Retrospective assessment of survival rate for short endosseous dental implants

Clinical outcomes of short dental implants supporting prostheses in the posterior region

Aim In clinically challenging scenarios with limited bone height and anatomical restrictions, the use of short implants have been proposed as a potential treatment strategy. The purpose of this retrospective study was to evaluate the clinical outcomes of short implants supporting prostheses in the posterior premolar region of the maxilla and mandible.Materials and methods A total of 30 patients requiring short 6 mm length implant placement in the posterior premolar region were included. Following a period of osseointegration, the implants were restored with either single crowns, fixed bridges or implant-supported removable overdentures. Implant and prosthetic survival with technical complications were recorded.Results In total, 45 implants were placed, with four failures reported before loading in two patients, resulting in a patient implant survival rate of 93.3% over the two-year follow-up. There was no statistically significant difference found between implant failure and arch placement. Prosthetic survival was 100% and minor technical complications recorded were low.Conclusion This study showed that short 6 mm implants could provide a viable treatment option, with high survival rates comparable with alternative bone augmentation procedures. Further research with longer observation periods would be required to validate these current findings.

Survival rates of ultra-short (<6 mm) compared with short locking-taper implants supporting single crowns in posterior areas: A 5-year retrospective study

Background

Short and ultra‐short implants represent a predictable treatment, in terms of implant survival, with patients presenting insufficient available bone volumes. Moreover, single crown restorations represent a gold standard in terms of oral hygiene.

Purpose

The aim of this retrospective study was to evaluate implant survival, marginal bone loss, and peri‐implant complications in 333 locking‐taper short and ultra‐short implants.

Materials and Methods

Implants were placed in the maxillary and mandibular posterior regions of 142 patients. Clinical and radiographic examinations were performed at 5‐year recall appointments.

Results

All implants placed consisted of 8.0‐, 6.0‐, and 5.0‐mm length, 38.14%, 34.53%, and 27.33%, respectively. Three hundred thirty‐two implants (one early failure) were rehabilitated with single crowns in 141 patients. In 45.48% of the implants the crown‐to‐implant ratio was ≥2, with a mean value of 1.94. Overall implant‐based survival after 5 years of follow‐up was 96.10%: 96.85%, 95.65%, and 95.60% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.82). Overall patient‐based survival was 91.55%. Regarding crestal bone level variations, average crestal bone loss and apical shift of the “first bone‐to‐implant contact point” position were 0.69 and 0.01 mm, respectively. Setting the threshold for excessive bone loss at 1 mm, during the time interval from loading to follow‐up, 28 implants experienced loss of supporting bone greater than 1 mm: 19 of them (67.85%) were surgically treated with a codified surgical regenerative protocol. After 60 months, a peri‐implantitis prevalence of 5.94% was reported, with an overall implant success of 94.06%: 95.93%, 92.73%, and 93.10% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.55).

Conclusion

Long‐term outcomes suggest that short and ultra‐short locking‐taper implants can be successfully restored with single crowns in the posterior area of the maxilla and mandible.

Retrospective study to identify associations between clinician training and dental implant outcome and to compare the use of MATLAB with SAS

Background

The aim of this study was to identify any associations between predictor variables, mainly clinician training and dental implant outcome, among the residents in different departments and to compare statistical analysis with the use of MATLAB R2017a™ to SAS version 9.4.

Methods

Dental records were reviewed from January 1, 2011, to December 31, 2015. Two thousand forty-eight dental implants were placed on 471 patients seen by residents from the departments of Periodontics, Prosthodontics, and Oral and Maxillofacial Surgery (OMFS) at Louisiana State University Health Sciences Center School of Dentistry. The following parameters were investigated by means of multilevel logistic regression analysis: demographics, implant parameters, department, and residents’ year of training.

Results

A total of 1449 implants were included in the study. Overall, within a 1–5-year time period, 1343 (92.6%) implants had survived and 106 (7.4%) implants failed. Discipline (p = 0.0004), residents’ year of training (p < 0.0001), and implant systems (p = 0.0024) showed significant associations with implant outcome. Periodontics had a survival rate of 94.14% followed by Prosthodontics (91.48%) and OMFS (89.64%). The survival rates of implants by year of training were as follows: third-year Periodontics and OMFS (94.20%), second-year (89.38%), and first-year (88.6%).

Conclusion

The level and type of clinician training had an impact on implant outcome in different residency programs. Further studies will be necessary to identify the reasons for the differences in implant failure rates.

Bone regeneration in diabetic patients. A systematic review

Background

Oral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence.

Material and Methods

A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: “Diabetes Mellitus”, “guided bone regeneration”, “bone regeneration”, “alveolar ridge augmentation”, “ridge augmentation”, bone graft*, “sinus floor augmentation”, “sinus floor elevation”, “sinus lift”, implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy).

Results

The initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series.

Conclusions

A low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied.

Key words:Diabetes Mellitus, guided bone regeneration, bone regeneration.

A pilot study using machine learning methods about factors influencing prognosis of dental implants

PURPOSE

This study tried to find the most significant factors predicting implant prognosis using machine learning methods.

MATERIALS AND METHODS

The data used in this study was based on a systematic search of chart files at Seoul National University Bundang Hospital for one year. In this period, oral and maxillofacial surgeons inserted 667 implants in 198 patients after consultation with a prosthodontist. The traditional statistical methods were inappropriate in this study, which analyzed the data of a small sample size to find a factor affecting the prognosis. The machine learning methods were used in this study, since these methods have analyzing power for a small sample size and are able to find a new factor that has been unknown to have an effect on the result. A decision tree model and a support vector machine were used for the analysis.

RESULTS

The results identified mesio-distal position of the inserted implant as the most significant factor determining its prognosis. Both of the machine learning methods, the decision tree model and support vector machine, yielded the similar results.

CONCLUSION

Dental clinicians should be careful in locating implants in the patient's mouths, especially mesio-distally, to minimize the negative complications against implant survival.

Short Dental Implants (6 mm) Versus Standard Dental Implants (10 mm) Supporting Single Crowns in the Posterior Maxilla and/or Mandible: 2-Year Results from a Prospective Cohort Comparative Trial

OBJECTIVES

The purpose of present study was to compare short (6 mm) with longer implants with the same surface use in the posterior maxilla and/or mandible.

MATERIAL AND METHODS

A total of 110 implants of 6 or 10 mm in length were placed with an internal hex (n = 60) and with a conical connection (n = 50) but the same material, surface and design, supporting single crowns in the posterior maxilla and/or mandible. Outcomes measured were implant survival and marginal bone level changes up to 24 months after loading.

RESULTS

Final group consisted of 105 implants: 6 mm (n = 58) and 10 mm (n = 47). Success rate after 24 months was similar between treatment groups (98.3% vs. 100%; P = 0.361). Failure rates of the short implants in mandible (1/18, 5.6%) and in maxilla (0/40, 0%) were also not significantly different (P = 0.133). Success rate after 2 years was similar between internal hex vs. conical connection implants (100% vs. 97.7%; P = 0.233). Subjects lost statistically significant marginal peri-implant bone in both groups, but without differences (6 mm group: 0.38 mm [95% CI = 0.09 to 0.67] vs. 10 mm group: 0.43 mm [95% CI = 0.15 to 0.61]; P = 0.465 at 24 months), in relation also to type of implant (internal hex vs. conical, P = 0.428 at 24 months) or operator (P = 0.875 at 24 months).

CONCLUSIONS

Short implants may be successful in the posterior areas during the first 24 months of loading, with similar outcomes to 10 mm long implants, supporting their use as a valid option in selected cases. However, larger and longer follow-ups of 5 years or more are needed.