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de Oliveira Rigotti RL, Tardelli JDC, Dos Reis AC, da Valente MLC. Influence of dental implant/mini-implant design on stress distribution in overdentures: a systematic review. Oral Maxillofac Surg 2024; 28:515-527. [PMID: 37665393 DOI: 10.1007/s10006-023-01177-z] [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: 05/13/2023] [Accepted: 08/18/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE Critically evaluate the existing literature and answer the question, "Does the dental implant/mini-implant design influence the stress distribution in prosthetic overdentures according to finite element analysis?". METHODS This systematic review was registered in the Open Science Framework (osf.io/2bquj) and followed the PRISMA protocols. The custom search strategy was applied to 4 databases. In vitro experimental studies that evaluated the influence of dental implant/mini-implant design on stress distribution in overdentures by FEM, without time and language restrictions, were included. The selection process was carried out in two stages by two reviewers independently. Risk of bias analysis was performed by a checklist of important parameters. RESULTS Sixty articles were evaluated by their title and abstract, four were selected for full reading, three were relevant, and nine were included by additional search. The 12 studies have a low risk of bias. The meta-analysis could not be performed due to the heterogeneity of the data (implant type, design variation, load intensity, and direction). CONCLUSION It can be inferred from the evaluated literature that design modifications influence the stress distribution, but as the FEM presents limitations inherent to the in vitro study, clinical trials are necessary to infer the effectiveness of the modifications. It should be noted that there is no consensus on which is the best thread design and that implants with a very narrow diameter are subject to the highest stress concentration.
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Affiliation(s)
- Renan Leonardi de Oliveira Rigotti
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil
| | - Mariana Lima Costa da Valente
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, USP-University of São Paulo, Av. Do Café, S/N, Ribeirão Preto, SP, 14040-904, Brazil.
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Khaohoen A, Sornsuwan T, Chaijareenont P, Poovarodom P, Rungsiyakull C, Rungsiyakull P. Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review. J Clin Med 2023; 12:6924. [PMID: 37959389 PMCID: PMC10649288 DOI: 10.3390/jcm12216924] [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: 10/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand;
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
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Padhye NM, Calciolari E, Zuercher AN, Tagliaferri S, Donos N. Survival and success of zirconia compared with titanium implants: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:6279-6290. [PMID: 37740825 PMCID: PMC10630218 DOI: 10.1007/s00784-023-05242-5] [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: 11/11/2022] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered. MATERIALS AND METHODS A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved. RESULTS Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0). CONCLUSION Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants. CLINICAL RELEVANCE Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up. TRIAL REGISTRATION Systematic review registration number-CRD42021288704 (PROSPERO).
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Affiliation(s)
- Ninad Milind Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Department of Medicine and Surgery, Centre of Dentistry, University of Parma, Parma, Italy
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK
- Clinic of Reconstructive Dentistry, Centre of Dental Medicine, Zurich, Switzerland
| | - Sara Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Center of Excellence for Toxicological Research, CERT, University of Parma, Parma, Italy
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (QMUL), London, UK.
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Mohamed AMA, Askar MG, El Homossany MEMB. Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study. BMC Oral Health 2022; 22:196. [PMID: 35599323 PMCID: PMC9125928 DOI: 10.1186/s12903-022-02228-9] [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: 02/27/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Correct choice of the implant design and the occlusal scheme is important for the success of implant supported restorations. So, the aim of the current study was to find out the difference in the stresses induced by the one piece dental implants designed to be used in the All-on-4® concept and the conventional two piece ones under simulated lateral occlusal schemes using nonlinear finite element analysis. Methods Two finite element models of the maxilla, implants, and prostheses were designed according to the All-on-4® concept. In the model TP, two piece dental implants were placed while in the model OP one piece dental implants were used. Two loading scenarios were applied to each model; the first one simulated a group function occlusal scheme while the second scenario simulated a canine guided one. Results The highest stress value was recorded in the model TP with the group function occlusion and the lowest stress value was in the model OP with the canine guidance occlusion. Conclusion The one-piece dental implants can be concluded to induce less stress compared to the two piece dental implants when used in the All-on-4® implant supported prosthesis in the different lateral occlusal schemes. Canine guided occlusion can be concluded to cause lower stress values in comparison to the group function occlusal scheme.
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Figliuzzi MM, Aiello D, Rengo C, Parentela L, Mangano C. 10-Year Evaluation of the First Root Analogue Implant on Humans, Made Using a CT Scan, CAD/CAM and DMLS. Biomimetics (Basel) 2022; 7:biomimetics7010032. [PMID: 35323189 PMCID: PMC8945815 DOI: 10.3390/biomimetics7010032] [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: 02/23/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 01/27/2023] Open
Abstract
Ten years ago, for the first time in humans, thanks to the DLMS (direct metal laser sintering) technique, we designed, built and inserted an immediate post-extraction custom-made root-analogue implant in Ti-6Al-4v with platform switching. The implant was inserted into the post-extraction socket, respecting the biological width. After 10 years, we wanted to evaluate the dimensional stability of the implant and the eventual crestal bone resorption. The evaluation was performed clinically with periodontal parameters and radiographically by means of an intraoral X-ray with the parallel technique measuring the distance between the base of the bone crest and the implant shoulder. It appears that the implant has maintained dimensional stability of the peri-implant soft tissues, and the crestal resorption is 0 mm. This could represent a step forward to make this experimental method a valid alternative to the current immediate post-extraction implant procedures in use.
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Affiliation(s)
- Michele Mario Figliuzzi
- Department of Health and Oral Sciences Periodontology Clinic, Medicine and Surgery School, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (D.A.); (L.P.)
- Correspondence:
| | - Domenico Aiello
- Department of Health and Oral Sciences Periodontology Clinic, Medicine and Surgery School, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (D.A.); (L.P.)
| | - Carlo Rengo
- Dental School of Periodonotogy, University of Naples “Federico II”, 80127 Napoli, Italy;
| | - Luca Parentela
- Department of Health and Oral Sciences Periodontology Clinic, Medicine and Surgery School, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy; (D.A.); (L.P.)
| | - Carlo Mangano
- Department of Medicine and Surgery, Dental School, University of Varese, 21100 Varese, Italy;
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Durrani F, Nahid R, Pandey S, Singh P, Pandey A. One-piece implants: Careful approach for complex rehabilitation. Natl J Maxillofac Surg 2021; 12:266-270. [PMID: 34483588 PMCID: PMC8386274 DOI: 10.4103/njms.njms_191_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 01/09/2021] [Indexed: 11/15/2022] Open
Abstract
It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved.
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Affiliation(s)
- Farhan Durrani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rakhshinda Nahid
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Preeti Singh
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aishwarya Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Forna N, Agop-Forna D. Esthetic aspects in implant-prosthetic rehabilitation. Med Pharm Rep 2019; 92:S6-S13. [PMID: 31989103 PMCID: PMC6978930 DOI: 10.15386/mpr-1515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022] Open
Abstract
The esthetic component is critical for the successful outcome and patients’ satisfaction regarding the implant-prosthetic therapy. The esthetic outcome success depends mostly on the optimization of the algorithms specific to the pro-implant and implant stage as well as to the designing and technological execution of the future prosthetic restoration. A proper planning of optimal facial esthetics must involve a multidisciplinary approach with inclusion of periodontists, orthodontists, oral surgeons and implantology specialists. The dental practitioner must consider various factors that influence the esthetic outcome (tooth position, root position of the adjacent teeth, biotype of the periodontium, tooth shape, smile line, implant site anatomy, implant positioning). Also, some factors (anatomical limits of the implant site, periodontal status, occlusal parameters), which can alter the final esthetic result, must be assessed prior to planning the esthetic parameters of the future prosthetic restoration. The esthetic outcome can be improved by using new digital technologies based on software applications for assessment of clinical and biological indices of the prosthetic field, virtual planning of implants positioning and design projection of future prosthetic restoration.
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Affiliation(s)
- Norina Forna
- Department Implantology, Removable Restorations, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Doriana Agop-Forna
- Department of Oral Surgery, Dental Medical Faculty, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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Yang G, Chen L, Gao Y, Liu H, Dong H, Mou Y. Risk factors and reoperative survival rate of failed narrow‐diameter implants in the maxillary anterior region. Clin Implant Dent Relat Res 2019; 22:29-41. [PMID: 31797552 DOI: 10.1111/cid.12867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/04/2019] [Accepted: 10/23/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Guangwen Yang
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Li Chen
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Ying Gao
- The 461 Clinical Department of the 964 Hospital of People's Liberation Army Changchun Jilin China
| | - Hui Liu
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Heng Dong
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
| | - Yongbin Mou
- Department of Oral Implantology Nanjing Stomatological Hospital, Medical School of Nanjing University Nanjing Jiangsu China
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