1
|
Gu Y, Zhang D, Tao B, Wang F, Chen X, Wu Y. A novel technique to quantify bone-to-implant contact of zygomatic implants: a radiographic analysis based on three-dimensional image registration and segmentation. Dentomaxillofac Radiol 2023; 52:20220210. [PMID: 36645052 PMCID: PMC9974236 DOI: 10.1259/dmfr.20220210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/01/2022] [Accepted: 11/21/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The purpose of this study is to establish a novel, reproducible technique to obtain the BIC area (BICA) between zygomatic implants and zygomatic bone based on post-operative cone-beam computed tomography (CBCT) images. Three-dimensional (3D) image registration and segmentation were used to eliminate the effect of metal-induced artifacts of zygomatic implants. METHODS An ex-vivo study was included to verify the feasibility of the new method. Then, the radiographic bone-to-implant contact (rBIC) of 143 implants was measured in a total of 50 patients. To obtain the BICA of zygomatic implants and the zygomatic bone, several steps were necessary, including image preprocessing of CBCT scans, identification of the position of zygomatic implants, registration, and segmentation of pre- and post-operative CBCT images, and 3D reconstruction of models. The conventional two-dimensional (2D) linear rBIC (rBICc) measurement method with post-operative CBCT images was chosen as a comparison. RESULTS The mean values of rBIC and rBICc were 15.08 ± 5.92 mm and 14.77 ± 5.14 mm, respectively. A statistically significant correlation was observed between rBIC and rBICc values ([Formula: see text]=0.86, p < 0.0001). CONCLUSIONS This study proposed a standardized, repeatable, noninvasive technique to quantify the rBIC of post-operative zygomatic implants in 3D terms. This technique is comparable to conventional 2D linear measurements and seems to be more reliable than these conventional measurements; thus, this method could serve as a valuable tool in the performance of clinical research protocols.
Collapse
Affiliation(s)
| | - Dingzhong Zhang
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Baoxin Tao
- Department of Second Dental Center and Oral Rehabilitation, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Wang
- Department of Oral Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | | | - Yiqun Wu
- Department of Second Dental Center and Oral Rehabilitation, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| |
Collapse
|
2
|
Sáez-Alcaide LM, Cortés-Bretón-Brinkmann J, Sánchez-Labrador L, Pérez-González F, Forteza-López A, Molinero-Mourelle P, López-Quiles J. Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review. Acta Odontol Scand 2022; 80:363-373. [PMID: 35044889 DOI: 10.1080/00016357.2021.2018494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.
Collapse
Affiliation(s)
- Luis Miguel Sáez-Alcaide
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Luis Sánchez-Labrador
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Fabián Pérez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alba Forteza-López
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Juan López-Quiles
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
3
|
Vrielinck L, Moreno‐Rabie C, Schepers S, Van Eyken P, Coucke W, Politis C. Peri‐zygomatic Infection Associated to Zygomatic Implants: a retrospective longitudinal cohort study. Clin Oral Implants Res 2022; 33:405-412. [DOI: 10.1111/clr.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/23/2021] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Luc Vrielinck
- Department of Oral and Maxillofacial Surgery Saint John´s Hospital Genk Belgium
| | - Catalina Moreno‐Rabie
- OMFS‐IMPATH Research Group Department of Imaging and Pathology Faculty of Medicine University of Leuven Leuven Belgium
- Department of Oral and Maxillofacial Surgery University Hospitals Leuven Leuven Belgium
| | - Serge Schepers
- Department of Oral and Maxillofacial Surgery Saint John´s Hospital Genk Belgium
| | | | - Wim Coucke
- Certified Freelance Statistician Heverlee Belgium
| | - Constantinus Politis
- OMFS‐IMPATH Research Group Department of Imaging and Pathology Faculty of Medicine University of Leuven Leuven Belgium
- Department of Oral and Maxillofacial Surgery University Hospitals Leuven Leuven Belgium
| |
Collapse
|
4
|
Maxillary Sinusitis as a Complication of Zygomatic Implants Placement: A Narrative Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Aims: The aim of this review is to consider maxillary sinusitis as a complication of zygomatic implants placements. Maxillary sinusitis a common complication but in the literature there are no reviews that focus only on this condition and its possible treatment. This review was carried out with to highlight the main findings of the literature on this topic and to improve knowledge in this field. Methods: The search strategy resulted in 155 papers. After selection of the inclusion criteria only 11 papers were examined. From the papers these, 12.3% patients presented maxillary sinusitis but only four studies evaluated sinusitis (both clinical and radiological evaluation). The most common treatment used by the authors were antibiotics alone or combined with functional endoscopic sinus surgery (FESS). Results: The literature shows an absence of precise and shared guidelines diagnosis and post-operative follow-up, and of the treatment of maxillary sinusitis following zygomatic implantology. It has not been determined if the surgical placement of ZIs is better than the other techniques for treatment of the onset of maxillary sinusitis in the post-operative period. Conclusion: To date there are no shared protocols for maxillary sinusitis treatment. In our experience, and according to the literature in the presence of risk factors such as age, comorbidities, smoking, nasal septal deviation or other anatomical variants, we suggested that FESS is performed at the same time as placement of zygomatic implants.
Collapse
|
5
|
Xing Gao B, Iglesias-Velázquez O, G F Tresguerres F, Rodríguez González Cortes A, F Tresguerres I, Ortega Aranegui R, López-Pintor RM, López-Quiles J, Torres J. Accuracy of digital planning in zygomatic implants. Int J Implant Dent 2021; 7:65. [PMID: 34291352 PMCID: PMC8295422 DOI: 10.1186/s40729-021-00350-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Zygomatic implants have been described as a therapeutic alternative for patients with severe maxillary atrophy in order to avoid bone augmentation procedures. Taking that into account, in these treatments, the key factor is the position of the implant, the virtual surgical planning (VSP) is widespread among most clinicians before surgery on the patient. However, there are no studies which evaluate the clinical relevance of these VSP. The aim of this study is to determine whether digital planning on zygomatic implants has any influence on the implant dimensions and position, even when performing conventional surgery afterwards. Results Fourteen zygomatic implants were placed in four patients. Pre-operative and post-operative helicoidal computed tomography were performed to each patient to allow the comparison between the digital planning and the final position of implants. Tridimensional deviation (TD), mesio-distal deviation (MDD), bucco-palatine deviation (BPD), and apico-coronal deviation (ACD) were evaluated as well as angular deviation (AD). Significative differences in apical TD were observed with a mean of 6.114 ± 4.28 mm (p < 0.05). Regarding implant position, only implants placed in the area of the first right molar reported significant differences (p < 0.05) for ACD. Also, implant length larger than 45 mm showed BPD significative differences (p < 0.05). Conclusions Zygomatic implant surgery is a complex surgical procedure, and although VSP is a useful tool which helps the clinician determine the number and the length of zygomatic implants as well as its proper position, surgical experience is still mandatory.
Collapse
Affiliation(s)
- B Xing Gao
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - O Iglesias-Velázquez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain.
| | - F G F Tresguerres
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - A Rodríguez González Cortes
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - I F Tresguerres
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - R Ortega Aranegui
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - R M López-Pintor
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - J López-Quiles
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| | - J Torres
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal, s/n (Ciudad Universitaria), 28040, Madrid, Spain
| |
Collapse
|
6
|
Mozzati M, Gallesio G, Goker F, Tumedei M, Cesare P, Tedesco A, Del Fabbro M. Immediate Oral Rehabilitation With Quad Zygomatic Implants: Ultrasonic Technique vs Conventional Drilling. J ORAL IMPLANTOL 2021; 47:205-213. [PMID: 32780812 DOI: 10.1563/aaid-joi-d-19-00195] [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] [Indexed: 11/22/2022]
Abstract
Inserting zygomatic implants is a challenging surgery and requires special care and great precision. Piezoelectric surgery offers several advantages: more precise bone cutting with improved intraoperative visibility and a low temperature increase. The aim of this case-control study was to evaluate whether ultrasonic instruments can be as effective as standard drilling instruments for zygomatic implant surgery in terms of clinical outcomes. Ninety-two patients with atrophic maxilla were included in the study. Implant sites were prepared with the ultrasonic technique (test group = 47 patients) or traditional drilling (control group = 45 patients). In total, 368 zygomatic implants were inserted (202 with the extrasinus technique, 77 with the sinus slot technique, and 89 with the Brånemark technique). Complete arch provisional prostheses were delivered 3 to 5 hours after the surgical operations. The mean follow-up after surgery was 24 months (range = 12-32 months). The primary outcome evaluations were based on implant survival rates and postoperative complications. Operative time and surgeon's stress were evaluated as secondary outcomes. Implant survival rate was 100% in the test and 98.89% in the control group. Postoperative complications were seen in 9 patients (4 in the test and 5 in the control group); the difference was not statistically significant. Operative time was longer in the test group; however, surgeons were more comfortable using ultrasonic instruments. Within the limitations of this preliminary study, the ultrasonic technique was a feasible alternative to traditional drilling for zygomatic implant surgery.
Collapse
Affiliation(s)
- Marco Mozzati
- SIOM Oral Surgery and Implantology Center, Turin, Italy
| | | | - Funda Goker
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara "Gabriele D'Annunzio", Chieti, Italy
| | | | | | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Dental Clinic, Milan, Italy
| |
Collapse
|
7
|
Favero V, Bacci C, Volpato A, Bandiera M, Favero L, Zanette G. Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures. Dent J (Basel) 2021; 9:dj9040046. [PMID: 33921608 PMCID: PMC8072957 DOI: 10.3390/dj9040046] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Pregnancy is a unique moment in a woman’s life, accompanied with several physiologic changes that have an impact on oral health. Aim of the study: The purpose of the present study was to conduct a critical review of published literature regarding pregnancy and dentistry, the most frequent oral diseases that are encountered during pregnancy, their correlation to adverse pregnancy events, and safe dental treatments that can be performed during pregnancy. Methods: A Medline/COCHRANE search was carried using specific keywords and MeSH terms, combined with the boolean operators “OR” and “AND”. Results: The search led to 146 publications including guidelines, meta-analyses, systematic and non-systematic reviews, published between 2000 and 2021. Discussion and conclusions: Due to the increased inflammatory and immune body response that characterizes pregnancy, periodontal conditions are often aggravated during pregnancy and periodontal disease encountered frequently in pregnant patients. There are conflicting study results in the literature regarding the association between periodontitis and adverse pregnancy outcomes. Periodontal treatment did not show a significant reduction in the adverse outcomes. Many dentists, often due to lack of information, are reluctant to provide dental treatment to pregnant women. However, preventive and restorative dental treatment is safe during pregnancy. Diagnostic radiographs may be performed after the first trimester if absolutely necessary. Analgesics (such as paracetamol) and anesthetics (such as lidocaine) are also considered safe. In case of infection, antibacterial drugs such as amoxicillin, ampicillin, and some cephalosporines and macrolides can also be prescribed. Organogenesis takes place in the first trimester, the time during which the fetus is susceptible to severe malformations (teratogenesis). The ideal time to perform dental treatment is the second trimester (week 17 to 28). However, acute pain or infections make the intervention of the dentist absolutely necessary and emergency treatment can be performed during the whole pregnancy period.
Collapse
Affiliation(s)
- Vittorio Favero
- Unit of Maxillofacial Surgery and Dentistry, University of Verona, 37129 Verona, Italy;
| | - Christian Bacci
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Andrea Volpato
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
- Correspondence: or
| | - Michela Bandiera
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Lorenzo Favero
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| | - Gastone Zanette
- Dental Clinic, Department of Neuroscience, University of Padua, 35129 Padua, Italy; (C.B.); (M.B.); (L.F.); (G.Z.)
| |
Collapse
|
8
|
D'Agostino A, Lombardo G, Favero V, Signoriello A, Bressan A, Lonardi F, Nocini R, Trevisiol L. Complications related to zygomatic implants placement: A retrospective evaluation with 5 years follow-up. J Craniomaxillofac Surg 2021; 49:620-627. [PMID: 33581959 DOI: 10.1016/j.jcms.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/03/2020] [Accepted: 01/31/2021] [Indexed: 10/22/2022] Open
Abstract
This retrospective study assessed zygoma implants in patients treated for upper maxilla extreme atrophy, trauma, cleft palate, or failed reconstruction. The implants were placed using Quad (4 zygoma implants) or mixed (zygoma and conventional implants in premaxilla) surgical technique, with intra-sinus or extra-sinus approach, followed by immediate or deferred loading. Clinical and radiographic evaluations were carried out at 5-year follow-up from loading. Implant survival, symptoms and signs of sinusitis, radiological alterations in terms of mucosal thickening or obliteration of the maxillary sinuses, oroantral communications, and peri-implant soft tissues were examined. A total of 42 patients, with 116 zygoma implants, were included in the study. The cumulative survival rate was 97.41%. One zygomatic bone fracture was assessed. Eight patients reported sinusitis, and two showed oro-antral communications. A comparison between mean pre- and post-operative Lund-Mackay scores showed a statistically significant increase of sino-nasal disease in the post-operative scores (p = 0.0019). Mucositis and gingival recession was observed in 21 and 8 implants respectively. Average recession was 2.52 ± 2.35 mm. According to our results, placement of zygoma implants has proved to be a predictable procedure, with a lower rate of severe complications compared to other treatment options in extreme upper jaw atrophy.
Collapse
Affiliation(s)
- Antonio D'Agostino
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Giorgio Lombardo
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Vittorio Favero
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.
| | - Annarita Signoriello
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Anna Bressan
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Fabio Lonardi
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Riccardo Nocini
- Unit of Otolaryngology, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| | - Lorenzo Trevisiol
- Unit of Maxillo-Facial Surgery and Dentistry, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy
| |
Collapse
|
9
|
Lombardo G, Signoriello A, Simancas-Pallares M, Marincola M, Nocini PF. Survival of Short and Ultra-Short Locking-Taper Implants Supporting Single Crowns in the Posterior Mandible: A 3-Year Retrospective Study. J ORAL IMPLANTOL 2020; 46:396-406. [PMID: 32315035 DOI: 10.1563/aaid-joi-d-19-00190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this retrospective study was to determine survival and peri-implant marginal bone loss of short and ultra-short implants placed in the posterior mandible. A total of 98 patients received 201 locking-taper implants between January 2014 and January 2015. Implants were placed with a 2-stage approach and restored with single crowns. Clinical and radiographic examinations were performed at 3-year recall appointments. At that time, the proportion of implant survival by length, and variations of crestal bone levels (mean crestal bone loss and mean apical shift of the "first bone-to-implant contact point" position) were assessed. Significance level was set at 0.05. The total number of implants examined 36 months after loading included: 71 implants, 8.0 mm in length; 82 implants, 6.0 mm in length; and 48 implants, 5.0 mm in length. Five implants failed. The overall proportion of survival was 97.51%, with 98.59% for the 8.0-mm implants, 97.56% for the 6.0-mm implants, and 95.83% for the 5.0-mm implants. No statistically significant differences were found among the groups regarding implant survival (P = .73), mean crestal bone loss (P = .31), or mean apical shift of the "first bone-to-implant contact point" position (P = .36). Single-crown short and ultra-short implants may offer predictable outcomes in the atrophic posterior mandibular regions, though further investigations with longer follow-up evaluations are necessary to validate our results.
Collapse
Affiliation(s)
- Giorgio Lombardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Annarita Signoriello
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| | - Miguel Simancas-Pallares
- Division of Oral & Craniofacial Health Sciences. Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pier Francesco Nocini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona, Italy
| |
Collapse
|
10
|
Aleksandrowicz P, Kusa-Podkańska M, Tomkiewicz W, Kotuła L, Perek J, Wysokińska-Miszczuk J. Platform switch hybrid zygoma implants improve prosthetics and marginal bone protection after extra-sinus placement. Clin Implant Dent Relat Res 2020; 22:186-192. [PMID: 32043837 PMCID: PMC7187363 DOI: 10.1111/cid.12878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of our studdy is clinical evaluation of Platform switch hybrid zygoma implants. MATERIALS AND METHODS 117 zygomatic implants were followed up during this time. They included 55 Brånemark System zygoma implants, 38 Noris implants, and 24 novel iRES hybrid implants with platform switch. RESULTS Bone quality and quantity are the prerequisite for successful implant treatment. Zygomatic implants are intended for patients with severely resorbed maxilla that cannot accommodate conventional implants without prior extensive bone grafting. Such regenerative procedures, like sinus lifts, prolong implant rehabilitation to several months (12-18). Furthermore, extensive grafts are less predictable showing varying degrees of graft resorption. Zygoma implants enable full, often immediate, reconstruction of the upper dental arch without the need for sinus lift treatment. The original zygoma protocol runs the implants through the sinus, requires general anesthesia, and positions the prosthetic platform of the implants on the palate, which makes prosthesis cumbersome. It also induces risk for post-op sinusitis. Extra-sinus approach with novel zygoma hybrid implants bypasses sinuses and positions the implant prosthetic platform on the crest allowing for same good prosthetics as on conventional dental implants. Furthermore, crestal threads and a platform-switch, of the novel zygoma design, increase implant anchorage and minimize marginal bone loss. The study presents evolution of zygoma implant rehabilitation protocol and zygoma implant design in our clinical practice over 15 years (2004-2019). CONCLUSION Extra-sinus zygomatic implant placement lowers the risk of post-op sinusitis and makes procedure possible to be done in local anesthesia.
Collapse
Affiliation(s)
| | | | - Witold Tomkiewicz
- Departament of Oral Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Kotuła
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Jan Perek
- Departament of Oral Surgery, Medical University of Warsaw, Warsaw, Poland
| | | |
Collapse
|
11
|
Davó R, Bankauskas S, Laurincikas R, Koçyigit ID, Mate Sanchez de Val JE. Clinical Performance of Zygomatic Implants-Retrospective Multicenter Study. J Clin Med 2020; 9:jcm9020480. [PMID: 32050501 PMCID: PMC7074322 DOI: 10.3390/jcm9020480] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 12/28/2022] Open
Abstract
The main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 ± 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols.
Collapse
Affiliation(s)
- Ruben Davó
- Instituto Davó, 03026 Alicante, Spain;
- Correspondence: (R.D.); (I.D.K.)
| | | | | | - Ismail Doruk Koçyigit
- Kirikkale University, Dentistry Faculty, Department of Oral & Maxillofacial Surgery, 71450 Kirikkale, Turkey
- Correspondence: (R.D.); (I.D.K.)
| | | |
Collapse
|
12
|
Albanese M, Zotti F, Lanaro L, Trojan D, Paolin A, Montagner G, Iannielli A, Rodella LF, Nocini PF. Fresh-frozen homologous bone in sinus lifting: histological and radiological analysis. ACTA ACUST UNITED AC 2019; 68:226-235. [PMID: 31822046 DOI: 10.23736/s0026-4970.19.04192-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The aim of this study was to evaluate radiological and histological characteristics of fresh-frozen homologous bone as grafting material for maxillary sinus floor augmentation. Radiological, histological and clinical evaluations were made. METHODS Twenty-three patients with a 2 mm to 6 mm alveolar ridge height in the posterior maxilla have been enrolled. Unilateral or bilateral sinus floor augmentations were performed with fresh frozen morcelized homologous bone. Together with implant placement, 7 months after surgery, a bone core was harvested for histological analysis. Radiological measurements were obtained by superimposition of CT scans carried out at the surgery time and six months later. A total of 93 implants were positioned. RESULTS A mean (±SD) increase in mineralized tissue height of 10.74±2.82 mm was noticed by comparing the CT scans. Histological analysis revealed the presence of newly formed bone in the grafted sites. The follow up period after the prosthetic load ranged from 8 to 31 months. One implant failure occurred. CONCLUSIONS Fresh frozen homologous bone seems to have a good healing pattern and to be a successful and steady grafting material for the treatment of maxillary ridge atrophy. It might be considered a valid alternative to autologous bone in sinus floor augmentation procedures.
Collapse
Affiliation(s)
- Massimo Albanese
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy -
| | - Luca Lanaro
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| | | | | | | | | | - Luigi F Rodella
- Section of Anatomy and Pathophysiology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Pier F Nocini
- Department of Surgery, Dentistry, Pediatrics and Gynecology, G. B. Rossi Polyclinic, University of Verona, Verona, Italy
| |
Collapse
|
13
|
Aleksandrowicz P, Kusa-Podkańska M, Grabowska K, Kotuła L, Szkatuła-Łupina A, Wysokińska-Miszczuk J. Extra-Sinus Zygomatic Implants to Avoid Chronic Sinusitis and Prosthetic Arch Malposition: 12 Years of Experience. J ORAL IMPLANTOL 2018; 45:73-78. [PMID: 30074849 DOI: 10.1563/aaid-joi-d-18-00034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This report retrospectively at the 12-year follow-up results of the treatment and rehabilitation of edentulous maxillae, applying extra-sinus zygomatic implants alone or in combination with intra-sinus zygomatic implants. We recruited 22 patients with 35 zygomatic Brånemark system implants; 24 implants in the standard Brånemark protocol through the sinus and 11 extra-sinus implants outside the sinus. Additionally, 147 regular implants were placed. The minimum follow-up period was 50 months to a maximum of 152 months. The zygoma survival rate after 12 years was 97.15%. Chronic sinusitis occurred in 11.42% of patients. We lost 1 (2.85%) zygomatic implant placed through the sinus and none of those in the extra-sinus position. The survival rate of the regular implants was 93.87%. Chronic sinusitis occurred in 4 patients (11.42%) who received zygomatic implants using standard protocol through the sinus. None of the extra-sinus zygoma patients developed sinusitis. Peri-implantitis was detected with only 3 zygomatic implants. In the original P-I Brånemark zygoma protocol the implants were passing through the sinus, which resulted in chronic sinusitis in some patients and malposition of the prosthetic platform toward the palate. These complications can be avoided by the extra-sinus placement of zygoma implants as demonstrated in this study.
Collapse
Affiliation(s)
| | | | | | - Lidia Kotuła
- 3 Department of Clinical Genetics, Medical University of Lublin, Poland
| | - Anna Szkatuła-Łupina
- 4 Department of Otolaryngology and Laryngological Oncology, Medical University of Lublin, Poland
| | | |
Collapse
|
14
|
Correia F, Pozza DH, Gouveia S, Felino A, Faria E Almeida R. The applications of regenerative medicine in sinus lift procedures: A systematic review. Clin Implant Dent Relat Res 2018; 20:229-242. [PMID: 29205768 DOI: 10.1111/cid.12561] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND Findings in regenerative medicine applied to the sinus lift procedures. PURPOSE Evaluate the effectiveness of regenerative medicine in sinus lift. MATERIALS AND METHODS An extensive search for manuscripts were performed by using different combinations of keywords and MeSH terms (Pub-med; Embase; Scopus; Web of Science Core Collection; Medline; Current Contents Connect; Derwent Innovations Index; Scielo Citation Index; Cochrane library). The full text selected articles are written in English, Portuguese, Spanish, Italian, German, or French, and published until 28 of November 2016. Inclusion criteria were: implant osteointegration, radiographic, histologic, and/or histomorphometric analysis, clinical studies in humans using of regenerative medicine. This systematic review was performed by selecting only randomized controlled clinical trials and controlled clinical trials. RESULTS Eighteen published studies (11 CT and 7 RCT) were considered eligible for inclusion in the present systematic review. These studies demonstrated considerable variation of biomaterial and cell technics used, study design, sinus lift technic, outcomes, follow-up, and results. CONCLUSION Only few studies have demonstrated potential of regenerative medicine in sinus lift; further randomized clinical trials are needed to achieve more accurate results.
Collapse
Affiliation(s)
- Francisco Correia
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Daniel Humberto Pozza
- Departamento de Biomedicina da Faculdade de Medicina, and Faculdade de Ciências da Nutrição e Alimentação, and I3s, Universidade do Porto, Porto, Portugal and Universidad Europea de Madrid
| | - Sónia Gouveia
- Instituto de Engenharia Eletrónica e Informática de Aveiro (IEETA/UA) and Centro de I&D em Matemática e Aplicações (CIDMA/UA), Universidade de Aveiro (UA), Portugal
| | - António Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| | - Ricardo Faria E Almeida
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
15
|
Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study. Int J Dent 2017; 2017:8434281. [PMID: 28751913 PMCID: PMC5511658 DOI: 10.1155/2017/8434281] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/23/2017] [Indexed: 12/14/2022] Open
Abstract
AIM To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. PATIENTS AND METHODS We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. RESULTS 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4-98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). CONCLUSIONS Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.
Collapse
|