Dental implants with fixed prosthodontics in oligodontia: A retrospective cohort study with a follow-up of up to 25 years

Pre-implant and implant management of oligodontia patients: A 10-year retrospective study

INTRODUCTION

the aim of this study was to report and assess the management and implant rehabilitation of oligodontia patients since its recognition in 2012 by french authorities in the nomenclature.

MATERIAL AND METHODS

we conducted a retrospective study in the Maxillofacial Surgery and Stomatology Department of the Lille University Hospital between January 2012 and May 2022. Patients had to present an oligodontia recognized under the ALD31 in adulthood, and to have benefited from a pre-implant/implant surgical treatment in the unit.

RESULTS

a total of 106 patients were included in the study. The mean number of agenesis was 12 per patient. The most missing teeth are the ones at the end of the series. After a pre-implant surgery phase including orthognathic surgery and/or bone grafting, 97 patients benefited from implant placements. The mean age for this phase was 19.38. A total of 688 implants were placed. The median number of implants placed was 6 per patient and 5 patients presented implant failures after or during the osseointegration phase (16 implants lost). The implant success rate was 97.6%. 78 patients benefited from rehabilitations by fixed implant-supported prostheses and 3 by implant-supported mandibular removable prostheses.

DISCUSSION

The described care pathway seems to us adapted to the patients followed in our department, with good functional and esthetic results. It would be necessary to evaluate on a national scale to adapt the management process.

Surgical bone augmentation procedures for oral rehabilitation of patients with oligodontia: A review with a systematic approach

Oligodontia is a developmental dental anomaly defined by the absence of 6 or more permanent teeth, excluding the third molars. We performed a review with a systematic approach and proposed a guideline for the choice of the bone augmentation surgery. The different bone augmentation technique terms were searched in the PubMed and Science Direct database. Clinical studies were eligible if they reported on pre-implant surgery in patients with oligodontia. The database search yielded 400 studies after duplicates removed. Thirty studies were finally included, involving 410 patients. Sixty-three sinus lifts were performed in 37 patients with no failure. Thirteen out of 33 patients with iliac bone transplantation and two out of 24 with parietal bone transplantation had resorption, one out of 4 patients who received allogeneic bone block had complete failure. Seventy-eight patients underwent guided bone regeneration, none had bone loss. No failure was found with the alveolar distraction osteogenesis technique. Four out of thirteen patients developed permanent hypoesthesia after inferior alveolar nerve transposition. The cumulative implant survival rate was 94.4% after bone augmentation procedures. Extensive edentulous areas should be grafted with parietal bone, as iliac grafts present a greater risk of resorption. Smaller edentulous areas should be treated by endobuccal harvesting or guided bone regeneration. Osteogenesis distraction and nerve transposition are effective surgeries for medium-to-large mandibular edentulous spaces. The implant survival rate is not significantly different between implants placed in grafted and nongrafted bone, the appropriate choice of bone augmentation technique can reduce the risk of peri‑implant bone resorption.

Primary Teeth Supported Fixed Prosthesis—A Predictable Treatment Alternative

Background: Individuals with tooth agenesis often present a significant clinical challenge for dental practitioners. This retrospective study evaluated clinical and radiological long-term functional and esthetic outcomes following restoration using primary teeth to support fixed all-ceramic prosthesis in patients with teeth agenesis. Methods: Patients with teeth agenesis and at least one year follow-up were included. Examinations included panoramic X-ray, clinical examination and family history records. Only primary teeth without permanent teeth underneath were chosen. All ceramic fixed restorations were used. All data were collected from patient files. Outcome parameters included: restoration parameters (restoration survival, restoration fractures, restoration detachment, restoration replacement, and secondary caries), plaque index, and gingival index. Results: The study included 58 porcelain restorations inserted in 25 individuals; mean age 12 ± 2.1 years (range 10–19 years); mean number of missing teeth 12.3 ± 9 (range 6–12). Mean follow-up 48 ± 6 months (range 12–60 months). All restorations survived up to last follow-up, rendering a survival rate of 100%. Restorations outcome—porcelain chipping (9%), detachment (2%), no restoration replacement nor secondary caries, mean gingival index—0.7 ± 0.5 and mean plaque index—0.9 ± 0.3. Conclusions: In tooth agenesis, restoration using primary teeth to support fixed all-ceramic prosthesis is a viable treatment alternative.

Outcomes of dental implants in young patients with congenital versus non-congenital missing teeth

Objective

This cross-sectional study aims to investigate the effect of the cause of missing teeth on the survival and subjective success of dental implant treatment (DIT) in young patients with missing teeth due to non-congenital causes (tooth loss) in comparison to patients with missing teeth because of congenital causes (hypodontia and oligodontia).

Material and methods

All patients were asked 7 questions to extract information about the survival and subjective success of DIT. Implant survival function was designed using the Kaplan-Meier analysis. Differences in implant success outcomes were studied using binary logistic regression analysis.

Results

One hundred ten patients aged 18 to 40 years old were included, whereof 32 patients with tooth loss, 25 patients with hypodontia and 53 patients with oligodontia. In the tooth loss group, implant survival reached 96.9%; in the hypodontia group 96.0%; and in the oligodontia group 88.7%. Regarding subjective implant success, patient satisfaction was significantly higher (p < 0.040) among patients with congenital missing teeth in comparison to patients with tooth loss. Other implant success components showed no statistically significant difference (p > 0.050) between the groups.

Conclusion

The cause of missing teeth does not influence implant survival. However, the cause of missing teeth does have a significant impact on patient satisfaction (implant success), ascertaining young patients with congenital missing teeth as more satisfied of DIT than young patients with tooth loss.

Clinical relevance

Young patients with tooth agenesis and with an increased number of missing teeth are more content about the treatment with dental implants than patients with tooth loss. Furthermore, a consensus regarding the assessment of implant success is an essential concern for clarification.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40729-021-00362-7.

Staged autogenous calvarial bone grafting and dental implants placement in the management of oligodontia: a retrospective study of 20 patients over a 12-year period

Oligodontia demands multidisciplinary management due to its repercussions on dentofacial growth. To place implants to realize implant-borne fixed denture, preimplant surgery may be necessary if bone volumes are insufficient. Our aim was to assess bone increase following autogenic bone grafting and to discuss prosthetic options. Twenty patients followed for oligodontia, who underwent bone grafting, were treated from 2008 to 2019. Transversal and vertical bone levels were measured pre- and postoperatively to assess alveolar ridge augmentation. Mean horizontal grafting increase was 4.60 mm [standard deviation (SD) 0.79 mm], mean sinus lift increase was 9.95 mm (SD 2.35 mm). Mean implants placed per patient was 9, mean implants placed on grafted site was 5 per patient. Overall implant survival rate was 100%. All patients benefited from prosthetic procedures when it was planned to perform implant-borne fixed dentures. Within the framework of a complete treatment plan (involving paediatric dentistry, dentofacial orthopaedics, oral and maxillofacial surgery, and prosthodontics), autologous bone grafting combined or not with orthognathic surgery is fully adapted to patients with oligodontia. It allows reconstruction of favourable bone volumes for placement of implants to realize implant-borne fixed dentures, with high implant survival rates and great improvements to quality of life.

The treatment dilemma of missing maxillary lateral incisors-Part II: Implant restoration

OBJECTIVE

This second of a two-part series reviews the single dental implant as the most current treatment alternative for replacement of a missing or lost maxillary lateral incisor. Assessments of dental maturity for implant placement, implant space requirements, surgical and restorative influence on soft tissue profiles, and implant success are reviewed.

OVERVIEW

Recent data indicates that implant success rates are high, and esthetics and soft tissue profiles appear to be stable for maxillary lateral incisor implants. Implant placement should be assessed by dental maturity of the specific patient as opposed to chronological age, and implant spacing should be developed and assessed by all team members.

CONCLUSIONS

Implant replacement of a missing lateral incisor is a predictable treatment mode if implant placement is deferred until dental maturity and then accurately placed in a well-developed site. Treatment involves more complicated planning and execution from team members than other alternatives, but innovations in techniques and materials render it a favorable alternative for lateral incisor replacement.

CLINICAL SIGNIFICANCE

Implant restoration of a missing or lost maxillary lateral incisor is surgically and restoratively more complex than space closure or a resin-bonded fixed dental prosthesis but demonstrates high success rates and high esthetic potential when team members follow strict treatment protocols.