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Kanayama M, Ferri M, Guzon FMM, Asano A, Alccayhuaman KAA, Rossi EFD, Botticelli D. Influence on marginal bone levels at implants equipped with blades aiming to control the lateral pressure on the cortical bone. An experimental study in dogs. Oral Maxillofac Surg 2024; 28:1139-1149. [PMID: 38429433 DOI: 10.1007/s10006-024-01228-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: 11/20/2023] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND To avoid cortical compression, several implant systems have included in the protocol dedicated drills aimed at widening the cortical region of osteotomy. However, the manual execution of this operation does not guarantee the necessary precision. Hence, the present study aimed to determine the optimal size of the recipient site at the level of the alveolar crest in relation to the size of the coronal region of the implant to achieve the best healing result. MATERIALS AND METHODS Blades of different diameters were incorporated into the coronal part of the implant to prepare the cortical region of the mandibular alveolar bone crest in different dimensions in relation to the collar of the implant. The differences in diameter of the blades in relation to the collar of the implant were as follows: one control group, -175 μm, and three test groups, 0 μm, + 50 μm, or + 200 μm. RESULTS The marginal bone loss (MBL) at the buccal aspect was 0.7 mm, 0.5 mm, 0.2 mm, and 0.7 mm in the - 175 μm, 0.0 μm, + 50 μm, + 200 μm groups, respectively. The differences were statistically significant between group + 50 μm and control group - 175 μm (p = 0.019), and between + 50 μm and + 200 μm (p < 0.01) groups. The level of osseointegration at the buccal aspect was more coronally located in the test groups than in the control group, whereas the bone-to-implant contact percentage was higher in the + 50 μm and + 200 μm groups. However, these differences were not statistically significant. CONCLUSIONS The lowest bone crest resorption and highest levels of osseointegration were observed in the 0.0 μm and + 50 μm groups. The cortical region where the blades had performed their cutting action showed regular healing with perfect hard and soft tissues sealing in all the groups. Cortical blades gathered bone particles, particularly in the + 200 μm group, which were incorporated into the newly formed bone. The results from the present experiment provide support to the use of blades that produce a marginal gap of 50 μm after implant insertion.
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Affiliation(s)
| | - Mauro Ferri
- Private Practice, Cartagena de Indias, 130001, Colombia
| | - Fernando M Muñoz Guzon
- Ibonelab SL, Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Akihisa Asano
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
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Meijer HJA, Slagter KW, Gareb B, Hentenaar DFM, Vissink A, Raghoebar GM. Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial. J Periodontol 2024. [PMID: 39129325 DOI: 10.1002/jper.24-0251] [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: 04/14/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation. METHODS Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. RESULTS The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups. CONCLUSIONS Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone. PLAIN LANGUAGE SUMMARY Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.
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Affiliation(s)
- Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Restorative Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kirsten W Slagter
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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de Araújo Nobre M, Santos D, Ferro A, Lopes A, Antunes CJ, Vitor I. Five- and 18-Year Outcome of Two Cases with Full-Arch Rehabilitations Ad modum All-on-4 in the Presence of Challenging Conditions. Eur J Dent 2024. [PMID: 39043210 DOI: 10.1055/s-0044-1787961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024] Open
Abstract
Placing implants in fresh postextraction sites is a borderline rehabilitation procedure. The purpose of this report is to describe the pre-, per-, and postoperative procedures for maintaining long-term stability of two full-arch rehabilitations through the All-on-4 protocol, performed in the presence of challenging conditions. Two patients were referred for full-arch rehabilitation with immediate function, with both patients presenting infection in the jaws: patient 1 with an implant (position #45) inserted in a cystic cavity; patient 2 with one implant (position #24) inserted transsinus after the removal of a cyst on the base of the maxillary sinus and another implant (position #15) inserted with a dehiscence. Both patients received a preoperative dental hygiene appointment, a regenerative surgical protocol, and were enrolled in a postoperative maintenance protocol. After surgery a provisional prosthesis was provided ensuring immediate function, and 6 months after surgery, the final prosthesis was delivered. During the follow-up appointments (final follow-up at 5 and 18 years), the implants were stable, and no infection was observed for both patients. The present case report describes two full-arch rehabilitations in immediate function, supported by dental implants inserted in the presence of challenging conditions that do not represent the norm, rather are highly demanding for the clinical team, warranting caution in the interpretation of the results.
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Affiliation(s)
| | - Diogo Santos
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
| | - Ana Ferro
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
| | - Armando Lopes
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
| | | | - Inês Vitor
- Department of Research, Development and Education, Maló Clinic, Lisbon, Portugal
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Yang Y, Geng N. Clinical study of immediate implant placement in posterior maxillary region assisted by dynamic real-time navigation: A randomized controlled trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101976. [PMID: 39043292 DOI: 10.1016/j.jormas.2024.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/30/2024] [Accepted: 07/20/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE To evaluate the accuracy of the implant accuracy and clinical effect of navigation-assisted immediate implant placement (IIP) in the posterior maxillary tooth region. METHODS This study included 60 patients with 96 implants undergoing IIP in the posterior maxillary region from January 2021 to December 2022, stratified into dynamic navigation and freehand implant groups. All clinical indicators, including initial stability, implant deviation (entry point deviation, end point deviation, depth deviation and angle deviation), marginal bone resorption and implant success rate, were systematically recorded. RESULTS All implants were successfully placed with an average torque of (24.38 ± 1.84)N.cm. The mean entry point deviation, apex point deviation and angular deviation in the navigation group were significantly smaller than that of the freehand group (P < 0.05). Marginal bone resorption was significantly less in the navigated group than in the freehand group (P < 0.05). All dental implants were considered an operational success and the mean follow-up time was (27.8 ± 8.4) months. CONCLUSION The application of dynamic navigation-assisted immediate implant placement in the maxillary posterior region can achieve good implant accuracy and satisfactory clinical results.
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Affiliation(s)
- Yun Yang
- Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guang dong, China
| | - Ningbo Geng
- Department of Oral Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guang dong, China.
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Rondone EM, Leitão-Almeida B, Pereira MS, Fernandes GVO, Borges T. The Use of Tissue Grafts Associated with Immediate Implant Placement to Achieve Better Peri-Implant Stability and Efficacy: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:821. [PMID: 38337515 PMCID: PMC10856075 DOI: 10.3390/jcm13030821] [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: 01/04/2024] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Background: The goal of this systematic study and meta-analysis was to evaluate the efficacy of hard and/or soft tissue grafts associated with type-1 implants on healing and treatment outcomes. The primary outcomes studied were implant survival rate, pocket depth, marginal peri-implant recession, bone loss, bone thickness (volumetric change), interproximal bone level, mesial and distal papilla migration, and radiographic evaluation; and the secondary parameters were Pink Esthetic Score (PES), vertical distance from implant shoulder and bone, Visual Analogue Score (VAS), Implant Stability Quotient (ISQ), and biological complications (fistulas, pain, mucositis, and peri-implantitis). Methods: The PICO strategy was used to formulate the hypothesis under study: "For patients who underwent extraction and immediate implant placement, what is the efficacy of using any type of graft (bone or soft tissue) compared to non-grafting regarding the peri-implant parameters?" The electronic search process was performed on the MedLine/PubMed and Cochrane databases. It included randomized controlled trials (RCTs) from the last 11 years (from 2012 to November 2023), which were identified and analyzed. Results: Nine RCTs (κ = 0.98) were selected (403 patients and 425 implants); they were divided into three groups: bone graft (75 patients and 75 implants inserted), bone graft and membrane (213 patients and 235 implants inserted), and without bone graft (115 patients and 115 implants inserted). Three studies calculated the mid-facial mucosa level and two reported better results when a connective tissue graft was combined with the xenograft, whereas another study found better results in the combination of a dual-zone technique with a xenograft. Three studies evaluated the total Pink Esthetic Score (PES) at 12 months, where the authors found no significant difference in using a xenogeneic graft with or without a membrane. In the same period, the facial bone thickness was assessed in two articles; the authors reported better results in graft-treated and flapless groups. The risk-of-bias assessment found four studies with low risk, four with moderate risk, and one with a high risk of bias. The meta-analysis showed a medium level of heterogeneity for the mid-facial mucosa level analysis (I2 = 46%) and an overall effect size of 0.79 (95% CI [0.18; 1.40]), a statistically significant results (p = 0.01), with a tendency to favor the experimental group. Also, there was a medium level of heterogeneity among studies regarding total PES (I2 = 45%), with no significant differences between studies (p = 0.91). Homogeneous results (I2 = 0%) were found among studies analyzing facial bone thickness, favoring the experimental group; the forest plot showed an effect of 0.37 (95% CI [0.25; 0.50]), which was statistically significant (p < 0.00001) for this parameter. Conclusions: Then, it was possible to conclude that using bone and soft tissue grafting techniques associated with immediate implant placement (IIP), even though they are not fundamental, was a valuable resource to prevent significant tissue reduction, reaching greater bone stability and higher levels in the Pink Esthetic Score (PES) and Visual Analogue Score (VAS).
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Affiliation(s)
- Enrico Maria Rondone
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Bruno Leitão-Almeida
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Miguel Silva Pereira
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- A. T. Still University—Missouri School of Dentistry & Oral Health, St. Louis, MO 63104, USA
| | - Tiago Borges
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
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The Effect of Photodynamic Therapy on the Early Outcome of Implants Placed on Patients with Periodontitis. PHOTONICS 2022. [DOI: 10.3390/photonics9070480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Immediate implant is a subtype of implant that is placed following tooth extraction within the socket without further delay. These implants are known to preserve the alveolar bone and minimize the total number of surgical interventions in a patient. 4 Photodynamic therapy (PDT) augments nonsurgical periodontal therapy using antibacterial mechanisms. PTD can be more effective in conjunction with scaling and root planing (SRP). The aim of this study is to assess the effects of PDT on the early outcomes of implants placed on patients with periodontitis with and without SRP at 9 months of follow-up. Materials and methods: A total of 23 implants were placed in 14 patients, with 11 in the test group and 12 in the control group. SRP was carried out prior to immediate implant placement in control sites, and PDT adjunctive to SRP (SRP + PDT) was performed in test sites before immediate implant placement. Plaque index, gingival index, probing pocket depth, clinical attachment level, and radiovisiographs were procured at baseline, 3 months, 6 months, and 9 months. Primary stability was examined at the time of implant placement, and the healing index was recorded a week later. Results: At the end of the 9 months of the study period, (SRP + PDT) group had a mean marginal bone loss of 0.95 mm, and the control group had 1.08 mm. Clinical parameters such as plaque index, gingival index, clinical attachment level, and probing depth showed definitive improvement after 9 months, compared with the baseline, but when the test and control groups were compared, the difference was statistically significant for plaque index and probing depth. The implants in both groups were followed up for a period of 9 months. There was an improvement in marginal bone loss but was not statistically significant. The survival of immediate implants in the PDT group was not different from those in the scaling and root planing group. Conclusion: The effect of PTD can be beneficially used as an adjunct to SRP. However, the effects were not significant. Photodynamic therapy can be effectively used as an adjunct to SRP owing to the better outcomes using PDT.
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