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Șalgău CA, Morar A, Zgarta AD, Ancuța DL, Rădulescu A, Mitrea IL, Tănase AO. Applications of Machine Learning in Periodontology and Implantology: A Comprehensive Review. Ann Biomed Eng 2024:10.1007/s10439-024-03559-0. [PMID: 38884831 DOI: 10.1007/s10439-024-03559-0] [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: 04/03/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
Machine learning (ML) has led to significant advances in dentistry, easing the workload of professionals and improving the performance of various medical processes. The fields of periodontology and implantology can profit from these advances for tasks such as determining periodontally compromised teeth, assisting doctors in the implant planning process, determining types of implants, or predicting the occurrence of peri-implantitis. The current paper provides an overview of recent ML techniques applied in periodontology and implantology, aiming to identify popular models for different medical tasks, to assess the impact of the training data on the success of the automatic algorithms and to highlight advantages and disadvantages of various approaches. 48 original research papers, published between 2016 and 2023, were selected and divided into four classes: periodontology, implant planning, implant brands and types, and success of dental implants. These papers were analyzed in terms of aim, technical details, characteristics of training and testing data, results, and medical observations. The purpose of this paper is not to provide an exhaustive survey, but to show representative methods from recent literature that highlight the advantages and disadvantages of various approaches, as well as the potential of applying machine learning in dentistry.
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Affiliation(s)
- Cristiana Adina Șalgău
- University of Agronomic Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
| | - Anca Morar
- National University of Science and Technology Politehnica Bucharest, Bucharest, Romania.
| | | | - Diana-Larisa Ancuța
- University of Agronomic Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
- Cantacuzino National Medical-Military Institute for Research and Development, Bucharest, Romania
| | - Alexandros Rădulescu
- University of Agronomic Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
| | - Ioan Liviu Mitrea
- University of Agronomic Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
| | - Andrei Ovidiu Tănase
- University of Agronomic Sciences and Veterinary Medicine of Bucharest, Bucharest, Romania
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Antal MA, Kiscsatári R, Braunitzer G, Piffkó J, Varga E, Eliaz N. Assessment of a novel electrochemically deposited smart bioactive trabecular coating (SBTC®): a randomized controlled clinical trial. Head Face Med 2024; 20:24. [PMID: 38627712 PMCID: PMC11022491 DOI: 10.1186/s13005-024-00426-0] [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: 12/15/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES A randomized controlled clinical trial of dental implants was conducted to compare the clinical properties of a novel electrochemically deposited calcium phosphate coating to those of a common marketed surface treatment. MATERIAL AND METHODS Forty implants of the same brand and type were placed in 20 fully edentulous participants requiring mandibular implantation. The two study groups were defined by the surface treatment of the implants. 20 implants in the control group were coated via a commercial electrochemical surface treatment that forms a mixture of brushite and hydroxyapatite, while the remaining 20 in the test group were coated with a novel electrochemical Smart Bioactive Trabecular Coating (SBTC®). A split-mouth design was employed, with each participants receiving one control implant in one mandibular side and a test implant in the other. To mitigate potential operator-handedness bias, control and test implants were randomly assigned to mandibular sides. All cases underwent digital planning, implant placement with a static surgical guide, and participants received locator-anchored full-arch dentures. The primary outcome was implant stability (measured using Osstell ISQ) assessed at insertion, loading, and then 3 months, 9 months, and 2 years post-insertion. The secondary outcome was bone level change (in millimeters) over the 2-year observation period. Oral health-related quality of life (OHRQL) was monitored using the OHIP-14 questionnaire. Complications and adverse events were recorded. RESULTS Successful osseointegration and implant stability were achieved in all cases, allowing loading. ISQ values steadily increased throughout the observation period. While no significant differences were observed between the SBTC® and control coatings, the test group exhibited a higher ISQ gain. Bone resorption was somewhat lower in the SBTC® but not significantly so. Patients' OHRQL significantly improved after denture delivery and remained stable throughout the follow-up. No complications or adverse events were observed. CONCLUSIONS Based on the study results, we conclude that the new surface treatment is a safe alternative to the widely used control surface, demonstrating similar osseointegrative properties and time-dependent bone level changes. Further research may explore the broader implications of these findings. TRIAL REGISTRATION The study is registered on clinicaltrials.gov under the identifier ID: NCT06034171.
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Affiliation(s)
- Mark Adam Antal
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, 6720 Tisza Lajos Krt. 64-66, Szeged, Hungary.
| | - Ramóna Kiscsatári
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | - József Piffkó
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | - Noam Eliaz
- Department of Materials Science and Engineering, Tel-Aviv University, Tel Aviv, Israel
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Zieliński R, Lipa S, Piechaczek M, Sowiński J, Kołkowska A, Simka W. Finite Element Analysis and Fatigue Test of INTEGRA Dental Implant System. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1213. [PMID: 38473684 DOI: 10.3390/ma17051213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
The study involved numerical FEA (finite element analysis) of dental implants. Based on this, fatigue tests were conducted according to the PN-EN 14801 standard required for the certification of dental products. Thanks to the research methodology developed by the authors, it was possible to conduct a thorough analysis of the impact of external and internal factors such as material, geometry, loading, and assembly of the dental system on the achieved value of fatigue strength limit in the examined object. For this purpose, FEM studies were based on identifying potential sites of fatigue crack initiation in reference to the results of the test conducted on a real model. The actions described in the study helped in the final evaluation of the dental system design process named by the manufacturer as INTEGRA OPTIMA 3.35. The objective of the research was to identify potential sites for fatigue crack initiation in a selected dental system built on the INTEGRA OPTIMA 3.35 set. The material used in the research was titanium grade 4. A map of reduced von Mises stresses was used to search for potential fatigue crack areas. The research [loading] was conducted on two mutually perpendicular planes positioned in such a way that the edge intersecting the planes coincided with the axis of the system. The research indicated that the connecting screw showed the least sensitivity (stress change) to the change in the loading plane, while the value of preload has a significant impact on the achieved fatigue strength of the system. In contrast, the endosteal implant (root) and the prosthetic connector showed the greatest sensitivity to the change in the loading plane. The method of mounting [securing] the endosteal implant using a holder, despite meeting the standards, may contribute to generating excessive stress concentration in the threaded part. Observation of the prosthetic connector in the Optima 3.35 system, cyclically loaded with a force of F ≈ 300 N in the area of the upper hexagonal peg, revealed a fatigue fracture. The observed change in stress peak in the dental connector for two different force application surfaces shows that the positioning of the dental system (setting of the socket in relation to the force action plane) is significantly decisive in estimating the limited fatigue strength.
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Affiliation(s)
- Rafał Zieliński
- Stomatologia na Ksiezym Mlynie, 16 D Tymienieckiego, 90-365 Lodz, Poland
| | - Sebastian Lipa
- Institute of Materials Science and Engineering, Lodz University of Technology, 90-924 Lodz, Poland
| | - Martyna Piechaczek
- Stomatologia na Ksiezym Mlynie, 16 D Tymienieckiego, 90-365 Lodz, Poland
| | - Jerzy Sowiński
- Private Dental Clinic, Tetmajera 3A Rd., 05-080 Izabelin C, Poland
| | - Agata Kołkowska
- Chemistry Students Research Society, Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
- Department of Inorganic Chemistry, Faculty of Chemistry, Analytical Chemistry and Electrochemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Wojciech Simka
- Chemistry Students Research Society, Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
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Gutierres E, Bergamo ETP, Carvalho LF, Coelho PG, Campos TMB, Piza MMDT, Lopes ACDO, Benalcazar Jalkh EB, Bonfante EA. Single geometry abutment for narrow and extra-narrow implant systems: Survival and failure modes. J Mech Behav Biomed Mater 2023; 143:105872. [PMID: 37201226 DOI: 10.1016/j.jmbbm.2023.105872] [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: 03/10/2023] [Revised: 04/22/2023] [Accepted: 04/23/2023] [Indexed: 05/20/2023]
Abstract
The use of identical prosthetic components for all implant diameters could reduce the production costs by companies and the complexity of component selection for the clinician and his team. However, it would imply in reduction of thickness of the cervical walls of tapered internal connection implants, which could compromise the reliability of narrow and extra-narrow implants. Therefore, this study aims to evaluate the probability of survival and failure modes of extra-narrow implant systems with the same internal diameter as standard-diameter implants using the same prosthetic components. It was used eigth different implant system configurations, including narrow (Ø 3.3 mm) (N) extra-narrow (Ø 2.9 mm) (EN) and extra-narrow-scalloped (Ø 2.9 mm) (ENS) implants, both with cementable abutments (Ce) or titanium bases (Tib) and one-piece implants (Ø 2.5 mm and Ø 3.0 mm) (OP) (Medens, Itu, SP, Brazil), comprising the following groups: OP 3.0; OP 2.5; N Ce; N Tib; EN Ce, EN Tib, ENS-Ce and ENS-Tib. The implants were embedded using polymethylmethacrylate acrylic resin in a 15 mm matrix. Standardized maxillary central incisor crowns were virtually designed and milled to fit on the different studied abutments and cemented using a dual self-adhesive resin cement. The specimens were submitted to SSALT (Step Stress Accelerated Life Testing) at 15 Hz in water until failure or suspension of the test, until a maximum load of 500 N. Fractographic analysis of the failed specimens were realized in scanning electron microscopy. All implant systems demonstrated high probability of survival (90-100%) for missions at 50 and 100 N and values of characteristic strength superior to 139 N. Failure modes were restricted to the abutment in all the implant configurations tested. Therefore, the use extra-narrow implants with standardized prosthetic components for different implant diameters is a viable option for the replacement of anterior teeth.
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Affiliation(s)
- Eliezer Gutierres
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | - Edmara Tatiely Pedroso Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | - Laura Firmo Carvalho
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | - Paulo G Coelho
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Tiago Moreira Bastos Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil; Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil.
| | - Mariana Miranda de Toledo Piza
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | | | - Ernesto Byron Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, São Paulo University - USP, Bauru, SP, Brazil.
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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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Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res 2022; 8:294-312. [PMID: 35014207 PMCID: PMC8874059 DOI: 10.1002/cre2.521] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022] Open
Abstract
Objectives The purpose of this systematic review and meta‐analysis was to compare implant‐supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient‐reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs. Material and Methods An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta‐analysis by using a random‐effects model. Results Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9–36.1) and patient satisfaction (−20.8 ± 0.2; 95% CI, −23.7 to −17.8) between treatments with conventional and implant‐supported removable dentures was statistically significant (p < .05). Implant‐supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri‐implant mucositis, were noted in ISRPDs during patient follow‐up. Studies assessing PROMs were very heterogeneous (I2 = 65%, p = .85; I2 = 75%, p = .88). Conclusions ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
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Affiliation(s)
- Octave N Bandiaky
- Division of Fixed Prosthodontics, University of Nantes, Nantes, France
| | - Dohoue L Lokossou
- School of Dentistry, University of El Hadji Ibrahima Niasse, Dakar, Sénégal
| | - Assem Soueidan
- Department of Periodontology, Rmes U1229, University of Nantes, Nantes, France
| | - Pierre Le Bars
- Division of Fixed Prosthodontics, CHU Nantes, Nantes, France
| | - Moctar Gueye
- Department of Odontology, Clinic of Fixed and Removable Prosthodontics, University of Dakar, Dakar, Senegal
| | - Elhadj B Mbodj
- Department of Odontology, Clinic of Fixed and Removable Prosthodontics, University of Dakar, Dakar, Senegal
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Nantes, Nantes, France
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Feroz S, Dias G. Hydroxypropylmethyl cellulose (HPMC) crosslinked keratin/hydroxyapatite (HA) scaffold fabrication, characterization and in vitro biocompatibility assessment as a bone graft for alveolar bone regeneration. Heliyon 2021; 7:e08294. [PMID: 34765797 PMCID: PMC8571510 DOI: 10.1016/j.heliyon.2021.e08294] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/08/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022] Open
Abstract
Wool derived keratin has garnered significant advancements in the field of biomaterials for hard tissue regeneration. The main limitation of keratin-based biomaterials for bone tissue engineering is their fragile nature. This paper proposes the development of a novel hydroxypropyl methylcellulose (HPMC) crosslinked keratin scaffold, containing hydroxyapatite as a major inorganic component by freeze drying technique for alveolar bone regeneration. The prepared keratin/hydroxyapatite/HPMC (K/HA/HPMC) scaffold was characterized to study its chemical, physical, and mechanical properties by Scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), Energy dispersive X-ray spectroscopy (EDX), X-Ray diffractometric (XRD) analysis. The SEM images of the scaffolds showed highly porous interconnected architecture with average pore size of 108.36 ± 22.56 while microcomputed tomographic analysis measured total porosity as 79.65 %±. Energy dispersive X-ray spectroscopic (EDX) analysis confirmed that inorganic component of scaffold was mainly composed of calcium and phosphorous ions having Ca/P molar ration of 1.6. The maximum compressive strength was found to be in the range of 0.841 ± 0.37 MPa. Furthermore, the K/HA/HPMC scaffold was structurally stable and weight loss of about 26% was observed when soaked in phosphate buffered solution (PBS) for 28 days. In vitro biocompatibility testing showed that K/HA/HPMC scaffold was cytocompatible and supported the attachment, proliferation of osteoblast (Saos-2) cells. Thus, the development of a non-toxic chemical cross-linking system with HPMC was investigated to fabricate K/HA/HPMC scaffold and our results showed great potential of these scaffolds to regenerate alveolar bone due to their structural similarity and excellent in vitro biocompatibility.
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Affiliation(s)
- Sandleen Feroz
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9054, New Zealand
| | - George Dias
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9054, New Zealand
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Lee CH, Mukundan A, Chang SC, Wang YL, Lu SH, Huang YC, Wang HC. Comparative Analysis of Stress and Deformation between One-Fenced and Three-Fenced Dental Implants Using Finite Element Analysis. J Clin Med 2021; 10:jcm10173986. [PMID: 34501431 PMCID: PMC8432445 DOI: 10.3390/jcm10173986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 01/03/2023] Open
Abstract
Finite element analysis (FEA) has always been an important tool in studying the influences of stress and deformation due to various loads on implants to the surrounding jaws. This study assessed the influence of two different types of dental implant model on stress dissipation in adjoining jaws and on the implant itself by utilizing FEA. This analysis aimed to examine the effects of increasing the number of fences along the implant and to compare the resulting stress distribution and deformation with surrounding bones. When a vertical force of 100 N was applied, the largest displacements found in the three-fenced and single-fenced models were 1.7469 and 2.5267, respectively, showing a drop of 30.8623%. The maximum stress found in the three-fenced and one-fenced models was 13.518 and 22.365 MPa, respectively, showing a drop of 39.557%. Moreover, when an oblique force at 35° was applied, a significant increase in deformation and stress was observed. However, the three-fenced model still had less stress and deformation compared with the single-fenced model. The FEA results suggested that as the number of fences increases, the stress dissipation increases, whereas deformation decreases considerably.
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Affiliation(s)
- Chia-Hsuan Lee
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
| | - Arvind Mukundan
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI), and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chiayi 62102, Taiwan;
| | - Szu-Chien Chang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
| | - Yin-Lai Wang
- Gentle Dental Clinic, No. 400, Baotai Rd., Fengshan Dist., Kaohsiung City 80284, Taiwan;
| | - Shu-Hao Lu
- Topology Medical Consultant Co., 12F., No. 812, Xinsheng Rd., Qianzhen Dist., Kaohsiung City 80284, Taiwan;
| | - Yu-Cheng Huang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
- Correspondence: (Y.-C.H.); (H.-C.W.)
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI), and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chiayi 62102, Taiwan;
- Correspondence: (Y.-C.H.); (H.-C.W.)
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Seyssens L, De Lat L, Cosyn J. Immediate implant placement with or without connective tissue graft: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:284-301. [PMID: 33125754 DOI: 10.1111/jcpe.13397] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/25/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12 months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs. RESULTS Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p < .001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p = .002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p = .06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. CONCLUSION CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness).
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Liesa De Lat
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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10
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Failure Modes and Survival of Anterior Crowns Supported by Narrow Implant Systems. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1057846. [PMID: 32964016 PMCID: PMC7495162 DOI: 10.1155/2020/1057846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Abstract
The reduced hardware design of narrow implants increases the risk of fracture not only of the implant itself but also of the prosthetic constituents. Hence, the current study is aimed at estimating the probability of survival of anterior crowns supported by different narrow implant systems. Three different narrow implant systems of internal conical connections were evaluated (Ø3.5 × 10 mm): (i) Active (Nobel Biocare), (ii) Epikut (S.I.N. Implant System), and (iii) BLX (Straumann). Abutments were torqued to the implants, and standardized maxillary incisor crowns were cemented. The assemblies were subjected to step-stress accelerated life testing (SSALT) in water through load application of 30 degrees off-axis lingually at the incisal edge of the crowns using a flat tungsten carbide indenter until fracture or suspension. The use level probability Weibull curves and reliability for completion of a mission of 100,000 cycles at 80 N and 120 N were calculated and plotted. Weibull modulus and characteristic strength were also calculated and plotted. Fractured samples were analyzed in a stereomicroscope. The beta (β) values were 1.6 (0.9-3.1) and 1.4 (0.9-2.2) for BLX and Active implants, respectively, and 0.5 (0.3-0.8) for the Epikut implant, indicating that failures were mainly associated with fatigue damage accumulation in the formers, but more likely associated with material strength in the latter. All narrow implant systems showed high probability of survival (≥95%, CI: 85-100%) at 80 and 120 N, without significant difference between them. Weibull modulus ranged from 6 to 14. The characteristic strength of Active, Epikut, and BLX was 271 (260-282) N, 216 (205-228) N, and 275 (264-285) N, respectively. The failure mode predominantly involved abutment and/or abutment screw fracture, whereas no narrow implant was fractured. Therefore, all narrow implant systems exhibited a high probability of survival for anterior physiologic masticatory forces, and failures were restricted to abutment and abutment screw.
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Abstract
Dental implants are frequently used to support fixed or removable dental prostheses to replace missing teeth. The clinical success of titanium dental implants is owed to the exceptional biocompatibility and osseointegration with the bone. Therefore, the enhanced therapeutic effectiveness of dental implants had always been preferred. Several concepts for implant coating and local drug delivery had been developed during the last decades. A drug is generally released by diffusion-controlled, solvent-controlled, and chemical controlled methods. Although a range of surface modifications and coatings (antimicrobial, bioactive, therapeutic drugs) have been explored for dental implants, it is still a long way from designing sophisticated therapeutic implant surfaces to achieve the specific needs of dental patients. The present article reviews various interdisciplinary aspects of surface coatings on dental implants from the perspectives of biomaterials, coatings, drug release, and related therapeutic effects. Additionally, the various types of implant coatings, localized drug release from coatings, and how released agents influence the bone–implant surface interface characteristics are discussed. This paper also highlights several strategies for local drug delivery and their limitations in dental implant coatings as some of these concepts are yet to be applied in clinical settings due to the specific requirements of individual patients.
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Ma M, Qi M, Zhang D, Liu H. The Clinical Performance of Narrow Diameter Implants Versus Regular Diameter Implants: A Meta-Analysis. J ORAL IMPLANTOL 2019; 45:503-508. [PMID: 31536434 DOI: 10.1563/aaid-joi-d-19-00025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study is to analyze 1- and 3-year clinical performances of narrow diameter implants (NDIs) versus regular diameter implants (RDIs). A search of electronic databases and a manual search was performed for the time period January 2000 to April 2018. A meta-regression was used to evaluate the effects of the "fixed effects" model on the implant survival rates, prosthesis success rates and marginal bone loss (MBL) with follow-up time of 1 year and 3 years. Of the 11 studies included, the overall combined 1-year implant survival rates were 98.14% for NDIs and 98.20% for RDIs. The overall combined 3-year implant survival rates were 98.71% for NDIs and 98.84% for RDIs. The corresponding values for 1-year prosthesis success rates were 96.94% for NDIs and 99.25% for RDIs. The corresponding values for 3-year prosthesis success rates were 89.25% for NDIs and 96.55% for RDIs. The meta-regression showed no significant differences between NDIs and RDIs regarding implant survival rates, prosthesis success rates, and MBL in 1-year and 3-year follow-up (P > .05). The results of this meta-analysis concluded that the implant diameter did not affect its survival rates, prosthesis success rates, and MBL in 1 and 3 years. The use of NDIs instead of bone augmentation procedures with RDIs did not affect its survival rates, prosthesis success rates, and MBL in the short-term and middle-term. However, more high-quality randomized controlled trials and long follow-up studies are needed on this topic.
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Affiliation(s)
- Meng Ma
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.,Institute of Stomatology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Mengxing Qi
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Dongsheng Zhang
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Hongchen Liu
- Institute of Stomatology, Chinese People's Liberation Army General Hospital, Beijing, China
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Elemek E, Urgancioglu A, Dincer J, Cilingir A. Does Implant-Abutment Interface affect Marginal Bone Levels around Implants? Eur J Dent 2019; 13:47-52. [PMID: 31170755 PMCID: PMC6635972 DOI: 10.1055/s-0039-1688538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE The use of dental implants with different types of surface roughness and implant-abutment interface has brought about a situation of marginal bone loss. Therefore, the aim of this study was to analyze and compare marginal bone levels of different types of osseointegrated dental implants with platform switch (Group A: Ankylos, Mannheim, Germany) and platform match (Group B: Dentsply Xive, Mannheim, Germany, and Group C: MIS Implant Technologies, Karmiel, Israel). MATERIALS AND METHODS One hundred and seven patients (52 men and 55 women) with a mean age of 54.79 (standard deviation ± 12.35) years and a total of 321 dental implants (Group A, n = 198; Group B, n = 58; and Group C, n = 65) placed in a private practice between April 2006 and May 2015 were retrospectively analyzed. In addition to demographic information and implant characteristics, marginal bone levels were evaluated by Image J (Wayne Rasband, National Institute of Health, Maryland) program. RESULTS The mean age of all patients was 54.79 ± 12.35 years, and 51.5% of them were women. Implants supporting fixed bridge were most commonly used in all groups (65%), whereas only 20% were restored with a single crown and 15% with overdentures. In total, 47.5% of all implants showed no marginal bone loss. Mean bone loss in Group A was significantly lower (0.81 ± 1.60 mm) as compared to Group B (1.58 ± 1.59 mm) and Group C (1.18 ± 1.36) (p < 0.005). CONCLUSION Among different types of dental implants, platform switch seems to preserve marginal bone levels and increase the long-term success of dental implants.
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Affiliation(s)
| | | | | | - Altug Cilingir
- Department of Prosthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
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MACHADO RCM, THOMÉ G, BERNARDES SR, MELO ACM. Morse taper implant macrodesign, loading protocol and site of installation – retrospective study of 5,601 implants. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.06919] [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
Abstract Introduction The long-term implant-supported prosthetic rehabilitation monitoring is extremely important in evaluating parameters that could interfere in the success of the treatment. Objective To evaluate the influence of macrodesign (shape of the body and apex), length and diameter, insertion torque, site of installation as well as the loading protocol, on long-term survival rates. Material and method The data obtained was from the medical records of rehabilitated patients who had had at least one Morse taper implant surgery done at ILAPEO School between 2006 -2012. Incomplete medical records, from which it would have been impossible to extract all data essential to complete the study, were excluded. Result A total of 1,142 patient’s medical records comprised the sample; documenting the progress of 5,601 implants, done in both jaws and mandibles. The final survival rate was 98.31%, over an average time of 37.54 months. The type of implant most used was cylindrical (70.33%). The mean installation torque most evidenced in the study was between 41 and 50 Ncm. A logistical regression analysis showed that none of the following variables, site of installation, body and apex shape designs and length, had any significant statistical influence on implant loss. Torque increase and diameter influenced implant loss while immediate loading favored implant maintenance. Conclusion It can be concluded that Morse taper implants present a long-term survival rate that can be lowered by excessive torque, as well as by the diameter of the implant.
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Affiliation(s)
| | - Geninho THOMÉ
- Instituto Latino Americano de Pesquisa e Ensino Odontológico, Brasil
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Short Implants: Analysis of 69 Implants Loaded in Mandible Compared With Longer Implants. J Craniofac Surg 2018; 29:2272-2276. [DOI: 10.1097/scs.0000000000004518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Rasouli R, Barhoum A, Uludag H. A review of nanostructured surfaces and materials for dental implants: surface coating, patterning and functionalization for improved performance. Biomater Sci 2018; 6:1312-1338. [PMID: 29744496 DOI: 10.1039/c8bm00021b] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The emerging field of nanostructured implants has enormous scope in the areas of medical science and dental implants. Surface nanofeatures provide significant potential solutions to medical problems by the introduction of better biomaterials, improved implant design, and surface engineering techniques such as coating, patterning, functionalization and molecular grafting at the nanoscale. This review is of an interdisciplinary nature, addressing the history and development of dental implants and the emerging area of nanotechnology in dental implants. After a brief introduction to nanotechnology in dental implants and the main classes of dental implants, an overview of different types of nanomaterials (i.e. metals, metal oxides, ceramics, polymers and hydrides) used in dental implant together with their unique properties, the influence of elemental compositions, and surface morphologies and possible applications are presented from a chemical point of view. In the core of this review, the dental implant materials, physical and chemical fabrication techniques and the role of nanotechnology in achieving ideal dental implants have been discussed. Finally, the critical parameters in dental implant design and available data on the current dental implant surfaces that use nanotopography in clinical dentistry have been discussed.
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Affiliation(s)
- Rahimeh Rasouli
- Department of Medical Nanotechnology, International Campus, Tehran University of Medical Sciences, Tehran, Iran.
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Influence of Implant Shape (Tapered vs Cylindrical) on the Survival of Dental Implants Placed in the Posterior Maxilla: A Systematic Review. IMPLANT DENT 2017; 25:855-860. [PMID: 27749519 DOI: 10.1097/id.0000000000000490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this review was to assess the effect of implant shape (tapered vs cylindrical) on the survival of dental implants placed in the posterior maxilla. METHODS Databases were searched from 1977 up to and including February 2015 using various key words. Only original clinical studies were included. Experimental studies, letters to the editor, review articles, case reports, and unpublished literature were excluded. The pattern of the present review was customized to mainly summarize the relevant information. RESULTS Five studies were included. The number of patients included ranged between 4 and 29 participants. In total, 7 to 72 implants were placed in the posterior maxilla. Tapered and cylindrical shaped implants were placed in 1 and 1 study, respectively. In 1 study, both 41 tapered and cylindrical implant were placed. In all studies, rough-surfaced and threaded implants were used. Three studies reported the diameter and lengths of implants placed, which ranged between 3.75 to 4 mm and 10 to 20 mm, respectively. The mean follow-up period and survival rate of implants ranged between 19 and 96 months and 84.2% to 100%, respectively. In 1 study, implants were placed subcrestally in the posterior maxilla. Guided bone regeneration was performed in none of the studies. In all studies, participants were nonsmokers and were systemically healthy. CONCLUSIONS There is no influence of implant shape on the survival of implants placed in the posterior maxilla.
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Effect of the Drilling Technique on Heat Generation During Osteotomy Preparation for Wide-Diameter Implants. IMPLANT DENT 2017; 25:825-828. [PMID: 27540847 DOI: 10.1097/id.0000000000000482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To test the hypothesis that there would be no difference in heat generation by reducing the number of drills during the implant site preparation relative to conventional drilling sequence. METHODS A total of 80 implant site preparations with 2 different diameters (5.6 and 6.2 mm) were performed on bovine ribs. Within the same diameter group, half of the preparations were performed by a simplified drilling procedure (pilot drill + final diameter drill) and the other half using the conventional drilling protocol, where multiple drills of increasing diameter were utilized. Heat production by different drilling techniques was evaluated by measuring the bone temperature using K-type thermocouple and a sensitive thermometer before and after each drill. RESULTS Mean for maximum temperature increase during site preparation of the 5.6- and 6.2-mm implants was 2.20°C, and it was 2.55°C when the site was prepared by the simplified procedure, whereas it was 2.80°C and 2.95°C for the sites prepared by the conventional technique, respectively. No significant difference in temperature increase was found when implants of the 2 chosen diameters were prepared either by the conventional or simplified drilling procedure. CONCLUSIONS The simplified drilling protocol produces similar amount of heat comparable to the conventional technique, which proved the initial hypothesis.
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Gupta B, Shadbolt B, Hyam D. Referral patterns of general dental practitioners for bone grafting and implant placement. Aust Dent J 2017; 62:311-316. [PMID: 28241381 DOI: 10.1111/adj.12507] [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: 02/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dental implant rehabilitation is a well-established procedure often conducted in the general dental practise setting. The outcomes for implant placement are reliable when the recipient site is favourable. The goal of this study was to assess the accuracy with which general dental practitioners (GDP) assess the bone volume available for implant placement and their referral patterns for implant sites, which may require bone grafting. METHODS Fifty-three GDP were surveyed and asked to assess five different scenarios and cone-beam scans for difficulty (0, 'no difficulty'; 5, 'the most difficult'), and bone grafting requirements ('yes'/'no' and 'who to perform'), prior to implant placement. RESULTS The GDP assessment of difficulty for the cases was: no graft required, 1.88; aesthetic zone involvement, 3.25; vertical deficiency, 2.8; sinus lift required, 3.68; and horizontal deficiency, 4.4. GDP seemed to have some difficulty identifying which cases required a bone graft, occasionally grafting a site with sufficient bone (12.5%), or not grafting a site with insufficient bone (45-75%). CONCLUSIONS These results show that GDP are accurate in assessing the difficulty of an implant case and conservative when it comes to attempting these complex cases. GDP are less confident when it comes to recognizing cases that require bone grafting, and what options are available.
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Affiliation(s)
- B Gupta
- Oral and Maxillofacial Unit, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - B Shadbolt
- Epidemiology and Statistics, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - D Hyam
- Oral and Maxillofacial Unit, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.,Australian National Medical School, Canberra, Australian Capital Territory, Australia
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Investigation of influence of different implant size and placement on stress distribution with 3-dimensional finite element analysis. IMPLANT DENT 2016; 23:716-22. [PMID: 25290280 DOI: 10.1097/id.0000000000000158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to analyze the biomechanical behavior of implants with varying number, inclination, and size, using 3-dimensional finite element (FE) analysis. MATERIAL AND METHODS A total of 10 FE models were constructed to simulate 5 implant placement configurations: 4 and 5 axial implants, 4 implants inclined with 17.5 degrees mesial and 35 degrees distal, and 2 axial and 2 distal implants inclined with 17.5 and 35 degrees, using implants of 3.5 and 5.5 mm diameters. A vertical load of 300 N was applied to the distal portion of a standardized size metal framework. RESULTS Increasing the number of implants decreased the stress in the bone for axially placed implant models. The short implants with a large diameter resulted in lower stress values in the bone, but higher stresses in the implant/abutment assembly than the long implants with a small diameter. Increasing diameter of implants decreased high stress concentration in the cortical bone, resulting from increasing cantilever length. CONCLUSIONS Decreasing cantilever length with distal implant inclination decreases the stress values in the implant, cortical bone, and framework.
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Jain N, Gulati M, Garg M, Pathak C. Short Implants: New Horizon in Implant Dentistry. J Clin Diagn Res 2016; 10:ZE14-ZE17. [PMID: 27790598 DOI: 10.7860/jcdr/2016/21838.8550] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022]
Abstract
The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.
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Affiliation(s)
- Neha Jain
- Reader, Department of Prosthodontics, Sudha Rustagi College of Dental Sciences and Research , Faridabad, Haryana, India
| | - Manisha Gulati
- Reader, Department of Prosthodontics, Sudha Rustagi College of Dental Sciences and Research , Faridabad, Haryana, India
| | - Meenu Garg
- Reader, Department of Prosthodontics, Sudha Rustagi College of Dental Sciences and Research , Faridabad, Haryana, India
| | - Chetan Pathak
- Senior Lecturer, Department of Prosthodontics, Sudha Rustagi College of Dental Sciences and Research , Faridabad, Haryana, India
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Al-Johany SS, Al Amri MD, Alsaeed S, Alalola B. Dental Implant Length and Diameter: A Proposed Classification Scheme. J Prosthodont 2016; 26:252-260. [PMID: 27379723 DOI: 10.1111/jopr.12517] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To propose a length-and-diameter-based classification scheme for dental implants to standardize terminology in the dental literature and communication between interested parties. MATERIALS AND METHODS This study was mainly based on searching two major resources: published scientific research papers and 14 of the most popular dental implant manufacturers. Indexed databases were searched from January 2004 up to and including February 2016 using the keywords "dental implant length" and "dental implant diameter." Retrieved titles and abstracts were screened, and related full-text articles were reviewed. Full-text articles that clearly stated the terms and measurements of implants used were included and considered for proposing this classification scheme. RESULTS The initial search for implant diameter and length yielded 1007 and 936 articles, respectively. A total of 85 studies (41 about diameter, 44 about length) were selected and reviewed. The remaining studies (966 about diameter, 892 about length) that did not abide by the eligibility criteria were excluded. The terms "long," "short," "standard," "wide," and "narrow" were the most commonly used terms in the literature. A classification scheme for implants by diameter and length was proposed. CONCLUSIONS Indexed publications contain a variety of terms used by authors to describe diameter and length of dental implants without conformity and standardization. The classification scheme proposed in this article could serve as a reference for interested parties.
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Affiliation(s)
- Sulieman S Al-Johany
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad D Al Amri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Suliman Alsaeed
- Department of Orthodontics, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bassam Alalola
- Department of Orthodontics, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Lin CS, Wu SY, Huang HY, Lai YL. Systematic Review and Meta-Analysis on Incidence of Altered Sensation of Mandibular Implant Surgery. PLoS One 2016; 11:e0154082. [PMID: 27100832 PMCID: PMC4839635 DOI: 10.1371/journal.pone.0154082] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 04/10/2016] [Indexed: 12/17/2022] Open
Abstract
Altered sensation (including paresthesia, dysesthesia and hypoesthesia) after mandibular implant surgery may indicate transient or permanent injury of the inferior alveolar nerve and the mental branch, and considerably lower patients’ satisfaction about the therapy. Previous studies have shown a great degree of variability on the incidence of altered sensation. We here reported the incidence of altered sensation after mandibular implant surgery based on a meta-analysis of 26 articles published between 1990.1.1 and 2016.1.1. Study quality and risk of bias was assessed and the studies with a lower score were excluded in the meta-analysis. Data synthesis was performed using the logistic-normal random-effect model. The meta-analyses revealed that the short-term (10 days after implant placement) and long-term (1 year after implant placement) incidence was 13% (95% CI, 6%-25%) and 3% (95% CI, 1%-7%), respectively. (2) For the patients who initially reported altered sensation, 80% (95% CI, 52%-94%) of them would return to normal sensation within 6 months after surgery, and 91% (95% CI, 78%-96%) of them would return to normal sensation one year after surgery. We concluded that dentist-patient communication about the risk of altered sensation is critical to treatment planning, since the short-term incidence of altered sensation is substantial (13%). When a patient reports altered sensation, regular assessment for 6 months would help tracing the changes of symptoms. In terms of long-term follow-up (1 year after surgery), the incidence is much lower (3%) and most patients (91%) would return to normal sensation.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| | - Shih-Yun Wu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
- Division of Family Dentistry, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yi Huang
- Biostatistics Task Force, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
- Division of Endodontics and Periodontology, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
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Clinical and Retrospective Evaluation of 4.1- or 4.3-mm-Diameter Implants Placed Immediately in the Molar Region: A Preliminary Study. J Oral Maxillofac Surg 2016; 74:489-96. [DOI: 10.1016/j.joms.2015.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 10/08/2015] [Accepted: 10/19/2015] [Indexed: 11/17/2022]
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Tomruk CO, Sençift MK, Capar GD. Prevalence of sinus floor elevation procedures and survival rates of implants placed in the posterior maxilla. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2015.1102610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Eazhil R, Swaminathan SV, Gunaseelan M, Kannan GV, Alagesan C. Impact of implant diameter and length on stress distribution in osseointegrated implants: A 3D FEA study. J Int Soc Prev Community Dent 2016; 6:590-596. [PMID: 28032053 PMCID: PMC5184395 DOI: 10.4103/2231-0762.195518] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aims and Objectives: Dimension of dental implant is an important parameter which has a considerable impact on the biomechanical load transfer characters and its prognosis. Excessive stress in the bone–implant interface may result in the failure of the implant. The aim of this study was to evaluate the impact of implant diameter and length on neighboring tissues around the implant. The results of the study will help in developing a scientific methodology to select appropriate implant diameter and length. Materials and Methods: In this study, tapered implants of different diameter and length were numerically analyzed using bone–implant models developed from computed tomography generated images of mandible with osseointegrated implants. The impact of various diameters on stress distribution was examined using implants with a length of 13 mm and diameters of 3.5 mm, 4.3 mm and 5.0 mm. Implants with a diameter of 4.3 mm and lengths of 10 mm, 13 mm, 16 mm was developed to examine the impact of various implant length. All materials were assumed to be linearly elastic and isotropic. Masticatory load was applied in a natural direction, oblique to the occlusal plane. The Statistical Package for the Social Sciences software package was used for statistical analysis. Results: Maximum von Mises stresses were located around the implant neck. It was demonstrated that there was statistically significant decrease in von Mises stress as the implant diameter increased. Conclusion: Within the limitations of this study there was statistically significant decrease in von Mises stress as the implant diameter increased.
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Affiliation(s)
- R Eazhil
- Department of Prosthodontics, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - Siva Vadivel Swaminathan
- Department of Prosthodontics, Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia
| | - Madhan Gunaseelan
- Department of Prosthodontics, Ram Dental Care, Yanbu, KSA, Saudi Arabia
| | - G Vijay Kannan
- Department of Prosthodontics, Asan Memorial Dental College and Hospital, Keerapakkam, Tamil Nadu, India
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Lee CT, Chen YW, Starr JR, Chuang SK. Survival analysis of wide dental implant: systematic review and meta-analysis. Clin Oral Implants Res 2015; 27:1251-1264. [PMID: 26705937 DOI: 10.1111/clr.12730] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Wide-diameter implants are frequently placed in molar sites to obtain appropriate restoration profiles, to rescue implants that lack stability, and to engage bone in extraction sites. However, studies of wide-diameter implant placement have provided conflicting evidence regarding clinical outcomes. This systematic review aims to analyze survival rates of wide-diameter implants (platform diameter ≥5 mm) and assess clinical variables potentially affecting failure rates. MATERIAL AND METHODS Electronic search was conducted using MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE from January 1980 to October 2014. Publication screening, data extraction, and quality assessment were performed. Failure rate per implant-year was analyzed using mix-effects Poisson regression model to obtain summary estimates of the 5-year survival rate. Relative risk (RR) was calculated to evaluate the association of different clinical variables with estimated failure rates. RESULTS Eleven retrospective studies and eight prospective studies having at least 1-year follow-up period were included in the analysis. The estimated 5-year survival rate was 92.67% (95% confidence interval: [79.60, 97.50]) in the retrospective studies and 97.76% (Confidence interval: [93.25, 99.27]) in the prospective studies. Implant surface and implant diameter were significantly associated with the failure events in the retrospective studies. CONCLUSIONS Placement of wide-diameter implants demonstrated a promising survival rate during 5-year follow-up. Further controlled trials with the control group and longer follow-up period are needed to provide the direct evidence comparing survival rates of wide implants with survival rates of narrower implants.
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Affiliation(s)
- Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ya-Wei Chen
- Oral and Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital and School of Dentistry, National Yang-Ming University, Taipei, Taiwan.,Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA
| | - Jacqueline R Starr
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, USA
| | - Sung-Kiang Chuang
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA.
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Li YJ, Lu CC. A Novel Scheme and Evaluations on a Long-Term and Continuous Biosensor Platform Integrated with a Dental Implant Fixture and Its Prosthetic Abutment. SENSORS (BASEL, SWITZERLAND) 2015; 15:24961-76. [PMID: 26404283 PMCID: PMC4634461 DOI: 10.3390/s151024961] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/04/2015] [Accepted: 09/10/2015] [Indexed: 11/16/2022]
Abstract
A miniature intra-oral dental implant system including a built-in biosensor device is proposed in this article. The dental implant system, or platform, is replaced over maxilla and allows relatively non-invasive procedures for a novel biosensing scheme for human blood analysis. Due to placement of the implant fixture, periodontal ligaments and the pulp structure, which are regarded as the main origin of pain, are thus removed, and long-term, continuous blood analysis and management through maxillary bone marrow becomes achievable through the dental implant platform. The new pathway of biological sensing is for the first time presented to realize an accurate and painless approach without injections. The dental implant system mainly consists of an implant fixture and a prosthetic abutment, a biosensor module, a bluetooth 4.0 wireless module and a dc button cell battery. The electrochemical biosensor possesses three electrodes, including working, reference and counter ones, which are arranged to pass through the titanium implant fixture below the biosensor module. The electrodes are exposed to the blood pool inside the maxillary bone marrow and perform oxidation/reduction reactions with the coating of biosensing enzyme. To prove the proposed platform, the immobilization process of glucose oxidase (GOD) enzyme and in vitro detections of glucose levels are successfully carried out, and proven sensitivity, linearity and repeatability of the glucose biosensor system are obtained. Moreover, a preliminary canine animal model adopting the new pathway shows significant consistency with the traditional method through dermal pricks for blood sugar detection. Despite the prospective results, further challenges in engineering implementation and clinical practices are addressed and discussed. In brief, the novel biosensing pathway and intra-oral biosensor platform may increasingly reveal their promising value and feasibilities in current bio-medical analysis, diagnosis, drug release and even healthcare technologies.
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Affiliation(s)
- Yu-Jung Li
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan.
| | - Chih-Cheng Lu
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan.
- Department of Mechanical Engineering, National Taipei University of Technology, Taipei 10608, Taiwan.
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Lee JT, Lee HJ, Park SY, Kim HY, Yeo IS. Consecutive unsplinted implant-supported restorations to replace lost multiple adjacent posterior teeth: A 4-year prospective cohort study. Acta Odontol Scand 2015; 73:461-6. [PMID: 25423023 DOI: 10.3109/00016357.2014.983543] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the various events occurring in unsplinted implant restoration in posterior jaws during a period of 4 years. MATERIALS AND METHODS From August 2008 to April 2009, eight volunteers (three men and five women) who had two or more consecutively missing teeth received 20 implants in posterior maxillae and mandibles. Unsplinted single crowns were delivered to each implant. For the 4-year follow-up periods, patients were enrolled in a maintenance schedule at 1, 3, 6, 12, 24, 36 and 48 months. The data, including a questionnaire, radiography, mobility and probing were recorded on regular check-ups. RESULTS A total of 20 implants in eight patients were followed up for 48 months, showing a 100% survival rate. Mean marginal bone loss around implants was 0.26 mm. Statistical analysis revealed insignificant correlation between metal-ceramic and zirconia-ceramic crowns and among implant lengths (8.5 mm, 10 mm and 11.5 mm). Mean probing depths were similar or insignificantly different, regardless of the materials used or length of implants. The most frequent complications, in decreasing order, were food impaction (65%) and porcelain chipping (45%), sensitivity (25%), pain (20%) and loose contact (15%). Compared with metal-ceramic crowns, zirconia-ceramic crowns showed more unfavorable cases of porcelain chipping (p=0.017), pain (p=0.007) and loose contact with an adjacent crown (p=0.031). CONCLUSIONS Within the limits of the sample size, this study showed that unsplinted implant-supported single restorations to replace consecutive posterior missing teeth may function well.
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Affiliation(s)
- Jung-Tae Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital , Seongnam , Korea
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Hentschel A, Herrmann J, Glauche I, Vollmer A, Schlegel KA, Lutz R. Survival and patient satisfaction of short implants during the first 2 years of function: a retrospective cohort study with 694 implants in 416 patients. Clin Oral Implants Res 2015; 27:591-6. [DOI: 10.1111/clr.12626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Andreas Hentschel
- Privat Practice; Zwickau Germany
- Department of Oral and Maxillofacial Surgery (Director: Prof. Dr. Dr. Dr. h.c. Friedrich Wilhelm Neukam); University Hospital Erlangen; Friedrich Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Jan Herrmann
- Privat Practice; Zwickau Germany
- Department of Oral and Maxillofacial Surgery (Director: Prof. Dr. Dr. Dr. h.c. Friedrich Wilhelm Neukam); University Hospital Erlangen; Friedrich Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Ingmar Glauche
- Faculty of Medicine Carl Gustav Carus; Institute for Medical Informatics and Biometry (IMB); Technische Universität Dresden; Dresden Germany
| | | | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery (Director: Prof. Dr. Dr. Dr. h.c. Friedrich Wilhelm Neukam); University Hospital Erlangen; Friedrich Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery (Director: Prof. Dr. Dr. Dr. h.c. Friedrich Wilhelm Neukam); University Hospital Erlangen; Friedrich Alexander Universität Erlangen-Nürnberg; Erlangen Germany
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Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: A systematic review and meta-analysis. J Dent 2015; 43:487-98. [PMID: 25778741 DOI: 10.1016/j.jdent.2015.03.003] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022] Open
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Photoelastic stress analysis of mandibular fixed prostheses supported by 3 dental implants. IMPLANT DENT 2014; 23:704-9. [PMID: 25290285 DOI: 10.1097/id.0000000000000170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To observe the photoelastic stress patterns generated around implants in relation to variations in the diameter and total number of implants supporting fixed complete-arch mandibular frameworks. MATERIALS AND METHODS Three different implant configurations were analyzed (n = 3): 5 standard implants with diameters of 3.75 mm (C), 3 standard implants with diameters of 3.75 mm (3S), and 3 wide implants with diameters of 5.0 mm (3W). The samples were subjected to a vertical compressive load (1.33 kgf) applied at the end of the distal cantilever of the framework. The shear stresses were calculated around the implants, and the data were analyzed using one-way analysis of variance. RESULTS The implants nearest to the loading showed higher stress values regardless of the group. The C group showed lower shear stress when compared with the other groups (P = 0.001). No significant difference was observed between the 3W and 3S groups (P = 0.785). CONCLUSION A reduction in the number of implants, regardless of the implant diameter, showed higher stress concentration around the implants. Five-implant configuration showed lower stress concentration and seems to be more biomechanically predictable.
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Gaviria L, Salcido JP, Guda T, Ong JL. Current trends in dental implants. J Korean Assoc Oral Maxillofac Surg 2014; 40:50-60. [PMID: 24868501 PMCID: PMC4028797 DOI: 10.5125/jkaoms.2014.40.2.50] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/02/2014] [Indexed: 01/09/2023] Open
Abstract
Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants.
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Affiliation(s)
- Laura Gaviria
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - John Paul Salcido
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Teja Guda
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joo L Ong
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
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Automated implant segmentation in cone-beam CT using edge detection and particle counting. Int J Comput Assist Radiol Surg 2013; 9:733-43. [DOI: 10.1007/s11548-013-0946-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 09/09/2013] [Indexed: 10/26/2022]
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