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Monaghesh E, Negahdari R, Samad-Soltani T. Application of virtual reality in dental implants: a systematic review. BMC Oral Health 2023; 23:603. [PMID: 37641060 PMCID: PMC10463367 DOI: 10.1186/s12903-023-03290-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVE A treatment approach that is widely used as a permanent and natural replacement for missing or extracted teeth is dental implants .VR is a computer-generated simulation that creates a three-dimensional (3D) image or environment. Advances in VR -based learning allow learners and students to practice and also help professionals plan a wide variety of surgical procedures, including the correct placement of dental implants. Therefore, in this systematic review, our aim was to investigate and evaluate the available virtual reality tools for dental implants and their effectiveness. MATERIALS AND METHODS Studies published up to 01/30/2023 which report the applications of using virtual reality technology in dental implants, were reviewed in three databases, including PubMed, Web of Science, and Scopus. All studies with evidence reporting the role of virtual reality technology in the field of dental implants were included in our analyses, written in English and published in peer-reviewed form, are included. Theoretical articles, and letters that did not provide original data, as well as studies that reported incomplete information, were excluded. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies, and decisive agreement was reached by discussion and consultation with the third researcher. Narrative synthesis was undertaken to summarize and report the findings. RESULTS Out of 1633 initial search results, nine were included in the present study based on the inclusion criteria. The focus of seven studies was on teaching and learning, and two studies have examined the implant planning procedure. The most commonly used hardware and software were head-mounted display and Unity3D, respectively. In almost all studies, the results showed that the use of virtual reality-based systems improves and enhances the skills of users, including dental students and specialists. CONCLUSIONS Our findings showed that VR is an effective method for teaching and planning the implant process. Although the use of VR technology is limited for various reasons such as cost, it can increase the skills of dental professionals in performing dental implants.
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Affiliation(s)
- Elham Monaghesh
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Negahdari
- Prosthodontics department, Dentistry faculty of tabriz medical university, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
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Foletti JM, Sterba M, Maurice P, Dibatista JC, de Gea R, Birault L. Effect of bone density on the survival of 407 sandblasted and acid-etched dental implants: A retrospective multicenter study. J Dent Res Dent Clin Dent Prospects 2023; 17:112-118. [PMID: 37649820 PMCID: PMC10462463 DOI: 10.34172/joddd.2023.39248] [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: 04/07/2023] [Accepted: 05/23/2023] [Indexed: 09/01/2023] Open
Abstract
Background This study evaluated the success and survival rate of sandblasted and acid-etched dental implants according to the patient's bone quality. Methods A multicenter retrospective study was conducted in five clinical centers between 2016 and March 2019. A total of 407 implants (KONTACTTM S, Biotech Dental, France) placed in 229 patients (61.5±12.9 years old) were included. Bone quality, classified as types D1 to D4 (Misch classification), maximal insertion torque, and bone loss were measured. The implant survival rate was evaluated after one year for the overall cohort and for each bone quality. The overall survival rate after four years was also estimated with a Kaplan-Meier analysis. Results After one year (12.8±9.6 months), eight implants were lost out of 407, representing an overall survival rate of 98%. It ranged from 100% for D1 to 89.7% for D4 (n=39), with significantly higher survival rates for D2 (n=93) and D3 (n=165) (98.9% and 98.2%, respectively) compared to D4. According to the Kaplan-Meier analysis, an overall survival rate of 96.5% was estimated after four years. An average maximal insertion torque of 45±12.6 N.cm and bone loss of 0.2±1.2 mm were measured. Conclusion The high overall survival rate (98%), the average maximal insertion torque (45 N.cm), and the low marginal bone loss indicated good clinical results with acid-etched implants. Despite the relatively high survival rate for each bone quality, the significantly lower results in the D4 group highlight the expected benefits of bone quality-based implants and surgical protocols.
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Affiliation(s)
- Jean-Marc Foletti
- Aix Marseille University, University Gustave Eiffel, LBA, Marseille, France
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
| | - Manon Sterba
- Aix Marseille University, University Gustave Eiffel, LBA, Marseille, France
- Glad Medical SAS, Salon-de-Provence, France
| | - Pascal Maurice
- Private Dental Practice 53 Route d’Uzès, 30000 Nîmes, France
| | | | - Raphael de Gea
- Private Dental Practice, 18 Chemin de Saint-Marc, 83150 Bandol, France
| | - Laurine Birault
- Private Dental Practice, 455 Promenade des Anglais, L’Arénas 06200 Nice, France
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Calazans Neto JV, Reis ACD, Valente MLDC. Osseointegration in additive-manufactured titanium implants: A systematic review of animal studies on the need for surface treatment. Heliyon 2023; 9:e17105. [PMID: 37484223 PMCID: PMC10361303 DOI: 10.1016/j.heliyon.2023.e17105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 07/25/2023] Open
Abstract
The objective of the systematic review is to find an answer to a question: "Do surface treatments on titanium implants produced by additive manufacturing improve osseointegration, compared to untreated surfaces?". This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022321351). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on March 22nd, 2022. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: articles in animals that addressed the influence of surface treatments on osseointegration in implants produced by additive manufacturing. Articles were excluded that (1) did not use titanium surface, 2) that did not evaluate surface treatments, 3) that did not described osseointegration, 4) Studies with only in vitro analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports and personal opinions.). 1003 articles were found and, after applying the eligibility criteria, 17 were used for the construction of this review. All included studies found positive osseointegration results from performing surface treatments on titanium. The risk of bias was analyzed using the SYRCLE assessment tool. Surface treatments are proposed to promote changes in the microstructure and composition of the implant surface to favor the adhesion of bone cells responsible for osseointegration. It is observed that despite the benefits generated by the additive manufacturing process in the microstructure of the implant surface, surface treatments are still indispensable, as they can promote more suitable characteristics for bone-implant integration. It can be concluded that the surface treatments evaluated in this systematic review, performed on implants produced by additive manufacturing, optimize osseointegration, as it allows the creation of a micro-nano-textured structure that makes the surface more hydrophilic and allows better contact bone-implant.
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Affiliation(s)
| | | | - Mariana Lima da Costa Valente
- Corresponding author. Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, FORP-USP. Av. Do Café, s/n, 14040Ribeirão Preto, Brazil.
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Roccuzzo A, Imber JC, Salvi GE, Roccuzzo M. Peri-implantitis as the consequence of errors in implant therapy. Periodontol 2000 2023; 92:350-361. [PMID: 36744582 DOI: 10.1111/prd.12482] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 09/04/2022] [Accepted: 12/22/2022] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. It is a highly prevalent disease, as extensively estimated by large-population, cross-sectional studies. As peri-implant diseases represent opportunistic infections, it is reasonable to assume that nonideal conditions, local and/or general, may favor the progression of peri-implant inflammation. Some of these conditions could be a result of poor planning and/or inadequate execution of any step of the entire process treatment. This article describes the major possible factors in implant therapy that may lead to peri-implantitis. For some of these (ie, inappropriate patient selection, insufficient periodontal therapy, lack of diagnosis and management of peri-implant mucositis, erratic supportive peri-implant/periodontal therapy) there is a good level of evidence, whereas for others (ie, wrong implant placement, poor postoperative care, inadequate prosthetic reconstruction, lack of assessment and management of peri-implant soft-tissue deficiencies) there is little scientific evidence. More research is therefore needed to clearly identify the errors and/or complications possibly leading to peri-implantitis, particularly over the long term.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillo-Facial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni Edoardo Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mario Roccuzzo
- Specialist Periodontal Private Practice, Torino, Italy
- Division of Maxillo-facial Surgery, University of Torino, Torino, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Abdelrehim A, Etajuri EA, Sulaiman E, Sofian H, Salleh NM. Magnitude of misfit threshold in implant-supported restorations: A systematic review. J Prosthet Dent 2022:S0022-3913(22)00613-8. [PMID: 36357194 DOI: 10.1016/j.prosdent.2022.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/25/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022]
Abstract
STATEMENT OF PROBLEM Attaining a passive fit in implant restorations is desirable but clinically difficult to achieve, especially in screw-retained prostheses. At a certain magnitude, this misfit will not cause mechanical and biological complications, but the exact level has yet to be determined. PURPOSE The purpose of this systematic review was to gather, compare, and appraise studies that attempted to determine the biological and mechanical tolerance of misfits. MATERIAL AND METHODS The review protocol was published in the Prospective Register for Systematic Reviews (PROSPERO; registration no. CRD42021268399) and follows the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search was conducted through PubMed, Ebscohost, and Web of Science followed by a manual search up to December 2021. RESULTS A total of 413 manuscripts were identified by electronic and manual search. After removing duplicates, nonrelevant titles, and abstract screening, 62 manuscripts were eligible for full-text assessment. Finally, a total of 13 articles (1 cross-sectional study, 1 retrospective and prospective, 7 in vitro studies, and 4 animal studies) met the eligibility criteria and were included in this review. A wide range of tolerable misfits were reported. Vertical misfit up to 1 mm and horizontal misfit up to 345 μm were associated with no adverse outcomes. CONCLUSIONS The current literature provides inadequate data to determine a clinical threshold of an acceptable misfit. However, this review demonstrated that the mechanical response to misfit is more critical than the biological response.
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Affiliation(s)
- Aly Abdelrehim
- Graduate student, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Enas Abdalla Etajuri
- Lecturer, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Eshamsul Sulaiman
- Associate Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hazrina Sofian
- Senior Lecturer, Department of Software Engineering, Faculty of Computer Science & Information Technology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nosizana Mohd Salleh
- Associate Professor, Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia.
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Rutkowski R, Smeets R, Neuhöffer L, Stolzer C, Strick K, Gosau M, Sehner S, Volz KU, Henningsen A. Success and patient satisfaction of immediately loaded zirconia implants with fixed restorations one year after loading. BMC Oral Health 2022; 22:198. [PMID: 35606734 PMCID: PMC9125844 DOI: 10.1186/s12903-022-02231-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/25/2022] [Indexed: 11/27/2022] Open
Abstract
Background There is limited evidence for the use of zirconium dioxide implants in immediate implant placement as well as for related immediate loading protocols. The aim of this retrospective study was to investigate the survival rate, success and patient satisfaction of immediately placed zirconia implants compared to delayed placed implants. Methods The study included 58 partially edentulous patients who were treated between 2013 and 2015 with immediate and delayed transgingival healing zirconium dioxide implants (SDS, Kreuzlingen/ Switzerland). In addition to survival and success rate, marginal bone loss was assessed using radiographs and soft tissue was evaluated using Pink Esthetic Score. Oral health-related quality of life was investigated prospectively using a modified OHIP questionnaire. Results The cumulative survival rate of all implants included was 92% with 88% classified as full success. No significant difference was found between the bone levels of immediately and delayed placed and immediately and delayed loaded implants. The mean Pink Esthetic Score after final prosthetic rehabilitation was 12.2/14 points indicating excellent esthetic clinical results. Analysis of the OHIP questionnaire showed a mean value of 0.54/100 points reflecting a high patient satisfaction. Conclusions Immediate and delayed placed as well as loaded zirconium dioxide implants showed excellent results regarding implant success and survival in this study. Zirconium dioxide implants may ensure excellent esthetic results and high patient satisfaction. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02231-0.
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Affiliation(s)
- Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Leon Neuhöffer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Carolin Stolzer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Kilian Strick
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Susanne Sehner
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. .,Division Regenerative Orofacial Medicine, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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Abstract
Implant therapy aims at providing the patient with a functional and esthetically pleasing rehabilitation in a long‐term perspective. The loss of an implant constitutes a major complication, which may have an impact on the treatment plan and/or jeopardize the longevity of the restoration. Implant loss may occur during the phase of osseointegration (early) or at a later time when the previously achieved osseointegration is lost (late). The present work evaluates the evidence on the occurrence of both events and discusses etiology, risk factors, and consequences.
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Affiliation(s)
- Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Alsulaimani L, Alqarni A, Almarghlani A, Hassoubah M. The Relationship Between Low Serum Vitamin D Level and Early Dental Implant Failure: A Systematic Review. Cureus 2022; 14:e21264. [PMID: 35178319 PMCID: PMC8843072 DOI: 10.7759/cureus.21264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/05/2022] Open
Abstract
The variety in shape and type of dental implants in the present time is considered one of the most successful evolutions in dentistry. This facilitates dental treatment options to restore patient function and appearance. However, numerous significant factors influence the predictability of survival or the success rates of dental implants, some of which, such as vitamin D levels, have not been included in many studies. The main purpose of this systematic review was to investigate whether there is a relationship between low serum levels of vitamin D and early dental implant failures (EDIFs). Our literature search involved international databases including PubMed, Directory of Open Access Journals (DOAJ), and Web of Science. Initially, according to our search criteria, 1200 studies were found. After excluding duplicates, incomplete studies, and studies not meeting our inclusion criteria, only six human studies were included in this research and analyzed. Finally, upon meticulous analysis of included studies, this systematic review revealed inconsistent results in articles with respect to the association between vitamin D deficiency and implant failures. Large-scale studies, especially clinically relevant studies, on this subject is recommended.
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Affiliation(s)
- Lujain Alsulaimani
- General Dentistry, Dentistry Program, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Abdullah Alqarni
- General Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Ammar Almarghlani
- Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Mathews DP, Knight DJ, O'Connor RV, Kokich VG. Interdisciplinary treatment of a patient with amelogenesis imperfecta: Case report with a 35-year follow-up. J ESTHET RESTOR DENT 2021; 33:968-975. [PMID: 34250721 DOI: 10.1111/jerd.12804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/19/2021] [Accepted: 06/24/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This case will illustrate the interdisciplinary management of an adolescent female patient with amelogenesis imperfecta (AI). It will contrast this approach and compare it to the previous "multidisciplinary" treatment rendered before the patient was referred for a second opinion. CLINICAL CONSIDERATIONS The patient had a family history of AI affecting all of her permanent teeth. There were many impacted teeth. The majority of her family and relatives afflicted by this opted for dentures. The patient had undergone 2 years of treatment and was told that her "braces would be removed next week." Her new dentist was concerned because the case was not ready to restore. CONCLUSION He recommended referral to another orthodontist for a second opinion and formulation of an interdisciplinary treatment plan that would include a periodontist, endodontist, and restorative dentist. The patient's family accepted the second opinion referral and restarted treatment with an interdisciplinary team. The restorative dentist was the quarterback for this integrated and sequenced approach. The case was ultimately restored. A 35 year follow-up shows stability with a caries free, periodontally healthy, esthetic result.
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Affiliation(s)
| | - Douglas J Knight
- Graduate Orthodontic Deptartment, University of Washington School of Dentistry, Tacoma, Washington, USA
| | | | - Vincent G Kokich
- Graduate Orthodontic Deptartment, University of Washington School of Dentistry, Tacoma, Washington, USA
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Wentorp F, Jablonowski L, Pink C, Holtfreter B, Kocher T. At which bone level are implants explanted? Clin Oral Implants Res 2021; 32:786-798. [PMID: 33755997 DOI: 10.1111/clr.13747] [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: 07/08/2020] [Revised: 02/07/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Clear guidelines when to remove an implant are missing. The aim of this study was to evaluate the amount of peri-implant bone loss at explantation by specialists. MATERIAL AND METHODS Implantology specialists were asked to provide implants explanted due to peri-implantitis with related clinical information. Early failures (survival time <12 months) were analyzed separately. Questionnaires inquired age, sex, smoking, implant location, usage of bone substitutes, and implant brand. Explants were measured and bone loss was assessed using radiographs. Covariate-adjusted mixed-effects models were evaluated for bone loss and survival time. RESULTS Twelve dental offices provided 192 explants from 161 patients with 99 related radiographs. Thirty-three (17.2%) explants were early failures. Excluding early failures, average survival time was 9.5 ± 5.8 years with absolute and relative bone loss of 7.0 ± 2.7 mm and 66.2 ± 23.7%, respectively. Late failures were removed at mean bone loss of 57.7% in the maxilla and 73.7% in the mandible irrespective of survival time. In fully adjusted mixed-effects models, only age at implantation (B = -0.19; 95% CI: -0.27, -0.10) remained a significant factor for survival time. Implants exhibited significantly more relative bone loss if they were positioned in the mandible (B = 17.3; 95% CI: 3.91, 30.72) or if they were shorter (B = -2.79; 95% CI: -5.50, -0.08). CONCLUSIONS Though the mean bone loss (66.2%) at which implants were explanted was in accordance with the literature, its wide variation and differentiation between jaws showed that the profession has no universally accepted threshold beyond which an implant cannot be preserved.
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Affiliation(s)
- Fionn Wentorp
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Lukasz Jablonowski
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
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Takamoli J, Pascual A, Martinez-Amargant J, Garcia-Mur B, Nart J, Valles C. Implant failure and associated risk indicators: A retrospective study. Clin Oral Implants Res 2021; 32:619-628. [PMID: 33629418 DOI: 10.1111/clr.13732] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate early and late implant loss rates in a sample of patients who had received implant therapy in a university setting as well as patient- and implant-related variables for implant failure. MATERIAL AND METHODS This is a retrospective analysis in a cohort of patients who were treated with implant-supported restorative therapy during the period 2001-2012. Patients were randomly selected from an electronic database and scheduled for an appointment to record subject and implant characteristics. The primary study outcome was implant loss (i.e., early and late implant failure). RESULTS A total of 190 patients and 710 implants were included. The mean time in function was 8.2 (SD 2.4) years. Four implants (0.6%) failed in four patients (2.1%) prior to connection of the restoration within a mean period of 1.5 (SD 1.3) months after surgical procedure. Moreover, 17 subjects (8.9%) exhibited late implant failure, representing 26 implants (3.7%), after a mean follow-up of 5 years (SD 2.2) from prosthesis connection. The final multivariable model indicated three factors related to late implant failure: subjects <55 years (OR = 3.62; 95% CI 1.46-10.22; p = .002), smokers/former smokers (OR = 6.25; 95% CI 1.70-17.52; p = .005), and implants with no access to interproximal hygiene (OR = 7.25; 95% CI 2.20-28.25; p < .001). CONCLUSIONS The rate for early and late implant failure in a sample of 190 patients who had received implant therapy in a university setting was 2.1% and 8.9%, respectively, at subject level. Subjects <55 years and smokers/former smokers as well as implants with inadequate access to interproximal hygiene were significantly associated with late implant failure.
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Affiliation(s)
- Joan Takamoli
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Andres Pascual
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Berta Garcia-Mur
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Valles
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Mathews DP. A Novel Solution to Treat Unesthetic Implant Restorations in the Esthetic Zone: A Case Report. Clin Adv Periodontics 2021; 12:21-25. [PMID: 33386774 DOI: 10.1002/cap.10145] [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: 10/05/2020] [Accepted: 12/22/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Soft tissue dehiscences and deficiencies can occur around implants especially when they are malpositioned. There is a dearth of information on burying these fixtures and bridging over them to improve the prosthetic result. The patient presented with a very functional fixed dental prosthesis (FDP) from #7 to #10 which had been in place for 20 years. The patient requested replacement of the restoration for a better esthetic outcome. CASE PRESENTATION The FDP was intact and did not need replacement other than for esthetic improvement. Implants were placed in the #8,9 sites and complications developed. After multiple hard and soft tissue surgeries, the case worsened. It was referred to a periodontist who reconstructed the site to ideal tissue levels. The patient had a very high smile line showing all of the soft tissue framework around the missing teeth. The prosthodontist and periodontist decided to leave the implants buried and bridged over them which resulted in an excellent esthetic outcome. CONCLUSION This case points out the importance of considering all possible treatment plans and involving the patient in the final decision. The seemingly apparent obvious plan would have been to restore the implants and try to achieve an esthetic result. However, after the implants were placed and developed complications, the decision to bury them improved the probability of a better esthetic outcome. The gingival levels and height of papillae were esthetically more acceptable with an FDP than what would have resulted if the fixtures were re-uncovered and restored.
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Mathews DP, Spear FM. Long‐term management of avulsed “hopeless” teeth in the adult dentition. J ESTHET RESTOR DENT 2020; 33:127-134. [DOI: 10.1111/jerd.12676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/21/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
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Arimizu C, Ayukawa Y, Kuwatsuru R, Haresaku S, Matsushita Y, Koyano K. Factors associated with discontinuation and resumption of implant maintenance therapy. J Oral Sci 2020; 62:356-359. [PMID: 32741849 DOI: 10.2334/josnusd.19-0318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Discontinuation of implant maintenance is the main risk factor for implant failure. The purpose of this study was to identify factors associated with previous discontinuation and resumption of maintenance among implant patients. A questionnaire survey was sent to 171 patients receiving implant maintenance at a university hospital; 169 patients responded. To assess the effect of job status, 26 patients (15.4%) with a history of maintenance discontinuation were classified as employed and nonemployed. The main reasons for previously discontinuing maintenance were work issues (in employed respondents) and dissatisfaction with treatment skill or chairside manner (in nonemployed respondents). The main reasons for resuming maintenance were those related to dental treatment (in employed respondents) and awareness of the importance of maintenance (in nonemployed respondents). There were significant differences in relation to job status in the reasons reported for discontinuing and resuming maintenance (both P < 0.05). The present findings suggest that oral health professionals should consider these factors when assisting patients in reducing the risk of implant failure.
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Affiliation(s)
- Chika Arimizu
- Department of Medical Technology, Kyushu University Hospital
| | - Yasunori Ayukawa
- Section of Implant & Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Rika Kuwatsuru
- Section of Implant & Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | | | - Yasuyuki Matsushita
- Section of Implant & Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Section of Implant & Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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15
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Zhang Q, Xu H, Bai N, Tan F, Xu H, Liu J. Matrix Metalloproteinase 9 is Regulated by LOX-1 and erk1/2 Pathway in Dental Peri-Implantitis. Curr Pharm Biotechnol 2020; 21:862-871. [PMID: 32081107 DOI: 10.2174/1389201021666200221121139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/12/2019] [Accepted: 02/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Dental peri-implantitis, which can be caused by several different microbial factors, is characterized by inflammatory lesions of the surrounding hard and soft tissues of an oral implant. Matrix Metalloproteinase 9 (MMP9) is thought to be involved in the pathogenesis of peri-implantitis. However, the regulatory mechanism of MMP9 in peri-implantitis has not been fully elucidated. In this study, we tried to evaluate the regulatory mechanism of MMP9 in peri-implantitis. METHODS We collected Peri-Implant Crevicular Fluid (PICF) from ten healthy implants and ten periimplantitis patients and compared their expression level of MMP9. We also cultured macrophages from the peripheral blood of healthy volunteers infected by Porphyromonas gingivalis to reveal the regulatory mechanism of MMP9 in peri-implantitis. Western blot, immunofluorescence staining and quantitative Polymerase Chain Reaction (RT-PCR) were used to better characterize the mechanism of MMP9. RESULTS The expression of MMP9 was up-regulated in peri-implantitis patient PICF and P. gingivalis infected human macrophages. LOX-1, not dectin-1, was found to mediate MMP9 expression in human macrophages with P. gingivalis infection. Expression of Erk1/2 was responsible for infection-induced MMP9 expression. Finally, use of a broad-spectrum metalloproteinase inhibitor impaired LOX-1 expression in infected macrophages. CONCLUSION Our results demonstrate that MMP9 is involved in dental peri-implantitis and is regulated by LOX-1 and Erk1/2. This LOX-1/MMP9 signaling pathway may represent a potential drug target for peri-implantitis.
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Affiliation(s)
- Qian Zhang
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Haitao Xu
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Na Bai
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Fei Tan
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
| | - Huirong Xu
- Department of Pathology, ZiBo Central Hospital, ZiBo, Shandong 255000, China
| | - Jie Liu
- Department of Prosthodontics, the Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
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16
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Jemt T, Eriksson J. Implant failures before and after peri‐implantitis surgery: A retrospective study on 207 consecutively treated patients. Clin Implant Dent Relat Res 2020; 22:567-573. [DOI: 10.1111/cid.12931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/22/2020] [Accepted: 06/02/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Torsten Jemt
- Brånemark Clinic Public Dental Health Care Service Gothenburg Region of Västra Götaland Sweden
- Department of Prosthetic Dentistry/Dental Material Science The Sahlgrenska Academy at Göteborg University Gothenburg Sweden
| | - Julia Eriksson
- Brånemark Clinic Public Dental Health Care Service Gothenburg Region of Västra Götaland Sweden
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Rare Case of Dental Implantation in the Segment with Residual Filling Material in the Mandibular Canal. Case Rep Dent 2020; 2020:2689353. [PMID: 32774936 PMCID: PMC7396082 DOI: 10.1155/2020/2689353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022] Open
Abstract
Dental implantation is the most popular method of restoring lost teeth. There are risk factors for dental implantation. These risk factors include the localization of residual filling material in the lumen of the mandibular canal in the selected jaw segment for implantation. A rare clinical case of dental implant placement with preservation of the safety zone relative to the residual siler in the mandibular canal is presented. A surgical guide was used for precise positioning. The treatment protocol was carried out without an immediate loading stage to monitor the possible development of symptoms.
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18
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Do TA, Le HS, Shen YW, Huang HL, Fuh LJ. Risk Factors related to Late Failure of Dental Implant-A Systematic Review of Recent Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3931. [PMID: 32498256 PMCID: PMC7312800 DOI: 10.3390/ijerph17113931] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 11/17/2022]
Abstract
Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental implant. The aim of this literature review was to summarize the influences of different potential risk factors on the incidence of late dental implant failure. The protocol of this systematic review was prepared and implemented based on the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) guideline. In December 2018, studies published within the previous 10 years on late dental implant failure were selected by fulfilling the eligibility criteria and the risk factors identified in qualified studies were extracted by using a predefined extraction template. Fourteen eligible studies were assessed. The common risk factors for late failure were divided into three groups according to whether they were related to (1) the patient history (radiation therapy, periodontitis, bruxism and early implant failure), (2) clinical parameters (posterior implant location and bone grade 4) or (3) decisions made by the clinician (low initial stability, more than one implant placed during surgery, inflammation at the surgical site during the first year or using an overdenture with conus-type connection). Clinicians should be cautions throughout the treatment process of dental implant-from the initial examination to the treatment planning, surgical operation and prosthesis selection-in order to minimize the risk of late failure of dental implant.
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Affiliation(s)
- Thanh An Do
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan; (T.A.D.); (Y.-W.S.)
| | - Hoang Son Le
- Department of Oral Surgery, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hồng Bàng, Phường 11, Quận 5, Ho Chi Minh City 700000, Vietnam;
| | - Yen-Wen Shen
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan; (T.A.D.); (Y.-W.S.)
| | - Heng-Li Huang
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan; (T.A.D.); (Y.-W.S.)
- Department of Bioinformatics and Medical Engineering, Asia University, 500 Lioufeng Rd., Wufeng, Taichung 41354, Taiwan
| | - Lih-Jyh Fuh
- School of Dentistry, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan; (T.A.D.); (Y.-W.S.)
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19
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Torsten J. Data on implant failures will show different results depending on how patients are compiled and analyzed: A retrospective study on 3902 individual patients treated either with one single implant or implants in the edentulous upper jaw. Clin Implant Dent Relat Res 2020; 22:226-236. [DOI: 10.1111/cid.12886] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/27/2019] [Accepted: 01/21/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Jemt Torsten
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of OdontologySahlgrenska Academy at Göteborg University Göteborg Sweden
- Board Certified Prosthodontist, Brånemark ClinicPublic Dental Health Service Sweden
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20
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Successive Reimplantation of Dental Implants Into Sites of Previous Failure. J Oral Maxillofac Surg 2020; 78:375-385. [DOI: 10.1016/j.joms.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/30/2022]
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21
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Cosyn J, De Lat L, Seyssens L, Doornewaard R, Deschepper E, Vervaeke S. The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:224-241. [PMID: 30624808 DOI: 10.1111/jcpe.13054] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 11/28/2022]
Abstract
AIM To compare immediate implant placement (IIP) to delayed single implant placement (DIP, ≥3 months post-extraction) in terms of implant survival (primary outcome), surgical, clinical, aesthetic, radiographic and patient-reported outcomes (secondary outcomes). MATERIALS AND METHODS Two reviewers independently performed an electronic search in PubMed, Web of Science, EMBASE and Cochrane and a hand search to identify eligible studies up to May 2018. Only randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP to DIP with at least 1 year of follow-up were selected for a qualitative analysis and meta-analysis. RESULTS The search identified 3 RCTs and 5 NRSs out of 2,589 titles providing data on 473 single implants (IIP: 233, DIP: 240) that had been in function between 12 and 96 months. One RCT showed unclear risk of bias, whereas all other studies demonstrated high risk. Meta-analysis showed significantly lower implant survival for IIP (94.9%) as compared to DIP (98.9%) (RR 0.96, 95% CI [0.93; 0.99], p = 0.02). All were early implant failures. A subgroup meta-analysis demonstrated a trend towards lower implant survival for IIP when postoperative antibiotics had not been administered (RR: 0.93, 95% CI [0.86; 1.00], p = 0.07). This was not observed among studies including the administration of postoperative antibiotics (RR: 0.98, 95% CI [0.94; 1.02], p = 0.35). Meta-analyses showed similar probing depth (WMD 0.43 mm, 95% CI [-0.47; 1.33], p = 0.35) and aesthetic outcomes as assessed by the pink aesthetic score (standardized WMD -0.03, 95% CI [-0.46; 0.39], p = 0.88) for IIP and DIP. Data on marginal bone loss were conflicting and highly biased. Soft tissue recession was underreported and available data were highly biased. Patient-reported outcomes were underreported, yet both IIP and DIP seemed well tolerated. CONCLUSION Immediate implant placement demonstrated higher risk for early implant loss than DIP. There is a need for RCTs comparing IIP to DIP with CBCT analyses at different time points and data on midfacial recession with the preoperative status as baseline. In these studies, the need for hard and soft tissue grafting should also be evaluated.
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Affiliation(s)
- Jan Cosyn
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Oral Health Research Group (ORHE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Liesa De Lat
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Ron Doornewaard
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Ellen Deschepper
- Faculty of Medicine and Health Sciences, Department of Biomedical statistics, Ghent University, Ghent, Belgium
| | - Stijn Vervaeke
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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22
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Ayoub A, Pulijala Y. The application of virtual reality and augmented reality in Oral & Maxillofacial Surgery. BMC Oral Health 2019; 19:238. [PMID: 31703708 PMCID: PMC6839223 DOI: 10.1186/s12903-019-0937-8] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 10/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery. Methods We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included. Results We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training. Conclusion Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education.
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Affiliation(s)
- Ashraf Ayoub
- Scottish Craniofacial Research Group, Glasgow University MVLS College, School of Medicine, Dentistry and Nursing, Glasgow University Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
| | - Yeshwanth Pulijala
- Scottish Craniofacial Research Group, Glasgow University MVLS College, School of Medicine, Dentistry and Nursing, Glasgow University Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK
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23
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Zhang Q, Liu J, Ma L, Bai N, Xu H. LOX-1 is involved in TLR2 induced RANKL regulation in peri-implantitis. Int Immunopharmacol 2019; 77:105956. [PMID: 31655342 DOI: 10.1016/j.intimp.2019.105956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/13/2019] [Accepted: 09/30/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore whether receptor activator of nuclear factor kappa-B ligand (RANKL) is involved in the nosogenesis of peri-implantitis and to reveal the regulatory mechanism in Porphyromonas gingivalis induced RANKL production. METHODS Therefore, we collected peri-implant crevicular fluid (PICF) and gingival tissues from healthy implants and peri-implantitis patients. The expression of RANKL in samples was tested by ELISA, Western blot and immunofluorescence staining. The production of RANKL in THP-1 macrophages stimulated with P. gingivalis was detected by qRT-PCR and Western blot. Then macrophages were pre-treated with neutralizing antibodies of Toll-like receptor 2 (TLR2) or lectin-type oxidized LDL receptor 1 (LOX-1) and inhibitors of TLR2, LOX-1 or Erk1/2 before P. gingivalis stimulation to evaluate the roles of TLR2, LOX-1 and Erk1/2 in RANKL production by qRT-PCR and Western blot. RESULTS The protein level of RANKL was higher in PICF of peri-implantitis patients than healthy implants. We observed increased RANKL expression in P. gingivalis infected macrophages compared to controls. RANKL induced by P. gingivalis stimulation was mediated by TLR2 and Erk1/2 signaling pathway in THP-1 macrophages. LOX-1 is involved in TLR2 induced RANKL expression. CONCLUSION RANKL was involved in peri-implantitis, and regulated by TLR2, LOX-1 and Erk1/2 signaling against P. gingivalis infection. As the novel inflammation pathway triggers, TLR2 and LOX-1 which mediate RANKL production seems to be potential drug targets of peri-implantitis.
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Affiliation(s)
- Qian Zhang
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
| | - Jie Liu
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Lei Ma
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Na Bai
- Department of Prosthodontics, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Huirong Xu
- Department of Pathology, ZiBo Central Hospital, ZiBo, Shandong Province, China
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24
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Adler L, Buhlin K, Jansson L. Survival and complications: A 9‐ to 15‐year retrospective follow‐up of dental implant therapy. J Oral Rehabil 2019; 47:67-77. [DOI: 10.1111/joor.12866] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 07/01/2019] [Accepted: 07/26/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Lottie Adler
- Department of Periodontology Folktandvården Stockholms län AB, Folktandvården Eastman Stockholm Sweden
- Division of Periodontology, Department of Dental Medicine Karolinska Institutet Huddinge Sweden
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine Karolinska Institutet Huddinge Sweden
| | - Leif Jansson
- Department of Periodontology Folktandvården Stockholms län AB, Folktandvården Eastman Stockholm Sweden
- Division of Periodontology, Department of Dental Medicine Karolinska Institutet Huddinge Sweden
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25
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Jensen OT, Jansen CE, Seo Y, Yellich G. Guided Nitinol-Retained (Smileloc) Single-Tooth Dental Restorations. Oral Maxillofac Surg Clin North Am 2019; 31:437-446. [PMID: 31147105 DOI: 10.1016/j.coms.2019.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Nitinol metal alloy that changes shape according to temperature has been in clinical use at select clinics worldwide for the past 2 years and is now released for general use. The Smileloc Abutment and nitinol sleeve enable "cementless," "screwless," crown fastening that saves time and cost with the prospect of replacement of much of the present, sometimes troublesome, anthropic, soon to be anachronistic, technology.
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Affiliation(s)
- Ole T Jensen
- Department of Oral Maxillofacial Surgery, University of Utah, School of Dentistry, 530 Wakara Way, Salt Lake City, Utah 84108, USA.
| | | | - Young Seo
- RODO Medical, Inc., 6399 San Ignacio Avenue, Suite 100, San Jose, CA 95119, USA
| | - George Yellich
- Santa Cruz Oral & Maxillofacial Surgery, 1663 Dominican Way, Suite 112, Santa Cruz, CA 95065, USA
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26
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Papaspyridakos P, Bordin TB, Natto ZS, El-Rafie K, Pagni SE, Chochlidakis K, Ercoli C, Weber HP. Complications and survival rates of 55 metal-ceramic implant-supported fixed complete-arch prostheses: A cohort study with mean 5-year follow-up. J Prosthet Dent 2019; 122:441-449. [PMID: 30982622 DOI: 10.1016/j.prosdent.2019.01.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Long-term outcomes with metal-ceramic (MC) implant-supported fixed complete dental prostheses (IFCDPs) are scarce. PURPOSE The purpose of this retrospective study was to assess the rate of biologic and technical complications in a cohort of edentulous patients treated with MC IFCDPs by residents after a mean clinical follow-up of 5 years (range: 1 to 12 years). MATERIAL AND METHODS Forty-one participants with 55 MC IFCDPs underwent a single-visit comprehensive examination that included a medical and dental history review and clinical and radiographic examinations. All supporting implants and prostheses were examined for biologic and technical complications. Life table analysis and Kaplan-Meier survival curves were calculated. RESULTS Of 359 moderately rough surface dental implants, 2 had failed in 1 patient after 11 years of functional loading, yielding a cumulative implant survival rate of 99.4%. Owing to the implant failure, 1 of 55 edentulous arches restored with IFCDPs failed, yielding a cumulative prosthesis survival rate of 98.2% after mean observation period of 5.0 years. Soft tissue recession was the most frequent minor biologic complication (annual rate 7.8% at the prosthesis level) for both cement and screw-retained IFCDPs (group C and S), and peri-implantitis (annual rate 1.6% at the implant level) the most frequent major biologic complication. Wear of porcelain (annual rate 8.0% at the prosthesis level) was the most frequent minor technical complication for both groups, and fracture of porcelain (annual rate 0.8% at the dental-unit level) was the most frequent major technical complication. Minor complications were the most frequent in both the groups (cement and screw retained). CONCLUSIONS High implant and prosthesis survival rates (above 98%) were achieved, yet substantial complication rates were encountered. The most frequent major biologic complication was peri-implantitis, with a 5-year implant-based rate of 8% (95% confidence interval [CI]: 5.8-11.1), whereas the most frequent major complication was fracture of porcelain with a 5-year dental unit-based rate of 4%. The estimated cumulative rates for "prosthesis free of biologic complications" were 50.4% (95% CI: 36.4% to 63.0%) at 5 years and 10.1% (95% CI: 3.5% to 20.8%) at 10 years, whereas for "prosthesis free of technical complications," they were 56.4% (95% CI: 41.7% to 68.8%) at 5 years and 9.8% (95% CI: 3.2% to 21.0%) at 10 years.
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Affiliation(s)
- Panos Papaspyridakos
- Assistant Professor, Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass; Visiting Assistant Professor, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY.
| | - Thaisa Barizan Bordin
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass; Instructor, Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Zuhair S Natto
- Assistant Professor, Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia; Adjunct Assistant Professor, Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass
| | - Khaled El-Rafie
- Assistant Professor, Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Sarah E Pagni
- Statistician, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Konstantinos Chochlidakis
- Assistant Professor and Program Director, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Carlo Ercoli
- Professor and Chair, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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27
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Causes of Death in Implant Patients Treated in the Edentulous Jaw: A Comparison between 2098 Deceased Patients and the Swedish National Cause of Death Register. Int J Dent 2019; 2019:7315081. [PMID: 30984265 PMCID: PMC6432731 DOI: 10.1155/2019/7315081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/14/2019] [Indexed: 01/11/2023] Open
Abstract
Background Previous research has reported an association between tooth loss and patient mortality, while the cause of death has not been elucidated. Objective The purpose was to describe and compare the cause of death in implant patients treated consecutively in the edentulous arch with a reference population. Methods Altogether, 3902 patients were included between 1986 and 2014. Data on the causes of death for deceased patients were compared to the Swedish National Cause of Death Register for a comparable time period. Standardised mortality ratios (SMRs) were calculated based on gender and age and tested for statistical significance. Results Most deceased patients (2,098) died from diseases in the circulatory system (CVD; 42%) and from cancers (26%). SMR indicated a generally increased mortality (total group) compared to the reference population during inclusion (P < 0.05; 1986–2014). Patients treated early (1986–1996) showed a lower SMR compared to patients treated later (P < 0.05; 1997–2014) especially related to CVDs. Younger patients (<60 years at surgery) showed an increased mortality due to CVDs when treated late (1997–2014; SMR = 5.4, P < 0.05). Elderly patients (>79 years at surgery) showed a significantly lower mortality in almost all observed causes of death (1986–2014; P < 0.05) with also a significantly lower mortality due to CVDs during the early period (1986–1996; SMR = 0.3, P < 0.05). Conclusion An overall increased mortality was observed for the edentulous implant patient compared to the reference population. Elderly patients (>79 years) showed significantly lower mortality for all causes of death independent of the time period of implant surgery. Younger patients (<60 years) present an increased risk for early mortality related to CVD. SMR for all causes of death increased for patients treated late (1997–2014) as compared to patients treated early (1986–1996).
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Francetti L, Cavalli N, Taschieri S, Corbella S. Ten years follow‐up retrospective study on implant survival rates and prevalence of peri‐implantitis in implant‐supported full‐arch rehabilitations. Clin Oral Implants Res 2019; 30:252-260. [DOI: 10.1111/clr.13411] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Nicolò Cavalli
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Silvio Taschieri
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery, Institute of Dentistry I. M. Sechenov First Moscow state medical University Moscow Russia
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Di Nardo D, Passariello C, Polimeni A, Testarelli L. A review on the prevention of inflammatory periimplant diseases. J Int Oral Health 2019. [DOI: 10.4103/jioh.jioh_45_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rodrigo D, Sanz‐Sánchez I, Figuero E, Llodrá JC, Bravo M, Caffesse RG, Vallcorba N, Guerrero A, Herrera D. Prevalence and risk indicators of peri‐implant diseases in Spain. J Clin Periodontol 2018; 45:1510-1520. [DOI: 10.1111/jcpe.13017] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/13/2018] [Accepted: 09/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Rodrigo
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
| | - Ignacio Sanz‐Sánchez
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
| | - Elena Figuero
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
| | | | - Manuel Bravo
- Preventive and Community DentistryUniversity of Granada Granada Spain
| | - Raul G. Caffesse
- Expert Group for Peri‐Implant DiseasesSociedad Española de Periodoncia y Osteointegración (SEPA Spanish Society of Periodontology and Osseointegration) Madrid Spain
| | - Nuria Vallcorba
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
| | - Adrián Guerrero
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research GroupUniversity Complutense Madrid Spain
- SEPA Foundation (Fundación SEPA de Periodoncia e Implantes Dentales) Madrid Spain
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Guido Mangano F, Ghertasi Oskouei S, Paz A, Mangano N, Mangano C. Low serum vitamin D and early dental implant failure: Is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients. J Dent Res Dent Clin Dent Prospects 2018; 12:174-182. [PMID: 30443302 PMCID: PMC6231147 DOI: 10.15171/joddd.2018.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/26/2018] [Indexed: 01/21/2023] Open
Abstract
Background. Since osseointegration depends on bone metabolism, low levels of vitamin D in the blood may negatively
affect bone formation around dental implants. To date, only a few studies have investigated the possible connection between
serum levels of vitamin D and early dental implant failure (EDIF), i.e. failure that occurs within 4 months after placement,
before the connection of the prosthetic abutment. The aim of this study was to investigate whether there is a relationship
between low serum levels of vitamin D and EDIF.
Methods. Data used for this retrospective study were derived from the records of a private dental clinic. Inclusion criteria
were patients who had been treated with dental implants, inserted with a submerged technique from January 2003 to December
2017. EDIF was the outcome of this study. Chi-squared test was used to investigate the effect of patient-related variables (age,
gender, smoking habit, history of periodontal disease and serum levels of vitamin D) on EDIF.
Results. Originally, 885 patients treated with 1,740 fixtures were enrolled in this study. Overall, 35 EDIFs (3.9%) were
reported. No correlation was found between EDIF and the patients' gender (P=0.998), age (P=0.832), smoking habit (P=0.473)
or history of periodontal disease (P=0.386). Three EDIFs (11.1%) were reported in 27 patients with serum levels of vitamin
D <10 ng/mL, 20 EDIFs (4.4%) in 448 patients with levels between 10 and 30 ng/mL, and 12 EDIFs (2.9%) in 410 patients
with levels >30 ng/mL. Although there was a clear trend toward an increased incidence of EDIF with lowering of serum
vitamin D levels, no statistically significant difference (P=0.105) was found among these three groups.
Conclusion. Within its limitations (retrospective design, low number of patients with severe blood levels of vitamin D
enrolled), this study failed to demonstrate a significant relationship between low serum levels of vitamin D and increased risk
of EDIF. However, since a dramatic increase in EDIFs with lowering of vitamin D levels in the blood has been reported,
further clinical studies with appropriate design (prospective or randomized controlled studies on a larger sample of severely
deficient patients) are needed to better investigate this topic
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Affiliation(s)
| | | | - Ana Paz
- Private Practice, Lisbon, Portugal
| | - Natale Mangano
- Division of Endocrinology and Metabolism, Moriggia Pelascini Hospital, Gravedona ed Uniti, Italy
| | - Carlo Mangano
- Department of Dental Sciences, University Vita Salute San Raffaele, Milan, Italy
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Papaspyridakos P, Barizan Bordin T, Kim YJ, DeFuria C, Pagni SE, Chochlidakis K, Rolim Teixeira E, Weber HP. Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: A retrospective study with up to 12-year follow-up. Clin Oral Implants Res 2018; 29:881-893. [PMID: 30043456 DOI: 10.1111/clr.13340] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/10/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). MATERIALS AND METHODS A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). RESULTS Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). The frequency of biologic complications was not statistically different between Group 1 and Group 2. The presence of high plaque index had significant effect on bone loss. CONCLUSIONS After a mean exposure time of 5.2 years postdefinitive prosthesis insertion (range: 1-12 years), implant survival rate of 98.7% was achieved. The six implant failures in three patients occurred after 5 years and affected the prosthesis survival. Soft tissue recession was the most frequent minor biologic complication, whereas peri-implantitis was the most frequent major biologic complication. A 10-year implant-based mucosal recession rate of 77% (95% CI: 68.2-87.9) and a 10-year implant-based peri-implantitis rate of 20% (95% CI: 16.9-24.9) were found.
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Affiliation(s)
- Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York
| | - Thaisa Barizan Bordin
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts.,Division of Postgraduate Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Yong-Jeong Kim
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Catherine DeFuria
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Sarah E Pagni
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York
| | - Eduardo Rolim Teixeira
- Division of Postgraduate Prosthodontics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Hans-Peter Weber
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
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Binshabaib M, ALHarthi SS, Salehpoor D, Michelogiannakis D, Javed F. Contribution of herpesviruses in the progression of periodontal and peri-implant diseases in systemically healthy individuals. Rev Med Virol 2018; 28:e1996. [DOI: 10.1002/rmv.1996] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Munerah Binshabaib
- Department of Periodontology, College of Dentistry; Princess Nourah Bint Abdulrahman University; Riyadh Saudi Arabia
| | - Shatha Subhi ALHarthi
- Department of Periodontology, College of Dentistry; Princess Nourah Bint Abdulrahman University; Riyadh Saudi Arabia
| | - Danial Salehpoor
- Department of General Dentistry, Eastman Institute for Oral Health; University of Rochester; Rochester New York USA
| | - Dimitrios Michelogiannakis
- Departments of Community Dentistry and Oral Disease Prevention and Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health; University of Rochester; Rochester New York USA
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health; University of Rochester; Rochester New York USA
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Madani E, Smeets R, Freiwald E, Sanj MS, Jung O, Grubeanu D, Hanken H, Henningsen A. Impact of different placement depths on the crestal bone level of immediate versus delayed placed platform-switched implants. J Craniomaxillofac Surg 2018; 46:1139-1146. [PMID: 29802060 DOI: 10.1016/j.jcms.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/16/2018] [Accepted: 05/02/2018] [Indexed: 10/16/2022] Open
Abstract
PURPOSE The preservation of peri-implant bone is one requirement for long-term success of dental implants. The purpose of this study was to evaluate the impact of subcrestal placement on the crestal bone level of immediate versus delayed placed implants after loading. MATERIALS AND METHODS In this retrospective study, data of 159 patients who received 330 implants was analyzed. Implants were placed subcrestally, crestally or supracrestally into fresh sockets or healed sites. Vertical bone level height was assessed radiographically and implants were followed up annually. The influence of patient and implant related risk factors for peri-implant bone loss was evaluated using a linear mixed model. RESULTS Depth of implant placement was significantly correlated with peri-implant bone loss (P = 0.001, 95% CI). Least effective loss of crestal bone was determined when implants were placed between 1 mm and 1.99 mm subcrestally. Smoking significantly enhanced the risk of peri-implant bone loss (P = 0.04, 95% CI). Immediate implant placement was not positively correlated with peri-implant bone loss (P = 0.51, 95% CI). CONCLUSION Within the limits of this study, implant placement 1.08 mm subcrestally may be recommendable in order to avoid supracrestal expositions of platform-switched titanium implants over time.
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Affiliation(s)
- Elika Madani
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Eric Freiwald
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Maryam Setareh Sanj
- Department of Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Ole Jung
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Division of Regenerative Orofacial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Oral and Maxillofacial Surgery, German Armed Forces Hospital, Hamburg, Germany.
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