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Hüfner M, David S, Brunello G, Kerberger R, Rauch N, Busch CV, Drescher D, Bourauel C, Becker K. Autoclaving-induced dimensional changes of three-dimensional printed surgical guides: An in vitro study. Clin Oral Implants Res 2024; 35:821-829. [PMID: 37565539 DOI: 10.1111/clr.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVES Surgical guides are frequently used for dental implant placement. The aim of this study was to evaluate the impact of the 3D printing process itself and subsequent steam autoclaving on the dimensional stability of five different resin/printer combinations (RPCs). MATERIALS AND METHODS Fifty identical surgical guides (10 per group) were produced consisting of five RPCs. Half of the guides (5 per group) were steam autoclaved with cycle 1 (121°C, 1 bar, 20.5 min) and the other half with cycle 2 (134°C, 2 bar, 5.5 min). All guides were scanned with a structured-light (SL) 3D scanner before (T0) and after (T1) autoclaving. Linear measurements along the x-, y-, and z-axes were performed at landmarks on the original STL file and on SL scans at T0 and T1, respectively. Wilcoxon signed-rank test, Kruskal-Wallis test, and linear mixed-effects models were performed, depending on the analysis. RESULTS Three-dimensional printing was associated with significant dimensional alterations for all RPCs. Steam autoclaving using cycle 1 was associated with significant shrinkage in x- (1 RPC), y- (2 RPCs), and z-direction (2 RPCs), while cycle 2 was also associated with shrinkage in x- (2 RPCs), y- (1 RPC), and z-direction (1 RPC). One resin did not present any dimensional changes independently of the cycle. CONCLUSIONS The majority of the guides presented minor but significant shrinkage due to 3D printing itself and both steam autoclaving cycles, the extent varied between different RPCs. Whether these changes compromise implant placement accuracy remains to be investigated.
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Affiliation(s)
- Mira Hüfner
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Samuel David
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Giulia Brunello
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Robert Kerberger
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Nicole Rauch
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Caroline Viola Busch
- Department of Oral Surgery, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
| | | | - Kathrin Becker
- Department of Orthodontics, University Hospital of Düsseldorf, Düsseldorf, Germany
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Wang SH, Fuh LJ, Chen MYC, Tsai MT, Huang HL, Peng SL, Hsu JT. Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods. Head Face Med 2024; 20:33. [PMID: 38760840 PMCID: PMC11100211 DOI: 10.1186/s13005-024-00434-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Michael Y C Chen
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
| | - Heng-Li Huang
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 413, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
| | - Jui-Ting Hsu
- Department of Dentistry, China Medical University Hospital, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
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Wang SH, Hsu JT, Fuh LJ, Peng SL, Huang HL, Tsai MT. New classification for bone type at dental implant sites: a dental computed tomography study. BMC Oral Health 2023; 23:324. [PMID: 37231447 DOI: 10.1186/s12903-023-03039-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE This study proposed a new classification method of bone quantity and quality at the dental implant site using cone-beam computed tomography (CBCT) image analysis, classifying cortical and cancellous bones separately and using CBCT for quantitative analysis. METHODS Preoperative CBCT images were obtained from 128 implant patients (315 sites). First, measure the crestal cortical bone thickness (in mm) and the cancellous bone density [in grayscale values (GV) and bone mineral density (g/cm3)] at the implant sites. The new classification for bone quality at the implant site proposed in this study is a "nine-square division" bone classification system, where the cortical bone thickness is classified into A: > 1.1 mm, B:0.7-1.1 mm, and C: < 0.7 mm, and the cancellous bone density is classified into 1: > 600 GV (= 420 g/cm3), 2:300-600 GV (= 160 g/cm3-420 g/cm3), and 3: < 300 GV (= 160 g/cm3). RESULTS The results of the nine bone type proportions based on the new jawbone classification were as follows: A1 (8.57%,27/315), A2 (13.02%), A3 (4.13%), B1 (17.78%), B2 (20.63%), B3 (8.57%) C1 (4.44%), C2 (14.29%), and C3 (8.57%). CONCLUSIONS The proposed classification can complement the parts overlooked in previous bone classification methods (bone types A3 and C1). TRIAL REGISTRATION The retrospective registration of this study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH 108-REC2-181.
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Affiliation(s)
- Shiuan-Hui Wang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung, 404, Taiwan.
- Department of Biomedical Engineering, China Medical University, Taichung, 404, Taiwan.
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Dentistry, China Medical University and Hospital, Taichung, 404, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, 404, Taiwan
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung, 404, Taiwan
- Department of Biomedical Engineering, China Medical University, Taichung, 404, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, 433, Taiwan
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Zingari F, Francesco G, Alessandro B, Paola B, Simone G, Sergio S. Use of Digital Articulator in Implant Supported Prosthetics. A Case Report. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2208020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
A case report is presented to demonstrate advantages of a new fully digital approach, from planning through to execution to immediate loading implant-prosthetic rehabilitation. Until now, the function of the diagnostic wax-up has not been assessable and the functionalization of the finished product, be it either a provisional or a definitive, has been entrusted entirely to the ability of the technician.
Case Description:
A female patient, unaffected by systemic disease and cranio-cervico-mandibular muscular pain, required removal of hopeless residual teeth of the upper arch and substitution with immediately loaded implants using guided surgery. A fully digital technique was performed using specific software to record individual condylar (axiography) movements and mastication cycles and to correlate these with initial intra-oral scans in order to create a virtual 3D individual value articulator. Seven implants were placed using guided surgery and the prosthetic rehabilitation was successfully performed as planned.
Conclusion:
The use of guided surgery guarantees atraumaticity and procedure predictability as documented in recent literature. However, in this case, for the first time, using the digital axiograph and digital articulator, it was possible to record the axiography of condylar movements in order to 'functionalize' the diagnostic wax-up prior to its insertion into guided surgery software. This clinical case suggests how the software's compatibility with intra-oral scan files, diagnostic wax-up, facial scans, CBCT and, in the near future, electromyography of mastication muscles permits the clinician to work on a virtual patient and analyze all critical aesthetic and functional parameters prior to guided surgery.
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Abstract
Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol.
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Lee DJW, Moon ES, Stephen K, Liu J, Kim DG. Influence of dental implantation on bone mineral density distribution: a pilot study. J Adv Prosthodont 2022; 14:143-149. [PMID: 35855316 PMCID: PMC9259350 DOI: 10.4047/jap.2022.14.3.143] [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: 01/06/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low5 and High5) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS Edentulous patients with implants had significantly greater HSD and High5 values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High5 values significantly increased after receiving implants (P < .022). CONCLUSION The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.
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Affiliation(s)
- Damian Jae-Whan Lee
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Eun-Sang Moon
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Kenneth Stephen
- The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Jie Liu
- Division of Orthodontics and Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Do-Gyoon Kim
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, OH, USA
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Abstract
The objective of this study was to evaluate the effect of bone–miniscrew contact percentage (BMC%) and bone quality and quantity on orthodontic miniscrew stability and the maximum insertion torque value (ITV). Orthodontic miniscrews of five different dimensions and several bovine iliac bone specimens were used in the evaluation. Miniscrews of each dimension group were inserted into 20 positions in bovine iliac bone specimens. The experiment was divided into three parts: (1) Bone quality and quantity were evaluated using cone-beam computed tomography (CBCT) and microcomputed tomography. (2) The 3D BMC% was calculated. (3) The ITVs during miniscrew insertion were recorded to evaluate the stability of the orthodontic miniscrews. The results indicated that longer and thicker miniscrews enabled higher ITVs. CBCT was used to accurately measure cortical bone thickness (r = 0.939, P < 0.05) and to predict the bone volume fraction of cancellous bone (r = 0.752, P < 0.05). BMC% was significantly influenced by miniscrew length. The contribution of cortical bone thickness to the ITV is greater than that of cancellous bone structure, and the contribution of cortical bone thickness to BMC% is greater than that of cancellous bone structure. Finally, the higher is BMC%, the greater is the ITV. This study concludes that use of CBCT may predict the mechanical stability of orthodontic miniscrews.
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Velasco-Ortega E, Jiménez-Guerra A, Ortiz-Garcia I, Garrido NM, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero JL, Cabanillas-Balsera D, López-López J, Monsalve-Guil L. Implant Treatment by Guided Surgery Supporting Overdentures in Edentulous Mandible Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211836. [PMID: 34831594 PMCID: PMC8622873 DOI: 10.3390/ijerph182211836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to show the clinical outcomes of implants inserted by guided surgery supporting mandibular overdentures in edentulous patients. PATIENTS AND METHODS Mandibular edentulous patients were diagnosed with an oral examination, cone-beam computerized tomography, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants by guided surgery. After flapless surgery, implants were early loaded with an overdenture at 6 weeks. RESULTS AND DISCUSSION Fourteen patients (nine females and five males) were treated with 28 implants. Four patients (28.6%) had a previous history of periodontitis. Five patients (35.7%) were smokers. Nine patients (64.3%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 44.7 ± 31.4 months. Clinical outcomes showed a global success of 100% of implants. Fourteen overdentures were placed in the patients over the implants. Mean marginal bone loss was 1.25 mm ± 0.95 mm. Four patients (28.6%) showed some kind of mechanical prosthodontic complications. Six implants (21.4%) were associated with peri-implantitis. CONCLUSIONS This study indicates that treatment of mandibular edentulous patients with overdentures by guided surgery and early loading of implants placed appears to be a successful implant protocol.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Alvaro Jiménez-Guerra
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Ivan Ortiz-Garcia
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Nuno Matos Garrido
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Jesús Moreno-Muñoz
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Enrique Núñez-Márquez
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - José Luis Rondón-Romero
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
| | - José López-López
- Department of Odontostomatoly, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, C/ Feixa LLarga s/n, 08907 Hospitalet de LLobregat, Spain
- Correspondence:
| | - Loreto Monsalve-Guil
- Department of Stomatology, Faculty of Dentistry, University of Seville, C/Avicena s/n, 421009 Seville, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (N.M.G.); (J.M.-M.); (E.N.-M.); (J.L.R.-R.); (D.C.-B.); (L.M.-G.)
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Prosthodontics Using Removable Platform Switching Technologies (Multiunit, On1) as Exemplified by Conical Connection Implant Systems for Early and Immediate Loading. Int J Dent 2021; 2021:6633804. [PMID: 33986808 PMCID: PMC8079217 DOI: 10.1155/2021/6633804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/01/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022] Open
Abstract
The removable platform switching technology (multiunit, Оn1) was tested intraoperatively using the passive placement technique as exemplified by a conical connection implant system, which makes it possible to visually control the placement of these platforms with respect to the alveolar bone in the correct orthopedic position. The technology is characterized by a rapid epithelialization of tissues around the base platform until the final integration of the implant, minimal trauma in the emergence profile zone, and an improved minimally invasive orthopedic protocol for working on a removable platform switching base.
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Can Male Patient's Age Affect the Cortical Bone Thickness of Jawbone for Dental Implant Placement? A Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084284. [PMID: 33919492 PMCID: PMC8072602 DOI: 10.3390/ijerph18084284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/25/2022]
Abstract
Dental implants are among the most common treatments for missing teeth. The thickness of the crestal cortical bone at the potential dental implant site is a critical factor affecting the success rate of dental implant surgery. However, previous studies have predominantly focused on female patients, who are at a high risk of osteoporosis, for the discussion of bone quality and quantity at the dental implant site. This study aimed to investigate the effect of male patients’ age on the crestal cortical bone of the jaw at the dental implant site by using dental cone-beam computed tomography (CBCT). This study performed dental CBCT on 84 male patients of various ages to obtain tomograms of 288 dental implant sites at the jawbone (41 sites in the anterior maxilla, 95 in the posterior maxilla, 59 in the anterior mandible, and 93 in the posterior mandible) for measuring the cortical bone thickness. A one-way analysis of variance and Scheffe’s test were performed on the measurement results to compare the cortical bone thickness at implant sites in the four jaw areas. The correlation between male patient age and cortical bone thickness at the dental implant site was determined. The four jaw areas in order of the cortical bone thickness were as follows: posterior mandible (1.07 ± 0.44 mm), anterior mandible (0.99 ± 0.30 mm), anterior maxilla (0.82 ± 0.32 mm), and posterior maxilla (0.71 ± 0.27 mm). Apart from dental implant sites in the anterior and posterior mandibles, no significant correlation was observed between male patients’ age and the cortical bone thickness at the dental implant site.
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Velasco-Ortega E, Jiménez-Guerra A, Ortiz-Garcia I, Moreno-Muñoz J, Núñez-Márquez E, Cabanillas-Balsera D, López-López J, Monsalve-Guil L. Immediate Loading of Implants Placed by Guided Surgery in Geriatric Edentulous Mandible Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084125. [PMID: 33924711 PMCID: PMC8069868 DOI: 10.3390/ijerph18084125] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 12/13/2022]
Abstract
The aim of this study was to show the clinical outcomes of the immediate loading of implants inserted by guided surgery in edentulous mandible patients. Edentulous mandible patients were diagnosed with oral examination, cone beam computerized tomography and diagnostic casts for intermaxillary relations and treated with 8–10 implants for rehabilitation with guided surgery and immediate loading. After flapless surgery, implants were loaded with an immediate acrylic temporary prosthesis. After a period of six months, a ceramic definitive full-arch prosthesis was placed. A total of 22 patients (12 females and 10 males) were treated with 198 implants. Eleven patients (50%) had a previous history of periodontitis. Six patients (27.3%) were smokers. The follow-up was 84.2 ± 4.9 months. Clinical outcomes showed a global success rate of 97.5% of implants. Five implants were lost during the healing phase with provisional prosthesis. Twenty-two fixed full-arch rehabilitations were placed in the patients over the 193 remaining implants. Mean marginal bone loss was 1.44 mm ± 0.45 mm. Six patients (27.3%) showed some kind of mechanical prosthodontic complication. Eighteen (9.3%) of the 193 remaining implants were associated with peri-implantitis. The antecedents of peri-implantitis are critical elements for the survival of the implants. The loss of implants was significant in patients who smoked up to 10 cigarettes, compared to non-smokers. Peri-implantitis is one of the key elements in the long-term follow-up of implants and it was more manifest in smoking patients, and in those with a history of peri-implantitis. Marginal bone loss was more significant in smokers. Full-arch rehabilitation is presented as a predictable alternative with minor fatigue problems that are easily solvable.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - Alvaro Jiménez-Guerra
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - Ivan Ortiz-Garcia
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - Jesús Moreno-Muñoz
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - Enrique Núñez-Márquez
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - Daniel Cabanillas-Balsera
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
| | - José López-López
- Faculty of Dentistry, Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, Hospitalet de LLobregat, 080997 Barcelona, Spain
- Correspondence:
| | - Loreto Monsalve-Guil
- Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (E.V.-O.); (A.J.-G.); (I.O.-G.); (J.M.-M.); (E.N.-M.); (D.C.-B.); (L.M.-G.)
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The Influence of Surgical Experience and Bone Density on the Accuracy of Static Computer-Assisted Implant Surgery in Edentulous Jaws Using a Mucosa-Supported Surgical Template with a Half-Guided Implant Placement Protocol-A Randomized Clinical Study. MATERIALS 2020; 13:ma13245759. [PMID: 33348589 PMCID: PMC7765911 DOI: 10.3390/ma13245759] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
The aim of our randomized clinical study was to analyze the influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery (CAIS) in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol. Altogether, 40 dental implants were placed in the edentulous jaws of 13 patients (novice surgeons: 18 implants, 6 patients (4 male), age 71 ± 10.1 years; experienced surgeons: 22 implants, 7 patients (4 male), age 69.2 ± 4.55 years). Angular deviation, coronal and apical global deviation and grey level measurements were calculated for all implants by a blinded investigator using coDiagnostiX software. 3DSlicer software was applied to calculate the bone volume fraction (BV/TV) for each site of implant placement. There were no statistically significant differences between the two study groups in either of the primary outcome variables. There was a statistically significant negative correlation between angular deviation and both grey level measurements (R-value: −0.331, p < 0.05) and BV/TV (R-value: −0.377, p < 0.05). The results of the study suggest that surgical experience did not influence the accuracy of implant placement. The higher the bone density at the sites of implant placement, the higher the accuracy of static CAIS.
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13
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Wang SH, Shen YW, Fuh LJ, Peng SL, Tsai MT, Huang HL, Hsu JT. Relationship between Cortical Bone Thickness and Cancellous Bone Density at Dental Implant Sites in the Jawbone. Diagnostics (Basel) 2020; 10:diagnostics10090710. [PMID: 32957724 PMCID: PMC7555203 DOI: 10.3390/diagnostics10090710] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022] Open
Abstract
Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe's posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery.
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Affiliation(s)
- Shiuan-Hui Wang
- Master Program for Biomedical Engineering, China Medical University, Taichung 404, Taiwan;
| | - Yen-Wen Shen
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (Y.-W.S.); (L.-J.F.); (H.-L.H.)
- Department of Dentistry, China Medical University and Hospital, Taichung 404, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (Y.-W.S.); (L.-J.F.); (H.-L.H.)
- Department of Dentistry, China Medical University and Hospital, Taichung 404, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404, Taiwan;
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung 433, Taiwan;
| | - Heng-Li Huang
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (Y.-W.S.); (L.-J.F.); (H.-L.H.)
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
| | - Jui-Ting Hsu
- School of Dentistry, China Medical University, Taichung 404, Taiwan; (Y.-W.S.); (L.-J.F.); (H.-L.H.)
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
- Correspondence:
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14
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Kivovics M, Szabó BT, Németh O, Iványi D, Trimmel B, Szmirnova I, Orhan K, Mijiritsky E, Szabó G, Dobó-Nagy C. Comparison between Micro-Computed Tomography and Cone-Beam Computed Tomography in the Assessment of Bone Quality and a Long-Term Volumetric Study of the Augmented Sinus Grafted with an Albumin Impregnated Allograft. J Clin Med 2020; 9:jcm9020303. [PMID: 31973237 PMCID: PMC7073646 DOI: 10.3390/jcm9020303] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
The purpose of our study was to compare micromorphometric data obtained by cone-beam computed-tomography (CBCT) and microcomputed-tomography (micro-CT) of the augmented sinus and to evaluate the long-term stability of the bone gain achieved using BoneAlbumin. Sinus lifts, and after 6-months, healing bone-biopsy and implant placement were carried out. Specimens were analyzed by micro-CT. A total of 16 samples were collected from nine patients (mean age 54.7 ± 6.5 years). Pre-, postoperative, and 3-year control CBCT-data were registered to determine from where the biopsy samples were harvested. Micromorphometric variables were calculated from the micro-CT- and CBCT-data, and their correlation was determined by Spearman's test. The volume of augmented bone was calculated at the time of implant placement and after 3 years. A positive correlation was found between bone-volume fraction, trabecular-separation, open-, and total-porosity, while a negative correlation was found between trabecular-thickness obtained from CBCT- and micro-CT-data (p < 0.05). Mean volumetric reduction of 39.28% (11.88-60.02%) was observed. Correlation of CBCT- and micro-CT-data suggested that micromorphometric analysis of CBCT reconstructions of the augmented sinuses provided reliable information on the microarchitecture of augmented bone. CBCT as a modality might be adequate in the analysis of bone quality in the augmented sinus. At the 3-year, control sinus grafts showed volumetric stability.
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Affiliation(s)
- Márton Kivovics
- Department of Community Dentistry, Semmelweis University, 1088 Budapest, Hungary; (O.N.); (D.I.)
- Correspondence:
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary; (B.T.S.); (B.T.); (C.D.-N.)
| | - Orsolya Németh
- Department of Community Dentistry, Semmelweis University, 1088 Budapest, Hungary; (O.N.); (D.I.)
| | - Dóra Iványi
- Department of Community Dentistry, Semmelweis University, 1088 Budapest, Hungary; (O.N.); (D.I.)
| | - Bálint Trimmel
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary; (B.T.S.); (B.T.); (C.D.-N.)
| | - Ilona Szmirnova
- Department of Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, 1085 Budapest, Hungary; (I.S.); (G.S.)
| | - Kaan Orhan
- Dentomaxillofacial Radiology Department, Ankara University, Ankara 06560, Turkey;
| | - Eitan Mijiritsky
- Head and Neck Maxillofacial Surgery, Department of Otoryngology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 62431, Israel;
| | - György Szabó
- Department of Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, 1085 Budapest, Hungary; (I.S.); (G.S.)
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary; (B.T.S.); (B.T.); (C.D.-N.)
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15
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Abstract
INTRODUCTION Implant osseointegration is strongly influenced by the bone quality at the implant insertion site. The present work aims to create distribution diagrams showing the average bone density at each position within the jaws. MATERIALS AND METHODS Data were retrospectively collected from 4 oral surgeons who sought bone-density measurements during implant placement using a torque-measuring implant micromotor. Statistical analyses were performed to investigate whether bone density correlated with the patients' sex and age and whether the bone-density values at different positions within each arch correlated to each other. RESULTS Records of 2408 patients and 6060 bone-density readings were retrieved, and density distribution diagrams were created. Density values showed a significant variation within subjects. Within the same jaw, density between adjacent positions showed significant differences. Density at a given position correlated significantly with that at the other positions in most cases. Bone density was significantly lower in women than in men; no significant correlation was found between bone density and the patient age. CONCLUSIONS Bone density of patients displays significant interindividual variation, thus meaningful assessment must be conducted on a patient-by-patient basis.
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Akoğlan M, Tatli U, Kurtoğlu C, Salimov F, Kürkçü M. Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla. Clin Implant Dent Relat Res 2017; 19:624-631. [PMID: 28493347 DOI: 10.1111/cid.12492] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.
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Affiliation(s)
- Mücahide Akoğlan
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Cem Kurtoğlu
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mehmet Kürkçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
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