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Mao Z, Bleiel H, Beuer F, Böse MWH, Soetebeer M. Occlusal changes on implant-supported single crowns with one year follow-up after loading: A systematic review and meta-analysis. J Dent 2024; 146:105000. [PMID: 38734300 DOI: 10.1016/j.jdent.2024.105000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE This systematic review evaluated the occlusal changes after loading with implant-supported single crowns. SOURCES An electronic literature search was conducted in PubMed, Embase and Cochrane library for randomized (RCTs) or non-randomized controlled clinical trials (CCTs), with a minimum of 10 patients. STUDY SELECTION Studies reporting the occlusal force changes on implant-supported single crowns - with natural teeth as antagonist - measured at baseline and after loading periods were included. 4 CCTs including 133 ISCs in posterior sites were included for meta-analysis. All analyzed ISCs had no contact at a light bite and a light contact at a heavy bite in MIP at loading (baseline). DATA The relative occlusal forces (ROFs) of each implant-supported single crown (ISC) or control tooth (CT) were extracted. ROFs were defined as percentage of the total occlusal force of the entire dentition at maximum intercuspal position (MIP). A meta-analysis was conducted to compare the ROF changes at different follow-up periods and the weighted mean differences in ROF between ISCs and CTs were pooled and analyzed. The amount of change in ROF was significantly lower in 6 to 12 months after loading comparing the follow-up period between baseline and 6 month (p < 0.05). At baseline and 3-month follow-up, CTs presented significant higher ROF than ISCs (p < 0.05), while no significant difference was found after half year following. CONCLUSIONS This study showed that the ROF changes significantly over time after loading of ISCs. It might prove that the occlusal concept defined at the time of prosthetic delivery changes or adapts naturally over time. CLINICAL SIGNIFICANCE The function of specific implant occlusal concept (no contact at a light bite and a light contact at a heavy bite in MIP) is limited over time and careful monitoring and occlusal adjustments should be recommendable during the first-year follow-up.
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Affiliation(s)
- Zhen Mao
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
| | - Hannah Bleiel
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Mats Wernfried Heinrich Böse
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Maren Soetebeer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
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Salgado-Peralvo AO, Kewalramani N, Liñares A, Peláez-Rico J. Restoring the functionality of implant-supported prostheses with a reloading technique: A clinical report. J Prosthet Dent 2024; 131:1000-1003. [PMID: 36609084 DOI: 10.1016/j.prosdent.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 01/06/2023]
Abstract
The prevalence of infraocclusion and/or loss of interproximal contact areas with implant-supported restorations is high, and replacement of these prostheses has been advocated for the treatment of mild or moderate infraocclusion; however, replacement is complicated if the manufacturer of the implant is unknown. A technique is presented for correcting the infraocclusion of posterior prostheses that are directly connected to the implant. Advantages include possibly preventing marginal bone loss secondary to the removal and reconnection of the prosthetic attachments and reducing the number of appointments.
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Affiliation(s)
- Angel-Orión Salgado-Peralvo
- Assistant Professor, Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Naresh Kewalramani
- Collaborating Professor, Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | - Antonio Liñares
- Associate Professor, Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jesús Peláez-Rico
- Associate Professor, Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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Kim JH, Yoon JH, Jeon HI, Kim DW, Park YB, Oh N. Prediction of lifespan and assessing risk factors of large-sample implant prostheses: a multicenter study. J Adv Prosthodont 2024; 16:151-162. [PMID: 38957292 PMCID: PMC11215039 DOI: 10.4047/jap.2024.16.3.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/13/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024] Open
Abstract
PURPOSE This study aimed to analyze factors influencing the success and failure of implant prostheses and to estimate the lifespan of prostheses using standardized evaluation criteria. An online survey platform was utilized to efficiently gather large samples from multiple institutions. MATERIALS AND METHODS During the one-year period, patients visiting 16 institutions were assessed using standardized evaluation criteria (KAP criteria). Data from these institutions were collected through an online platform, and various statistical analyses were conducted. Risk factors were assessed using both the Cox proportional hazard model and Cox regression analysis. Survival analysis was conducted using Kaplan-Meier analysis and nomogram, and lifespan prediction was performed using principal component analysis. RESULTS The number of patients involved in this study was 485, with a total of 841 prostheses evaluated. The median survival was estimated to be 16 years with a 95% confidence interval. Factors found to be significantly associated with implant prosthesis failure, characterized by higher hazard ratios, included the 'type of clinic', 'type of antagonist', and 'plaque index'. The lifespan of implant prostheses that did not fail was estimated to exceed the projected lifespan by approximately 1.34 years. CONCLUSION To ensure the success of implant prostheses, maintaining good oral hygiene is crucial. The estimated lifespan of implant prostheses is often underestimated by approximately 1.34 years. Furthermore, standardized form, online platform, and visualization tool, such as nomogram, can be effectively utilized in future follow-up studies.
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Affiliation(s)
- Jeong Hoon Kim
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Joon-Ho Yoon
- Department of Prosthodontics, NHIS Ilsan Hospital, Goyang, Republic of Korea
| | - Hae-In Jeon
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Dong-Wook Kim
- Department of Information and Statistics, Research Institute of Natural Science, Gyeongsang National University, Jinju, Republic of Korea
- Department of Bio & Medical Bigdata (BK21 Plus), Gyeongsang National University, Jinju, Republic of Korea
| | - Young-Bum Park
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Namsik Oh
- Department of Dentistry, School of Medicine, Inha University, Incheon, Republic of Korea
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Chen HH, Lin GH, Kao RT, Yeh YT. Survival rate of teeth adjacent and nonadjacent to dental implants: A retrospective cohort study. J Periodontol 2024. [PMID: 38742582 DOI: 10.1002/jper.23-0739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The aim of this retrospective study was to investigate the risk of tooth loss for teeth adjacent and nonadjacent to dental implants. METHODS A total of 787 patients with an average follow-up of 57.1 months were examined to define the tooth loss, cumulative survival rate, and odds ratio (OR) for teeth adjacent versus nonadjacent to implants. A multivariate logistic regression was employed to assess the association between dental history and various recorded etiologies of tooth loss among teeth adjacent to implants. RESULTS The incidence of tooth loss for teeth adjacent to implants was 8.1% at the tooth level and 15.1% at the patient level, while 0.7% and 9.5% at the tooth and patientlevel for teeth nonadjacent to implants. The 10-year cumulative survival rate for teeth adjacent to implants was 89.2%, and the primary etiology of tooth loss was root fracture (45.2%). The risk of tooth loss among teeth adjacent versus nonadjacent to implants was significantly higher (OR 13.15). Among teeth adjacent to implants, root canal-treated teeth had a significantly higher risk of tooth loss due to root fracture (OR 7.72), a history of existing restoration significantly increased the risk of tooth loss due to caries (OR 3.05), and a history of periodontitis significantly increased the risk of tooth loss due to periodontitis (OR 38.24). CONCLUSION The present study demonstrated that after patients received dental implant treatment, teeth adjacent to implants showed a 13.2-fold higher risk of tooth loss compared to teeth nonadjacent to implants, with the primary etiology being root fracture.
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Affiliation(s)
- Hsuan-Hung Chen
- Division of Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Guo-Hao Lin
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Richard T Kao
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
- Private Practice, Cupertino, California, USA
| | - Yu-Ting Yeh
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
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Puengpaiboon U, Rattanapan N, Pasam VK, Sukjamsri C. Finite Element Analysis of Anterior Implant-Supported Restorations with Different CAD-CAM Restorative Materials. Eur J Dent 2024. [PMID: 38744334 DOI: 10.1055/s-0044-1785532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Due to the lack of literature concerning the selection of crown materials for the restoration of anterior teeth, this study aimed to investigate the effects of six distinct computer-aided design and computer-aided manufacturing (CAD-CAM) crown materials on stress and strain distribution within implant-supported maxillary central incisor restorations, employing finite element analysis (FEA). Furthermore, a comparative analysis was conducted between models that incorporated adjacent natural teeth and those that did not, intending to guide the selection of the most suitable modeling approach. MATERIALS AND METHODS Crown materials, including Lava Ultimate, Enamic, Emax CAD, Suprinity, Celtra Duo, and Cercon xt ML, were the subjects of the investigation. FEA models incorporating Coulomb friction were developed. These models were subjected to an oblique load, simulating the average maximum bite force experienced by anterior teeth. The potential for failure in titanium implant components and the prosthesis crown was evaluated through von Mises and principal stress, respectively. Furthermore, the failure of crestal bone was assessed through principal strain values. STATISTICAL ANALYSIS Stress values for each implant component and strain values of the bone were extracted from the models. To assess the impact of the six groups of crown materials, Kruskal-Wallis analysis of variance and post-hoc comparisons were conducted. Additionally, a statistical comparison between the two groups with Lava Ultimate and Cercon xt ML was performed using the Mann-Whitney U test to determine the difference in the two modeling approaches. RESULTS Higher crown material stiffness led to decreased stress in the abutment, fixture, and retaining screw, along with reduced strain in the surrounding bone. However, the decrease in stress and strain values became less significant with increasing crown stiffness. Additionally, the model with adjacent teeth showed significantly lower stress and strain concentrations compared to the model without adjacent teeth. CONCLUSION Crowns with a high elastic modulus were the optimal choice for anterior teeth restoration. Constructing FEA models with adjacent teeth was highly recommended to gain a deeper understanding of the mechanical behavior of dental implant restorations.
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Affiliation(s)
- Usanee Puengpaiboon
- Department of General Dentistry, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Nichapat Rattanapan
- Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Vamsi Krishna Pasam
- Department of Mechanical Engineering, National Institute of Technology Warangal, Warangal, Telangana, India
| | - Chamaiporn Sukjamsri
- Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, Thailand
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Stilwell C. Occlusal considerations in maintaining health of implants and their restorations. Br Dent J 2024; 236:773-779. [PMID: 38789754 PMCID: PMC11126375 DOI: 10.1038/s41415-024-7407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Dental implants are a regular feature in daily clinical practice and there is a need to undertake routine assessment and maintenance of implants and their restorations on par with that provided for natural teeth. Occlusal checks form an important part of the maintenance regime for preserving the integrity of implants, their restorations, and health of the peri-implant tissues. Implant restorations are subjected to the full characteristics and magnitude of occlusal forces, including those associated with parafunction. Compared with the periodontal ligament around teeth, the biophysical response to occlusal forces of osseointegration is different through the more rigid link of implant to bone and reduced proprioception. Risks attributable to occlusal forces primarily affect implant restorations and they are elevated in the presence of bruxism. The occlusal guidelines recommended by the literature are aimed at reducing these risks and regular assessment and maintenance of the occlusion is essential. A four-step sequence is presented to ensure that the annual occlusal checks include the patient's input and evaluation of restoration integrity, occlusal scheme, additional protection, and spatial changes.
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Affiliation(s)
- Charlotte Stilwell
- Specialist in Prosthodontic Dentistry, Specialist Dental Services, Harley Street, London, W1G 7HX, UK; Division of Gerodontics and Removable Prosthodontics, University of Geneva, Geneva, Switzerland.
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7
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Ahumada-DeGirolamo D, Azocar A, Delpiano-Mesina C, Maldonado-Cortés P, Muñoz MA, Luque-Martínez I, Bravo-Gallardo F. Splinting or non-splinting of fixed prostheses on adjacent implants: A critical review. J Prosthodont Res 2024; 68:206-214. [PMID: 37648482 DOI: 10.2186/jpr.jpr_d_22_00220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted. STUDY SELECTION A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart. RESULTS A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design. CONCLUSIONS The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
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Affiliation(s)
| | - Andrea Azocar
- Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Carlos Delpiano-Mesina
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Pedro Maldonado-Cortés
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Miguel Angel Muñoz
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Issis Luque-Martínez
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Francisco Bravo-Gallardo
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
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Al-Juboori MJ, Al-Attas MA, Minichetti J, Akhikar J. The Use of Splinted Versus Nonsplinted Prosthetic Design in Dental Implants: A Literature Review. J ORAL IMPLANTOL 2024; 50:50-64. [PMID: 38329841 DOI: 10.1563/aaid-joi-d-23-00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
The choice of a splinted or nonsplinted implant-supported prosthesis should be based on solid scientific evidence that considers the conditions and needs of each patient. This review elaborates on the factors that directly influence clinical decisions between splinted or nonsplinted dental implants. Digital and manual searches of the published literature were conducted to identify studies that examined splinted prostheses (SPs) and nonsplinted prostheses (NSPs). The search terms used, alone or in combination, were "splinting prosthesis," "nonsplinting prosthesis," "prosthetic design," "stress distribution in dental implant," "implant loading," "implant occlusion," and "crestal bone resorption." Ninety-four studies were selected to compare and address the details emphasized in this study. Thirty-four reported articles were not directly related to restoration design but were reviewed to better understand the influence of mechanical risk factors, finite element analysis limits, and criteria for implant survival and treatment success. There are advantages and disadvantages of splinting implants together. NSPs are the ideal choice because they resemble natural teeth. Splinting a restored implant will cause the implant to appear as part of one unit and is indicated in more compromised situations, unfavorable conditions, or when pontic spaces and cantilevers are needed in implant prostheses.
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Affiliation(s)
| | | | - John Minichetti
- Department of Dentistry, Englewood Hospital, Englewood, NJ, USA
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9
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Sisli SN, Gul-Ates E, Ozcelik TB, Yilmaz B, Revilla-León M. Survival of root canal-treated teeth adjacent to an implant: A retrospective case-control study. J Dent 2023; 139:104742. [PMID: 37839623 DOI: 10.1016/j.jdent.2023.104742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES To evaluate the survival of root canal treated (RCT) teeth adjacent to an implant compared with that of RCT teeth of the same patient non-adjacent to an implant. MATERIALS AND METHODS RCT tooth of each patient adjacent to an implant were included in the test group. The control group consisted of another RCT tooth of the same patient; the control RCT tooth was not adjacent to an implant and selected to be of the same type of the RCT tooth in the test group. 72 teeth of 36 patients with at least 4-year follow-up were included. In addition to survival, other clinical and demographic parameters investigated were age, sex, tooth type and position, presence of a crown, presence of retreatment, presence of a post-core, presence of adjacent edentulous area, presence of implant-supported fixed prosthetic restoration on the antagonist tooth and periapical health status. Pearson Chi-Square and Fisher Exact tests were used to compare the test and the control groups with categorical variables (α=0.05). Survival curves were obtained by the Kaplan-Meier method, and the Log-rank test was performed to compare the survival probabilities (α=0.05). RESULTS No significant difference in survival rates was observed between the test and the control groups (p = 0.72). Similarly, no significant relationship was found between the investigated clinical variables and the survival rates of RCT teeth (p>0.05). Survival times differed depending on the presence of an adjacent edentulous area (p<0.001) and the periapical health status (p = 0.026). CONCLUSIONS RCT teeth with unhealed periapical tissues had a shorter cumulative survival time. Similarly, those adjacent to an edentulous area had shorter cumulative and complication-free survival times. CLINICAL SIGNIFICANCE This is the first study to determine the survival outcome of a RCT tooth adjacent to an implant compared to a non-adjacent one in the same patient. Being adjacent to an implant did not have a detrimental effect on the survival time and rate of RCT teeth.
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Affiliation(s)
- S N Sisli
- Department of Endodontics, School of Dentistry, Baskent University, Ankara, Turkey.
| | - E Gul-Ates
- Department of Biostatistics, Faculty of Medicine, Baskent University, Ankara 06490, Turkey; Institutional Big Data Management Coordination Office, Middle East Technical University, Ankara, Turkey
| | - T B Ozcelik
- Department of Prosthodontics, School of Dentistry, Baskent University, Ankara, Turkey
| | - B Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, OH, USA
| | - M Revilla-León
- AEGD Residency, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, TX, USA; Affiliate Faculty Graduate Prosthodontics, Restorative Dentistry Department, School of Dentistry, University of Washington, Seattle, WA, USA; Researcher at Revilla Research Center, Madrid, Spain
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10
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Giglio GD, Giglio AB. Achieving optimal implant esthetics using a team approach Part 1 a review of evidence-based criteria in implant treatment. J Prosthet Dent 2023; 130:661-662. [PMID: 37739881 DOI: 10.1016/j.prosdent.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
As dental implants have evolved into a universally accepted treatment option, it is essential to identify nuances of the peri-implant complex and their impact on treatment given the increasing evidence of peri-implantitis and implant loss. A thorough knowledge of anatomy and biology, careful treatment planning, correct placement, prosthetic and occlusal design, and proper long-term maintenance all play a role in dental implant therapy. The goal of this part 1 presentation is to review evidence-based criteria in implant treatment including the surgical and restorative parameters, and the desired implant features, with the objective of achieving predictable results that improve the longevity of the implant and restoration, maintain peri-implant health, and optimize the esthetic outcome. By following science-based guidelines, implant treatment can be improved and simplified with more predictable results, especially in the esthetic zone, where demands are greater and there is less room for error.
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Affiliation(s)
- Graziano D Giglio
- Adjunct Clinical Associate Professor, Advanced Education Program in Prosthodontics, New York University College of Dentistry, New York, NY.
| | - Ana Becil Giglio
- Adjunct Clinical Associate Professor, Advanced Education Program in Periodontics and Implant Dentistry, New York University College of Dentistry, New York, NY
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11
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Galindo-Moreno P, Catena A, Lopez-Chaichio L, Borges T, O’Valle F, Torrecillas-Martínez L, Padial-Molina M. The Influence of History of Severe Periodontitis on Estimated Long-Term Marginal Bone Loss around Implants Restored with Fixed Segmented Full-Arch Rehabilitation. J Clin Med 2023; 12:6665. [PMID: 37892803 PMCID: PMC10607884 DOI: 10.3390/jcm12206665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the long-term marginal bone level (MBL) of implants supporting fixed full-arch restoration in patients who had previously lost their dentition due to severe periodontitis. This retrospective study included 35 patients in whom 342 implants with internal tapered conical connections were placed. MBL was analyzed radiographically over time and a long-term estimation of MBL was calculated. A mixed linear model with abutment height, graft, diameter and location (maxilla/mandible) as factors and gender, age, implant length and prosthetic variables as covariates was used to evaluate the influence on MBL. MBL in these patients showed an estimator of predictions at 4108 days after loading of -0.307 mm, SE = 0.042. Only 0.15% of implants were radiographically affected with MBL of 3 mm or more. The mixed linear model results showed a main effect of the type of opposing dentition, gender, implant diameter, and abutment height. Particularly, an abutment height of 1 mm had associated larger MBL than the remaining heights. Thus, it can be concluded that dental implants restored with fixed segmented full-arch rehabilitation in patients with a history of severe periodontal disease do not suffer important marginal bone loss if some specific factors are considered, mainly the use of long transmucosal abutments (≥2 mm).
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
| | - Andres Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, 18071 Granada, Spain
| | | | - Tiago Borges
- Centre of Interdisciplinary Research in Health, and Faculty of Dentistry, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
| | - Francisco O’Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Department of Pathology and IBIMER, School of Medicine, University of Granada, 18071 Granada, Spain
| | - Laura Torrecillas-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Private Practice, 18008 Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
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12
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Yu SH, Saleh MHA, Wang HL. Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision-making process. Periodontol 2000 2023; 93:107-128. [PMID: 37529966 DOI: 10.1111/prd.12512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between a simultaneous or staged approach involves considering multiple variables. This paper proposed a decision-making process that serves as a guideline for choosing the best treatment choice based on the available evidence and the author's clinical experience.
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Affiliation(s)
- Shan-Huey Yu
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Private Practice, Vienna, Virginia, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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14
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Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, Burgess J, Peschke A, Heintze SD, Kühnisch J. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig 2023; 27:2573-2592. [PMID: 36504246 PMCID: PMC10264483 DOI: 10.1007/s00784-022-04814-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document. MATERIALS AND METHODS An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision. RESULTS Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1-4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match). CONCLUSION The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling. CLINICAL RELEVANCE The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.
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Affiliation(s)
- Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Sabine Mesinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Niek Opdam
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Loomans
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Trieste, Italy and Children's Hospital "Burlo Garofolo," Institute for Maternal and Child Health, Trieste, Italy
| | - John Burgess
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Arnd Peschke
- IvoclarVivadent AG, Research & Development, Schaan, Liechtenstein
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
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15
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Rutkowski JL, Iyer S. Occlusion and Dental Implants-Where Are We? J ORAL IMPLANTOL 2023; 49:229-232. [PMID: 37315320 DOI: 10.1563/aaid-joi-d-4903.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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16
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Wu ML, Lai PY, Cheong F, Zhou WC, Xu SH, Li H, Shen S. Application in the analysis of the occlusal force of free-end missing tooth implant restoration with T-SCAN III. Front Bioeng Biotechnol 2023; 11:1039518. [PMID: 37091346 PMCID: PMC10116052 DOI: 10.3389/fbioe.2023.1039518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/07/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction: The occlusal force of the teeth in the dental arch and the remaining adjacent natural teeth will change after implant restoration with a free-end missing tooth. This study intends to use the T-SCAN III scanner to collect dynamic quantitative data before and after the restoration of free-end implants and to explore the application of the T-SCAN III in redistributing the occlusal force of free-end implants.Methods: In this study, 24 patients with free-end implant restoration were selected, and their occlusion was tested before, immediately after, and 3 months after implant restoration.Results: In all 24 cases, the bite force of the first natural tooth adjacent to the implanted tooth after restoration changed from 19.12% ± 9.48%–12.93% ± 11.47% (p < 0.01). For additional data analysis, all cases were further subdivided by single implant and fixed bridge restorations. In 17 cases, there was a successful follow-up after 3 months. The percentage of the total bite force of dental arch with implant increased from 41.92% ± 10.78%–53.06% ± 10.71% (p < 0.01).Discussion: This study shows that the free-end implant restoration protects the remaining natural teeth, and the patient’s missing dental arch bite force improves within 3 months of implant restoration.
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Affiliation(s)
- Ming-Le Wu
- Department of Stomatology, Affiliated Stomatological Hospital of Jinan University (Daliang Hospital Shunde District Foshan City), Foshan City, Guangdong Province, China
| | - Peng-Yu Lai
- School of Stomatology, Jinan University, Guangzhou City, Guangdong Province, China
| | - Fan Cheong
- School of Stomatology, Jinan University, Guangzhou City, Guangdong Province, China
| | - Wen-Cheng Zhou
- School of Stomatology, Jinan University, Guangzhou City, Guangdong Province, China
| | - Sang-Hui Xu
- School of Stomatology, Jinan University, Guangzhou City, Guangdong Province, China
| | - Hui Li
- Department of Otorhinolaryngology and Head Neck Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Shan Shen, ; Hui Li,
| | - Shan Shen
- Department of Stomatology, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Shan Shen, ; Hui Li,
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Ding Q, Pu T, Tu Y, He M, Wang S, Zhang L, Liu J, Zhou Y. Effect of a novel interocclusal recording method on occlusal accuracy of implant-supported fixed prostheses: A randomized clinical trial. Clin Oral Implants Res 2023; 34:275-284. [PMID: 36695644 DOI: 10.1111/clr.14040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To investigate the effect of a novel interocclusal recording method on the occlusal accuracy of implant-supported fixed prostheses for partially dentate patients with distal extension. MATERIALS AND METHODS Twenty patients with two or more adjacent teeth missing in the distal extension and scheduled to receive implant-supported fixed prostheses were enrolled. Two interocclusal recording methods were used: placing polyvinyl siloxane (PVS) on the interocclusal recording caps (test), and placing PVS on healing abutments (control). The intraoral occlusal contacts in maximal intercuspal position (MIP) were compared with those in the mounted casts to calculate sensitivity and positive predictive value (PPV). Then, patients were randomly allocated into two groups to determine which interocclusal record would be used. The implant prostheses' evaluations mainly included occlusal adjustment height, volume, and time, occlusal contact score based on articulating paper examination. Paired-samples t-test, Mann-Whitney U test, and least squares regression analyzed the statistic differences. RESULTS The test method had higher sensitivity to detect intraoral occlusal contacts than the control method (p = .002), but similar PPV (p = .10). During the prostheses' evaluations, the occlusal adjustment height in the test group was significantly lower than that in the control group [99.4 (53.2, 134.2) vs. 159.0 (82.3, 247.8) μm, p = .03], while the occlusal contact score before adjustment was higher (p = .006). The groups had similar occlusal adjustment volume and time. CONCLUSIONS The novel interocclusal recording method for implant-supported fixed prostheses was more accurate and could reduce the occlusal adjustment.
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Affiliation(s)
- Qian Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Tingting Pu
- Denture Processing Center, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Ya Tu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Mingzhu He
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Shimin Wang
- Denture Processing Center, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Jianzhang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
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18
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Zhou T, Mirchandani B, Li XX, Mekcha P, Buranawat B. Quantitative parameters of digital occlusal analysis in dental implant supported restorative reconstruction recent 5 years: a systematic review. Acta Odontol Scand 2023; 81:1-17. [PMID: 35617455 DOI: 10.1080/00016357.2022.2077980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aims of this systematic review were to evaluate the clinical masticatory performance of implant-supported restorations, observe the occlusal force changes in the distribution of the implant restoration and reveal the positive and negative contributing factors of implant design and components based on the outcomes of digital occlusal measurement. MATERIAL AND METHODS An extensive search was conducted through PubMed and CENTRAL to identify clinical trials on implant-retained restorations using digital occlusal analysis methods. Two researchers assessed the identified studies and data extraction independently, and the data synthesis strategies without meta-analysis that summarizes the effect estimates were adopted. RESULTS The search screened 3821 titles and abstracts, then full-text analysis for 26 articles was performed, and 14 studies were included in the quantitative synthesis. Four of six studies for implant-retained overdenture showed statistically significant improved bite force when immediate loading (p = .00045, .00005, .00055, and .00005, respectively), and no statistically significant results in the other two studies (p = .225, .371, respectively.) However, the results of the favoured intervention were not statistically significant (p = .104, .166, respectively) in two studies of single posterior implant restorations. In all three studies, the bite force distributed on the implant prostheses of partially fixed implant-retained restoration increased statistically significantly (p = .013, .001, .05, respectively). CONCLUSIONS The edentulous restoration supported by implants seems to significantly improves bite force and chewing efficiency compared with conventional dentures. Regular quantitative occlusal measurement is recommended to avoid the possible risk of overload. Smaller implants size and relatively small and flexible attachment designs may be more conducive to the stability and retention of the restoration of atrophy of alveolar bone.
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Affiliation(s)
- Ting Zhou
- Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China.,Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Bharat Mirchandani
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Xing-Xing Li
- Department of Prosthodontics, School of Stomatology, Kunming Medical University, Yunnan, PR China
| | - Pichaya Mekcha
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontics and Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
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19
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Venugopalan S, R S, N T, Maiti S. An Analysis of Implant Prosthesis and Its Dynamic Occlusal Contacts. J Long Term Eff Med Implants 2022; 33:1-7. [PMID: 36382699 DOI: 10.1615/jlongtermeffmedimplants.2022038732] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The prosthetic replacement is achieved for the functional aspect of the stomatognathic system. Achieving prosthetic occlusion is challenging and has an occlusal concept of its own when the type of prosthesis varies. The implant occlusion differs for its load transfer concept and longevity. The study was employed to assess the dynamic occlusal contact in implant occlusion through digital means. The study was carried out on implant prosthesis and its dynamic parameters were evaluated using T-Scan Novus (BioResearch, Inc., Brown Deer, WI, USA) in a university hospital setting after collecting 35 patients. Mandibular arch prosthesis tends to swing from high intensity to low or no contacts frequently and when the percentage of implant crown contact at 10% is present there is more of implant protected occlusion achieved. Use of T-Scan Novus can reveal more occlusal details in functional form which can help in achieving new treatment goals.
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Affiliation(s)
- Suresh Venugopalan
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Subhasree R
- Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, India
| | - Thiyaneswaran N
- Department of Implantology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai-77, India
| | - Subhabrata Maiti
- Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, 600077, Tamil Nadu, India
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20
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Tang C, Du Q, Luo J, Peng L. Simultaneous placement of short implants (≤ 8 mm) versus standard length implants (≥ 10 mm) after sinus floor elevation in atrophic posterior maxillae: a systematic review and meta-analysis. Int J Implant Dent 2022; 8:45. [PMID: 36197540 PMCID: PMC9535054 DOI: 10.1186/s40729-022-00443-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The objective of this meta-analysis was to compare the clinical outcomes of using short implants (≤ 8 mm) inserted with osteotome sinus floor elevation (OSFE) and standard implants (≥ 10 mm) inserted with sinus floor elevation (SFE) in atrophic posterior maxillae with insufficient residual bone height (RBH). Methods An electronic search was performed on PubMed, EMBASE, and the Cochrane Library from 1994 to July 2022, in combination with a manual search of references in relevant articles. Randomized controlled trials (RCTs) that compared the clinical results between short and standard implant placement with SFE were included. The primary outcomes were implant survival rate and marginal bone loss (MBL); the secondary outcome was complication rate. Results Three RCTs were included, totaling 138 short and 156 standard implants. The results of the meta-analysis showed no significant differences between the short and standard implant groups in survival rate (RR = 1.02, 95% CI 0.96–1.08, p = 0.570), MBL (MD = − 0.13, 95% CI − 0.32 to 0.07, p = 0.190) and complication rate (intra-surgical complication: RR = 1.14, 95% CI 0.46–2.83, p = 0.770; post-operative complication: RR = 1.34, 95% CI 0.71–2.55, p = 0.370). Conclusions Using short implants (≤ 8 mm) combined with OSFE might be an alternative to standard implants (≥ 10 mm) with SFE when the RBH of the posterior maxilla is insufficient. Based on a short-term clinical observation, short implants with OSFE show good results in terms of survival rate, MBL, and complication incidence. Graphical Abstract ![]()
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Affiliation(s)
- Chenxi Tang
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Qianhui Du
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jiaying Luo
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
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21
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Di Fiore A, Montagner M, Sivolella S, Stellini E, Yilmaz B, Brunello G. Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J Clin Med 2022; 11:jcm11164812. [PMID: 36013048 PMCID: PMC9409652 DOI: 10.3390/jcm11164812] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | | | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Department of Oral Surgery, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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22
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Liao M, Wang C, Wang C, Xu Y. Influence of bone morphology on the mechanobiological stimuli distribution of maxillary anterior labial bone: A biomechanical study. J ESTHET RESTOR DENT 2022; 34:1085-1095. [PMID: 35674468 DOI: 10.1111/jerd.12935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/14/2022] [Accepted: 05/23/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study intended to ascertain the dimensional effects of labial bone thickness and height on the mechanobiological stimuli distribution of maxillary anterior labial bone through biomechanical analysis. MATERIAL AND METHODS Twelve 3D finite element models of an anterior maxillary region with an implant were computer-simulated, including four levels of labial bone thicknesses (2, 1.5, 1.0, and 0.5 mm) and three levels of labial bone heights (normal, reduced by 1/3, reduced by 1/2). A 45° buccolingual oblique load of 100 N was applied to the implant restoration. RESULTS Equivalent stress and principal strain mainly concentrated on crestal bone around the implant neck. The maximum equivalent stress in bone decreased as labial bone mass decreased, while the maximum principal strain and the displacement of dental implant increased as labial bone mass decreased. No significant difference of these three indicators was observed, when the labial bone thickness changed in the range of 2.0-1.0 mm with sufficient labial bone height. CONCLUSIONS In terms of biomechanics, the thickness of labial bone plate was recommended ≥1 mm. Sufficient labial bone height was warranted to prevent the stability of the implants from being seriously affected. The labial bone heights were more effective than thicknesses on the mechanobiological stimuli response of the dental implant-bone system. CLINICAL SIGNIFICANCE For this 3D finite element study, the biomechanical responses under different bone mass conditions were explored, in order to predict the process of bone remodeling and provide valid clinical recommendations for the decision-making process regarding the choices of tissue augmentation for some specific esthetic implantation cases for future clinical applications.
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Affiliation(s)
- Menglin Liao
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Chunjuan Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China.,Key Laboratory of Biomechanics and Mechanobiology (Beihang University), Ministry of Education, China.,School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yamei Xu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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23
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Can Botulinum Toxin-A Contribute to Reconstructing the Physiological Homeostasis of the Masticatory Complex in Short-Faced Patients during Occlusal Therapy? A Prospective Pilot Study. Toxins (Basel) 2022; 14:toxins14060374. [PMID: 35737035 PMCID: PMC9227267 DOI: 10.3390/toxins14060374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023] Open
Abstract
The physiological homeostasis of the masticatory complex in short-faced patients is too robust to be disintegrated and reconstructed due to the powerful masseter muscle. This study innovatively introduced the botulinum toxin-A (BTX-A) into the field of dental occlusal treatment, providing a novel and minimally invasive therapy perspective for the two major clinical problems in these patients (low treatment efficiency and high rates of complications). In total, 10 adult patients with skeletal low angle seeking occlusal treatment (age: 27.0 ± 6.1 years; 4 males and 6 females) were administered 30−50 U of BTX-A in each masseter muscle and evaluated before and 3 months after injection based on cone-beam computed tomography (CBCT). We found a significant reduction in the thickness of the masseter muscle (MMT) (p < 0.0001). With regards to occlusion, we found a significant increase in the height of the maxillary second molar (U7-PP) (p < 0.05) with significantly flattened occlusal curves (the curve of Spee [COS] (p < 0.01), and the curve of Wilson [COW] (p < 0.05)). Furthermore, the variations in the temporomandibular joint exhibited a significant reduction in the anterior joint space (AJS) (p < 0.05) and superior joint space (SJS) (p < 0.05). In addition, the correlation analysis of the masticatory complex provided the basis for the following multiple regression equation: MMT = 10.08 − 0.11 COW + 2.73 AJS. The findings from our pilot study indicate that BTX-A, as a new adjuvant treatment attempt of occlusal therapy for short-faced patients, can provide a more favorable muscular environment for subsequent occlusal therapy through the adjustment of the biting force and may contribute to the reconstruction of healthier homeostasis of the masticatory complex. However, further research is required to establish the reliability and validity of these findings.
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Immediate Maxillary Full-Arch Rehabilitation of Periodontal Patients with Terminal Dentition Using Tilted Implants and Bone Augmentation: A 5-Year Retrospective Cohort Study. J Clin Med 2022; 11:jcm11102902. [PMID: 35629027 PMCID: PMC9147479 DOI: 10.3390/jcm11102902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 12/01/2022] Open
Abstract
Background: All-on-four protocols with tilted implants in the maxilla are used to rehabilitate the terminal dentition of the severe generalized periodontitis patients. Data on long-term biological complications are scarce. Methods: Eighty-four axial and forty-six tilted immediate implants have been placed in the extraction sockets of 23 patients according to a four–six implants protocol combined with ridge augmentation. Within 72 h, a provisional prosthesis was cemented to the implants; after 6 months, a cemented ceramic–metallic prosthesis was delivered. The patients were followed for up to 5 years. Results: The 5-year survival rate of the straight and tilted implants was 100% and 97.8, and the prosthetic one was 100%. Marginal bone loss (MBL) of the straight implants was 0.42 ± 0.67 and 0.59 ±1.01 mm on the mesial and distal sides; for the tilted, it was 0.37 ± 0.68 and 0.34 ±0.62 mm, and the differences were not statistically significant. Implant position, smoking, keratinized mucosal width, and cantilever did not affect MBL. Peri-implant mucositis involved 29.4% and 22.2% of the straight and tilted implants, respectively; peri-implantitis involved 5.8% and 4.4% of the straight and tilted implants, respectively, without statistical significance. Conclusions: This immediate loading protocol’s 5-year survival and success rates were high. No difference between the straight and tilted implants was found regarding survival, success rates, and MBL.
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Yu W, Chen S, Ma L, Ma X, Xu X. Biomechanical Analysis of Different Framework Design, Framework Material and Bone Density in the Edentulous Mandible With Fixed Implant-Supported Prostheses: A Three-Dimensional Finite Element Study. J Prosthodont 2022; 32:309-317. [PMID: 35546271 DOI: 10.1111/jopr.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 04/24/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The objective of this finite element study was to investigate the effect of different framework designs, framework materials, and bone densities on the stress distribution of fixed implant-supported prostheses for edentulous mandibles. MATERIALS AND METHODS Under the condition of 2-mm cortical bone, 16 models were created in the edentulous mandible to simulate different framework designs (1-piece or 3-piece frameworks) with different framework material (pure titanium, zirconia, polyetheretherketone, or carbon fiber-reinforced polyetheretherketone) in-high or low-density trabecular bone. Then, vertical loading and oblique loading at 75° were applied to the anterior and posterior regions. The stress distribution and stress concentration region of implant and peri-implant bone with different combinations were compared by finite element analysis. RESULTS The use of the 1-piece zirconia framework in high-density trabecular bone improved stress distribution on implants and peri-implant bone. The region of stress concentration is located in the buccal cervix of the distal implants and the distobuccal portion of the cortical bone in all models. To improve the stress distribution on fixed implant-supported dentures for edentulous mandibles, the 1-piece framework and zirconia represent the better combinations. CONCLUSION Under the condition of 2-mm cortical bone thickness, the full-arch zirconia framework had minimum von Mises stress on implants and peri-implant bone in all models, and high trabecular bone density greatly decreased the stress on cortical bone. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wenqian Yu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Siyi Chen
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Li Ma
- Department of Vip center, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoni Ma
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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Keshari R, Chand P, Singh BP, Jurel SK, Singh R, Singh PK. Comparison of Crestal Bone Loss and Osteocalcin Release Kinetics in Immediately and Delayed Loaded Implants: A Randomised Controlled Trial. J Prosthodont 2022; 31:579-584. [PMID: 35150170 DOI: 10.1111/jopr.13495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To compare concentration and release kinetics of osteocalcin and crestal bone loss under immediate and delayed loading conditions during osseointegration. MATERIALS AND METHODS Forty-one patients who were indicated for rehabilitation with dental implants randomly received either implant with placement of permanent prosthesis after 3 months (delayed loading) or implant with placement of permanent prosthesis within 7 days (immediate loading). Radiographic assessment of crestal bone loss at the mesial and distal surface was done at 3, 6 and 12 months after implant placement. Peri-implant sulcular fluid was collected immediately from the buccal surface at two sites after implant insertion and also, at 7, 15, 30 and 90 days after surgery. The level of osteocalcin was evaluated using ELISA and data were compared using two sample t-test. Differences between two groups were analyzed by unpaired Student's t test. Intragroup comparison was done by repeated measures ANOVA. RESULTS Mean crestal bone loss was lower in the immediate loading group compared to the delayed loading group at 3, 6 and 12 months (P < 0.001). Intragroup comparison revealed a statistically significant increase in osteocalcin levels in both group I (F = 26712.2) and group II (F = 10497.2) at the predetermined time intervals CONCLUSIONS: Lesser crestal bone loss and early release of osteocalcin was found in the immediately loaded condition than in the delayed loaded condition. The study substantiates that immediately loaded implants shows less crestal bone as well as early release of osteocalcin facilitating upregulation of bone metabolism, improving long term health of bone and prognosis of implants. Immediately loaded implants can be a better treatment protocol provided there is adequate bone and primary stability. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rishabh Keshari
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Pooran Chand
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Balendra P Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Sunit K Jurel
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Ranjana Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Punit Kumar Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
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Occlusal change in posterior implant-supported single crowns and its association with peri-implant bone level: a 5-year prospective study. Clin Oral Investig 2022; 26:4217-4227. [PMID: 35129663 DOI: 10.1007/s00784-022-04394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study aims to analyze the 5-year occlusal change in posterior implant-supported single crowns and the association between the relative occlusal force (ROF) and peri-implant bone level. MATERIALS AND METHODS Partially edentulous patients who had received implant-supported single crowns in the posterior region were included. Occlusal examinations with a computerized occlusion analysis system were conducted at 0.5, 3, 6, 12, 24, 36, 48, and 60 months after delivery of the implant-supported single crown. The ROFs of implant-supported single crowns, mesial adjacent teeth, and control natural teeth were recorded. Intraoral periapical radiographs were taken at each follow-up time to evaluate marginal bone level (MBL). Ordinary least square regression was used to analyze the association between ROF and MBL. RESULTS Thirty-seven posterior implant-supported single crowns in 33 participants (23.9 to 70.0 years) were followed up for 0.5 to 60 months [(42.4 ± 26.0) months]. The ROF of implant-supported single crowns increased from 2 weeks to 3 months (P < 0.01) and increased continuously between all two sequential time points from 6 to 36 months, with significant differences (P < 0.05). Then ROFs of implant-supported single crowns were significantly higher than those of control teeth at 48 and 60 months (P < 0.05). Regression analysis showed that ROF was significantly associated with MBL with a coefficient of 0.008 (P < 0.05). CONCLUSION The ROFs of posterior implant-supported single crown have significant change during 5 years' follow-up. The association between ROF and MBL has limited clinical significance. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR-ROC-17012240. CLINICAL RELEVANCE The occlusion of implant-supported single crowns should be carefully monitored during follow-up examinations, and occlusal adjustment should be considered to prevent overloading.
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Ryan LL, Kohles SS. A temporospatial histomorphometric analysis of bone density adjacent to acid-etched self-tapping dental implants with an external hexagon connection in the female baboon. Clin Oral Investig 2022; 26:2143-2154. [PMID: 34585261 DOI: 10.1007/s00784-021-04195-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To characterize osseointegration as the percent of bone-implant contact (%BIC) along the surface (0.0 mm) as well as at surface profiles 0.5 mm and 1.0 mm lateral to the implant, determining any differences between early occlusally loaded and non-loaded implants. MATERIAL AND METHODS In ten adult female baboons, 120 dental implants were randomly placed in opposing mandibular and maxillary locations. Eighty sites had two groups of healing (no load) of either 1 (n = 40) or 2 (n = 40) months leading to 3 months of functional loading. These sites received full acid-etched surface implants. The 40 control implants represented healing only periods (no load) for 1 (n = 10), 2 (n = 10), 4 (n = 10), and 5 (n = 10) months. These implants were of a vertically split surface texture design (acid-etched and machined). Block sections and photomicrographs were obtained. Blinded histometric analyses determined the %BIC via a superimposed template. RESULTS The unloaded groups (1, 2, and 4 months) had higher %BIC compared to the 5-month group (p < 0.0001). The loaded groups exhibited mean bone densities of 59.2% and 55.5% (1-month healing at 0.5 mm and 1.0 mm, respectively) and 61.0% and 57.1% (2-month healing at 0.5 mm and 1.0 mm, respectively) with no significant difference between healing time (p = 0.4118). CONCLUSION There was a lateral increase in %BIC in the loaded compared to unloaded groups. CLINICAL RELEVANCE The decrease in bone densities at the 5-month unloaded group suggests that there is a critical earlier time period when dental implants should be placed into functional load.
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Affiliation(s)
- Lara L Ryan
- Johnson County Periodontics, Dental Implants, and Laser Surgery, Overland Park, KS, USA
| | - Sean S Kohles
- Kohles Bioengineering, 1731 SE 37th Avenue, Portland, OR, 97214-5135, USA.
- Division of Biomaterials & Biomechanics, School of Dentistry, and Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA.
- Department of Human Physiology, University of Oregon, Eugene, OR, USA.
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Maximal Bite Force Measured via Digital Bite Force Transducer in Subjects with or without Dental Implants—A Pilot Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The aims of the current study were as following: (1) to evaluate the maximal bite forces in patients with dental implants versus patients without dental implants, as measured by a digital bite force transducer (GM10); (2) to evaluate the influences of sex, age, and sleep/awake bruxism on the maximal bite forces of the two groups. Forty patients recruited to the study were divided into two groups: test group (“implant”) if they had one or more posterior restored implants and control group (“no-implant”) without the presence of posterior dental implants. A digital bite fork (GM10) was used to measure the bite forces from three posterior occluding pairs in all participants. Differences in the mean values between the test and control groups and between different sexes were evaluated using one-way and two-way ANOVA tests. A cross-tabulation analysis was conducted to identify a trend line between the groups. There was no significant difference in the maximal bite force between the test and control groups (p = 0.422), but the cross-tabulation analysis revealed a clear trend of a stronger representation of the “no-implant” group at higher occlusal forces. A significant difference was detected between the maximal biting forces of male and female subjects (p = 0.030 in the implant group, p = 0.010 in the no-implant group), regardless of the experimental group. The presence of bruxism and clenching did not influence the bite force values (p = 0.953), and a significant difference was not found between the age groups (p = 0.393). Within the limitations of this study, it may be assumed that there was no significant difference between the maximal bite forces between patients with and without dental implants but that there was a trend line implicating a stronger representation of the “no-implant” group at higher forces. In addition, the results revealed a significant sex-related difference in the maximal occlusal force. Further studies with larger sample sizes are warranted.
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Manchikalapudi G, Basapogu S. Finite Element Analysis of effect of cusp inclination and occlusal contacts in PFM and PEEK implant-supported crowns on resultant stresses. Med J Armed Forces India 2022; 78:80-87. [PMID: 35035048 PMCID: PMC8737102 DOI: 10.1016/j.mjafi.2020.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/12/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Effect of prosthesis design on occlusal overload and long-term implant stability cannot be overstated. In Porcelain Fused to Metal (PFM) crowns, low cusp inclination and occlusal contacts limited to central fossa ensure axially directed forces on an implant but often pose esthetic and functional challenges. It is theorized that resilient Polyetheretherketone (PEEK) crowns have shock absorption capacity for favorable stress distribution. This study compared two implant crown materials and evaluated the effect of cusp inclination and occlusal contact distribution on resultant stresses. METHODS Thirty 3D finite element models of implant-supported PFM and PEEK crowns, generated using Solidedge 3D CAD solid modeling software (v19, Siemens PLM Software Inc.,US), were used to study the effect of 3 cups inclinations (0°, 15°, 30°) under five load conditions, with 300N force distributed over one, two, or three contact areas and exported to ANSYS (v18.1, ANSYS Inc. Pennsylvania, US) for stress analysis. RESULTS Maximum stress in both PFM and PEEK models was at the neck of the implant under Load 3(300N distributed over three contact areas: central fossa, buccal cusp tip, marginal ridge). Minimum stress in all models was under Load 1(300N applied at one contact area in central fossa). Maximum stresses were recorded for 30° cusp inclination in PFM models. CONCLUSION In both PFM and PEEK crown models, contact areas placed away from the implant axis generated greater implant and peri-implant stresses and had more effect on resultant stresses than that of increase in cusp inclination. The effect of cusp inclination on the resultant stresses was dependent on the crown material.
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Affiliation(s)
- Githanjali Manchikalapudi
- Assistant Professor (Prosthodontics), Government Dental College & Hospital, Hyderabad, Telangana, India,Corresponding author.
| | - Sreeramulu Basapogu
- Professor & Head (Prosthodontics), Government Dental College and Hospital, Hyderabad, Telangana, India
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Decker AM, Kapila YL, Wang HL. The psychobiological links between chronic stress-related diseases, periodontal/peri-implant diseases, and wound healing. Periodontol 2000 2021; 87:94-106. [PMID: 34463997 PMCID: PMC8459609 DOI: 10.1111/prd.12381] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic stress is a relevant disease to periodontal practice, encompassing 25%-28% of the US population (American Psychological Association 2015). While it is well established that chronic psychologic stress can have significant deleterious systemic effects, only in recent decades have we begun to explore the biochemical, microbial, and physiologic impacts of chronic stress diseases on oral tissues. Currently, chronic stress is classified as a "risk indicator" for periodontal disease. However, as the evidence in this field matures with additional clinically controlled trials, more homogeneous data collection methods, and a better grasp of the biologic underpinnings of stress-mediated dysbiosis, emerging evidence suggests that chronic stress and related diseases (depression, anxiety) may be significant contributing factors in periodontal/peri-implant disease progression and inconsistent wound healing following periodontal-related therapeutics. Ideal solutions for these patients include classification of the disease process and de-escalation of chronic stress conditions through coping strategies. This paper also summarizes periodontal/implant-related therapeutic approaches to ensure predictable results for this specific patient subpopulation.
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Affiliation(s)
- Ann M Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Yvonne L Kapila
- Department of Orofacial Sciences, University of California San Francisco School of Dentistry, San Francisco, California
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
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Yesilyurt NG, Tuncdemir AR. An evaluation of the stress effect of different occlusion concepts on hybrid abutment and implant supported monolithic zirconia fixed prosthesis: A finite element analysis. J Adv Prosthodont 2021; 13:216-225. [PMID: 34504673 PMCID: PMC8410301 DOI: 10.4047/jap.2021.13.4.216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.
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Affiliation(s)
| | - Ali Riza Tuncdemir
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
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Nelluri VV, Roseme KM, Gedela RK. A 3-year prospective cohort study on mandibular anterior cantilever restorations associated with screw-retained implant-supported prosthesis: An in vivo study. J Indian Prosthodont Soc 2021; 21:150-160. [PMID: 33938864 PMCID: PMC8262442 DOI: 10.4103/jips.jips_446_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aim: The aim of this study is to evaluate the survival of single implant supported cantilever prosthesis (ISCP) replacing missing two adjacent natural teeth in the anterior mandible. Settings and Design: In vivo - Prospective cohort study. Materials and Methods: Thirty patients with missing both mandibular central incisors were selected. A single implant was used to replace the missing teeth and restored with cantilever screw-retained prosthesis. Twenty-two patients were followed for 3 years for the implant and prosthetic success. Statistical Analysis Used: Weibull test for survival probability. Results: Survival probability of the ISCP for the first 100 days was found to be 97.55%, for 200 days, it was 71.4%, for 250 days, it was 46%, and for 365 days, it was 3.9%, i.e., 20 prosthesis had screw loosening after prosthetic loading. However, it increased to 95.2% at the end of 3 years. Conclusion: Screw-retained ISCP developed early technical complications. After prosthetic loading, the survival probability of the screw-retained ISCP was very low (3.9%) at one year, which increased to 95.2% after retightening and retorquing of the abutment screw, porcelain repair and conformation of the tongue to the prosthesis. The most common prosthetic failure was screw loosening (81%), followed by porcelain fracture (14.3%), and implant survival of 95% at the end of three years.
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Affiliation(s)
| | | | - Rajani Kumar Gedela
- Department of Periodontics, Army College of Dental Sciences, Secunderabad, Telangana, India
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34
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Dini C, Borges GA, Costa RC, Magno MB, Maia LC, Barão VAR. Peri-implant and esthetic outcomes of cemented and screw-retained crowns using zirconia abutments in single implant-supported restorations-A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:1143-1158. [PMID: 34352144 DOI: 10.1111/clr.13824] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the peri-implant tissue changes and esthetic outcomes of cemented and screw-retained crowns of single-tooth implants in the esthetic zone using zirconia abutments. MATERIAL AND METHODS An electronic search was performed on nine databases. The risk-of-bias was assessed by the revised Cochrane risk-of-bias tool for randomized (RoB 2) and non-randomized (ROBINS-I) clinical trials. Marginal bone level change, soft tissue thickness, bleeding on probing, probing depth, survival rates of implants and crowns, complications, plaque and papilla indexes, and pink esthetic score data were extracted and analyzed. The certainty of evidence was accessed through the GRADE approach. RESULTS Nine records were included and 7 were used in the meta-analyses. Screw-retained crowns presented greater marginal bone level change (MD -0.04 [-0.08, -0.00] p = 0.04, I2 = 0%) compared to cemented crowns up to 1-year. At 3 and 4 years no significant differences (p > 0.05) were observed. Soft tissue thickness did not differ between groups (p > 0.05). The bleeding on probing was higher in cemented group than in screw-retained crowns at 1-year (MD 0.17 [0.08, 0.27] p = 0.0005, I2 = 0%), at medium-term periods (3 and 4 years) no statistically significant differences (p > 0.05) were observed for this outcome. Probing depth, survival rates of implants and crowns, complications, and plaque index, as well as esthetic analysis using the papilla index and pink esthetic score did not differ statistically (p > 0.05) between both retention systems at short and medium-term periods. CONCLUSION The connection system considering zirconia abutments presented no influence on peri-implant parameters and esthetics evaluation for medium-term periods (3 and 4 years).
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Affiliation(s)
- Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Raphael Cavalcante Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rua Rodolpho Paulo Rocco - Cidade Universitária, Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP, Piracicaba, Brazil
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Zhou T, Wongpairojpanich J, Sareethammanuwat M, Lilakhunakon C, Buranawat B. Digital occlusal analysis of pre and post single posterior implant restoration delivery: A pilot study. PLoS One 2021; 16:e0252191. [PMID: 34214089 PMCID: PMC8253389 DOI: 10.1371/journal.pone.0252191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives The purposes of this study were to analyze the effects of single posterior implant restorations delivery on the redistribution of bite force and to evaluate the changes in occlusal force distribution of prostheses and potential influencing factors on occlusion variation at different stages. Materials and methods Thirty-two single posterior restorations in 30 participants (18 women and 12 men aged 27 to 75 years) were placed into either a unilateral single-tooth defect (n = 17) or on either side of a bilateral teeth defects (n = 15). The bite force (%) of the prostheses, teeth and segments at the maximum intercuspation position (MIP) was evaluated using a T-scan at 5 stages (pre-placement, immediately following placement, and 2 weeks, 3 months, and 6 months post-placement). Results The occlusal force of implant-supported prostheses was significantly (P = .000) lower than those of the control natural teeth at the baseline, then no significant difference was found with that of the mesial teeth at 3 months, and finally it was significantly (P = .000) lower than that of the distal teeth at 6 months; meanwhile, it significantly (P = .008) increased by a mean of 2.04 times from 2 weeks (3.39 ± 2.61%) to 3 months (6.90 ± 4.77%), whereas no significant difference (P = .900) was found from 3 months (6.90 ± 4.77%) to 6 months (7.31 ± 4.60%). In addition, the bite force of the posterior segment on the restored side of both unilateral and bilateral gaps was significantly (P = .013,.001) improved by 3.31% and 6.83%, respectively, although the discrepancy in bite force significantly (P = .039) increased from an initial 3.52% to 5.02% for subjects with bilateral defects, accompanying increases in the proportion (15.38%) of the level III bilateral bite force deviation (P >.05). Conclusions Bite force and masticatory ability can be improved with the immediate delivery of a single posterior implant restoration. The bite force distributed on the implant prosthesis inevitably increases after placement of implant prostheses, a routine follow-up and occlusal evaluation are strongly needed.
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Affiliation(s)
- Ting Zhou
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
- Department of Orthodontics, School of Stomatology, Kunming Medical University, Yunnan, China
| | - Jirapa Wongpairojpanich
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Maytha Sareethammanuwat
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Charukrit Lilakhunakon
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontics & Implant Dentistry, Faculty of Dentistry, Thammasat University, Phatum Thani, Thailand
- * E-mail:
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Gvetadze RS, Strekalov AA, Smerdov AA. [Study of the effect of the occlusal surface of a natural tooth and fixed partial dentures supported by dental implants on the stress distribution by finite element analysis]. STOMATOLOGII︠A︡ 2021; 100:13-18. [PMID: 34180619 DOI: 10.17116/stomat202110003113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the effect of the occlusal surface of a natural tooth, cement-retained and screw-retained fixed partial dentures supported by dental implants and the coefficient of friction on the stress distribution in the peri-implant bone at maximum and minimum principal stresses. MATERIAL AND METHODS Study of maximum and minimum principal stresses in models with natural teeth and artificial crowns supported by dental implants, taking into account the coefficient of friction using the finite element analysis. RESULTS In models represented by fixed partial dentures supported by dental implants and a natural tooth, the maximum tensile stresses arise in the cortical bone in the cervical region of the artificial crown, and the maximum compressive stresses occur both in the cortical layer in the cervical region of the artificial crown and in the cervical region of the tooth. In models with two fixed partial dentures supported by dental implants or two natural teeth, the stress distributions in the cortical layers in the upper and lower jaw are almost identical. CONCLUSION Modeling the antagonist and adding to the FEA model is important in order to determine the precise and realistic direction of the resulting force vector. Amplification of the number of contact areas should be considered when modeling the occlusal surface of artificial crowns supported by dental implants.
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Affiliation(s)
- R Sh Gvetadze
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A A Strekalov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A A Smerdov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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37
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Papazoglou E, Charalambous C. Analog-digital hybrid impression technique in an elderly patient: A case report. Clin Case Rep 2021; 9:2179-2184. [PMID: 33936659 PMCID: PMC8077252 DOI: 10.1002/ccr3.3975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 11/24/2022] Open
Abstract
The hybrid impression technique consists of an initial alginate impression that provides a preoperative cast upon which a diagnostic wax-up and a silicone index are made. The wax-up is digitized; thus, the final altered digital impression is limited to absolute minimum time, effort and ensures comfort for the patient.
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Affiliation(s)
- Efstratios Papazoglou
- Department of Operative DentistrySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
| | - Constantinos Charalambous
- Postgraduate program in Restorative DentistrySchool of DentistryNational and Kapodistrian University of AthensAthensGreece
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38
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Goldstein G, Goodacre C, Taylor T. Occlusal Schemes for Implant Restorations: Best Evidence Consensus Statement. J Prosthodont 2021; 30:84-90. [PMID: 33783094 DOI: 10.1111/jopr.13319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Numerous studies have focused on the various complications with implant-retained restorations and a common thread in these publications is the potential for occlusal overload. The purpose of this Best Evidence Consensus Statement on implant occlusal schemes was to review the literature to determine the level of scientific evidence upon which the articles are based. MATERIALS AND METHODS Limiting the search to Clinical trials, Randomized Controlled Trials, Systematic Reviews, Meta-analyses, the key words: dental implants, occlusion, found no citations. Expanding the search to Journal articles found 1,483 results, 20 of which pertained to the question. Doing a similar search including Journal Articles, the key words: dental implants and occlusal scheme found 47 citations, 17 of which were pertinent to the question. RESULTS After eliminating duplicates and non-relevant articles, 15 were included in the review. Nineteen additional articles were culled by going through the reference lists in the aforementioned articles. CONCLUSIONS There is a lack of scientific evidence regarding the occlusal scheme utilized with implant restorations that will minimize or eliminate complications. In light of this lack of scientific evidence, the style of occlusion a practitioner utilizes with tooth or mucosal supported prostheses may be used with implant-supported restorations until compelling evidence dictates otherwise.
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Affiliation(s)
| | - Charles Goodacre
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Thomas Taylor
- Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, CT
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39
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Goldstein G, Wiens JP. The Occlusion Project, Evidence for its Future. J Prosthodont 2021; 30:3-4. [PMID: 33783086 DOI: 10.1111/jopr.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/27/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Jonathan P Wiens
- Adjunct Clinical Professor, Department of Restorative Dentistry, University of Detroit Mercy School of Dentistry, Detroit, MI
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40
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Bozyel D, Taşar Faruk S. Biomechanical Behavior of All-on-4 and M-4 Configurations in an Atrophic Maxilla: A 3D Finite Element Method. Med Sci Monit 2021; 27:e929908. [PMID: 33774647 PMCID: PMC8015646 DOI: 10.12659/msm.929908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In edentulous patients, the concept of 4 implants with early loading has been widely used in clinical settings. In the case of bone atrophy in the anterior maxilla, using short implants or an angulated implant may be a good choice for treatment. The occlusal scheme remains a key aspect of All-on-4. The aim of this study was to use the 3-dimensional (3D) finite element method (FEM) to evaluate how different All-on-4 designs for canine-guided and group function occlusion affected the distribution of stress in the atrophic premaxilla. MATERIAL AND METHODS A 3D edentulous maxilla model was created and in 3D FEM, 3 different configurations - M4, All-on-4, and short implant - were modeled by changing the anterior implants and using 2 different occlusal schemes. For each model, the occlusal load was applied to simulate lateral movements. For cortical bone, the maximum and minimum principal stress values were generated, and for ductile materials, von Mises stress values were obtained. RESULTS No significant differences were detected among the models; generally, however, the highest stress values were observed in the M-4 model and the models with short implants. Slightly higher stress values were observed in the group function occlusion group than in the canine-guided occlusion group. CONCLUSIONS To promote better primary stabilization, M-4 or short implant configurations with canine-guided occlusion appear to be preferable for patients who have severe atrophy in the anterior maxilla.
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Affiliation(s)
- Delal Bozyel
- Department of Prosthodontics, Near East University, Nicosia, Cyprus
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41
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Carosi P, Lorenzi C, Lio F, Laureti M, Ferrigno N, Arcuri C. Short implants (≤6mm) as an alternative treatment option to maxillary sinus lift. Int J Oral Maxillofac Surg 2021; 50:1502-1510. [PMID: 33637392 DOI: 10.1016/j.ijom.2021.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/15/2020] [Accepted: 02/06/2021] [Indexed: 02/03/2023]
Abstract
The aim of this systematic review was to evaluate survival rate of short dental implants placed in the posterior area of the maxilla. The electronic literature search of studies published between January 1, 2010 and February 29, 2020 was performed using specific word combinations. The outcome was to meta-analyse the implant survival rate (ISR). The search generated 238 potential studies. After screening procedures, only nine randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. ISR of short implants ranged from 91.9% to 100%, while standard-length implants ISR ranged from 82.9% to 100% with a follow-up from 1 to 5 years in function. The risk ratio difference was 1.24 (95% confidence interval: 0.63-2.45, P=0.52) for short dental implants failure when compared with standard dental implants, and was not statistically significant. Based on the evidence of the included studies, short implants (≤6mm) reported high survival rates over short to medium follow-up in posterior maxilla, but the long-term success is as yet not demonstrated.
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Affiliation(s)
- P Carosi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy.
| | - C Lorenzi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - F Lio
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - M Laureti
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - N Ferrigno
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Rome 'Tor Vergata', Rome, Italy
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Shen XT, Li JY, Luo X, Feng Y, Gai LT, He FM. Peri-implant marginal bone changes with implant-supported metal-ceramic or monolithic zirconia single crowns: A retrospective clinical study of 1 to 5 years. J Prosthet Dent 2021; 128:368-374. [PMID: 33618860 DOI: 10.1016/j.prosdent.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia has excellent mechanical and biologic properties. However, evidence of the clinical properties of implant-supported monolithic zirconia prostheses is limited. PURPOSE The purpose of this retrospective clinical study was to compare the peri-implant marginal bone changes of metal-ceramic and monolithic zirconia single crowns in the posterior region after prosthetic loading. MATERIAL AND METHODS A total of 224 participants treated with 327 implants restored with either metal-ceramic or monolithic zirconia single crowns in the posterior region between 2012 and 2016 were included in this study. Clinical outcomes, including the plaque index, peri-implant probing depth, and bleeding on probing, were recorded, and the marginal bone level was recorded by using the panoramic radiographs obtained at implant placement, second-stage surgery, and the most recent follow-up visit. The included parameters were analyzed with the nonparametric Mann-Whitney tests (α=.05). RESULTS The mean follow-up time was 30.4 months, and the cumulative survival rate of implants was 100% and that of the prostheses was 99.1%. The plaque index was 0.46 in the metal-ceramic group, which was significantly higher (P<.05) than 0.37 in the monolithic zirconia group. However, no significant differences (P>.05) were observed in peri-implant probing depth and bleeding on probing between the 2 groups. The marginal bone level at implant placement, second-stage surgery, and the most recent follow-up visit was above the implant platform in both the metal-ceramic and monolithic zirconia groups. The marginal bone changes of the metal-ceramic group was 0.31 mm in the healing period and 0.38 mm in the prosthetic loading period, while in the monolithic zirconia group, it was 0.25 mm in the healing period and 0.43 mm in the prosthetic loading period; no significant differences (P>.05) were observed between the 2 groups. CONCLUSIONS The peri-implant marginal bone level change was comparable after prosthetic loading for metal-ceramic and monolithic zirconia single crowns, although monolithic zirconia was associated with reduced plaque.
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Affiliation(s)
- Xiao-Ting Shen
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, PR China
| | - Jia-Ying Li
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Xin Luo
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yi Feng
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Li-Ting Gai
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Fu-Ming He
- Chief physician, Department of Oral Implantology and Prosthodontics, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, PR China.
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Leighton Y, Carpio L, Weber B, Dias FJ, Borie E. Clinical evaluation of single 4-mm implants in the posterior mandible: A 3-year follow-up pilot study. J Prosthet Dent 2020; 127:80-85. [PMID: 33234301 DOI: 10.1016/j.prosdent.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Extra-short implants in the posterior mandible can increase the functional surface area and reduce the risk of implant overload. However, reports of treatment using single extra-short implants in the posterior mandible with a midterm follow-up are lacking. PURPOSE The purpose of this prospective pilot study was to evaluate the clinical behavior of single extra-short 4-mm implants placed in the posterior mandible during a follow-up of 3 years from implant restoration. MATERIAL AND METHODS A total of 18 participants with a single extra-short 4-mm-long implant placed in the area of the mandibular first molars participated in this pilot study. The survival and success rates of implants, as well as biologic and prosthetic variables, were evaluated during a follow-up of 3 years from implant restoration. RESULTS The survival rate of the implants was 100%, with no implant or biologic complications recorded. One prosthetic complication (loosening of 1 screw) was observed. CONCLUSIONS Single extra-short (4 mm) implants in the posterior mandible showed favorable clinical behavior during the first 3-years of follow-up.
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Affiliation(s)
- Yerko Leighton
- Professor, Department of Oral Implantology, Universidad de Los Andes, Santiago, Chile
| | - Luis Carpio
- Professor, Department of Prosthodontics, Universidad de Cuenca, Cuenca, Ecuador
| | - Benjamin Weber
- Assistant Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile
| | - Fernando Jose Dias
- Associate Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile
| | - Eduardo Borie
- Associate Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile.
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Shi JY, Qian SJ, Gu YX, Qiao SC, Tonetti MS, Lai HC. Long-term outcomes of osteotome sinus floor elevation without grafting in severely atrophic maxilla: A 10-year prospective study. J Clin Periodontol 2020; 47:1528-1535. [PMID: 32929768 DOI: 10.1111/jcpe.13365] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/27/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of the present study was to report 10-year results of osteotome sinus floor elevation (OSFE) without grafting severely atrophic maxilla (residual bone height ≤4 mm). MATERIALS AND METHODS Patients undergoing OSFE without grafting and implant placement were included for 10-year examinations. Implant survival, complication-free survival, modified bleeding index (mBI), modified plaque index (mPI), pocket probing depth (PPD), peri-implant marginal bone loss (MBL), endo-sinus bone gain (ESBG) and mean cost of recurrence were evaluated. RESULTS Overall, 23 patients with 35 implants attended 10-year examination. Cemented implant crowns or implant-supported fixed dental prostheses were delivered to the patients. Kaplan-Meier implant survival was 89.2% at implant level and 84.1% at patient level. Complication-free survival was 26.0% at patient level and 37.0% at implant level. The average complication-free survival time was 74.6 months (95% CI: 63.2-86.0 months) at implant level and 69.1 months (95% CI: 54.8-83.4 months) at patient level. The mBI, mPI, PPD, MBL and ESBG at 10-year follow-up were 0.91 ± 0.58, 0.48 ± 0.51, 2.94 ± 0.79 mm, 1.63 ± 0.83 mm and 2.72 ± 0.51 mm, respectively. The cost of managing recurrence was 43.6% of the initial cost of treatment. CONCLUSION The results of the present study indicate that OSFE without grafting is a reliable treatment option in severely atrophic maxilla. Acceptable survival rate, stable MBL and ESBG could be achieved within 10 years. Low complication-free survival and high costs of recurrence management need to be considered.
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Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Ying-Xin Gu
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Maurizio S Tonetti
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,European Research Group on Periodontology, Berne, Switzerland
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Abstract
The advent of new technologies in the field of medicine and dentistry is creating improvements that lead clinicians to have materials and procedures able to improve patients’ quality of life. The aim of this article is to evaluate occlusion load and its consequences on fixed implant-supported prosthesis. New materials have granted clinicians the possibility achieve great aesthetic results in dental prosthesis, and new procedures allow them to standardize and give precise and repeatable results, especially for the functional and long-term stability aspects of products. Some principles should be carefully evaluated and applied to every dental prosthesis; the evaluation of the forces and fitting of meso-structures to dental implants, an aspect that is often not well considered by clinicians, is the main focus of this article.
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Coyac BR, Leahy B, Li Z, Salvi G, Yin X, Brunski JB, Helms JA. Bone formation around unstable implants is enhanced by a WNT protein therapeutic in a preclinical in vivo model. Clin Oral Implants Res 2020; 31:1125-1137. [PMID: 32881143 DOI: 10.1111/clr.13659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/10/2020] [Accepted: 08/08/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Our objective was to test the hypothesis that local delivery of a WNT protein therapeutic would support osseointegration of an unstable implant placed into an oversized osteotomy and subjected to functional loading. MATERIALS AND METHODS Using a split-mouth design in an ovariectomized (OVX) rat model, 50 titanium implants were placed in oversized osteotomies. Implants were subjected to functional loading. One-half of the implants were treated with a liposomal formulation of WNT3A protein (L-WNT3A); the other half received an identical liposomal formulation containing phosphate-buffered saline (PBS). Finite element modeling estimated peri-implant strains caused by functional loading. Histological, molecular, cellular, and quantitative micro-computed tomographic (µCT) imaging analyses were performed on samples from post-implant days (PID) 3, 7, and 14. Lateral implant stability was quantified at PID 7 and 14. RESULTS Finite element analyses predicted levels of peri-implant strains incompatible with new bone formation. Micro-CT imaging, histological, and quantitative immunohistochemical (IHC) analyses confirmed that PBS-treated implants underwent fibrous encapsulation. In those cases where the peri-implant environment was treated with L-WNT3A, µCT imaging, histological, and quantitative IHC analyses demonstrated a significant increase in expression of proliferative (PCNA) and osteogenic (Runx2, Osterix) markers. One week after L-WNT3A treatment, new bone formation was evident, and two weeks later, L-WNT3A-treated gaps had a stiffer interface compared to PBS-treated gaps. CONCLUSION In a rat model, unstable implants undergo fibrous encapsulation. If the same unstable implants are treated with L-WNT3A at the time of placement, then it results in significantly more peri-implant bone and greater interfacial stiffness.
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Affiliation(s)
- Benjamin R Coyac
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Brian Leahy
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Zhijun Li
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Giuseppe Salvi
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Xing Yin
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - John B Brunski
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Jill A Helms
- Department of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
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Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. Eur J Dent 2020; 14:672-682. [PMID: 32882741 PMCID: PMC7536094 DOI: 10.1055/s-0040-1715779] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite the success rates of dental implants, peri-implantitis presents as the most common complication in implant dentistry. This review discusses various factors associated with peri-implantitis and various available treatments, highlighting their advantages and disadvantages. Relevant articles on peri-implantitis published in English were reviewed from August 2010 to April 2020 in MEDLINE/PubMed, Scopus, and ScienceDirect. The identified risk indicators of peri-implant diseases are plaque, smoking, history of periodontitis, surface roughness, residual cement, emergence angle >30 degrees, radiation therapy, keratinized tissue width, and function time of the implant, sex, and diabetes. Peri-implantitis treatments can be divided into nonsurgical (mechanical, antiseptic, and antibiotics), surface decontamination (chemical and laser), and surgical (air powder abrasive, resective, and regenerative). However, mechanical debridement alone may fail to eliminate the causative bacteria, and this treatment should be combined with other treatments (antiseptics and surgical treatment). Surface decontamination using chemical agents may be used as an adjuvant treatment; however, the definitive clinical benefit is yet not proven. Laser treatment may result in a short-term decrease in periodontal pocket depth, while air powder abrasive is effective in cleaning a previously contaminated implant surface. Surgical elimination of a pocket, bone recontouring and plaque control are also effective for treating peri-implantitis. The current evidence indicates that regenerative approaches to treat peri-implant defects are unpredictable.
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Affiliation(s)
- Dinesh Rokaya
- International College of Dentistry, Walailak University, Bangkok, Thailand.,Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Viritpon Srimaneepong
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wichaya Wisitrasameewon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Manoj Humagain
- Department of Periodontics, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Sun X, Yang J, Ma X, Liu S, Zhang J. Complex Rehabilitation for an Adolescent with Ectodermal Dysplasia-A 10-Year Follow-Up. J Prosthodont 2020; 30:7-12. [PMID: 32808400 DOI: 10.1111/jopr.13238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/29/2022] Open
Abstract
Maxillofacial rehabilitation of patients with ectodermal dysplasia (ED) often presents clinical challenges due to hypodontia and hypoplastic alveolar bone. This clinical report describes a 16-year-old patient suffering from ED who displayed severe hypodontia, maxillary retrusion and thin knife-edge alveolar crest. This patient was treated with distraction osteogenesis and a bone graft harvested from the iliac crest to correct maxillary retrusion and bone insufficiency. Six months later, implants were inserted. Then, implant-supported overdentures were completed. Although a new implant was reinserted during the 10-year follow-up, the results showed that combination surgical treatment achieved a predictable, functional and esthetic outcome in a patient suffering from ED.
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Affiliation(s)
- Xiaodi Sun
- Department of Oral Implantology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China.,State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
| | - Jing Yang
- Department of Oral Implantology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Xiaoli Ma
- Department of Oral Implantology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Songyun Liu
- Department of Oral Implantology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
| | - Jian Zhang
- Department of Oral Implantology, Tianjin Stomatological Hospital, Hospital of Stomatology, Nankai University, Tianjin, China
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de Souza Rendohl E, Brandt WC. Stress distribution with extra-short implants in an angled frictional system: A finite element analysis study. J Prosthet Dent 2020; 124:728.e1-728.e9. [PMID: 32694020 DOI: 10.1016/j.prosdent.2020.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Short and extra-short implants with Morse taper connections were developed to avoid grafting procedures. How the stresses around these implants differ with abutments of different angulations is unclear. PURPOSE The purpose of this finite element study was to analyze the stress distribution in different structures (abutment, implant, and bone) of an extra-short implant with a Morse taper connection to the abutment (Arcsys-FGM-Brazil) (5.0×5.0 mm and 4.3×5.0 mm) when different abutment degrees were used. MATERIAL AND METHODS Eight 3D models were designed according to each group under analysis: group 5DS (5.0×5.0-mm implants with straight abutment), group 5DA (5.0×5.0-mm implants with 20-degree angled abutments), group 4DS (4.3×5.0-mm implants with straight abutments), and group 4DA (4.3×5.0-mm implants with 20-degree angled abutments). Axial and oblique loads of 150 N were applied on the mandibular molar crowns. RESULTS The oblique loads and angled abutments had higher stress values in the whole model (implant, abutment, and bone) than the axial loads and straight abutments. Implants with a different diameter had almost the same stress distribution on the implant, abutment, and bone. The yield limit was exceeded in the cortical bone with oblique loads and was also exceeded in implant models when an angled abutment with oblique loads was used. CONCLUSIONS Extra-short implants with Morse taper connections to the abutment had higher stress concentrations with an angled abutment on oblique loads, and the peri-implant bone was the most damaged structure.
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Affiliation(s)
| | - William Cunha Brandt
- Full Professor, Department of Implantology, University of Santo Amaro, UNISA, Sao Paulo, Brazil
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Lee BA, Kim B, Kim YT. Supraeruption as a consideration for implant restoration. J Periodontal Implant Sci 2020; 50:260-267. [PMID: 32643329 PMCID: PMC7443384 DOI: 10.5051/jpis.2000140007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose The aim of this study was to compare the prevalence, amount, and rate of supraeruption of the maxillary second molar according to sex, age, and history of periodontitis. Methods Data were collected retrospectively from the charts and panoramic radiographs of 65 patients who were scheduled to undergo implant placement at the site of the mandibular second molar. The amount of supraeruption of the maxillary second molar and the alveolar bone level of the neighboring teeth were measured on digital panoramic radiographs. The prevalence was evaluated in each group, and univariate and multivariate logistic regression analyses were used to identify factors influencing the prevalence of supraeruption. The amount and the rate of supraeruption were compared between pairs of groups using the Mann-Whitney U test. For all tests, P values <0.05 were considered to indicate statistical significance. Results Supraeruption occurred in 78% of the patients. The prevalence of supraeruption was affected by sex, age, and history of periodontitis. The mean amount of supraeruption was 0.91 mm and the mean rate of supraeruption was 0.14 mm/month. The amount and the rate of supraeruption showed no significant differences according to sex, age, or the distance from the cementoenamel junction to the alveolar bone crest (P>0.05). Conclusions These results show that the amount of supraeruption on the maxillary second molar was similar to the thickness of the enamel on the occlusal surface. When a single implant is scheduled to be placed on the mandibular second molar, supraeruption of the antagonist should be considered.
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Affiliation(s)
- Bo Ah Lee
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Byoungheon Kim
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Young Taek Kim
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
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