Soft and Hard Tissues Healing at Immediate Transmucosal Implants Placed Into Molar Extraction Sites With Collagen Membrane Uncovered: A 12-month Prospective Study

Effect of Implant Surface Roughness and Macro- and Micro-Structural Composition on Wear and Metal Particles Released

Background: Considerations about implant surface wear and metal particles released during implant placement have been reported. However, little is known about implant surface macro- and microstructural components, which can influence these events. The aim of this research was to investigate accurately the surface morphology and chemical composition of commercially available dental implants, by means of multivariate and multidimensional statistical analysis, in order to predict their effect on wear onset and particle release during implant placement. Methods: The implant surface characterization (roughness, texture) was carried out through Confocal Microscopy and SEM-EDS analysis; the quantitative surface quality variables (amplitude and hybrid roughness parameters) were statistically analyzed through post hoc Bonferroni’s test for pair comparisons. Results: The parameters used by discriminant analysis evidenced several differences in terms of implant surface roughness between the examined fixtures. In relation to the observed surface quality, some of the investigated implants showed the presence of residuals due to the industrial surface treatments. Conclusions: Many structural components of the dental implant surface can influence the wear onset and particles released during the implant placement.

Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis

Background

Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis.

Material and methods

Electronic and manual literature searches were performed by two independent reviewers in several data-bases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol.

Results

Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15–0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I² = 15.2%.

Conclusion

In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.

Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area: A randomized controlled trial clinical study with one-year follow-up

BACKGROUND

In previous studies, immediate implant placement in molar sites has been widely applied.

PURPOSE

To study the clinical effect and feasibility of immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing for failing teeth in the maxillary molar area.

MATERIAL AND METHODS

Patients who required implantation surgry to replace a failing tooth in the maxilla molar region were selected. Patients were randomized into two groups: immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (test group) or delayed implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing (control group). The outcome criteria were the success rates of implants, Cone Beam Computer Tomography (CBCT) data and results of the subjective satisfaction survey performed with a visual analog scale (VAS).

RESULTS

All implants had good initial stability after implantation. The survival rate of implants was 100% at 1-year follow-up. At the time of permanent restoration, the differences in average horizontal shrinkage of alveolar bone (W1) on the buccal side between the test group (0.65 ± 0.12 mm) and the control group (1.23 ± 0.32 mm) were statistically significant (P < .0001); however, no statistically significant difference (P = .515) was observed on the palatal side (0.3 ± 0.10 mm vs 0.28 ± 0.08 mm). The difference in vertical resorption of alveolar bone (H1) on the buccal side between the test group (0.60 ± 0.18 mm) and the control group (1.53 ± 0.19 mm) was statistically significant (P < .0001), but no statistically significant difference (P = .190) in the reduction of palatal alveolar bone (0.24 ± 0.12 mm vs 0.29 ± 0.13 mm) was observed. After 1-year loading, no statistically significant difference (P > .05) in vertical or horizontal changes (W2, H2) were identified in the test group or control group. Patient satisfaction in both groups was similar (8.36 ± 1.01 vs 8.14 ± 1.35), and the difference between groups was not statistically significant (P = .638).

CONCLUSION

Immediate implant placement combined with maxillary sinus floor elevation utilizing the transalveolar approach and nonsubmerged healing is feasible for the maxillary molar area, and the clinical effect is satisfactory.