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Kang Y, Zheng X, Zhang D, Li S, Xu S, Chen L, Zhang Z, Lin X. One-Abutment at One-Time in Posterior Edentulism: A Systematic Review and Meta-Analysis. J Craniofac Surg 2023; 34:e720-e724. [PMID: 37253247 DOI: 10.1097/scs.0000000000009428] [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: 01/23/2023] [Accepted: 04/06/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to investigate the clinical significance of one-abutment at one-time protocol in healed posterior edentulism. METHODS An online search was undertaken in November 2022, which included PubMed, Cochrane Library, Wiley Online Library, and Google Scholar in addition to manual searching. The Cochrane Collaboration tool was performed to assess the quality of selected articles. Marginal bone loss (MBL) was estimated by the performance of meta-analysis. Moreover, all the pooled analyses were based on random-effect models. Subgroup analysis was applied to evaluate the effects of different variables. RESULTS In line with the inclusion criteria, 6 trials with 446 dental implants were identified. The meta-analysis showed a total of 0.22 mm less MBL within 6 months and decreased by 0.30 mm at 1-year follow-up in favor of one-abutment at one-time protocol. A significant loss MBL was found in implants placed equicrestally using one-abutment at one-time protocol [6 months: mean difference (MD): -0.22 mm; 95% CI, -0.34 to 0.10 mm, P =0.0004; 12 months: MD: -0.32 mm; 95% CI, -0.40 to -0.24 mm, P <0.00001), whereas no difference was found between 2 groups in an implant placed subscrestally (6 months: MD: 0.14 mm; 95% CI, -0.03 to 0.22 mm; P =0.11; 12 months: MD: -0.12 mm; 95% CI, -0.32 to 0.08 mm; P =0.23). CONCLUSIONS Implant platform position might greatly affect the marginal bone level. Moreover, one-abutment at one-time protocol demonstrated better bone preservation in implants placed equicrestally in healed posterior edentulism. CLINICAL RELEVANCE This study highlights the significant clinical application of one-abutment at one-time protocol in healed posterior edentulism.
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Affiliation(s)
- Yujie Kang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Xianghuai Zheng
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Danya Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Shaobing Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Lei Chen
- Department of Burns, Wound Repair and Reconstruction, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P.R. China
| | - Zhaoqiang Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
| | - Xi Lin
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, PR China
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Dandekar S, Lahoti K, Gade J, Agrawal M. Comparative evaluation of circumferential crestal bone loss after 1 year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using cone-beam computed tomography: A randomized controlled trial. J Indian Prosthodont Soc 2023; 23:226-233. [PMID: 37929361 PMCID: PMC10467325 DOI: 10.4103/jips.jips_129_23] [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: 03/28/2023] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 11/07/2023] Open
Abstract
Aim The study was aimed to evaluate circumferential crestal bone level after one year of implant placement with flapless versus flap surgery using surgical template after immediate loading in the posterior mandibular region using CBCT. Setting and Design The study was designed as a Randomized controlled trial. Material and Methods 32 implants were placed in single edentulous spaces in the mandibular posterior region after random allocation into two groups: Flap surgery (Group A) and Flapless surgery (Group B). Virtual implant planning was performed using Blue Sky Bio software, and static CBCT guided 3D printed surgical templates were fabricated for all participants of both the groups. Immediate non-functional temporization was performed. Circumferential crestal bone levels were assessed after surgery and one-year follow-up using CBCT and XELIS software. Vertical bone loss (VBL) and horizontal bone loss (HBL) was assessed on four sides: buccal, lingual, mesial and distal. Statistical Analysis Used Data was analyzed using Statistical Package for Social Sciences IBM Corp. Released 2017, IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp.) and Graph Pad Prism 7.0 version. The level of significance was chosen <0.05. Chi square test was performed to assess the difference in the age in the two groups. Mann-Whitney U test was performed to compare the two groups for outcome measure. Graphically, quantile-quantile (Q-Q) plot was made using mean and standard deviation for normality verification of data. Results 100% survival rate and patient compliance was observed along the one-year follow-up duration. By using Mann-Whitney U test, statistically significant difference was found in the vertical bone loss among participants of Flap surgery (Group A) and Flapless surgery (Group B) on all the four sides after one year of implant placement. However, significant results were not obtained for the difference in the horizontal bone level. Conclusion Within the limitations of this study, vertical bone loss measured circumferentially was more positively correlated with the implants placed with flap surgery compared to flapless surgery after immediate loading in the posterior mandibular region after one year.
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Affiliation(s)
- Sayali Dandekar
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Krishankumar Lahoti
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Jaykumar Gade
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Megha Agrawal
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
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Lahoti K, Dandekar S, Gade J, Agrawal M. Comparative evaluation of crestal bone level by flapless and flap techniques for implant placement: Systematic review and meta-analysis. J Indian Prosthodont Soc 2021; 21:328-338. [PMID: 34810360 PMCID: PMC8617445 DOI: 10.4103/jips.jips_208_21] [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] [Indexed: 11/04/2022] Open
Abstract
Aim :To compare the crestal bone level of flapless technique of dental implant placement with the flap technique. Setting and Design This Systematic review and Meta-analysis was conducted according to the Preferred Reporting Items For Systematic Review and Meta-Analyses (PRISMA) Guidelines and registered with PROSPERO. Materials and Methods Electronic search of Medline and Google scholar databases for articles from 2010 till March 2020 was performed. Studies comparing the crestal bone level with both the techniques were included. After the collection of data, the risk of bias was assessed for each study. Statistical Analysis Used Meta-analysis was executed using RevMan 5 software version 5.3. Results 23 studies were included. Statistically significant difference in crestal bone level was found between flapless and flap surgery with mean difference of -0.14 (flapless placement versus flap surgery; 95% CI: -0.24 to -0.03; P = 0.01FNx01). The difference in crestal bone level between the 2 groups was not statistically significant with a mean difference of -0.05(Guided flapless placement versus flap surgery; 95% CI: -0.10 to 0.00; P=0.06). Meta-analysis of the freehand flapless surgery with flap surgery generated a mean difference of -0.20 which was found to be statistically significant (Freehand flapless placement versus flap surgery; 95% CI: -0.37 to -0.03; P=0.02FNx01). Conclusions Flapless placement of implant can positively influence crestal bone loss in comparison with conventional flap technique.
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Affiliation(s)
- Krishankumar Lahoti
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Sayali Dandekar
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Jaykumar Gade
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Megha Agrawal
- Department of Prosthodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
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Gao X, Qin S, Cai H, Wan Q. Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials. Int J Implant Dent 2021; 7:100. [PMID: 34595691 PMCID: PMC8484394 DOI: 10.1186/s40729-021-00380-5] [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: 04/28/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Information about the aesthetic effects of flapless in implant surgeries is scant. Differences of the survival rate (SR) and crestal bone loss (CBL) between the two techniques were also controversial. Thus, this review was aimed to compare the general and aesthetic effects of flapless and flap approaches in implant surgeries. Materials and methods Following the principals of PRISMA, literature databases were searched for the eligible randomized controlled trials (RCTs) comparing the clinical performances of flap and flapless techniques. After that, relevant data of selected studies were pooled and analyzed to compare SR, bleeding on probing (BOP), probing depth (PD), visual analogue scale (VAS), papillae presentation index (PPI), keratinized mucosa (KM) width and CBL between the two techniques. Results Fourteen RCTs were included. No significant difference was found in SR (RR = − 0.01, 95% confidence interval (CI) (− 0.05, 0.04)), BOP (OR = 0.40, 95% CI (0.15, 1.02)), KM width (WMD = − 0.42, 95% CI (− 1.02, 0.17)) between two groups. Subgroup analysis revealed that the difference of CBL was insignificant in two groups (WMD = − 0.13, 95% CI (− 0.63, 0.38)). However, flap techniques would lead more peri-implant PD (WMD = − 0.37, 95% CI (− 0.51, − 0.23)). Subgroup analysis also indicated lower VAS scores in flapless group after 1 day (WMD = − 1.66, 95% CI (− 2.16, − 1.16)) but comparable pain experience after 3 days (WMD = − 0.59, 95% CI (− 1.33, 0.16)). Mean difference of PPI (WMD = 0.32, 95% CI (0.28, 0.35)) between the two groups was significant. Conclusions The flapless procedure showed a superiority in preserving gingival papillae, reducing postoperative pain and peri-implant PD compared to the flap procedure, while exhibiting comparable effects on SR, BOP, KW width changes and CBL. Flapless technique is more recommended at the ideal soft and hard tissue implanting sites.
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Affiliation(s)
- Xiaomeng Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China
| | - Siyu Qin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China
| | - He Cai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China.
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China.
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Lin X, Gao Y, Ding X, Zheng X. Socket shield technique: A systemic review and meta-analysis. J Prosthodont Res 2021; 66:226-235. [PMID: 34526435 DOI: 10.2186/jpr.jpr_d_20_00262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the clinical feasibility of the socket shield technique (SST). STUDY SELECTION An electronic search of the PubMed, Cochrane Central Register of Controlled Trials, and Wiley Online Library databases, and a manual reference search for articles published up to September 2020 was conducted. Meta-analysis was performed to estimate marginal bone loss (MBL), changes in buccal bone width (cBBW), pink esthetic score (PES), implant stability quotient (ISQ), implant failure rate, and complication rate between SST and conventional immediate implant placement (IIP). All pooled analyses were based on random effects models. RESULTS Sixteen relevant studies were ultimately selected by two independent reviewers: four randomized clinical trials (RCTs), four case-control studies, and eight retrospective studies. Meta-analysis revealed a trend toward lower MBL and cBBW and higher PES in the SST group. ISQ, implant failure rate, and complication rate were similar between the groups. CONCLUSIONS The included studies provided evidence that SST may be a feasible treatment option. However, this technique should not be used as a routine clinical protocol due to the lack of evidence-based consensus guidelines, large-scale RCTs, and long-term follow-up data. Therefore, there is an urgent need for well-conducted RCTs in this field.
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Affiliation(s)
- Xi Lin
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Yan Gao
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xianglong Ding
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xianghuai Zheng
- Affiliated Implantology center, Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
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Hattingh A, De Bruyn H, Van Weehaeghe M, Hommez G, Vandeweghe S. Contour Changes Following Immediate Placement of Ultra-Wide Implants in Molar Extraction Sockets without Bone Grafting. J Clin Med 2020; 9:jcm9082504. [PMID: 32759638 PMCID: PMC7464762 DOI: 10.3390/jcm9082504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 01/18/2023] Open
Abstract
The aim was to evaluate ridge reduction and mucosal recession following immediate placement of ultra-wide implants in molar sockets, without bone grafting. Impressions were taken prior to tooth extraction, 4 months and 1 year after implant placement. The casts were digitized and compared. Mucosal recessions and horizontal ridge reduction were measured. A total of 16 implants were in the maxilla and 11 in the mandible. At the buccal aspect, there was a mean reduction of 0.94 mm after 4 months and 0.89 mm after one year (p = 0.933). At the palatal/lingual aspect, this was 1.09 mm after 4 months and 0.69 mm after 1 year (p = 0.001). After 1 year, a recession of 0.59 mm was measured at the zenith, 1.04 mm at the mesial and 0.98 mm at the distal papilla. The mean midfacial horizontal ridge reduction was 1.23 mm after 4 months and 1.45 mm after 1 year. At the midpalatal/midlingual aspect, the mean horizontal reduction was 1.43 mm after 4 months and 1.16 mm after 1 year. Immediate implant placement without bone grafting in the posterior jaw yields a significant horizontal ridge reduction and minor mucosal recession. Clinicians should anticipate the amount of ridge reduction and consider augmentation at the time of implant placement.
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Affiliation(s)
- André Hattingh
- Private Practice for Periodontology and Oral Implantology, Sevenoaks, Kent TN15 8BQ, UK;
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Hugo De Bruyn
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Dental Faculty, Radboud University Medical Hospital, 6525EX Nijmegen, The Netherlands
| | - Manù Van Weehaeghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Geert Hommez
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Stefan Vandeweghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Correspondence: ; Tel.: +32-9-332-59-22
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Praça LDFG, Teixeira RC, Rego RO. Influence of abutment disconnection on peri-implant marginal bone loss: A randomized clinical trial. Clin Oral Implants Res 2020; 31:341-351. [PMID: 31925984 DOI: 10.1111/clr.13572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/30/2019] [Accepted: 12/30/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss. MATERIAL AND METHODS Twenty-four participants received single-unit implants and were randomly assigned into one of the two groups: the definitive abutment group (DEF), in which the definitive abutments were connected at the same time as the implant was inserted; and as a control, the healing abutment group (HEA), in which the healing abutments were disconnected and reconnected three times, at 8, 10, and 12 weeks after surgery. Peri-implant marginal bone level was measured through radiographic follow-up performed immediately after the surgery (baseline), at 8 weeks and after 6, 12, and 24 months. Implant stability and peri-implant health were assessed by resonance frequency analysis and peri-implant probing, respectively. RESULTS At the end of 2 years, the mean bone level was -0.18 ± 0.12 mm for the DEF group and -0.13 ± 0.13 mm for the HEA group, resulting in a cumulative bone loss of -0.61 ± 0.10 mm and -0.81 ± 0.15 mm, respectively, with no statistical difference between groups. Bone level changes showed statistically significant differences only between 0 and 2 months (DEF: -0.70 ± 0.12 mm; HEA: -0.36 ± 0.10 mm) and between 2 and 6 months (DEF: -0.11 ± 0.11 mm; HEA: -0.65 ± 0.14 mm). No differences were observed between the groups for implant stability, probing depth, and bleeding on probing. CONCLUSION Immediate connection of the prosthetic abutments did not reduce bone loss in comparison with three disconnections of the healing abutments.
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Affiliation(s)
- Luciano de Freitas Guimarães Praça
- Divisions of Prosthodontics and Implant Dentistry, Department of Dentistry, University of Fortaleza, Fortaleza, Brazil.,Graduate Program in Dentistry, Department of Clinical Dentistry, Federal University of Ceara, Fortaleza, Brazil
| | | | - Rodrigo Otavio Rego
- Graduate Program in Dentistry, Department of Clinical Dentistry, Federal University of Ceara, Fortaleza, Brazil.,Division of Periodontics, Department of Dentistry, School of Dentistry at Sobral, Federal University of Ceara, Sobral, Brazil
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