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Block MS. What Factors May Influence a Clinician's Choice for an Implant System for Their Patients? J Oral Maxillofac Surg 2024:S0278-2391(24)00335-5. [PMID: 38876147 DOI: 10.1016/j.joms.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Clinicians have to decide which implant system to use for their patients. Factors influencing a clinician's choice of a specific implant are not well-established. PURPOSE The purpose of this study was to identify factors that may influence clinician's choice of implant. STUDY DESIGN, SETTING, SAMPLE This cross-sectional study used a survey instrument that was sent to dentists. Inclusion criteria included if the doctor's name was the addressee and if their website indicated they utilize implants. Exclusion criteria included if the email address was directed to individuals other than the clinician or if the respondent does not place implants as indicated by their website. PREDICTOR VARIABLE The predictor variable was the provider type (oral and maxillofacial surgeon, general dentist, prosthodontist, or periodontist). MAIN OUTCOME VARIABLE The outcome variables were factors that may influence clinician's choice of implants, measured by their ranked responses. COVARIATES Age and sex were the covariates. ANALYSES The survey data were evaluated as group in total and separated for each provider type. Factors affecting clinical choice were ranked. A mean score was determined. Responses were evaluated using analysis of variance with significance at P value < .05 to determine if there were differences among the groups. RESULTS After applying inclusion and exclusion criteria, the final study sample consisted of 353 clinicians, of whom 230 (65.1%) responded to the survey. Factors scored as extremely or somewhat important were ranked from high to low as follows: clinical trial evidence (92%), ease of use (88%), familiarity with system (73%), restorative dentist's preference (72%), cost (63%), sales representative (59%), key opinion leader (66%), a laboratory's preference (45%), implant company providing continuing education (66%), and implant company can grow practice (65%). There were differences among providers for the factors that influence choice of implant for cost (P value = .02), sales representative (P value = .015), the key opinion leader (P value = .01), laboratory preference (P value = .002), providing continuing education (P value = .02), and implant company can grow my practice (P value = .035). CONCLUSION AND RELEVANCE Four factors that highly influenced provider's choice of a specific implant were evidence for success, ease of use, cost, and familiarity with the implant.
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Affiliation(s)
- Michael S Block
- Clinical Professor, Department of Oral and Maxillofacial Surgery, LSU school of Dentistry, New Orleans, LA; Private Practice, Metairie, LA.
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Wen G, Zhang Y, Xie S, Dong W. The influence of two distinct surface modification techniques on the clinical efficacy of titanium implants: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101855. [PMID: 38582353 DOI: 10.1016/j.jormas.2024.101855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/03/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE To compare the effectiveness of anodized and sandblasted large-grit acid-etched surface modification implants in clinical applications. METHODS This systematic review has been registered at PROSPERO (CRD42023423656). A systematic search was performed using seven databases. The meta-analysis was performed using the RevMan 5.4 program and Stata 17.0 software. An analysis of the risk of bias in the included studies was conducted using the Cochrane Handbook for Systematic Reviews of Interventions and the Newcastle-Ottawa scale. RESULTS A comprehensive analysis of 16 studies, which collectively encompassed a total of 2768 implants, was finished. Following a five years follow-up, the meta-analysis showed that the cumulative survival rate of implants was lower in the anodized group compared to the sandblasted large-grit acid-etched group (RR, 3.47; 95 % confidence interval [CI], 1.23 to 9.81; P = 0.02). Furthermore, the anodized group and the sandblasted large-grit acid-etched group had similar marginal bone loss over the one to three years follow-up period. However, it was observed that the marginal bone loss increased at the five years follow-up period in the anodized group in comparison to the sandblasted large-grit acid-etched group (SMD, 2.98; 95 % CI, 0.91 to 5.06; P = 0.005). In terms of biological complications, plaque index, bleeding on probing, and probing pocket depth, we found no statistically significant differences between the anodized and sandblasted large-grit acid-etched group. CONCLUSIONS The sandblasted large-grit acid-etched group exhibited higher implants cumulative survival rate and less marginal bone loss compared to the anodized group. Moreover, both groups demonstrated similar incidences of biological complications, plaque index, bleeding on probing, and probing pocket depth, suggesting overall equivalence in these aspects.
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Affiliation(s)
- Guochen Wen
- School of Stomatology, North China University of Science and Technology, Tangshan 063000, China
| | - Yan Zhang
- School of Stomatology, North China University of Science and Technology, Tangshan 063000, China
| | - Shanen Xie
- School of Stomatology, North China University of Science and Technology, Tangshan 063000, China
| | - Wei Dong
- School of Stomatology, North China University of Science and Technology, Tangshan 063000, China.
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Yum H, Han HS, Kim K, Kim S, Cho YD. The cumulative survival rate of sandblasted, large-grit, acid-etched dental implants: a retrospective analysis. J Periodontal Implant Sci 2024; 54:122-135. [PMID: 37524380 PMCID: PMC11065536 DOI: 10.5051/jpis.2301440072] [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: 03/01/2023] [Revised: 04/26/2023] [Accepted: 05/11/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE This retrospective study aimed to assess the long-term cumulative survival rate of titanium, sandblasted, large-grit, acid-etched implants over a 10-year follow-up period and investigate the factors affecting the survival rate and change in marginal bone loss (MBL). METHODS The study included 400 patients who underwent dental implant placement at the Department of Periodontology of Seoul National University Dental Hospital (SNUDH) between 2005 and 2015. Panoramic radiographic images and dental records of patients were collected and examined using Kaplan-Meier analysis, Cox proportional hazards regression analysis, and multiple regression analysis to determine the survival rates and identify any factors related to implant failure and MBL. RESULTS A total of 782 implants were placed with a follow-up period ranging from 0 to 16 years (mean: 8.21±3.75 years). Overall, 25 implants were lost, resulting in a cumulative survival rate of 96.8%. Comparisons of the research variables regarding cumulative survival rate mostly yielded insignificant results. The mean mesial and distal MBLs were 1.85±2.31 mm and 1.59±2.03 mm, respectively. Factors influencing these values included age, diabetes mellitus (DM), jaw location, implant diameter, bone augmentation surgery, and prosthetic unit. CONCLUSIONS This study found that the implant survival rates at SNUDH fell within the acceptable published criteria. The patients' sex, age, DM status, implant location, implant design, implant size, surgical type, bone augmentation, and prosthetic unit had no discernible influence on long-term implant survival. Sandblasted, large-grit, acid-etched implants might offer advantages in terms of implant longevity and consistent clinical outcomes.
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Affiliation(s)
- Haeji Yum
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Kitae Kim
- Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Korea.
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Al-Hindi M, Al-Fotawi R, Al-Tamimi A, Khalil O, Al-Osaimi N, Al-Ghamdi K, Heji K. Effect of hypothyrodism's medication (T4) on implant osstointegration: A case series and literature search. Int J Surg Case Rep 2021; 79:255-262. [PMID: 33485178 PMCID: PMC7820912 DOI: 10.1016/j.ijscr.2021.01.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Hypothyroidism reduces the recruitment, maturation, and activity of bone cells, decreasing bone resorption and formation. Several investigations have reported that T4 replacement therapy is associated with a significant decrease in bone mineral density in various skeletal parts, while others have failed to corroborate these results. The present study describes both a literature review and our own experience with dental implants in patients with hypothyroidism undergoing T4 replacement therapy. CASE PRESENTATION The study included two parts: a literature review and case series. The literature review included 12 articles documenting the success rate of osseointegrated dental implants in patients with hypothyroidism. The clinical cases were chosen from King Saud University Dental College, Riyadh. The patients' identity was only available to the main researcher. The inclusion criteria for the clinical cases were: T4-treated hypothyroidism, age 20-60 years, and use of dental implants with a follow-up period of 6-12 months after loading. The exclusion criteria were: any other medical condition alongside hypothyroidism, syndromic hypothyroidism, pregnancy, current smoking, bruxism, and hypothyroidism caused by surgical excision combined with radiotherapy. The following parameters were assessed: insertion torque (IT), crestal bone height (CBH), mesial bone width (MBW), and distal bone width (DBW) at different time points, probing depth, and signs of infection. DISCUSSION Seventeen dental implants placed in patients with T4-treated hypothyroidism showed median IT success (42.4 N⋅cm; range: 35-45 N⋅cm). The median crestal bone loss was measured at 6-12 months after loading was 0.6 mm (range: 0.5-0.7. mm). Conversely, the median bone loss differences in MBW and DBW at 6-12 months after loading were 0.3 mm and 0.2 mm, respectively. CONCLUSION After a 1-year follow-up, patients with T4-treated hypothyroidism who had received dental implants fulfilled the criteria for successful implants.
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Affiliation(s)
- Mariam Al-Hindi
- Oral and Maxillofacial Surgery Dept, Dental Collage, King Saud University, Saudi Arabia
| | - Randa Al-Fotawi
- Oral and Maxillofacial Surgery Dept, Dental Collage, King Saud University, Saudi Arabia.
| | | | - Osama Khalil
- Dental Faculty, King Saud University, Saudi Arabia
| | | | | | - Khloud Heji
- Prosthodontic dept, Dental Faculty, King Saud University, Saudi Arabia
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Cosola S, Marconcini S, Boccuzzi M, Menchini Fabris GB, Covani U, Peñarrocha-Diago M, Peñarrocha-Oltra D. Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186920. [PMID: 32971869 PMCID: PMC7557536 DOI: 10.3390/ijerph17186920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Abstract
Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years.
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Affiliation(s)
- Saverio Cosola
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Correspondence:
| | - Simone Marconcini
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Michela Boccuzzi
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Giovanni Battista Menchini Fabris
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Department of Stomatology, University of Studies Guglielmo Marconi, 44, 00193 Roma, Italy
| | - Ugo Covani
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
| | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
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Esposito M, Ardebili Y, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev 2019; 10:CD003815. [PMID: 31600407 PMCID: PMC6786862 DOI: 10.1002/14651858.cd003815.pub5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007. OBJECTIVES Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis. DATA COLLECTION AND ANALYSIS At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading. MAIN RESULTS We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces. AUTHORS' CONCLUSIONS Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
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Affiliation(s)
- Marco Esposito
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore Building, Oxford RoadManchesterUKM13 9PL
| | | | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore Building, Oxford RoadManchesterUKM13 9PL
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Rosa EC, Deliberador TM, Nascimento TCDLD, Kintopp CCDA, Orsi JSR, Wambier LM, Khajotia SS, Esteban Florez FL, Storrer CLM. Does the implant-abutment interface interfere on marginal bone loss? A systematic review and meta-analysis. Braz Oral Res 2019; 33:e068. [PMID: 31576952 DOI: 10.1590/1807-3107bor-2019.vol33.0068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/13/2019] [Indexed: 11/22/2022] Open
Abstract
The objective of this systematic review was to compare the conical internal connection (IC) with the external hexagonal connection (EH) on the occurrence of marginal bone loss (ΔMBL). Different databases were used to carry out the selection of the elected studies. The studies were judged according to the risk of bias as "high", "low" and "unclear" risk. For the meta-analysis we included only studies that could extract the data of ΔMBL, survival rate (SR) and probing depth (PD). No statistically significant differences were found for ΔMBL data at one, three- and five-year survival rates between implant connections (p <0.05), however statistically significant differences were found for PD between EH and IC implants (1-year follow-up) -0.53 [95%CI -0.82 to -0.24, p = 0.0004]. This present systematic review demonstrated that there are no significant differences between IC and EH implants for both ΔMBL and SR at 1, 3 e 5 years after functional loading, although better PD values were observed for implants pertaining to the IC connections. Considering the high heterogeneity, more well-delineated, randomized clinical trials should be conducted.
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Affiliation(s)
- Enéias Carpejani Rosa
- Universidade Positivo, School of Health Sciences, Graduate Program in Dentistry, Curitiba, PR, Brazil
| | | | | | | | - Juliana Shaia Rocha Orsi
- Universidade Positivo, School of Health Sciences, Graduate Program in Dentistry, Curitiba, PR, Brazil
| | - Letícia Maíra Wambier
- Universidade Positivo, School of Health Sciences, Graduate Program in Dentistry, Curitiba, PR, Brazil
| | - Sharukh Soli Khajotia
- The University of Oklahoma Health Sciences Center, Division of Dental Biomaterials, Department of Restorative Sciences, Oklahoma City, Oklahoma, USA
| | - Fernando Luis Esteban Florez
- The University of Oklahoma Health Sciences Center, Division of Dental Biomaterials, Department of Restorative Sciences, Oklahoma City, Oklahoma, USA
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Troiano G, Lo Russo L, Canullo L, Ciavarella D, Lo Muzio L, Laino L. Early and late implant failure of submerged versus non-submerged implant healing: A systematic review, meta-analysis and trial sequential analysis. J Clin Periodontol 2019; 45:613-623. [PMID: 29574852 DOI: 10.1111/jcpe.12890] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of this systematic review was to analyse current evidence regarding differences in early and late implant failure as well as in marginal bone level (MBL) changes between submerged and non-submerged healed dental implants. METHODS PUBMED, SCOPUS, EMBASE and Web of Science databases were searched for prospective randomized and non-randomized controlled studies addressing direct comparison between submerged and non-submerged implant healing, without performing immediate loading. Early and late implant failure (before or after 6 months from implant placement, respectively) together with MBL were the investigated outcomes. Risk of bias assessment was performed using the Cochrane Collaboration Tool for Randomized clinical trials. Meta-analysis was performed and the power of the meta-analytic findings determined by trial sequential analysis (TSA). RESULTS Eleven studies met the inclusion criteria and were included in the review. Results of this systematic review revealed a small higher rate (2%) of early implant failure when a non-submerged healing approach is performed. Late implant failure appears not to be different in submerged or non-submerged healing, but the power of evidence, as determined by TSA, is not high. If we consider MBL changes at 1 year from implant load, it seems that non-submerged healing may better preserve marginal bone, although with a small effect size (0.13 mm). CONCLUSIONS Implants placed with a non-submerged technique have a higher risk (2%) of early failure. The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania - Luigi Vanvitelli, Naples, Italy
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Saulacic N, Schaller B. Prevalence of Peri-Implantitis in Implants with Turned and Rough Surfaces: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e1. [PMID: 31069039 PMCID: PMC6498817 DOI: 10.5037/jomr.2019.10101] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/12/2019] [Indexed: 01/12/2023]
Abstract
Objectives Moderately-rough implant surface may improve implant therapy in terms of bone integration, but the increased surface roughness might affect the initiation and development of peri-implantitis. The aim of the present review was to compare the prevalence of peri-implantitis in implants with rough and turned (machined) implant surfaces. Material and Methods An electronic literature search was conducted of the MEDLINE and EMBASE databases for articles published between 1 January 1990 and 1 March 2018. Clinical human studies in the English language that had reported on prevalence of peri-implantitis in tuned and rough surface implants were searched. The initial search resulted in 690 articles. Results Eight articles with 2992 implants were included in the systematic review. The incidence of peri-implantitis for two implant surfaces varied between studies. A meta-analysis was not feasible due to the heterogeneity among studies. Implant with rough surfaces were more favourable for plaque accumulation during short-term follow-up. On a long-term, turned implants surfaces were associated with more plaque and higher peri-implant bone loss. Peri-implant clinical parameters and survival rate for two implant surfaces was similar. Conclusions Within the limitations of the present study, rough implant surface does not seem to increase the incidence of peri-implantitis in comparison to turned implants surface.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, BernSwitzerland
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Faculty of Medicine, University of Bern, BernSwitzerland
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Lee DW, Kim NH, Lee Y, Oh YA, Lee JH, You HK. Implant fracture failure rate and potential associated risk indicators: An up to 12-year retrospective study of implants in 5,124 patients. Clin Oral Implants Res 2019; 30:206-217. [PMID: 30672029 DOI: 10.1111/clr.13407] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study investigated fracture rates and risk indicators for fractures in internal connection dental implants. MATERIAL AND METHODS We performed a retrospective analysis of 19,006 internal connection implants used in fixed restoration in 5,124 patients (4,570 males, 554 females) at the Dental Hospital of Veterans Health Service Medical Center between 2006 and 2015. Patients were followed through June 2018 (0.03-12.39 years post-installation). Clinical factors (age, sex, implant diameter, implant length, placement site, bone graft, fixture material, cervical feature, abutment connection, microthread, and platform switching) were recorded. Kaplan-Meier survival analysis identified risk indicators associated with an implant fracture. Cox regression models elucidated potential fracture risks. RESULTS One hundred and seventy-four implants fractured in 135 patients, for an incidence rate of 0.92% after an average of 4.95 ± 2.14 years of use. Kaplan-Meier estimates showed that the 3-, 5-, and 10-year survival rates of implants were 99.8%, 99.2%, and 97.7%, respectively. In the multivariable Cox regression model, the diameter, location, history of bone graft, and microthread presence were significantly correlated with implant fractures. Wide-diameter implants had a reduced fracture risk within 90 months, after which the diameter did not correlate with fractures. Implants placed in the anterior mandible had a lower fracture risk within 90 months; mandibular premolar implants corresponded with a lower risk after 90 months. Implants without a history of bone graft or microthreads were more likely to fracture throughout the follow-up time. CONCLUSIONS These results elucidate risk indicators for implant fractures and facilitate their reduction in clinical practice.
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Affiliation(s)
- Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Na-Hong Kim
- Department of Prosthodontics, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Young Lee
- Research Institute of Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Yeon-Ah Oh
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Periodontology, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
| | - Hyung-Keun You
- Department of Periodontology, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
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Messias A, Nicolau P, Guerra F. Titanium dental implants with different collar design and surface modifications: A systematic review on survival rates and marginal bone levels. Clin Oral Implants Res 2018; 30:20-48. [PMID: 30466192 DOI: 10.1111/clr.13389] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 01/15/2023]
Abstract
AIM The aim of this study was to compare clinical and radiographic outcomes of dental implants with different neck characteristics. METHODS A protocol-oriented search aimed at the question: "In patients subjected to tooth replacement with screw-type dental implants does the modification of the implant neck macro- or microgeometry contribute to the improvement of survival rates and maintenance of the peri-implant marginal bone levels?" Primary outcomes were survival and marginal bone level (MBL) changes evaluated on randomized controlled trials with >10 participants and follow-up >1 year. Risk of bias was evaluated using the Cochrane Collaboration's tool. The review follows the PRISMA statement. RESULTS Forty-three studies compared: (a) One- versus two-piece implants (N = 7); (b) Two-piece implants with different neck characteristics (machined and rough collars, microthreads, LASER microtexturing) (N = 21); (c) Two-piece implants with macrogeometry modifications (tapering, back-tapering, and scalloping) (N = 6). One- and two-piece implants showed similar survival (RR = 0.45, 95% CI: [0.12, 1.66], p = 0.23) and MBL changes (WMD = 0.09 mm, 95% CI: [-0.27, 0.45], p = 0.64) at 1-year post-loading. Machined collar implants have higher risk of early failure than rough collar implants (RR = 3.96, 95% CI: [1.12, 13.93], p = 0.03) and 0.43 mm higher bone resorption (95% CI: [0.0, 0.86], p = 0.05). Microthreads (WMD = 0.07 mm, 95% CI: [-0.01, 0.15], p = 0.10) and LASER microtexturing (WMD = 0.15 mm, 95% CI: [-0.35, 0.65], p = 0.56) do not reduce bone resorption. Scalloped implants have 1.26 mm higher resorption (95% CI: [0.72, 2.00], p < 0.001). CONCLUSIONS One- and two-piece implants have similar survival and MBL changes. Rough collar implants have lower MBL changes than machined collar implants. Additional modifications to rough collars are irrelevant.
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Affiliation(s)
- Ana Messias
- Dentistry Department, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Pedro Nicolau
- Dentistry Department, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Fernando Guerra
- Dentistry Department, Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
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12
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Jordana F, Susbielles L, Colat-Parros J. Periimplantitis and Implant Body Roughness. IMPLANT DENT 2018; 27:672-681. [DOI: 10.1097/id.0000000000000834] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Gamper FB, Benic GI, Sanz-Martin I, Asgeirsson AG, Hämmerle CHF, Thoma DS. Randomized controlled clinical trial comparing one-piece and two-piece dental implants supporting fixed and removable dental prostheses: 4- to 6-year observations. Clin Oral Implants Res 2017; 28:1553-1559. [DOI: 10.1111/clr.13025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Felix B. Gamper
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ignacio Sanz-Martin
- Section of Periodontology; Faculty of Odontology; University Complutense of Madrid; Madrid Spain
| | - Asgeir G. Asgeirsson
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
- Faculty of Odontology; University of Iceland; Reykjavik Iceland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center for Dental Medicine; University of Zurich; Zurich Switzerland
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14
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Adler L, Liedholm E, Silvegren M, Modin C, Buhlin K, Jansson L. Patient satisfaction 8-14 years after dental implant therapy - a questionnaire study. Acta Odontol Scand 2016; 74:423-9. [PMID: 27136739 DOI: 10.1080/00016357.2016.1177661] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this questionnaire study was to investigate patient satisfaction 8-14 years after dental implant therapy and complications influencing the degree of satisfaction. MATERIALS AND METHODS A questionnaire was sent by post to 587 patients at a specialist clinic of periodontology. The questionnaire consisted of 19 statements or questions such as the degree of satisfaction with the implants and knowledge of complications. In nine of the questions, respondents were asked to grade the extent of their agreement with a statement by selecting from fixed answers. Three of the questions were designed to be answered using a visual analog scale. RESULTS In total, 400 individuals (81%) responded to the questionnaire. The mean time elapsed since implant installation was 10 years. A great majority (81%) experienced a high chewing comfort and was satisfied or sufficiently satisfied (94%) with the aesthetic aspects of their implant restorations, while 32% of the individuals had experienced problems with their implant reconstructions. The disadvantage that patients remarked on was the cost of the treatment. Those who had experienced problems with their implant reconstructions were also less satisfied with the treatment. CONCLUSION A great majority of the patients expressed a high degree of satisfaction with their dental implants 8-14 years after the treatment. Patients were less satisfied if they had experience of problems with their implant reconstructions and in cases when the clinicians were unable to resolve their complications.
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Affiliation(s)
- Lottie Adler
- Department of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Eva Liedholm
- Department of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Sweden
| | - Malin Silvegren
- Department of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Sweden
| | - Carolina Modin
- Department of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Sweden
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Leif Jansson
- Department of Periodontology, Public Dental Service at Kista and Skanstull, Stockholm County Council, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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15
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Tey VHS, Phillips R, Tan K. Patient-related outcome measures with implant therapy after 5 years. Clin Oral Implants Res 2016; 28:683-688. [DOI: 10.1111/clr.12862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - Rachel Phillips
- Singapore Clinical Research Institute; Singapore City Singapore
| | - Ken Tan
- Singapore Clinical Research Institute; Singapore City Singapore
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16
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Shigehara S, Ohba S, Nakashima K, Takanashi Y, Asahina I. Immediate Loading of Dental Implants Inserted in Edentulous Maxillas and Mandibles: 5-Year Results of a Clinical Study. J ORAL IMPLANTOL 2015; 41:701-5. [DOI: 10.1563/aaid-joi-d-14-00018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to evaluate the long-term outcome of immediately loaded full-arch, fixed, one-piece prostheses supported by dental implants inserted in completely edentulous maxillae and mandibles. Twenty-eight completely edentulous jaws in 27 patients were treated with screw-fixed provisional prostheses on the same day as implant insertion. A total of 189 implants were inserted into the jaws of the patients. All provisional prostheses were the one-piece bridge type and were made with acrylic resin. Final restoration was performed more than 2 months after surgery. Implant survival rate, prosthesis success rate, and complications during the follow-up period were evaluated. Implant size (diameter and length) and bone quality (Hounsfield units) of the region of the implant were also analyzed. Mean follow-up time was 77.9 months. The cumulative survival rate of the implants was 100%, and the success rate of the prostheses was also 100% during the observation time. Although 3 types of minor complications occurred in 10 jaws (10/28; 35.7%), no major complications were found. Immediate loading of dental implants produces an equivalent outcome as that reported in previous studies using conventional loading. We believe this study not only adds to the immediate loading data but also confirms that the immediate loading technique may be most advantageous strategy for edentulous patients.
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Affiliation(s)
| | - Seigo Ohba
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; previously with Division of Dentistry and Oral Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medicine, University of Fukui, Fukui, Japan
| | - Ken Nakashima
- Takanashi Dental Clinic, Chuou-ku, Nihon-bashi, Japan
| | - Yoshiaki Takanashi
- Shonan Dental Care Implant Clinic, city, Japan, and Takanashi Dental Clinic, city, Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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17
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ELsyad MA, Errabti HM, Mustafa AZ. Mandibular Denture Base Deformation with Locator and Ball Attachments of Implant-Retained Overdentures. J Prosthodont 2015; 25:656-664. [DOI: 10.1111/jopr.12356] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Moustafa Abdou ELsyad
- Department of Removable Prosthodontics, University of Mansoura; Faculty of Dentistry; Eldakahlia Egypt
| | | | - Aisha Zakaria Mustafa
- Department of Removable Prosthodontics, University of Mansoura; Faculty of Dentistry; Eldakahlia Egypt
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18
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Vandeweghe S, Hawker P, De Bruyn H. An Up to 12-Year Retrospective Follow-Up on Immediately Loaded, Surface-Modified Implants in the Edentulous Mandible. Clin Implant Dent Relat Res 2015; 18:323-31. [DOI: 10.1111/cid.12322] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stefan Vandeweghe
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Belgium
| | - Peter Hawker
- Victoria Specialist Centre; Adelaide South Australia Australia
| | - Hugo De Bruyn
- Department of Periodontology and Oral Implantology; Dental School; Faculty of Medicine and Health Sciences; University of Ghent; Belgium
- Periodontology, Oral Implantology, Removable and Implant Prosthetics; Ghent University; Belgium
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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19
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Esposito M, Ardebili Y, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev 2014:CD003815. [PMID: 25048469 DOI: 10.1002/14651858.cd003815.pub4] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007. OBJECTIVES Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis. DATA COLLECTION AND ANALYSIS At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading. MAIN RESULTS We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces. AUTHORS' CONCLUSIONS Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
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Affiliation(s)
- Marco Esposito
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Coupland 3 Building, Oxford Road, Manchester, UK, M13 9PL
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20
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Gastaldo JFG, Pimentel AC, Gomes MH, Sendyk WR, Laganá DC. Stress Analysis on Single Cobalt/Chrome Prosthesis With a 15-mm Cantilever Placed Over 10/13/15-mm-length Implants: A Simulated Photoelastic Model Study. J ORAL IMPLANTOL 2014; 41:706-11. [PMID: 24914673 DOI: 10.1563/aaid-joi-d-13-00139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of study was to assess the stress around 10/13/15-mm implants in the mandibular area with a 15-mm cantilevered acrylic-resin-coated prostheses following the application force, using the photoelasticity method. Three photoelastic mandibular models were created containing 10-, 13-, and 15-mm implants in length and 3.75 mm in diameter. The implants had bore internal hex connections and were placed parallel to the intermental region. Abutments with 1-mm high cuffs were placed over the implants, and a single cobalt/chrome metallic prosthesis with a 15-mm cantilever, coated with thermoplastic acrylic resin, was placed on top. Loads of 1.0 and 3.0 bars were applied, and the images were photographed and assessed by photoelasticity method. The greatest stress levels were observed for the 10-mm implants. The stress pattern was the same regardless of implant length; only the magnitude of the stress along the implant body revealed changes. Increased implant length played a role in reducing stress on the investigated area of the model, and the 15-mm implants exhibited the best performance in regard to stress distribution. The highest stress levels were found in the implants closest to the cantilever and the central implant. The longest implants were more favorable in regard to the stress distribution on the peri-implant support structures in the 15-mm cantilevered prosthesis under loads.
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Affiliation(s)
| | | | - Maria Helena Gomes
- 1 Department of Dental Prosthesis, University of São Paulo - USP, Sao Paulo, Brazil
| | - Wilson Roberto Sendyk
- 2 Department of Implant Dentistry, University of Santo Amaro - UNISA, Sao Paulo, Brazil
| | - Dalva Cruz Laganá
- 1 Department of Dental Prosthesis, University of São Paulo - USP, Sao Paulo, Brazil
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21
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Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil 2014; 41:443-76. [PMID: 24612346 DOI: 10.1111/joor.12157] [Citation(s) in RCA: 239] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2014] [Indexed: 12/18/2022]
Abstract
This study reviews the literature regarding the factors contributing to failures of dental implants. An electronic search was undertaken including papers from 2004 onwards. The titles and abstracts from these results were read to identify studies within the selection criteria. All reference lists of the selected studies were then hand-searched, this time without time restrictions. A narrative review discussed some findings from the first two parts where separate data from non-comparative studies may have indicated conclusions different from those possible to draw in the systematic analysis. It may be suggested that the following situations are correlated to increase the implant failure rate: a low insertion torque of implants that are planned to be immediately or early loaded, inexperienced surgeons inserting the implants, implant insertion in the maxilla, implant insertion in the posterior region of the jaws, implants in heavy smokers, implant insertion in bone qualities type III and IV, implant insertion in places with small bone volumes, use of shorter length implants, greater number of implants placed per patient, lack of initial implant stability, use of cylindrical (non-threaded) implants and prosthetic rehabilitation with implant-supported overdentures. Moreover, it may be suggested that the following situations may be correlated with an increase in the implant failure rate: use of the non-submerged technique, immediate loading, implant insertion in fresh extraction sockets, smaller diameter implants. Some recently published studies suggest that modern, moderately rough implants may present with similar results irrespective if placed in maxillas, in smoking patients or using only short implants.
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Affiliation(s)
- B R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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22
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Chen YY, Chen WP, Chang HH, Huang SH, Lin CP. A novel dental implant abutment with micro-motion capability—Development and biomechanical evaluations. Dent Mater 2014; 30:131-7. [DOI: 10.1016/j.dental.2013.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/18/2013] [Accepted: 10/18/2013] [Indexed: 11/28/2022]
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23
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Bishti S, Strub JR, Att W. Effect of the implant-abutment interface on peri-implant tissues: a systematic review. Acta Odontol Scand 2014; 72:13-25. [PMID: 23834528 DOI: 10.3109/00016357.2013.799712] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the present systematic review was to determine the peri-implant tissue response to different implant abutment materials and designs available and to assess the impact of tissue biotype. MATERIALS AND METHODS Relevant literature published between December 2009 and August 2012 was searched to identify studies dealing with different implant abutment designs and materials, as well as the response of different tissue biotypes. The search terms used, in simple or multiple conjunctions, were 'implant abutment', 'interface', 'material', 'peri-implant', 'soft tissue' and 'esthetic'. Studies were selected according to pre-determined inclusion and exclusion criteria. RESULTS The initial search yielded 2449 titles. After a subsequent filtering process, 23 studies were finally selected. The included studies revealed different factors responsible for the stability of peri-implant tissue and the esthetic outcome. These factors include tissue biotype and architecture, implant abutment material and implant abutment design. Several designs were suggested to prevent marginal bone loss and soft tissue recession. These included scalloped implants, platform-switched implants and gingivally converged or concave implant abutments. Due to the limited number of studies and the heterogeneity in their designs, it was not possible to perform a statistical analysis of the data. CONCLUSIONS The current literature provides insufficient evidence about the effectiveness of different implant abutment designs and materials in the stability of peri-implant tissues.
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Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics, School of Dentistry, University Hospital , Freiburg , Germany
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24
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External versus internal abutment connection implants: a survey of opinions and decision making among experienced implant dentists in Japan. Odontology 2013; 103:75-83. [PMID: 24343790 DOI: 10.1007/s10266-013-0141-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 11/24/2013] [Indexed: 10/25/2022]
Abstract
Internal connection implants have been attracting attention in recent years leading to their being adopted for many implant systems and an increase in market share over other connections. However, internal connection implants have only been used clinically for a short period of time resulting in few clinical studies investigating outcomes and a lack of comparative clinical evidence to support their use over external hex systems at this time. Given the fact that clinical evidence is lacking regarding implant connection performance comparisons, it is important to understand what information clinicians use to choose between systems. The purpose of this study regarding implant decision-making was to ask clinicians to provide subjective evaluations of internal connection implants, in comparison with external connection implants. The survey was constructed to cover four aspects of interest; general responder information, surgical procedures and experience, prosthodontic treatments and outcomes, and implant complications. The dentists' responses indicated that internal connection implants are as user-friendly as external hex implants with respect to implant surgery, but they are favored for prosthodontic handling because impression coping and abutment placement are felt to be easier. In addition, it was revealed that dentists strongly feel that there is a lack of biological and prosthodontic evidence to support the use of internal connection implants. The findings reveal the responding clinicians recognize that they often make decisions without compelling evidence to favor one system over another. Decisions are often based on perceived ease of use or third party (colleague or manufacturer) input. For future investigations, we will seek to better understand the relative influence and validity of all forms of information used (especially third party input), as well as what barriers exist to clinicians' use of more evidence based data.
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Sjöström T, Brydone AS, Meek RMD, Dalby MJ, Su B, McNamara LE. Titanium nanofeaturing for enhanced bioactivity of implanted orthopedic and dental devices. Nanomedicine (Lond) 2013; 8:89-104. [PMID: 23256494 DOI: 10.2217/nnm.12.177] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Titanium (Ti) is used as a load-bearing material in the production of orthopedic devices. The clinical efficacy of these implants could be greatly enhanced by the addition of nanofeatures that would improve the bioactivity of the implants, in order to promote in situ osteo-induction and -conduction of the patient's stem and osteoprogenitor cells, and to enhance osseointegration between the implant and the surrounding bone. Nanofeaturing of Ti is also currently being applied as a tool for the biofunctionalization of commercially available dental implants. In this review, we discuss the different nanofabrication strategies that are available to generate nanofeatures in Ti and the cellular response to the resulting nanofeatures. In vitro research, in vivo studies and clinical trials are considered, and we conclude with a perspective about the future potential for use of nanotopographical features in a therapeutic setting.
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Affiliation(s)
- Terje Sjöström
- School of Oral & Dental Science, University of Bristol, Bristol, UK
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26
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de Vasconcellos LGO, Kojima AN, Nishioka RS, de Vasconcellos LMR, Balducci I. Axial loads on implant-supported partial fixed prostheses for external and internal hex connections and machined and plastic copings: strain gauge analysis. J ORAL IMPLANTOL 2013; 41:149-54. [PMID: 23574373 DOI: 10.1563/aaid-joi-d-10-00174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this in vitro study was to use strain gauge (SG) analysis to compare the effects of the implant-abutment joint, the coping, and the location of load on strain distribution in the bone around implants supporting 3-unit fixed partial prostheses. Three external hexagon (EH) implants and 3 internal hexagon (IH) implants were inserted into 2 polyurethane blocks. Microunit abutments were screwed onto their respective implant groups. Machined cobalt-chromium copings and plastic copings were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in a cobalt-chromium alloy (n = 5): group 1 = EH/machined. group 2 = EH/plastic, group 3 = IH/machined, and group 4 = IH/plastic. Four SGs were bonded onto the surface of the block tangentially to the implants. Each metallic structure was screwed onto the abutments and an axial load of 30 kg was applied at 5 predetermined points. The magnitude of microstrain on each SG was recorded in units of microstrain (με). The data were analyzed using 3-factor repeated measures analysis of variance and a Tukey test (α = 0.05). The results showed statistically significant differences for the type of implant-abutment joint, loading point, and interaction at the implant-abutment joint/loading point. The IH connection showed higher microstrain values than the EH connection. It was concluded that the type of coping did not interfere in the magnitude of microstrain, but the implant/abutment joint and axial loading location influenced this magnitude.
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Affiliation(s)
- Luis Gustavo Oliveira de Vasconcellos
- 1 Department of Dental Materials and Prosthodontics, School of Dentistry of São José dos Campos, São Paulo State University, São José dos Campos, Brazil
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27
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Bressan E, Lops D. Conometric retention for complete fixed prosthesis supported by four implants: 2-years prospective study. Clin Oral Implants Res 2013; 25:546-52. [DOI: 10.1111/clr.12121] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Eriberto Bressan
- Department of Oral Surgery; Dental Clinic; School of Dentistry; University of Padova; Padova Italy
| | - Diego Lops
- Department of Prosthodontics; Dental Clinic; School of Dentistry; University of Milan; Milan Italy
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28
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Thoma DS, Sanz Martin I, Benic GI, Roos M, Hämmerle CHF. Prospective randomized controlled clinical study comparing two dental implant systems: demographic and radiographic results at one year of loading. Clin Oral Implants Res 2013; 25:142-9. [DOI: 10.1111/clr.12120] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ignacio Sanz Martin
- Section of Periodontology; Faculty of Odontology; University Complutense of Madrid; Madrid Spain
| | - Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Malgorzata Roos
- Senior Statistician; Division of Biostatistics; Institute of Social and Preventive Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Gracis S, Michalakis K, Vigolo P, Vult von Steyern P, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2012; 23 Suppl 6:202-16. [DOI: 10.1111/j.1600-0501.2012.02556.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Gracis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Konstantinos Michalakis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Paolo Vigolo
- Department of Clinical Odontostomatology; University of Padova; Institute of Clinical Dentistry; Padova; Italy
| | | | - Marcel Zwahlen
- Institute of Social and Preventive Medicine; University of Berne; Bern; Switzerland
| | - Irena Sailer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Sciences; Center for Dental Medicine; University of Zurich; Zurich; Switzerland
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Cairo F, Sanz I, Matesanz P, Nieri M, Pagliaro U. Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance. J Clin Periodontol 2012; 39 Suppl 12:81-107. [DOI: 10.1111/j.1600-051x.2011.01839.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Cairo
- Department of Periodontology; University of Florence; Florence; Italy
| | - Ignacio Sanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Paula Matesanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Michele Nieri
- Department of Periodontology; University of Florence; Florence; Italy
| | - Umberto Pagliaro
- Department of Periodontology; University of Florence; Florence; Italy
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Retrospective Multicenter Evaluation of Tapered Implant With a Sandblasted and Acid-Etched Surface at 1 to 4 Years of Function. IMPLANT DENT 2011; 20:280-4. [DOI: 10.1097/id.0b013e318218123b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Elsyad MA, Al-Mahdy YF, Fouad MM. Marginal bone loss adjacent to conventional and immediate loaded two implants supporting a ball-retained mandibular overdenture: a 3-year randomized clinical trial. Clin Oral Implants Res 2011; 23:496-503. [DOI: 10.1111/j.1600-0501.2011.02173.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Scarano A, Piattelli A, Assenza B, Sollazzo V, Lucchese A, Carinci F. Assessment of Pain Associated with Insertion Torque of Dental Implants. A Prospective, Randomized-Controlled Study. Int J Immunopathol Pharmacol 2011; 24:65-9. [DOI: 10.1177/03946320110240s212] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated pain experience following dental implant placement in relation to insertion torque using questionnaires. A total 80 implants were placed in 20 patients. Each patient received 4 implants at different times. One implant was inserted and, then, after 40 days was placed the second implant, after 80 days was placed the third implant and after 120 days was placed the fourth implant. At each time the peri-implant bone levels were evaluated on intraoral radiographs taken with the paralleling technique. The implants were placed with a dynamometric key at 35N, 50N, 65N, 85N. Patients were asked to evaluate their pain experience during surgery, 24 hours after surgery, and at 2 days, 4 days, 1, 2, and 4 weeks after surgery on special pain assessment forms. A separate form was used for each time point. Pain was assessed using a descriptive numerical rating scale of 0 to 10, with 0 indicative of no pain and 10 representing the worst pain imaginable. Patients were instructed that a score of 1 to 3 was indicative of mild pain, 4 to 6 was indicative of moderate pain, and 7 to 10 was indicative of severe pain. A significant correlation pain scores and insertion torque was found between group III and group IV vs group II and group I during surgery, at 24 hours, 2 days, 4 days, 1 week, 2 weeks p⩽0.05. No statistical difference was found between group I vs. group II during surgery, at 24 hours, 2 days, 4 days, 1 week, 2 weeks p⩾0.05. In conclusion, elevated insertion torque values produces pain and resoption of the crestal bone around the implants.
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Affiliation(s)
- A. Scarano
- Dental School, University of Chieti-Pescara, Italy
| | - A. Piattelli
- Dental School, University of Chieti-Pescara, Italy
| | | | - V. Sollazzo
- Orthopedic Clinic, University of Ferrara, Ferrara, Italy
| | - A. Lucchese
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
| | - F. Carinci
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
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Hasturk H, Kantarci A, Ghattas M, Schmidt M, Giordano RA, Ashman A, Diekwisch TG, Van Dyke T. The use of light/chemically hardened polymethylmethacrylate, polyhydroxyethylmethacrylate, and calcium hydroxide graft material in combination with polyanhydride around implants in minipigs: part I: immediate stability and function. J Periodontol 2011; 82:1339-52. [PMID: 21342001 DOI: 10.1902/jop.2011.100617] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The present study is designed as a proof-of-concept study to evaluate light/chemical hardening technology and a newly formulated polymethylmethacrylate, polyhydroxyethylmethacrylate, and calcium hydroxide (PPCH) plus polyanhydride (PA) (PPCH-PA) composite graft material as a bone substitute compared to positive and negative controls in a minipig model. METHODS PPCH-PA (composite graft); PPCH alone (positive control), PA alone (positive control), and no graft (negative control) were compared. Four mandibular premolar teeth per quadrant were extracted; a total of 48 implants were placed into sockets in three minipigs. Abutments were placed protruding into the oral cavity 4 mm in height for immediate loading. Crestal areas and intrabony spaces were filled with PPCH-PA, PPCH, or PA using a three-phase delivery system in which all graft materials were hardened by a light cure. In the negative control group, implant sites were left untreated. At 12 weeks, block sections containing implants were obtained. Evaluations included periodontal probing, pullout-force load, and stability measurements to determine implant stability, radiographs to examine bone levels, and scanning electron microscopy (SEM)-energy-dispersed spectroscopy to determine bone-to-implant contact. RESULTS Probing measurements did not reveal any pathologic pocket formation or bone loss. Radiographs revealed that immediate implant placement and loading resulted in bone at or slightly apical to the first thread of the implant in all groups at 12 weeks. Stability test values showed a relative clinical stability for all implants (range: -7 to +1); however, implants augmented with PPCH-PA exhibited a statistically significantly greater stability compared to all other groups (P <0.05). The newly formed bone in PPCH-PA-treated sites was well organized with less marrow spaces and well-distributed osteocytes. SEM revealed a tighter implant-socket interface in the PPCH-PA group compared to other groups with reduced microfissures and implant-bone interface fractures during pullout testing, whereas implants treated with PA or no graft showed ≈ 10-μm microfissures between the implant and bone with fractures of the intrathread bone. CONCLUSIONS The newly formulated chemically hardened graft material PPCH-PA was useful in immediate implant placement after tooth extraction and resulted in greater stability and a well-organized implant-bone interface with immediate loading, especially in those areas where cancellous bone was present. The results of this proof-of-concept study warranted further research investigating different healing times and longer durations.
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Affiliation(s)
- Hatice Hasturk
- Department of Periodontology, The Forsyth Institute, Cambridge, MA 02142, USA
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Karabuda ZC, Abdel-Haq J, Arιsan V. Stability, marginal bone loss and survival of standard and modified sand-blasted, acid-etched implants in bilateral edentulous spaces: a prospective 15-month evaluation. Clin Oral Implants Res 2010; 22:840-9. [DOI: 10.1111/j.1600-0501.2010.02065.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Vandeweghe S, Cosyn J, Thevissen E, Teerlinck J, De Bruyn H. The Influence of Implant Design on Bone Remodeling around Surface-Modified Southern Implants®. Clin Implant Dent Relat Res 2010; 14:655-62. [DOI: 10.1111/j.1708-8208.2010.00308.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pommer B, Zechner W, Watzak G, Ulm C, Watzek G, Tepper G. Progress and trends in patients' mindset on dental implants. II: implant acceptance, patient-perceived costs and patient satisfaction. Clin Oral Implants Res 2010; 22:106-12. [DOI: 10.1111/j.1600-0501.2010.01969.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Astra Tech, Brånemark, and ITI Implants in the Rehabilitation of Partial Edentulism: Two-Year Results. IMPLANT DENT 2010; 19:437-46. [DOI: 10.1097/id.0b013e3181f57110] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Palmquist A, Omar OM, Esposito M, Lausmaa J, Thomsen P. Titanium oral implants: surface characteristics, interface biology and clinical outcome. J R Soc Interface 2010; 7 Suppl 5:S515-27. [PMID: 20591849 DOI: 10.1098/rsif.2010.0118.focus] [Citation(s) in RCA: 155] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bone-anchored titanium implants have revolutionized oral healthcare. Surface properties of oral titanium implants play decisive roles for molecular interactions, cellular response and bone regeneration. Nevertheless, the role of specific surface properties, such as chemical and phase composition and nanoscale features, for the biological in vivo performance remains to be established. Partly, this is due to limited transfer of state-of-the-art preparation techniques to complex three-dimensional geometries, analytical tools and access to minute, intact interfacial layers. As judged by the available results of a few randomized clinical trials, there is no evidence that any particular type of oral implant has superior long-term success. Important insights into the recruitment of mesenchymal stem cells, cell-cell communication at the interface and high-resolution imaging of the interface between the surface oxide and the biological host are prerequisites for the understanding of the mechanisms of osseointegration. Strategies for development of the next generation of material surface modifications for compromised tissue are likely to include time and functionally programmed properties, pharmacological modulation and incorporation of cellular components.
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Affiliation(s)
- Anders Palmquist
- BIOMATCELL Vinn Excellence Center for Biomaterials and Cell Therapy, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
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Cosyn J, Vandenbulcke E, Browaeys H, Van Maele G, De Bruyn H. Factors associated with failure of surface-modified implants up to four years of function. Clin Implant Dent Relat Res 2010; 14:347-58. [PMID: 20491819 DOI: 10.1111/j.1708-8208.2010.00282.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The relative impact of innovative treatment concepts on the failure of surface-modified implants is not well understood. This retrospective study aimed to explore this using data obtained in a university postgraduate training center. MATERIAL AND METHODS Patients treated with implants for a variety of indications over a 3-year period were included. All implants had been at least 1 year in function. Clinical records were evaluated for implant failure and in reference to implant length/diameter/location, time from tooth loss to implant placement, bone condition (native/grafted), surgical protocol (two-/one-stage), loading protocol (delayed/early/immediate), type of prosthesis (removable/fixed), surgeon's experience level (resident/trainee) and specialty (periodontist/oral surgeon). The impact of each covariate on failure was tested using the Fisher's exact test. Kaplan-Meier survival functions were constructed and Mantel-Cox log-rank tests were used to compare survival functions. To correct for possible interaction, Cox proportional Hazards regression was adopted. RESULTS Forty-one of 1,180 (3.5%) implants were lost in 34/461 (7.4%) patients (245 ♀, 216 ♂; mean age 51, range 18-90). Factors showing significant impact on failure on the basis of univariate analyses were implant location (p = .015), surgical protocol (p = .002), loading protocol (p = .002), surgeon's experience level (p = .035) and specialty (p = .001). When controlling for other covariates, only the loading protocol had a significant influence (p = .049) with early loading more prone to failure (p = .014) when compared with delayed loading. Immediate loading and delayed loading showed comparable implant survival (p = .311). CONCLUSIONS Implant therapy may be highly successful in a training center where inexperienced clinicians are strictly monitored and personally guided. Implant specific variables do not affect implant survival but early loading is a risk indicator for implant failure, whereas immediate loading is not.
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Affiliation(s)
- Jan Cosyn
- Department of Periodontology and Oral Implantology, University of Ghent, Faculty of Medicine and Health Sciences, Ghent, Belgium.
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Multi-factorial analysis of variables influencing the bone loss of an implant placed in the maxilla: Prediction using FEA and SED bone remodeling algorithm. J Biomech 2010; 43:644-51. [DOI: 10.1016/j.jbiomech.2009.10.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 10/05/2009] [Accepted: 10/15/2009] [Indexed: 11/21/2022]
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External Hexagon and Internal Hexagon in Straight and Offset Implant Placement: Strain Gauge Analysis. IMPLANT DENT 2009; 18:512-20. [DOI: 10.1097/id.0b013e3181bcc621] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kallus T, Bessing C, Homsi G, Eklund I. Five-Year Evaluation of Lifecore Restore® Implants: A Retrospective Comparison with Nobel Biocare MK II® Implants. Clin Implant Dent Relat Res 2009; 11:167-77. [DOI: 10.1111/j.1708-8208.2008.00115.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eliasson A, Blomqvist F, Wennerberg A, Johansson A. A Retrospective Analysis of Early and Delayed Loading of Full-Arch Mandibular Prostheses Using Three Different Implant Systems: Clinical Results with Up to 5 Years of Loading. Clin Implant Dent Relat Res 2009; 11:134-48. [DOI: 10.1111/j.1708-8208.2008.00099.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Akça K, Fanuscu MI, Caputo AA. Effect of Compromised Cortical Bone on Implant Load Distribution. J Prosthodont 2008; 17:616-20. [DOI: 10.1111/j.1532-849x.2008.00365.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bhatavadekar N. Assessing the evidence supporting the claims of select dental implant surfaces: a systematic review. Int Dent J 2008; 58:363-70. [DOI: 10.1111/j.1875-595x.2008.tb00358.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Coulthard P, Esposito M, Jokstad A, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: surgical techniques for placing dental implants. Cochrane Database Syst Rev 2008; 2008:CD003606. [PMID: 18646091 PMCID: PMC10682686 DOI: 10.1002/14651858.cd003606.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Many variations in the surgical technique for the placement of dental implants have been developed since the introduction of implant surgery into clinical practice. These include variations in the timing of implant placement in relation to the tooth removal, and variations in the way the recipient bone site is prepared, amongst others. OBJECTIVES To test the null hypothesis of no difference in the success, function, morbidity, patient satisfaction and cost-effectiveness of different surgical techniques for placing dental implants, against the alternative hypothesis of a difference. SEARCH STRATEGY The Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched. In addition, the bibliographies of review articles were checked for studies outside the handsearched journals and personal references were searched. 55 implant companies were also contacted. SELECTION CRITERIA Randomised controlled clinical trials (RCTs) of implant surgical techniques. DATA COLLECTION AND ANALYSIS Authors were contacted for details of randomisation and data and quality assessment was carried out (ME, PC). Data were independently extracted, in duplicate, by two reviewers (HW, PC). The Cochrane Oral Health Group's statistical guidelines were followed. MAIN RESULTS Four RCTs (six publications) were suitable for inclusion in this review of the nine RCTs (11 publications) identified. Two different aspects of implant surgical technique were reported in these RCTs. These were, two versus four implants to support a mandibular overdenture and crestal versus vestibular incision for implant placement. At the patient level there were no statistically significant differences for any of these alternative techniques with respect to implant failures, marginal bone levels, morbidity or patient satisfaction. AUTHORS' CONCLUSIONS This review included studies evaluating the surgical techniques of two versus four implants to support a mandibular overdenture and crestal versus vestibular incision for implant placement. Based on the available results of RCTs, there is no strong evidence supporting superior success with one or other of the alternative techniques for either of these two aspects of surgical technique. These conclusions are based on a few RCTs for each aspect of surgical technique and some with relatively short follow-up periods and few patients.
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Affiliation(s)
- Paul Coulthard
- School of Dentistry, The University of ManchesterDepartment of Oral and Maxillofacial SurgeryHigher Cambridge StreetManchesterUKM15 6FH
| | - Marco Esposito
- School of Dentistry, The University of ManchesterDepartment of Oral and Maxillofacial SurgeryHigher Cambridge StreetManchesterUKM15 6FH
| | - Asbjorn Jokstad
- University of Toronto, Faculty of DentistryNobel Biocare Chair in Prosthodontics124 Edward StreetTorontoCanadaON M5G 1G6
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health Group, MANDECHigher Cambridge StreetManchesterUKM15 6FH
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Esposito M, Murray-Curtis L, Grusovin MG, Coulthard P, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev 2007:CD003815. [PMID: 17943800 DOI: 10.1002/14651858.cd003815.pub3] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant surface modifications have been developed for enhancing clinical performance. OBJECTIVES To test the null hypothesis of no difference in clinical performance between various root-formed osseointegrated dental implant types. SEARCH STRATEGY We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of relevant clinical trials and review articles for studies outside the handsearched journals. We wrote to authors of the identified randomised controlled trials (RCTs), to more than 55 oral implant manufacturers; we used personal contacts and we asked on an internet discussion group in an attempt to identify unpublished or ongoing RCTs. No language restriction was applied. The last electronic search was conducted on 13 June 2007. SELECTION CRITERIA All RCTs of oral implants comparing osseointegrated implants with different materials, shapes and surface properties having a follow up of at least 1 year. DATA COLLECTION AND ANALYSIS Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). MAIN RESULTS Forty different RCTs were identified. Sixteen of these RCTs, reporting results from a total of 771 patients, were suitable for inclusion in the review. Eighteen different implant types were compared with a follow up ranging from 1 to 5 years. All implants were made in commercially pure titanium and had different shapes and surface preparations. On a 'per patient' rather than 'per implant' basis no significant differences were observed between various implant types for implant failures. There were statistically significant differences for perimplant bone level changes on intraoral radiographs in three comparisons in two trials. In one trial there was more bone loss only at 1 year for IMZ implants compared to Brånemark (mean difference 0.60 mm; 95% CI 0.01 to 1.10) and to ITI implants (mean difference 0.50 mm; 95% CI 0.01 to 0.99). In the other trial Southern implants displayed more bone loss at 5 years than Steri-Oss implants (mean difference -0.35 mm; 95% CI -0.70 to -0.01). However this difference disappeared in the meta-analysis. More implants with rough surfaces were affected by perimplantitis (RR 0.80; 95% CI 0.67 to 0.96) meaning that turned implant surfaces had a 20% reduction in risk of being affected by perimplantitis over a 3-year period. AUTHORS' CONCLUSIONS Based on the available results of RCTs, there is limited evidence showing that implants with relatively smooth (turned) surfaces are less prone to lose bone due to chronic infection (perimplantitis) than implants with rougher surfaces. On the other hand, there is no evidence showing that any particular type of dental implant has superior long-term success. These findings are based on a few RCTs, often at high risk of bias, with few participants and relatively short follow-up periods. More RCTs should be conducted, with follow up of at least 5 years including a sufficient number of patients to detect a true difference. Such trials should be reported according to the CONSORT recommendations (http://www.consort-statement.org/).
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Affiliation(s)
- M Esposito
- School of Dentistry, Department of Oral and Maxillofacial Surgery, University of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.
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Khayat PG, Milliez SN. Prospective Clinical Evaluation of 835 Multithreaded Tapered Screw-Vent Implants: Results After Two Years of Functional Loading. J ORAL IMPLANTOL 2007; 33:225-31. [PMID: 17912964 DOI: 10.1563/1548-1336(2007)33[225:pceomt]2.0.co;2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Multithreaded tapered screw implants have been used for several years, but lack of clinical documentation about marginal bone stability and survival rates have raised concerns about the design among some clinicians. This study prospectively evaluated the survival rates, success rates, and marginal bone stability of multithreaded tapered screw implants. A total of 835 implants in diameters of 3.7 mm (9%), 4.7 mm (76%), and 6.0 mm (15%) were placed in 328 patients using a single-stage, delayed-loading protocol. The implants were restored with a variety of prostheses and monitored over 2 years of functional loading. Five implants failed and were removed before loading. Cumulative implant survival was 99.4% (n = 835); differences between mandibular (99.0%, n = 408) and maxillary (99.8%, n = 427) implants were not statistically significant (P > .20). Mean marginal bone resorption was 1.66 mm (+/- 0.13 mm). Six implants failed to meet the success criteria by sustaining mesial and distal bone loss below the first implant thread; however, they remained stable and continued functioning without pain or inflammation. Cumulative implant success was 98.6% (n = 835); differences between maxillary (98.6%) and mandibular (98.8%) implants were not statistically significant (P > .20). Success rates by implant diameter were 98.6% (3.7 mm), 98.4% (4.7 mm), and 100% (6 mm). After 2 years of functional loading, survival and success rates for multithreaded tapered implants placed in a nonsubmerged protocol equaled or surpassed those of single-thread, straight-walled implant historical controls.
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Al-Nawas B, Hangen U, Duschner H, Krummenauer F, Wagner W. Turned, Machined Versus Double-Etched Dental Implants In Vivo. Clin Implant Dent Relat Res 2007; 9:71-8. [PMID: 17535330 DOI: 10.1111/j.1708-8208.2007.00030.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Positive effects on the clinical outcome of moderately rough implant surfaces are described. Intercomparison of clinical data, however, is rarely found. PURPOSE The aim of this study was to compare the clinical results of two macroscopically identical implants, the one with a turned, machined and the other with an etched surface. MATERIALS AND METHODS In a retrospective cohort study, the included implants followed the criteria: standard surgical protocol, >12 months in situ; minimally rough self-threading implants with a turned, machined surface (Mk II Nobel Biocare AB, Göteborg, Sweden], n=210); etched implants of the same macrodesign (3i Implant Innovations Inc., Palm Beach Gardens, FL, USA], n=151), length > or = 10 mm. Clinical data and implant success were rated. Resonance frequency analysis (RFA) and Periotest (Siemens AG, Bensheim, Germany) were measured and related to the corresponding implant survival rate in the respective group. RESULTS The total number of implants was 361, of which 264 (73%) were subject to clinical reexamination. RFA and Periotest could be recorded in 25% of the implants. Neither clinically relevant nor statistically significant differences between the surface designs were found in the RFA (64 +/- 8.6 vs 63 +/- 9.7), in Periotest (-2 +/- 3.3 vs -1 +/- 5.1), and in mean survival periods (49 months, 95% confidence interval CI]: 46-51 months, for the turned vs 46 months, 95% CI: 43-49 months, for the double-etched implant). After osteoplastic procedures, a significantly higher rate of implant losses in the turned, machined implant group was observed (17 vs 1) with a mean survival period of 43 (40-46) months for the turned and 46 (45-48) months for the double-etched implants. CONCLUSION No difference between implants with two different minimally rough surfaces was found. A positive effect of surface roughness is observed in poor quality bone, but the pivotal proof of this effect is still lacking.
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Affiliation(s)
- B Al-Nawas
- Oral and Maxillofacial Surgery, J. Gutenberg University Hospital Mainz, Augustusplatz 2, D-55131 Mainz, Germany.
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