm) and the volume loss (mm3) on each LDS sample, as well as the linear antagonist wear (mm) on LDS cusps. Mean values were calculated for LDS-Cylinders (0.186 mm, 0.322 mm3, 0.220 mm, respectively), LDS-on-Implant (0.128 mm, 0.166 mm3, 0.199 mm, respectively), and LDS-on-Tooth-Replica (0.098 mm, 0.107 mm3, 0.172 mm, respectively) and compared using one-way-ANOVA and Tukey's tests. The level of significance was set at 0.05 in all tests. Wear facets were inspected under a scanning electron microscope. Data analysis revealed that abutment rigidity was able to significantly affect the wear pattern of LDS, which seems to be more intense on rigid implant-abutment supports compared to resilient teeth replicas with artificial periodontal ligament.
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Affiliation(s)
| | - Francesco De Angelis
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
| | - Edoardo Sorrentino
- Department of Innovative Technologies in Medicine & Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy;
| | - Agnieszka Mielczarek
- Department of Conservative Dentistry, Medical University of Warsaw, 02091 Warsaw, Poland;
| | - Matteo Buonvivere
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
| | - Camillo D’Arcangelo
- Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, “G. D’Annunzio” University of Chieti, 66100 Chieti, Italy; (M.B.); (C.D.)
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