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Azoubel E, Azoubel MCF, de Oliveira GJPL, Bezerra FJB, Santos JN. Survival analysis of dental implants placed in horizontally severely resorbed maxillae after reconstruction with xenogeneic graft: a case series. Oral Maxillofac Surg 2024; 28:1161-1168. [PMID: 38480619 DOI: 10.1007/s10006-024-01239-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 03/11/2024] [Indexed: 08/18/2024]
Abstract
PURPOSE To evaluate the survival rates of dental implants with a hybrid macrostructure and the surface biomimetically coated with nanohydroxyapatite, placed in horizontally atrophic maxillae previously submitted to the guided bone regeneration (GBR) procedure, associated with the use of a deproteinized bovine bone graft (DBB). METHODS Twenty-five patients who received 196 implants were involved in this study. First, these patients were submitted to GBR procedures and maxillary sinus lift, where DBB was used as the grafting material. The dental implants were placed after a minimum period of 6 months of the grafting procedures. The patients were followed up every six months and clinical/radiographic examinations were performed to assess the implants, using the following indicators as a reference: (1) Absence of mobility; (2) Absence of pain. Data about the age, surgery time, smoking status, implant size, and time between the grafting procedure and implant placement were correlated with implant failures. RESULTS Twelve implants failed, generating a survival rate of 94.23%. None of the variables analysed correlated with the implant failures. CONCLUSION Implants with a hybrid macrostructure and surface biomimetically coated with nanohydroxyapatite present good survival rates in horizontally atrophic maxillae grafted with DBB.
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Affiliation(s)
- Eduardo Azoubel
- Department of Oral Surgery, School of Dentistry, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, Brazil.
| | - Maria Cecília Fonseca Azoubel
- Department of Periodontology, School of Dentistry, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | | | | | - Jean Nunes Santos
- Department of Oral Pathology, School of Dentistry, Universidade Federal da Bahia (UFBA), Salvador, Brasil
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Malchiodi L, Fiorino A, Merlino L, Cucchi A, Zotti F, Nocini PF. Analysis of ultra-short implants with different angulations: a retrospective case-control study with 2 to 9 years of follow-up. Clin Oral Investig 2024; 28:79. [PMID: 38183469 DOI: 10.1007/s00784-023-05460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Does the angulation of ultrashort implants influence the stability of the peri-implant bone? The present study aimed to evaluate the effectiveness of non-axial ultrashort implants after 2 to 9 years of follow-up in resorbed alveolar ridges. MATERIALS AND METHODS All partially edentulous patients with ultrashort implants (< 6 mm) used in the posterior region of an atrophic mandible or maxilla, to support partial dentures in conjunction with standard implants, were included in this study. Peri-implant bone loss, success and survival rates, crestal bone levels, crown-to-implant ratio and implant angulation were measured for each implant. Implants were divided into two groups: straight implants with angulation < 17° (control group) and tilted implants with angulation > 17° (test group). Statistical analysis was used to find any significant differences between the two study groups and to investigate significant linear correlations among all the variables (p = 0.05). RESULTS A total of 42 ultrashort implants with a mean of 4 years of follow-up were included: 20 ultrashort axially loaded implants and 22 tilted implants. Mean crestal bone levels from baseline loading to maximum follow-up did not reveal statistical differences in regard to PBL; mean success and survival rates were 100% in all groups. CONCLUSIONS PBL, success and survival rates of axial ultrashort implants and tilted ultrashort implants are comparable to those of conventional implants. CLINICAL RELEVANCE This retrospective study revealed that ultrashort implants, even when placed with an angulation > 17°, can safely be used to support partial fixed prostheses. Further prospective clinical studies with larger samples and prospective design are needed to confirm these findings.
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Affiliation(s)
- Luciano Malchiodi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Antonino Fiorino
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Via S. Pansini 5, 80131, Naples, Italy.
| | | | | | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
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Abdul Rahim M, Khan K, Chrcanovic BR. Influence of Crown-Implant Ratio and Implant Inclination on Marginal Bone Loss around Dental Implants Supporting Single Crowns in the Posterior Region: A Retrospective Clinical Study. J Clin Med 2023; 12:jcm12093219. [PMID: 37176659 PMCID: PMC10179148 DOI: 10.3390/jcm12093219] [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: 03/31/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The aim of this present record-based retrospective study was to investigate the influence of the crown-implant ratio (CIR) and implant inclination in relation to the occlusal plane on the marginal bone loss (MBL) around dental implants supporting single crowns in the posterior region of the jaws. All the cases of implant-supported single crowns in the premolar and molar regions were initially considered for inclusion. Only implants not lost, with baseline radiographs taken within 12 months after implant placement and with a minimum of 36 months of radiological follow-up, were considered for the analysis of MBL. Univariate linear regression models were used to compare MBL over time between 12 clinical covariates, after which a linear mixed-effects model was built. After the exclusion of 49 cases, a total of 316 implant-supported single crowns in 234 patients were included. The results from the statistical models suggested that implant inclination and anatomical- and clinical CIR (the main related factors investigated in the study) were not statistically significantly related to MBL over time. Age (older people), tooth region (premolar), and bruxism (bruxers) had a statistically significant influence on MBL over time.
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Affiliation(s)
| | - Kashmala Khan
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
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Filipov I, Chirila L, Bolognesi F, Cristache CM. Buccally or Lingually Tilted Implants in the Lateral Atrophic Mandible: A Three-Year Follow-Up Study Focused on Neurosensory Impairment, Soft-Tissue-Related Impaction and Quality of Life Improvement. Medicina (B Aires) 2023; 59:medicina59040697. [PMID: 37109655 PMCID: PMC10143031 DOI: 10.3390/medicina59040697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023] Open
Abstract
Background and Objectives: In the severely resorbed posterior mandible, implant placement requires either bone regenerative procedures, subperiosteal implants or short implant placement with drawbacks including morbidity and increased treatment costs and duration. To overcome these inconveniences, some unconventional alternatives have been suggested, such as buccally or lingually tilted implants in the lateral mandible, bypassing the inferior alveolar nerve. The aim of the present retrospective study was to evaluate the three-year survival rate of implants inserted in the posterior atrophic mandible, bypassing the inferior alveolar nerve. The assessment was focused on the occurrence of postoperative complications related to neurosensory impairment and soft tissue impaction, as well as overall improvement in quality of life. Materials and Methods: Patients with severe bone atrophy in the lateral area of the mandible were included in the present study. Only the implants tilted either buccally or lingually to bypass the inferior alveolar nerve were analysed. The relation between peri-implant soft tissue and the healing abutment was assessed and a secondary revision surgery was performed when indicated. The Semmes–Weinstein pressure neurological test was used for qualitative assessment of inferior alveolar nerve function and the Geriatric Oral Health Assessment Index (GOHAI) was used for evaluating Oral-Health-Related Quality of Life (OHRQoL). Results: Fourteen implants were placed in nine patients during the evaluation period. Survival rate was 100%, temporary paraesthesia occurred in one patient and a limited definitive paraesthesia was seen in another patient. Mild or significant discomfort related to soft tissue impaction with healing abutment was observed in six out of nine patients. A statistically significant OHRQoL improvement was observed in all patients. Conclusions: Despite the limited number of patients and observation time, insertion of implants buccally or lingually bypassing the inferior alveolar nerve is a predictive treatment option for patients with severe bone atrophy in the posterior mandible.
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Affiliation(s)
- Iulian Filipov
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
- Department of Maxillofacial Surgery, “Queen Maria” Military Emergency Hospital, 9 Pietii Str., 500007 Brasov, Romania
| | - Lucian Chirila
- Department of Oral and Maxillofacial Surgery, “Carol Davila” University of Medicine and Pharmacy, 19 Plevnei Ave., 010221 Bucharest, Romania
| | - Federico Bolognesi
- Oral and Maxillo-Facial Surgery Unit, IRCCS Policlinico di Sant’Orsola, Via Giuseppe Massarenti, 9, 40138 Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 59 Via S. Vitale, 40100 Bologna, Italy
| | - Corina Marilena Cristache
- Department of Dental Techniques, “Carol Davila” University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd., 050474 Bucharest, Romania
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Hamilton A, Jamjoom FZ, Alnasser M, Starr JR, Friedland B, Gallucci GO. Tilted versus axial implant distribution in the posterior edentulous maxilla: A CBCT analysis. Clin Oral Implants Res 2021; 32:1357-1365. [PMID: 34423882 DOI: 10.1111/clr.13836] [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: 12/22/2020] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to determine whether distally angulating an implant is a successful strategy to avoid the maxillary sinus and the need for bone augmentation, while increasing the anterior-posterior (A-P) implant distribution in the edentulous maxilla. MATERIALS AND METHODS In 115 patients with edentulous maxillae, virtual implant planning was performed utilizing cone-beam computer tomographs. Axial (8 mm length) and tilted (12 mm length) dental implants with 30-degree and 45-degree angulation were virtually positioned to avoid entering the maxillary sinus, while maximizing A-P distribution. Measurements were made between the tilted and axial implants to assess the change in A-P distribution of implants at the implant and abutment levels. RESULTS Forty-seven sites (20.4%) were not able to have either treatment modality with insufficient bone for implant placement. Axial implants were placed more distally than 45-degree and 30-degree tilted implants in 24% and 42% of sites, respectively. The average change in A-P spread measured at the implant level, for 30- and 45-degree tilted implants was -0.25 mm (95% CI -0.76, 0.26) and 1.9 mm (95% CI 1.4, 2.3), respectively. When measured from the center of each multi-unit abutment the average increase in A-P distances for tilted implants appears larger in the 30-degree and 45-degree groups by 0.97 mm and 1.74 mm, respectively compared to measurements at the implant level. CONCLUSIONS Angulating 12 mm implants provides a limited increase in A-P distribution of implants in edentulous rehabilitation in most situations. In certain patients, the use of 8mm axial implants may provide a greater A-P spread.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, WA, Australia
| | - Faris Z Jamjoom
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Muhsen Alnasser
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jacqueline R Starr
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Bernard Friedland
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Chair of the Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Fan Z, Liu Y, Wang ZL. Tilted implantation technique for edentulous patients. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:377-385. [PMID: 34409792 DOI: 10.7518/hxkq.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The tilted implantation technique is characterized by placing the implant at an angle of more than 15° and less than 45° from the horizontal plane. This technique can avoid damaging the maxillary sinus, inferior alveolar nerve, nasal base, and other anatomical structures when the height of the upper and lower jaw available bone is insufficient, to maximize the use of available bone and avoid a large range of bone increment. The tilted implantation technique can reduce the trauma of the surgery, increase the possibility of immediate restoration and shorten the treatment cycle, which has been widely used clinically. In this review, the scope of application, design elements, design scheme and complications of the tilted implantation technique for edentulous patients will be described.
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Affiliation(s)
- Zhen Fan
- Dept. of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Yue Liu
- Dept. of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Zuo-Lin Wang
- Dept. of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
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Boukhlif A, Merdji A, Roy S, Alkhaldi H, Abu-Alshaikh I, Della N, Cristache CM, Hillstrom R. Effect of supporting implants inclination on stability of fixed partial denture: A finite element study. Proc Inst Mech Eng H 2020; 234:1162-1171. [DOI: 10.1177/0954411920944109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this finite element study was to analyze effect of supporting implants inclination on stress distribution in the bone for a four-unit fixed partial denture. A three-dimensional finite element model of mandibular molar section of the bone to receive implants was constructed. Three implant-supported fixed partial dentures, with null, moderate and wide tilting, of 0°, 15° and 30° implant inclinations, respectively, were modeled. A mechanical load of 10 MPa was applied in coronal–apical direction on bridge framework at the regions of crowns positions. The finite element analysis was performed, and von Mises stress levels were calculated. Peak stress concentration in the cortical bone was observed mostly around the implant necks, in inter-implants line. There was favorable stress distribution during loading, with peak stress being 90.04 MPa for 0°, which decreased to 54.33 MPa for 15° and 46.36 MPa for 30° inclination. The supporting implants inclination in fixed partial denture plays an important role in stress distribution and may be helpful in preventing bone loss and implant failure. This phenomenon is likely to be more pronounced in bones of poor quality. Within the limitation of this study, it seems that the inclination of implants in fixed partial denture has a favorable effect on stress distribution pattern values around the supporting implants.
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Affiliation(s)
- Amel Boukhlif
- Faculty of Science & Technology, University of Mascara, Mascara, Algeria
| | - Ali Merdji
- Faculty of Science & Technology, University of Mascara, Mascara, Algeria
- Laboratory of Mechanics and Materials Physics (LMPM), Mechanical Engineering Department, University of Sidi Bel-Abbes, Sidi Bel Abbès, Algeria
| | - Sandipan Roy
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Chennai, India
| | - Hashem Alkhaldi
- Mechanical Engineering Department, The University of Jordan, Amman, Jordan
- Department of Mechanical Engineering, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Nourddine Della
- Faculty of Science & Technology, University of Mascara, Mascara, Algeria
| | | | - Rajshree Hillstrom
- Department of Bioengineering, Tandon School of Engineering, New York University, New York, NY, USA
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Trbakovic A, Toljanic JA, Kumar VV, Thor A. Eight to eleven-year follow-up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study. Clin Implant Dent Relat Res 2019; 22:69-76. [PMID: 31860148 DOI: 10.1111/cid.12874] [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: 06/23/2019] [Revised: 10/26/2019] [Accepted: 11/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a lack of long-term evaluations of immediately loaded implants in patients with compromised maxillary bone. PURPOSE To evaluate long-term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume. MATERIAL AND METHODS Follow-up was performed on subjects who received six implants loaded within 24 hours with screw-retained fixed prostheses. Twenty-five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8-11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing. RESULTS The mean follow-up was 9 years and 2 months (101-131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0-11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5-13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing. CONCLUSION This nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.
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Affiliation(s)
- Amela Trbakovic
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Joseph A Toljanic
- Midwestern University College of Dental Medicine-Illinois, Downers Grove, Illinois
| | - Vinay V Kumar
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Andreas Thor
- Department of Surgical Sciences, Plastic & Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
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