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Bregagnol RB, Coltro MPDL, Villarinho EA, Triches DF, Alonso FR, Mezzomo LAM, de Macedo BB, Teixeira ER, Vigo A, Shinkai RSA. Long-term clinical performance of short 6-mm implants supporting single crowns in the posterior region: A 10-year cohort study. Clin Implant Dent Relat Res 2024; 26:158-169. [PMID: 37882144 DOI: 10.1111/cid.13287] [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: 06/20/2023] [Revised: 09/10/2023] [Accepted: 10/02/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Long-term clinical success of non-splinted, posterior, and short implants still is unclear. This prospective cohort study reports the 10-year follow-up of 6-mm implants supporting single crowns in the posterior region, and patient-reported outcomes. METHODS Baseline sample comprised 20 patients treated with 46 screw-retained crowns supported by 6-mm implants with moderately rough implant surface. Participants were recalled for a 10-year clinical follow-up to assess survival rates, biologic and mechanic conditions, quality of life (OHIP-14), and treatment satisfaction. Data were collected with clinical-radiographic exams and analyzed using descriptive and inferential statistics. RESULTS Fourteen patients with 35 implant-crown units were examined after 127.6 ± 11.8 months. For the entire cohort period, 7/46 implants were lost (survival estimate: 77.7% at 133 months), and mechanic complications occurred in 14/46 units (survival estimate: 66.4% at 116 months). In the Cox models, "maximum occlusal force" had a significant effect for implant loss (p = 0.038) and for prosthetic screw loosening (p = 0.038); "arch" and "bruxism" were not significant. Peri-implant bone loss was 0.4 ± 0.6 mm at 10 years. For peri-implant bone level, "crown-to-implant ratio" (p < 0.001) and "time" (p = 0.001) were significant. Bone levels differed from baseline to 12, 48, and 120 months. Satisfaction VAS was 94.0 ± 7.9 mm and OHIP-14 was 2.3 ± 2.2. CONCLUSION Single screw-retained crowns supported by 6-mm implants have an acceptable long-term clinical performance, with stable peri-implant bone levels after 10 years of function.
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Affiliation(s)
- Raphaela Brambilla Bregagnol
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Private Practice, Porto Alegre, Brazil
| | | | | | - Diego Fernandes Triches
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Private Practice, Porto Alegre, Brazil
| | - Fernando Rizzo Alonso
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Private Practice, Jaú, Brazil
| | - Luís André Mendonça Mezzomo
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- School of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Eduardo Rolim Teixeira
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Alvaro Vigo
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rosemary Sadami Arai Shinkai
- School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- School of Dentistry, University of São Paulo, São Paulo, Brazil
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Hashemi S, Tabatabaei S, Baghaei K, Fathi A, Atash R. Long-Term Clinical Outcomes of Single Crowns or Short Fixed Partial Dentures Supported by Short (≤6 mm) Dental Implants: A Systematic Review. Eur J Dent 2024; 18:97-103. [PMID: 37591286 PMCID: PMC10959620 DOI: 10.1055/s-0043-1771028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
Long-term clinical outcomes of short dental implants (≤6 mm) supporting single crowns or short fixed partial dentures have been reported differently in different studies and need more clarification. This systematic study evaluated the rate of bone loss (BL), the durability of implants equal to or shorter than 6 mm supporting single crowns or short fixed partial dentures, and prosthetic-related side effects during 5 years of follow-up. Five databases (PubMed, MEDLINE, Scopus, Google Scholar, and Cochrane) were electronically and manually searched for longitudinal studies with a follow-up period of 5 years or more until January 2023. The study question was, "Does the implant equal to or shorter than 6 mm affect BL and survival rate of the implant-supported prosthesis after 5 years of follow-up?". From 752 identified articles, nine studies were selected for further evaluation. After 5 years of follow-up, most studies had more than 90% survival rate and the maximum BL was 0.54 mm. Still, in internal and external connections, these changes were not substantial. For example, screw loosening was the most common problem with implanted prostheses. Implants of 6 mm or shorter are a suitable treatment option in atrophic ridges with good durability and fewer side effects during a follow-up period of more than 5 years.
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Affiliation(s)
- Sara Hashemi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shivasadat Tabatabaei
- The School of Public Health, Boston University, Boston, Massachusetts, United States
| | - Kimia Baghaei
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Fathi
- Dental Prosthodontics Department, Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Atash
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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Zhang JP, Wang ZH, Zhang J, Qiu J. Convolutional neural network-based measurement of crown-implant ratio for implant-supported prostheses. J Prosthet Dent 2024:S0022-3913(24)00008-8. [PMID: 38278668 DOI: 10.1016/j.prosdent.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
STATEMENT OF PROBLEM Research has revealed that the crown-implant ratio (CIR) is a critical variable influencing the long-term stability of implant-supported prostheses in the oral cavity. Nevertheless, inefficient manual measurement and varied measurement methods have caused significant inconvenience in both clinical and scientific work. PURPOSE This study aimed to develop an automated system for detecting the CIR of implant-supported prostheses from radiographs, with the objective of enhancing the efficiency of radiograph interpretation for dentists. MATERIAL AND METHODS The method for measuring the CIR of implant-supported prostheses was based on convolutional neural networks (CNNs) and was designed to recognize implant-supported prostheses and identify key points around it. The experiment used the You Only Look Once version 4 (Yolov4) to locate the implant-supported prosthesis using a rectangular frame. Subsequently, two CNNs were used to identify key points. The first CNN determined the general position of the feature points, while the second CNN finetuned the output of the first network to precisely locate the key points. The network underwent testing on a self-built dataset, and the anatomic CIR and clinical CIR were obtained simultaneously through the vertical distance method. Key point accuracy was validated through Normalized Error (NE) values, and a set of data was selected to compare machine and manual measurement results. For statistical analysis, the paired t test was applied (α=.05). RESULTS A dataset comprising 1106 images was constructed. The integration of multiple networks demonstrated satisfactory recognition of implant-supported prostheses and their surrounding key points. The average NE value for key points indicated a high level of accuracy. Statistical studies confirmed no significant difference in the crown-implant ratio between machine and manual measurement results (P>.05). CONCLUSIONS Machine learning proved effective in identifying implant-supported prostheses and detecting their crown-implant ratios. If applied as a clinical tool for analyzing radiographs, this research can assist dentists in efficiently and accurately obtaining crown-implant ratio results.
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Affiliation(s)
- Jin-Ping Zhang
- Postgraduate student, Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, PR China
| | - Ze-Hui Wang
- Graduate student, Jiangsu University of Science and Technology, Zhenjiang, PR China
| | - Juan Zhang
- Graduate student, Zhenjiang Stomatological Hospital, Zhenjiang, PR China
| | - Jing Qiu
- Professor, Department of Oral Implantology, Affiliated Hospital of Stomatology, Jiangsu Province Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, PR China.
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Häggman-Henrikson B, Ali D, Aljamal M, Chrcanovic BR. Bruxism and dental implants: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:202-217. [PMID: 37589382 DOI: 10.1111/joor.13567] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/24/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Overload from bruxism may affect survival of dental implants. OBJECTIVES To evaluate implant failure and marginal bone loss (MBL) in patients presenting with probable bruxism compared to non-bruxers. The study was registered in PROSPERO (CRD42021238397). METHODS An electronic search September 2022 in PubMed/Medline, Web of Science and Science Direct was combined with a hand search. Two independent reviewers carried out abstract screening, full-text assessment, quality assessment (National Institutes of Health tool) and data extraction. Only studies that provided information on self-report and clinical examination needed for the diagnosis of at least 'probable' bruxism were included. A pairwise random-effect meta-analysis was carried out. RESULTS In total 1338 studies were identified, and after screening and full-text assessment 27 studies that presented data on 2105 implants in probable bruxers and 10 264 implants in non-bruxers were included, with 138 and 352 implant failures in respective groups. the meta-analysis showed that implants placed in probable bruxers had a higher risk of failure than in non-bruxers (OR 2.189; 95% CI 1.337, 3.583, p = .002). A meta-regression showed that follow-up time did not affect this OR. Eighteen studies provided general data on MBL but did not report results separated between bruxers and non-bruxers. Therefore, an analysis of MBL was not possible. CONCLUSION The results of the present systematic review show that implants placed in probable bruxers present a significantly higher risk of failure than implants placed in non-bruxers. This should be considered in treatment planning and management of implant patients.
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Affiliation(s)
| | - David Ali
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D’Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227995. [PMID: 36431480 PMCID: PMC9695726 DOI: 10.3390/ma15227995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/31/2023]
Abstract
Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Mauro Marincola
- Dental Implant Unit, Research Department, Faculty of Dentistry, University of Cartagena, Cartagena 130001, Colombia
| | - Pietro Liboni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Paolo Faccioni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio D’Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
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Short Implants versus Longer Implants with Sinus Floor Elevation: A Systemic Review and Meta-Analysis of Randomized Controlled Trials with a Post-Loading Follow-Up Duration of 5 Years. MATERIALS 2022; 15:ma15134722. [PMID: 35806845 PMCID: PMC9267683 DOI: 10.3390/ma15134722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
This study compared the outcome of fixed prostheses supported by short implants (<8 mm) and longer implants (≥8 mm) with an elevated sinus floor after 5 years of follow-up. The literature searches were performed electronically and manually in PubMed, EMBASE, and Web of Science databases to identify relevant articles published from 1 January 2013 to 31 January 2020. We selected eligible studies using inclusion criteria and assessed their quality. From 1688 identified studies, five randomized controlled trials were included. Between the short implant group and the control group, the implant failure-related pooled risk ratio (RR) was 3.64 (p = 0.07). The RR for technical complications was 2.61 (p = 0.0002), favoring longer implants. Marginal peri-implant bone loss after 1 and 5 years of function showed statistically significant less bone loss at short implants (1 year: mean difference = 0.21 mm; p < 0.00001; 5 years: mean difference = 0.26 mm; p = 0.02). The implant failure and the biological failure of both groups were similar after 5 years of follow-up. Short implants could be an alternative to long implants with an elevated sinus floor for atrophic maxillae in aging populations. Studies with larger trials and longer periods of follow-up (10 years) remain essential.
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Seelig da Cunha K, De Lima Coltro MP, Drummond LG, Ozkomur A, Villarinho EA, Teixeira ER, Vigo Á, Shinkai RSA. Biomechanical variables affect peri-implant bone loss in implant-supported fixed complete dentures: a methodological and prospective study. J Prosthodont Res 2022; 67:173-179. [PMID: 35613872 DOI: 10.2186/jpr.jpr_d_21_00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Implant-supported fixed complete dentures (IFCD) experience failures and complications related to biological and technical risk factors. This study investigated the effect of biomechanical variables of IFCD on 1-year peri-implant bone loss at the buccal, palatal/lingual, mesial, and distal implant sides. A new method was used to measure the geometric biomechanical variables of IFCD using cone beam computed tomography (CBCT). METHODS The study sample consisted of 246 external hexagon implants supporting 48 hybrid IFCD in 44 patients. CBCT images obtained immediately (T0) and 1 year (T1) after prosthesis installation were used to measure the support polygon area, clinical crown/implant (C/I) ratio (vertical lever), anteroposterior power and resistance arms, anterior and posterior cantilevers (horizontal levers), and peri-implant bone remodeling (T1-T0). Data were analyzed using multilevel multivariable models. RESULTS The average total bone loss in the mandible and maxilla were 0.88 mm, with a loss of 0.62 mm in the mandible and 1.08 mm in the maxilla. The C/I ratio had a significant effect on bone loss on the mesial, distal, and palatal/lingual sides (P <.05). The anterior cantilever had a protective effect on the lingual side of the anterior implant. No effect on bone loss was found for the support polygon area, posterior cantilever, resistance arm, or power arm (P >.05). CONCLUSIONS The results suggest that the C/I ratio and anterior cantilever in IFCD affect peri-implant bone loss according to the implant side and position in the arch.
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Affiliation(s)
- Kael Seelig da Cunha
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | - Maria Paula De Lima Coltro
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Ahmet Ozkomur
- Lutheran University of Brazil, Post-graduate Program in Dentistry, Canoas, Brazil
| | - Eduardo Aydos Villarinho
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Álvaro Vigo
- Federal University of Rio Grande do Sul, Post-graduate Program in Epidemiology, Porto Alegre, Brazil
| | - Rosemary S A Shinkai
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil.,University of São Paulo, School of Dentistry, São Paulo, Brazil
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Lombardo G, Signoriello A, Marincola M, Liboni P, Bonfante EA, Nocini PF. Survival rates of ultra-short (<6 mm) compared with short locking-taper implants supporting single crowns in posterior areas: A 5-year retrospective study. Clin Implant Dent Relat Res 2021; 23:904-919. [PMID: 34796619 PMCID: PMC9299664 DOI: 10.1111/cid.13054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/22/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022]
Abstract
Background Short and ultra‐short implants represent a predictable treatment, in terms of implant survival, with patients presenting insufficient available bone volumes. Moreover, single crown restorations represent a gold standard in terms of oral hygiene. Purpose The aim of this retrospective study was to evaluate implant survival, marginal bone loss, and peri‐implant complications in 333 locking‐taper short and ultra‐short implants. Materials and Methods Implants were placed in the maxillary and mandibular posterior regions of 142 patients. Clinical and radiographic examinations were performed at 5‐year recall appointments. Results All implants placed consisted of 8.0‐, 6.0‐, and 5.0‐mm length, 38.14%, 34.53%, and 27.33%, respectively. Three hundred thirty‐two implants (one early failure) were rehabilitated with single crowns in 141 patients. In 45.48% of the implants the crown‐to‐implant ratio was ≥2, with a mean value of 1.94. Overall implant‐based survival after 5 years of follow‐up was 96.10%: 96.85%, 95.65%, and 95.60% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.82). Overall patient‐based survival was 91.55%. Regarding crestal bone level variations, average crestal bone loss and apical shift of the “first bone‐to‐implant contact point” position were 0.69 and 0.01 mm, respectively. Setting the threshold for excessive bone loss at 1 mm, during the time interval from loading to follow‐up, 28 implants experienced loss of supporting bone greater than 1 mm: 19 of them (67.85%) were surgically treated with a codified surgical regenerative protocol. After 60 months, a peri‐implantitis prevalence of 5.94% was reported, with an overall implant success of 94.06%: 95.93%, 92.73%, and 93.10% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.55). Conclusion Long‐term outcomes suggest that short and ultra‐short locking‐taper implants can be successfully restored with single crowns in the posterior area of the maxilla and mandible.
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Affiliation(s)
- Giorgio Lombardo
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Annarita Signoriello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pietro Liboni
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Pier F Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
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The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis. J Prosthet Dent 2021; 126:497-502. [DOI: 10.1016/j.prosdent.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/23/2023]
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Posterior jaws rehabilitation with < 7mm-short implants. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e45-e56. [PMID: 34563727 DOI: 10.1016/j.jormas.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The results with shorter and shorter implants have been revolutionizing the implantology scenario and are worthy of being well-analyzed and understood. This review aims to add further knowledge about the last 10-years observation period on < 7mm-short implants in the posterior atrophic jaws, better defining the indication of their use. METHODS From a Medline database research, systematic reviews, controlled and no- controlled trials (CT, n-CT) with ≥ 3years-follow-ups on <7 mm / ≥ 5mm-short implants (group A), and clinical studies with ≥ 1year-follow-up on 4mm-short implants (group B) were considered. The outcomes, in terms of implant survival rate (SR), marginal bone loss (MBL), and complications were analyzed according to the duration of follow-ups, implant site (maxilla and mandible), type of prosthesis (single crown or splinted units), vertically impaired or normal sites. RESULTS Thirty-four trials (28 for group A and six for group B) were selected. Group A: a mean follow up of 5,8 (3-10) years came out; pre-and post-loading SR range was 94.4- 100% and 89.6-100%, respectively; the range of MBL was 0.12-1.49; 50% of CT found less statistically significant surgical complications in comparison with standard implants (ST) in reconstructed sites, while major prosthetic problems were recorded with short -implants (SH) in 37.5% of CT; in no atrophied sites, a mean SR range of 86.7-100 % vs. 88-100 % and a total bone loss of 2 vs.1.6 for SH vs.ST emerged. Group B: the overall mean follow-up period was 2,3 years, and the pre-and post- SR ranges were 93-100 % and 87.5-100 %, respectively. The MBL range was 0.02- 0.63 mm. All RCT reported significantly fewer surgical complications with SH than with ST in reconstructed mandibles within one year. No prosthetic complications were reported for up to 5 years using no pontics or cantilevers fixed bridges. CONCLUSIONS Similar or even better results for SH than ST in terms of post-loading SR and MBL came out for < 7mm/ ≥ 5mm-short implants in atrophic bone regardless of the prosthetic solutions, with less surgical complications but a few more prosthetic problems; the good results up to 5 years for 4mm-short implants in mandibles are associated with splinted and no-risk prosthetic solutions.
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Fonseca M, Haro-Adanez M, Pieralli S, Bresavscek M, Yilmaz B, Att W. Short vs. regular length implants to rehabilitate partially edentulous mandible: a 2-year prospective split-mouth clinical study. J ORAL IMPLANTOL 2021; 48:277-284. [PMID: 34287628 DOI: 10.1563/aaid-joi-d-20-00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many studies have evaluated short implants (SIs); however, it is still unclear whether SIs are reliable and can be used to simplify surgical and prosthetic protocols with successful clinical outcomes. The aim of this non-random, conveniently sampled, prospective, split-mouth study was to compare the clinical outcomes when short (SI) (≤8 mm) or regular-length implants (RIs) (>10 mm) were used in the posterior mandible two years after the delivery of splinted reconstructions. Each participant (N=10) received four implants in the posterior mandible; two SIs were placed on one side, and two RIs were placed contra-laterally. Implants were restored with splinted, screw-retained, porcelain-fused-to-metal reconstructions. Survival and success rates, peri-implant marginal bone level (MBL), and soft tissue parameters were evaluated. No participant drop-outs were recorded. Both types of implants showed 100% success and survival rates. From prosthetic delivery to 24 months post-loading, bone remineralization of +0.40 mm for the SIs and +0.36 mm for the RIs was observed without statistically significant differences in MBL between the implant types (p=0.993). SIs showed significantly higher (p=0.001) clinical attachment level (CAL) and probing depth (PD) values. Chipping occurred in one situation in the RI group resulting in a 97.5% prosthetic success rate, which was 100% for the SIs. After 2 years, SIs with splinted reconstructions showed comparable clinical outcomes to those of RIs. Further long-term controlled clinical studies with balanced experimental designs evaluating random and larger populations are required to corroborate these findings.
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Affiliation(s)
- Manrique Fonseca
- Universitat Bern Senior Lecturer Department of Reconstructive Dentistry and Gerodontology Freiburgstrasse 7 SWITZERLAND Bern Bern 3010 +41 79 640 22 14 University of Bern
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Raabe C, Monje A, Abou-Ayash S, Buser D, von Arx T, Chappuis V. Long-term effectiveness of 6 mm micro-rough implants in various indications: A 4.6- to 18.2-year retrospective study. Clin Oral Implants Res 2021; 32:1008-1018. [PMID: 34129707 PMCID: PMC8457202 DOI: 10.1111/clr.13795] [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: 11/01/2020] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/03/2022]
Abstract
Objectives To evaluate the long‐term effectiveness of 6 mm implants in various indications with a micro‐rough surface after 4.6–18.2 years in function and to assess key factors associated with implant survival, success, and biologic/technical complications. Materials and methods Fifty‐five patients with seventy‐four 6 mm implants placed from 2000 to 2013 attended the re‐examination assessing well‐established clinical and radiographic parameters, biologic and prosthetic complications, and patient‐reported outcome measures. Results Five implants were lost after a mean follow‐up period of 9.1 years resulting in a survival rate of 93.2%. All losses occurred in free‐end situations in the mandible. Smoking habit significantly reduced implant survival (hazard ratio 36.25). Two implants exhibited a history of peri‐implantitis, and one implant showed progressive marginal bone loss (MBL) resulting in a success rate of 89.2%. The mean MBL amounted to 0.029 mm. Increased MBL was found for implants placed in the maxilla (0.057 mm) and for implants with a diameter of 4.1 mm (0.043 mm). Soft tissue thickness (1.39 mm) and width of keratinized mucosa (1.91 mm) had no effect on MBL. Patient‐reported outcome measures showed high satisfaction (mean VAS scores 88%) and high quality of life (mean OHIP‐G14 score 2.2). Conclusion The present study demonstrated survival and success rates of 93.2% and 89.2% for 6 mm implants used in various indications. A factor leading to higher implant failure was smoking, whereas modulating factors increasing annual MBL included implants placed in the maxilla and implants with a diameter of 4.1 mm compared to 4.8 mm.
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Affiliation(s)
- Clemens Raabe
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alberto Monje
- Department of Periodontology, University Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, The University of Michigan, Ann Arbor, MI, USA
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Daniel Buser
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Thomas von Arx
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Segalla DB, Villarinho EA, Correia ARM, Vigo Á, Shinkai RSA. A within-subject comparison of short implants in the posterior region: retrospective study of up to 10 years. J Adv Prosthodont 2021; 13:172-179. [PMID: 34234927 PMCID: PMC8250189 DOI: 10.4047/jap.2021.13.3.172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This intra-patient retrospective study of up to 10 years evaluated the clinical success and risk factors of 6- and 8-mm long implants and their respective prostheses. MATERIALS AND METHODS The sample consisted of patients treated at a Military Polyclinic dental service, who received both 6- and 8-mm long tissue level implants in the posterior region of the same arch. Data were collected from the dental charts, clinical and radiographic exams, self-report of sleep bruxism, measurement of maximum occlusal force, and clinical crown-to-implant (C/I) ratio. Data were analyzed by descriptive and inferential statistics with univariate and hierarchical multivariate models, at the 0.05 significance level. RESULTS The 30 patients (27 women) had 85 implants and 83 prostheses. Two implants were lost before prosthesis installation (implant survival: 97.6%). Ten events of prosthetic complication (screw tightening loss) occurred in five patients (success rate: 87.9%) in a single moment. Only the variable C/I ratio had a significant effect for repairable prosthesis complication (P<.05). CONCLUSION The results suggest that 6- and 8-mm long implants have similar long-term clinical success for implants and prostheses.
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Affiliation(s)
- Douglas Blum Segalla
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.,Military Policlinic of Porto Alegre, Porto Alegre, Brazil
| | | | - André Ricardo Maia Correia
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, Portugal
| | - Álvaro Vigo
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Leighton Y, Carpio L, Weber B, Dias FJ, Borie E. Clinical evaluation of single 4-mm implants in the posterior mandible: A 3-year follow-up pilot study. J Prosthet Dent 2020; 127:80-85. [PMID: 33234301 DOI: 10.1016/j.prosdent.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Extra-short implants in the posterior mandible can increase the functional surface area and reduce the risk of implant overload. However, reports of treatment using single extra-short implants in the posterior mandible with a midterm follow-up are lacking. PURPOSE The purpose of this prospective pilot study was to evaluate the clinical behavior of single extra-short 4-mm implants placed in the posterior mandible during a follow-up of 3 years from implant restoration. MATERIAL AND METHODS A total of 18 participants with a single extra-short 4-mm-long implant placed in the area of the mandibular first molars participated in this pilot study. The survival and success rates of implants, as well as biologic and prosthetic variables, were evaluated during a follow-up of 3 years from implant restoration. RESULTS The survival rate of the implants was 100%, with no implant or biologic complications recorded. One prosthetic complication (loosening of 1 screw) was observed. CONCLUSIONS Single extra-short (4 mm) implants in the posterior mandible showed favorable clinical behavior during the first 3-years of follow-up.
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Affiliation(s)
- Yerko Leighton
- Professor, Department of Oral Implantology, Universidad de Los Andes, Santiago, Chile
| | - Luis Carpio
- Professor, Department of Prosthodontics, Universidad de Cuenca, Cuenca, Ecuador
| | - Benjamin Weber
- Assistant Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile
| | - Fernando Jose Dias
- Associate Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile
| | - Eduardo Borie
- Associate Professor, Department of Integral Dentistry of Adults, Universidad de La Frontera, Temuco, Chile.
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15
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Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
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Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
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CT-based dentulous mandibular alveolar ridge measurements as predictors of crown-to-implant ratio for short and extra short dental implants. Sci Rep 2020; 10:16229. [PMID: 33004827 PMCID: PMC7530749 DOI: 10.1038/s41598-020-73180-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/25/2020] [Indexed: 12/17/2022] Open
Abstract
The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and horizontal dimensions of dentulous posterior mandibles in a sample of 18- to 25-year-olds were measured, and correlations of these dimensions with sex and site were investigated. Mandibular computed tomography scans from 100 subjects were considered. Vertical and horizontal bone and tooth measurements were taken at the sites of the second premolar (PM), and the mesial and distal roots of the first and second molars (M1m, M1d, M2m and M2d, respectively). A hypothetical crown-to-implant ratio (C/I R) was calculated assuming the insertion of short and extra short implants (5, 6 or 7 mm), at 1.5 mm from the inferior alveolar canal, maintaining the position of the existing occlusal plane. All vertical bone dimensions decreased from the PM to the M2d. Width measurements increased from the mesial (PM) to the distal sites (M1m, M1d, M2m and M2d). Males had significantly greater vertical and horizontal measurements than females at all sites. The mean C/I R was higher than 2 for all sizes of implant. The C/I R was lower for the second molar than for the second premolar, while it was similar for the first molar and the second premolar. Males had a higher C/I R than females. Computed tomography can be used to study the anatomical features of alveolar bone, and to predict some clinical aspects of prosthetic rehabilitation with implants, such as the crown-to-implant ratio in conditions of serious bone atrophy.
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Vazouras K, Souza AB, Gholami H, Papaspyridakos P, Pagni S, Weber H. Effect of time in function on the predictability of short dental implants (≤6 mm): A meta‐analysis. J Oral Rehabil 2020; 47:403-415. [DOI: 10.1111/joor.12925] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/01/2019] [Accepted: 12/09/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Konstantinos Vazouras
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Andre Barbisan Souza
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Hadi Gholami
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Sarah Pagni
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston MA USA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
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18
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Prosthetic Rehabilitation of the Posterior Atrophic Maxilla, Short (≤6 mm) or Long (≥10 mm) Dental Implants? A Systematic Review, Meta-analysis, and Trial Sequential Analysis: Naples Consensus Report Working Group A. IMPLANT DENT 2019; 28:590-602. [PMID: 31274666 DOI: 10.1097/id.0000000000000919] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the clinical and patient-reported outcomes of ≤6-mm implants with those of ≥10-mm implants placed after both lateral and transcrestal sinus floor elevation. MATERIALS AND METHODS Using PubMed (MEDLINE), EMBASE, and Cochrane, a literature search for randomized controlled trials was performed. All the outcome variables were evaluated through a quantitative meta-analysis, and the influence of other clinical covariates were determined with a metaregression. For the survival outcomes, trial sequential analysis (TSA) was performed to adjust results for type I and II errors and to analyze the power of the available evidence. RESULTS After full-text reading, 12 studies were included in the analyses. No statistically significant difference was found after 3 years between the 2 study groups (P = 0.36). Short implants displayed fewer biological complications (P = 0.05), less marginal bone loss (MBL) from implant placement (P < 0.01), and reduced surgical time and treatment cost. However, long implants showed a statistically significant smaller number of prosthetic complications (P = 0.03). TSA confirmed the results of the meta-analysis, revealing that additional studies are needed due to low statistical power of the available evidence. CONCLUSION The placement of short implants is a predictable option in treating patients with maxillary atrophy up to a 3-year follow-up. Studies with a longer observational period are needed to study the long-term performance of these implants.
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19
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Peixoto RF, Tonin BSH, Martinelli J, Macedo AP, de Mattos MDGC. In vitro digital image correlation analysis of the strain transferred by screw-retained fixed partial dentures supported by short and conventional implants. J Mech Behav Biomed Mater 2019; 103:103556. [PMID: 31785542 DOI: 10.1016/j.jmbbm.2019.103556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE This study used digital image correlation (DIC) to evaluate the strain transferred by splinted and non-splinted screw-retained fixed partial dentures (FPDs) supported by short and conventional implants. MATERIAL AND METHODS Four polyurethane models were fabricated to simulate half of the mandibular arch with acrylic resin replicas of the first premolar. Short (5 mm) and/or conventional (11 mm) implants replaced the second premolar and the first and second molars. Groups were: G1, two conventional (second premolar and first molar) and one short (second molar) implant; G2, one conventional (second premolar) and two short (first and second molar) implants; G3, three short implants; and G4, three conventional implants. Splinted (S) and non-splinted (NS) FPDs were screwed to the implant abutments. Occlusal load and a single point load on the second premolar, both of 250 N, were applied. Strain in the horizontal direction (Ɛxx) was calculated and compared using the DIC software. RESULTS Splinted crowns presented the highest strain magnitudes of all tested groups (p < 0.05). The strain was concentrated near the short implants and presented a higher magnitude compared to conventional implants, especially in G2S (-560.13 μS), G3S (-372.97 μS), and G4S (-356.67 μS). CONCLUSIONS Splinted crowns presented a higher strain concentration around the implants, particularly near the implant replacing the first molar. A combination of short and conventional implants seems to be a viable alternative for the rehabilitation of the posterior edentulous mandible with reduced bone height.
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Affiliation(s)
- Raniel Fernandes Peixoto
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
| | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janisse Martinelli
- School of Dentistry, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
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20
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Demirkol N, Demirkol M. The Diameter and Length Properties of Single Posterior Dental Implants: A Retrospective Study. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.541657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Meijer HJA, Boven C, Delli K, Raghoebar GM. Is there an effect of crown-to-implant ratio on implant treatment outcomes? A systematic review. Clin Oral Implants Res 2019; 29 Suppl 18:243-252. [PMID: 30306696 PMCID: PMC6221159 DOI: 10.1111/clr.13338] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES High crown-to-implant ratios may lead to complications due to unfavorable occlusal forces, including nonaxial forces, on the bone surrounding the neck of the implant and within the connection of the crown and implant itself. The aim of this study was to perform a systematic review on the influence of crown-to-implant ratio of single-tooth, nonsplinted, implants on biological and technical complications. MATERIALS AND METHODS MEDLINE (1950-January 2018), EMBASE (1966-January 2018), and Cochrane Central Register of Controlled Trials database (1800-January 2018) were searched to identify eligible studies. Inclusion criteria were as follows: crown-to-implant ratio of single-tooth, nonsplinted, implant-supported restorations in the posterior maxilla or mandible and follow-up of at least 1 year. Main outcome measures were as follows: implant survival rate, marginal bone level changes, biological complications, and technical complications. Two reviewers independently assessed the articles. A meta-analysis was carried out for implant survival rate and peri-implant bone changes. RESULTS Of 154 primarily selected articles, eight studies fulfilled the inclusion criteria. Study groups presented a mean crown-to-implant ratio varying from 0.86 (with 10-mm implants) to 2.14 (with 6-mm implants). The meta-analysis showed an implant survival of more than 99% per year and mean peri-implant bone changes of <0.1 mm per year. Limited biological and technical complications were reported. CONCLUSION Data reviewed in the current manuscript on crown-to-implant ratio, ranging from 0.86 to 2.14, of single-tooth, nonsplinted, implants did not demonstrate a high occurrence of biological or technical complications.
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Affiliation(s)
- Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Carina Boven
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Hasanoglu Erbasar GN, Hocaoğlu TP, Erbasar RC. Risk factors associated with short dental implant success: a long-term retrospective evaluation of patients followed up for up to 9 years. Braz Oral Res 2019; 33:e030. [DOI: 10.1590/1807-3107bor-2019.vol33.0030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 03/14/2019] [Indexed: 11/22/2022] Open
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Evaluation of the Cortical Deformation Induced by Distal Cantilevers Supported by Extra-Short Implants: A Finite Elements Analysis Study. Symmetry (Basel) 2018. [DOI: 10.3390/sym10120762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of the study was to analyze the distribution of stresses caused by an axial force in a three-dimensional model with the finite element method in the implant-supported fixed partial denture with distal overhang (PPFIVD) on short dental implants in the posterior edentulous maxilla. Methods: geometrical models of the maxilla with a bone remnant of 9 and 5 mm were created. Straumann SP® (Base, Switzerland) implants were placed in the premolar area. Two groups with subgroups were designed. Group A (GA): PPFIVD on two implants (GA1: 4.1 × 8 mm and GA2: 4.1 × 4 mm); Group B (GB): PPFIVD on the single implant (GB1: 4.1 × 8 mm and GB2: 4.1 × 4 mm). It was applied to a static force of 100 N to 30°. Results: PPFIVD on two implants reached the maximum tension in GA2 with respect to GA1; the difference was not significant in implants. In the maxilla GA2 was lower in relation to GA1; the difference was not significant. In PPFIVD over an implant, the stress was greater in GB2 with respect to GB1; the difference was significant in maxilla and implants. Peri-implant bone micro deformations and prosthesis-implant displacements were observed. Conclusions: PPFIVD over short splinted implants could be viable in the maxilla with reduced bone height, being an option when lifting the floor of the maxillary sinus. The rehabilitation with unitary implant (4 mm) did not provide adequate results. The dominant tensions evidenced bone micro-distortions with a displacement of the prosthesis-implant set. The real statement of this paper was to define that short splinted implants can be used in soft bone with high success rate in reducing bending forces.
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Abstract
Dental implants are a mainstream treatment protocol to replace missing teeth. Patient and clinician demands have led to shorter length and narrower diameter implants, immediately placed implants into infected sites, and the use of implants in children. This article reviews some of the controversial topics in implant dentistry, and presents the evidence that supports and challenges these newer techniques. Because long-term studies are often not available, especially for implants in infected sites, mini implants, and implants in the growing patient, the field continues to evolve.
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Starch-Jensen T, Nielsen HB. Prosthetic Rehabilitation of the Partially Edentulous Atrophic Posterior Mandible with Short Implants (≤ 8 mm) Compared with the Sandwich Osteotomy and Delayed Placement of Standard Length Implants (> 8 mm): a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2018; 9:e2. [PMID: 30116514 PMCID: PMC6090250 DOI: 10.5037/jomr.2018.9202] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 01/26/2023]
Abstract
Objectives Test the hypothesis of no difference in prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) compared with the sandwich osteotomy and delayed placement of standard lengths implants (> 8 mm). Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search was conducted by including studies published in English. No year of publication restriction was applied. Results Six randomized controlled trials characterized by low or moderate risk of bias fulfilled the inclusion criteria. There were no statistically significant differences (P > 0.05) in the survival rate of suprastructures and implants between the two treatment modalities after one year. Sandwich osteotomy and delayed implant placement demonstrated statistically significant higher long-term peri-implant marginal bone loss as well as biological and technical complications compared with short implants (P < 0.0001). Moreover, patients significantly favoured prosthetic rehabilitation with short implants (P < 0.0001). Conclusions Short implants and the sandwich osteotomy with delayed placement of standard length implants appear to result in predictable outcomes in terms of high survival rate of suprastructures and implants after prosthetic rehabilitation of the partially edentulous atrophic posterior mandible. However, further long-term randomized controlled trials assessing donor site morbidity, an economic perspective, professional and patient-related outcome measures with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of short implants for prosthetic rehabilitation of the partially edentulous atrophic posterior mandible compared with the sandwich osteotomy and delayed placement of standard length implants.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
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IBELLI GS, ASSAF F, SANTOS ABS, SANTOS MBP, OLIVEIRA GJPLD, MARGONAR R, QUEIROZ TP. Clinical comparison of short and conventional implants placed in the posterior region of the mandible. A pilot study. REVISTA DE ODONTOLOGIA DA UNESP 2017. [DOI: 10.1590/1807-2577.04017] [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 Objective To evaluate and correlate the values of radiographic bone density, peri-implant bone height and resonance frequency analysis (RFA) of short or conventional implants placed in the posterior region of the mandible after installing a prosthesis. Material and method Eleven patients were selected for this prospective parallel pilot study. The prostheses were supported by two types of implants: short implants (n = 18) (5.0 x 5.5 mm and 5.0 x 7.0 mm) and conventional implants (n = 23) (4.0 x10 mm and 4.0 x 11.5 mm). The implants were evaluated by RFA, by measuring the bone height, and peri-implant bone density. The implants were evaluated at the periods T0 (immediately after installation of the prosthesis), T1 (after 90 days), and T2 (after 180 days). Result There were no statistically significant differences between groups with respect to radiographic bone density (152.50 ± 15.39 vs. 157.60 ± 28.46, for conventional and short implants, respectively at T2), stability of the implants (Conventional implants: 66.76 ± 10.39 at T0, and 61.85 ± 8.38 at T2 vs. Short implants: 57.50 ± 12.17 at T0, and 61.53 ± 7.39 at T2) and peri-implant bone loss (0.03 mm vs.-0.17 mm, for conventional and short implants, respectively at T2). Additionally, a significant correlation between the evaluated parameters was not detected. Conclusion The short and conventional implants presented similar stability, bone level and density after the activation of occlusion loading.
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Hingsammer L, Watzek G, Pommer B. The influence of crown-to-implant ratio on marginal bone levels around splinted short dental implants: A radiological and clincial short term analysis. Clin Implant Dent Relat Res 2017; 19:1090-1098. [PMID: 29024303 DOI: 10.1111/cid.12546] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/06/2017] [Accepted: 09/15/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The amount of marginal bone resorption around dental implants is considered to have a significant impact on implant stability as well as implant survival rates. PURPOSE The aim of this prospective study was to investigate the influence of prosthetic as well as patient specific factors on marginal bone loss around short dental implants. MATERIALS AND METHODS Seventy-six implants, which supported splinted crowns were included for investigation. All implants were from the same type and had an intraosseous length of 6.5 mm and a diameter of 4.0 mm. Twenty implants were additionally splinted onto longer ones. Measurements of marginal bone loss were performed at a mean of 12.38 months after prosthetic loading and the mean follow-up for clinical evaluation was 20.52 months. RESULTS Overall two implant failures were recorded, revealing a survival rate of 97.3%. Marginal bone resorption around 72 short implants measured 0.71 mm (SD: 0.74 mm) and was found to have a strong correlation with calculated Crown-to-Implant ratio (r = .71; P < .001). Age, gender, insertion torque, implant surface area, location, position, bone quality, and insertion torque did not influence peri-implant bone loss after one year of loading. CONCLUSION Within the limitations of the study, it is suggested that Crown-to-Implant ratios should not exceed 1.7 to avoid increased early marginal bone loss.
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Affiliation(s)
- Lukas Hingsammer
- University Hsopital Zurich, Department of Oral and Maxillofacial Surgery, Frauenklinikstrasse 24, 8032 Zurich, Switzerland.,Oral Surgeon, Academy of Oral Implantology, Lazarettgasse 19/DG, 1090 Vienna, Austria
| | - Georg Watzek
- Oral Surgeon, Academy of Oral Implantology, Lazarettgasse 19/DG, 1090 Vienna, Austria
| | - Bernhard Pommer
- Oral Surgeon, Academy of Oral Implantology, Lazarettgasse 19/DG, 1090 Vienna, Austria
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