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Fathi A, Mosharraf R, Ghorbani M, Saberipour S. Effect of shape and design of the internal connection of tissue-level and bone-level implants on detorque values and removal forces: An in vitro study. J Prosthet Dent 2024; 131:1135.e1-1135.e5. [PMID: 38632028 DOI: 10.1016/j.prosdent.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 04/19/2024]
Abstract
STATEMENT OF PROBLEM Optimal implant stability and preventing complications such as screw loosening are paramount concerns for implant-supported prostheses. However, studies examining the influence of various internal connection designs on detorque values and removal forces, critical aspects of implant success, are lacking. PURPOSE The purpose of this in vitro study was to assess the impact of the shape and design of the internal connection in tissue-level and bone-level implants on the detorque value and the force required for abutment removal from the implant. MATERIAL AND METHODS Forty dental implants were securely mounted in 10×6×20-mm acrylic resin blocks positioned perpendicular to the surface. The implants were divided into 4 groups (n=10): bone-level SM Torx, tissue-level PSI Torx, bone-level UF Hex, and tissue-level UF Hex implants. After exposure to a dynamic loading test at 31.2 N, 2 Hz and 106 cycles, measurements were made of both detorque values and removal forces. Statistical analyses, including 1-way ANOVA with a post hoc Tukey test and Kolmogorov-Smirnov test, were conducted to assess the results (α=.05). RESULTS The differences in detorque values among the 4 groups were statistically similar (P=.087). In terms of removal force values, tissue-level PSI implants exhibited the highest values, while bone-level UF implants had the lowest values, with significant differences in the removal forces among the 4 groups (P<.001). Pairwise comparisons revealed significant differences among the groups (P<.001), except for the comparison between tissue-level PSI and bone-level SM implants (P=.108). CONCLUSIONS While detorque values remain consistent across implant types, the shape and design of the internal connection of implants has a significant impact on the removal force required for abutment detachment from the implant.
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Affiliation(s)
- Amirhossein Fathi
- Assistant Professor, Dental Materials Research Center, Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ramin Mosharraf
- Professor, Dental Materials Research Center, Department of Prosthodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Ghorbani
- Graduate student, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Saberipour
- Graduate student, Dental Students' Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Alghamdi M, Kudara Y, Bokhary A, Papathanasiou A, Papaspyridakos P. Digital workflow for prosthetic management of malpositioned implant in an adolescent patient: A 20-year follow-up. J ESTHET RESTOR DENT 2024. [PMID: 38770703 DOI: 10.1111/jerd.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE Dental implants placed in adolescent patients pose a challenge to restore and maintain an esthetic outcome over longer period of follow-up. Maxillomandibular changes throughout adulthood may lead to complications such as implant infraocclusion and interproximal contact loss. This case report describes an alternate prosthetic treatment strategy for maxillary single implant placed in an adolescent patient in the esthetic zone with inappropriate implant axis and screw hole placement. CLINICAL CONSIDERATIONS With temporary restorations, the gingiva and soft tissues were shaped to imitate the emerging profile of the contralateral side. A zirconia screw-retained abutment was customized as a copy-mirror from the contralateral prepared tooth to mimic the exact shape and to avoid labiolingual over contour by computer-aided design/computer-assisted manufacture (CAD/CAM). The porcelain laminate veneer was bonded to the zirconia abutment. Porcelain adhesive approach was used instead of traditional principles of retention and resistance form of the abutment. CONCLUSIONS A functional and esthetic outcome was achieved and maintained, while a minimally invasive procedure was implemented to use the malplaced implant instead of explanting it. CLINICAL SIGNIFICANCE The present report illustrates the prosthetic management of a malpositioned dental implant placed 20 years ago, utilizing a minimally invasive digital protocol.
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Affiliation(s)
- Mohanned Alghamdi
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- UniDents Clinic, Jeddah, Saudi Arabia
| | - Yukio Kudara
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Aikaterini Papathanasiou
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
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Han J, Pyo SW, Kim S, Chang JS. An esthetic clinical approach for the management of an infrapositioned implant-retained maxillary incisor crown. Heliyon 2024; 10:e30837. [PMID: 38774106 PMCID: PMC11107190 DOI: 10.1016/j.heliyon.2024.e30837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/29/2024] [Accepted: 05/06/2024] [Indexed: 05/24/2024] Open
Abstract
Infrapositioning of implants in the maxillary anterior region can cause esthetic complications, including soft tissue problems. These complications commonly occur in implants placed in young adults. However, there are many clinical reports of implant infrapositioning in the maxillary anterior region after the fourth decade of life. This clinical report describes a case of infrapositioning of the maxillary central incisor wherein esthetic results were obtained through surgical and prosthetic approaches. The surgical approach improved the gingiva shape using the tunnel technique, and the prosthetic approach increased gingiva thickness by adjusting the shape of the abutment, resulting in a shape similar to the natural teeth.
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Affiliation(s)
- Jinwoo Han
- Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, South Korea
| | - Se-Wook Pyo
- Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, South Korea
| | - Sunjai Kim
- Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, South Korea
| | - Jae-Seung Chang
- Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, South Korea
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Berberi A, Zoghbi AE, Aad G, Tehini G. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024; 25:213-220. [PMID: 38690692 DOI: 10.5005/jp-journals-10024-3659] [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] [Indexed: 05/02/2024]
Abstract
AIM The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. MATERIALS AND METHODS A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. RESULTS Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. CONCLUSION The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. CLINICAL SIGNIFICANCE Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.
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Affiliation(s)
- Antoine Berberi
- Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon, Phone: +961 37331173, e-mail: ;
| | - Amine El Zoghbi
- Department of Prosthodontics and Occlusion, Faculty of Dental Medicine Saint Joseph University, Beirut, Lebanon
| | - Georges Aad
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon
| | - Georges Tehini
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon, and College of Healthcare Technology, American University of Baghdad
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Sanatnama E, Frantz L, Ahlin E, Naoumova J. Implant-supported crowns on maxillary laterals and canines-a long-term follow-up of aesthetics and function. Clin Oral Investig 2023; 27:7545-7555. [PMID: 37940682 PMCID: PMC10713674 DOI: 10.1007/s00784-023-05344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C). MATERIALS AND METHODS Thirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed. RESULTS Patients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively). CONCLUSIONS The PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term. CLINICAL RELEVANCE Although ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.
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Affiliation(s)
- Elnaz Sanatnama
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Lena Frantz
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Erik Ahlin
- Specialist Clinic for Orthodontics, Borås, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Julia Naoumova
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Bernal G, Ruiz L, Aellos F, Salazar C, Sadowsky SJ. Clinical and cone beam computed tomography outcomes of maxillary anterior implant restorations after immediate implant placement with interim restorations: A 1- to 14-year retrospective analysis. J Prosthet Dent 2023:S0022-3913(23)00362-1. [PMID: 37451900 DOI: 10.1016/j.prosdent.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/18/2023]
Abstract
STATEMENT OF PROBLEM: Achieving and maintaining optimal tissue health and esthetics when immediately placing maxillary anterior implants with interim restorations has been challenging and the clinical outcomes heterogenous. PURPOSE The purpose of this retrospective study was to evaluate the clinical outcomes of immediate placement of maxillary anterior implants with interim restorations and compare the tomographic and clinical results before and after implant placement in participants followed for 1 to 14 years. MATERIAL AND METHODS Twenty participants receiving 25 postextraction single implants in the anterior maxilla were studied. Clinical parameters included pink esthetic score (PES) and white esthetic score (WES), peri-implant phenotype, implant probing, plaque index, and cone beam computed tomography (CBCT) to compare initial and at least 1 year after crown placement (postoperative). For qualitative variables, a descriptive analysis was carried out. The PES and WES results were analyzed by using nonparametric statistics, the median (ME) and the interquartile range (IQR) were used as summary measures, and the Wilcoxon sum of signs test was used to compare the total scores between the intervention area and the contralateral tooth. To compare pre- and postoperative data points, the paired t test was used (α=.05). RESULTS Mean ±standard deviation (SD) time of follow-up was 7.6 ±4.2 years. Twenty participants with a mean ±SD age of 62.4 ±11.0 years old received 25 implants. Mean ±SD initial torque value at implant placement was 38.6 ±9.63 Ncm. Bone height at the top of the alveolar ridge (BH) and bone width at the middle of the alveolar ridge (BW2) showed a statistically significant decrease between the initial and subsequent CBCT measurements (both P<.001). Likewise, the bone width at the alveolar crest (BW1) showed a statistically significant decrease between the initial and post-CBCT measurements (P=.006). Facial bone integrity (FBI) revealed a statistically significant increase between the initial and postoperative time periods (P<.001). The PES index showed a median of 9.0 IQR (8-10), statistically lower than the contralateral tooth (P=.032). No significant differences were found for the WES index or for FBI, regardless of the peri-implant phenotype. CONCLUSIONS Immediate implant placement in the maxillary anterior sextant was found to be a predictable procedure with good esthetic results when the protocol described was used. Labial bone loss is inevitable after tooth extraction but can be compensated for by filling the space with a xenograft material. Long-term gingival tissue integrity was maintained, regardless of phenotype, in periodontally healthy participants.
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Affiliation(s)
- Guillermo Bernal
- Professor, Department of Prosthodontics, Javeriana University School of Dentistry, Bogotá, Colombia; Private practice, Bogotá, Colombia.
| | | | - Fabiana Aellos
- Post-doctoral Fellow, Plastic and Reconstructive Department, Stanford Medical School, Stanford, Calif
| | | | - Steven J Sadowsky
- Professor, Department of Implant Dentistry, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
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Kadkhodazadeh M, Amid R, Moscowchi A, Lakmazaheri E. Short-term and long-term success and survival rates of implants supporting single-unit and multiunit fixed prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00008-2. [PMID: 36781339 DOI: 10.1016/j.prosdent.2022.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 02/13/2023]
Abstract
STATEMENT OF PROBLEM Whether placing implants to replace each missing tooth or using implant-supported fixed partial dentures provides better outcomes is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to assess the success and survival rates of implants supporting single-unit and multiunit fixed prostheses by using conventional protocols for placement and loading in short- and long-term follow-ups. MATERIAL AND METHODS An electronic search was conducted in PubMed, Scopus, and Web of Science for studies published up to March 17, 2022. Comparative studies that reported the success or survival rates of both single-unit and splinted multiunit prostheses were considered for qualitative and quantitative analyses. RESULTS A total of 68 publications comprising 11 271 implants were included. Compared with the single prostheses, the splinted multiunit group showed no significant differences in implant success rates in the short-term (risk difference=-0.004; 95% confidence interval (CI)=-0.033 to 0.025; P=.780) and long-term (risk difference=0.003; 95% confidence interval (CI)=-0.029 to 0.034; P=.874) follow-ups. Significant statistical differences were also not found in terms of the survival rates of the 2 groups (short-term risk difference=-0.004; 95% CI=-0.031 to 0.023; P=.779, long-term risk difference=-0.002; 95% CI=-0.029 to 0.025; P=.887). CONCLUSIONS Implants supporting single-unit or splinted multiunit prostheses seem to be a predictable treatment in terms of survival and success over short and long periods. Nonetheless, it seems that cantilever and nonsplinted multiunit prostheses should be used with more caution.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Associate Professor, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Associate Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Assistant Professor, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Lakmazaheri
- Undergraduate student, Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kohal RJ, Vach K, Butz F, Spies BC, Patzelt SBM, Burkhardt F. One-Piece Zirconia Oral Implants for the Support of Three-Unit Fixed Dental Prostheses: Three-Year Results from a Prospective Case Series. J Funct Biomater 2023; 14:jfb14010045. [PMID: 36662092 PMCID: PMC9864364 DOI: 10.3390/jfb14010045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
The objective was to investigate the clinical and radiological outcome of one-piece zirconia oral implants to support three-unit fixed dental prostheses (FDP) after three years in function. Twenty-seven patients were treated with a total of 54 implants in a one-stage surgery and immediate provisionalization. Standardized radiographs were taken at implant placement, after one year and after three years, to evaluate peri-implant bone loss. Soft-tissue parameters were also assessed. Linear mixed regression models as well as Wilcoxon Signed Rank tests were used for analyzing differences between groups and time points (p < 0.05). At the three-year evaluation, one implant was lost, resulting in a cumulative survival rate of 98.1%. The mean marginal bone loss amounted to 2.16 mm. An implant success grade I of 52% (bone loss of ≤2 mm) and success grade II of 61% (bone loss of ≤3 mm) were achieved. None of the evaluated baseline parameters affected bone loss. The survival rate of the zirconia implants was comparable to market-available titanium implants. However, an increased marginal bone loss was observed with a high peri-implantitis incidence and a resulting low implant success rate.
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Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Correspondence:
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Zinkmattenstr. 6a, 79108 Freiburg, Germany
| | - Frank Butz
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Belchenstr. 6a, 79189 Bad Krozingen, Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Sebastian Berthold Maximilian Patzelt
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Am Dorfplatz 3, 78658 Zimmern ob Rottweil, Germany
| | - Felix Burkhardt
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
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Albrektsson T, Tengvall P, Amengual-Peñafiel L, Coli P, Kotsakis G, Cochran DL. Implications of considering peri-implant bone loss a disease, a narrative review. Clin Implant Dent Relat Res 2022; 24:532-543. [PMID: 35639515 PMCID: PMC9542069 DOI: 10.1111/cid.13102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/16/2022]
Abstract
Background Peri‐implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time. Purpose To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri‐implantitis. Material and Methods This paper is written as a narrative review of the long‐term clinical investigations available in the literature. Results Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10–15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20–30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20–30 years of follow up. Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re‐evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment. Conclusions Oral implant systems have been found to function with very good clinical outcome over follow‐up times of 20–30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri‐implantitis.
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Affiliation(s)
- Tomas Albrektsson
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pentti Tengvall
- Department of Biomaterials, Institute Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Pierluigi Coli
- Specialist in Periodontics and Prosthodontics, Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Georgios Kotsakis
- Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - David L Cochran
- Department of Periodontology, University of Texas, San Antonio, USA
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Jayanetti J, Shah K, Chao D, Drago C. Double sleeve guided placement of quadruple zygomatic implants for rehabilitation of a patient with ectodermal dysplasia: A clinical report. J Prosthet Dent 2021:S0022-3913(21)00503-5. [PMID: 34656306 DOI: 10.1016/j.prosdent.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022]
Abstract
The surgical and prosthodontic treatment for a 22-year-old man with ectodermal dysplasia is described and illustrated. He had never managed to wear complete dentures, and implant-retained or implant-supported prostheses were indicated. However, the placement of conventional maxillary endosseous implants was contraindicated. A novel surgical template with double sleeves was used to guide osteotomies for 4 zygomatic implants used with an unloaded, one-stage approach. After confirming osseointegration, prosthetic rehabilitation began with an interim implant-supported fixed prosthesis to evaluate esthetics, phonetics, and hygiene maintenance. Clinical challenges included lip biting and speech articulation.
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Affiliation(s)
- Jay Jayanetti
- Assistant Professor, Division of Advanced Prosthodontics, University of California Los Angeles School of Dentistry, Los Angeles, Calif
| | - Krina Shah
- Preceptor, Division of Oral and Maxillofacial Surgery, University of California Los Angeles School of Dentistry, Los Angeles, Calif
| | - Denny Chao
- Assistant Professor, Division of Advanced Prosthodontics, University of California Los Angeles School of Dentistry, Los Angeles, Calif
| | - Carl Drago
- Adjunct Associate Professor, Graduate Prosthodontics, Marquette University School of Dentistry, Milwaukee, Wis.
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Winitsky N, Naimi-Akbar A, Nedelcu R, Jemt T, Smedberg JI. 3-D tooth movement adjacent to single anterior implants and esthetic outcome. A 14- to 20-year follow-up study. Clin Oral Implants Res 2021; 32:1328-1340. [PMID: 34403160 DOI: 10.1111/clr.13833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To report three-dimensional (3-D) movement of teeth adjacent to single-implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome. MATERIALS AND METHODS 3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement, and marginal bone-level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index. RESULTS 3-D movement of adjacent teeth between 0 and 2.5 mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1 mm was observed in 30% of the patients and was significantly associated with LAFH ≥70 mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients. CONCLUSIONS Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.
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Affiliation(s)
- Nicole Winitsky
- Department of Prosthetic Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Prosthetic Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Surgery, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Robert Nedelcu
- Department of Surgical Sciences, Plastic, Oral, and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
| | - Torsten Jemt
- Department of Prosthetic Dentistry/Dental Material Science, Institute of Odontology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.,Brånemark Clinic, Public Dental Health Service, Region of Västra Götaland, Sweden
| | - Jan-Ivan Smedberg
- Department of Prosthetic Dentistry, Folktandvården Eastmaninstitutet, Folktandvården Stockholms län AB, Stockholm, Sweden.,Division of Prosthetic Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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12
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Schwartz O, Thomsen M, Dickmeiss E, Andreasen JO. Effect of donor-specific blood transfusions on allotransplanted teeth in a monkey model: Histoquantification of periodontal healing. Dent Traumatol 2021; 38:20-33. [PMID: 34250719 DOI: 10.1111/edt.12703] [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] [Received: 11/25/2020] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND/AIMS Pre-transplant blood transfusions have previously shown a positive effect on organ allograft survival in humans and various animal species. The aims of this study were, first, to evaluate the effect of pre-transplant donor-specific blood transfusions on periodontal healing of fully developed allotransplanted teeth in monkeys; and second, to investigate the immune response against donor antigens and to determine a possible correlation between alloimmune reactions and histopathological signs of rejection. MATERIAL AND METHODS Twenty monkeys (Cercopithecus aethiops) were divided into ten pairs with similar sizes of incisors. One monkey in each pair gave three transfusions to the other monkey with 1-week intervals. One week after the last transfusion, each pair exchanged simultaneously a central maxillary incisor and a lateral mandibular incisor. The corresponding central maxillary and mandibular lateral incisors were autotransplanted to the contralateral sockets. All teeth were treated endodontically per-operatively. Histocompatibility was evaluated by mixed lymphocyte culture before the first transfusion, while alloantibodies and cell-mediated alloresponses were measured before transfusions and at 2 and 8 weeks after transplantation. All animals were sacrificed 8 weeks after tooth transplantation. Serial sections of the transplanted teeth were quantified histologically. RESULTS Mixed lymphocyte cultures showed positive reactions in 19 of 20 cases, indicating incompatibility. The majority of the monkeys developed antibodies towards the tooth donor. Cell-mediated cytotoxicity was negative in all monkeys. Histoquantification revealed a mean score of 70% normal periodontal ligament (PDL) in autotransplanted teeth, with 5% ankylosis. The allografts had a mean score of 17% normal PDL and 63% ankylosis, with no significant influence of transfusion. However, in the mandibular grafts, a tendency towards a positive transfusion effect was seen. CONCLUSIONS Donor-specific blood transfusion did not reduce ankylosis in tooth allografts. The healing of mandibular incisor tooth allografts was improved, but not that of maxillary incisors. Donor-specific antibodies showed no effect on the survival of allograft PDL.
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Affiliation(s)
- Ole Schwartz
- Department of Oral and Maxillofacial Surgery, Rigshospitalet (University Hospital), Copenhagen, Denmark
| | - Mogens Thomsen
- Blood Bank, State Serum Institute, Copenhagen, Denmark.,CERPOP, Inserm, UPS, Université de Toulouse, Toulouse, France
| | - Ebbe Dickmeiss
- Blood Bank, State Serum Institute, Copenhagen, Denmark.,Department of Clinical Immunology, Rigshospitalet, Copenhagen, Denmark
| | - Jens Ove Andreasen
- Department of Oral and Maxillofacial Surgery, Rigshospitalet (University Hospital), Copenhagen, Denmark
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Iglhaut G, Salomon S, Fretwurst T, Thomas P, Endres J, Kessler S, Summer B. Cross-sectional evaluation of clinical and immunological parameters at partially microgrooved vs machined abutments in humans. Int J Implant Dent 2021; 7:46. [PMID: 34031775 PMCID: PMC8144255 DOI: 10.1186/s40729-021-00329-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The objective of the present study was to examine the clinical and immunological parameters in samples collected from the peri-implant crevicular fluid (PICF) of machined titanium (M) abutments compared to titanium abutments with a laser-microtextured surface (LMS) on dental implants. MATERIAL AND METHODS A total of 40 patients with one titanium implant, half of them (n=20) provided with a M abutment (control group) and the other half (n=20) with LMS abutments (test group), were included in the study. Clinical parameters pocket probing depth (PD), full-mouth plaque score (FMPS), radiographic bone loss (RBL), clinical attachment level (CAL), mucosal recession (MR), bleeding on probing (BOP), and width of keratinized mucosa (KM) were evaluated. The peri-implant sulcus fluid was analyzed for cytokines IL-1α, IL-1β, IL-6, IL-8, and IL-10 via flow cytometry. RESULTS Clinical evaluation demonstrated no significant difference of PD (mean LMS = 3.50 mm/SD 0.95 mm vs mean M = 3.45 mm/SD 0.76 mm (p=0.855)), MR (mean LMS = 0.30 mm/SD 0.57 mm vs mean M = 0.35 mm/SD 0.67 mm (p=0.801)), CAL (mean LMS = 3.60 mm/SD 1.14 mm vs mean M = 3.55 mm/SD 0.89 mm (p=0.878)), and KM (mean LMS = 2.03 mm/SD 1.08 mm vs mean M = 2.13 mm/SD 0.92 mm (p=0.754)) between LMS and M abutments. LMS abutments showed less BOP than M abutments (26.7% vs 30.8%), but statistically not significant (p = 0.2235). Radiographic bone loss (mean LMS = 0.22 mm/SD 0.44 mm vs mean M = 0.59 mm/SD 0.49 mm) was reduced in the test group in comparison with the control group (p=0.016). In the collected PICF, the levels of pro-inflammatory cytokines IL-1α (median LMS = 180.8 pg/ml vs M = 200.9 pg/ml (p=0.968)) and IL-1β (median LMS = 60.43 pg/ml vs M = 83.11 pg/ml (p=0.4777)) were lower, and the levels of IL-6 (median LMS = 180.8 pg/ml vs M = 200.9 pg/ml (p<0.0001)) were significantly lower in the test group. In contrast, the levels of IL-8 (median LMS = 255.7 pg/ml vs M = 178.7 pg/ml (p=0.3306)) were higher in the test group, though not significantly. The levels of anti-inflammatory IL-10 were significantly increased in the test group (LMS median = 0.555 pg/ml vs M median = 0.465 pg/ml (p=0.0365)). IL-1β showed a significant correlation to radiologic bone loss (p=0.0024). The other variables IL-1α, IL-6, IL-8, and IL-10 had no significant correlation to radiological bone loss. CONCLUSION Within the limitations of this study, titanium implants provided with laser-microtextured surface abutments seem to demonstrate less pro-inflammatory and more anti-inflammatory activity and to show reduced radiographic bone loss compared to machined titanium abutments. CLINICAL RELEVANCE The use of laser-microtextured surface abutments might have the potential to support peri-implant tissue health.
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Affiliation(s)
- Gerhard Iglhaut
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany. .,Private Center of Oral Surgery, Bahnhofstrasse 20, 87700, Memmingen, Germany.
| | | | - Tobias Fretwurst
- Department of Oral and Craniomaxillofacial Surgery, Translational Implantology, Center for Dental Medicine, University Medical Center of Freiburg, Freiburg, Germany
| | - Peter Thomas
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Janina Endres
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Selina Kessler
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
| | - Burkhard Summer
- Department of Dermatology and Allergology, Ludwig Maximilians University of Munich, Munich, Germany
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Zhang LQ, Zhao YN, Zhang YQ, Zhang Y, Liu DG. Morphologic analysis of alveolar bone in maxillary and mandibular incisors on sagittal views. Surg Radiol Anat 2021; 43:1009-1018. [PMID: 34023911 DOI: 10.1007/s00276-020-02640-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/29/2020] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to analyze the morphologic features of alveolus in relatively healthy maxillary and mandibular incisors using cone-beam-computed tomography (CBCT). METHODS CBCT images of 318 patients were retrospectively acquired. Alveolar bone in incisive area was divided into: type 1 (thick), type 2 (relatively thick with mono-plate concavity), type 3 (thin with double-plate concavities), and type 4 (vulnerably thin). Alveolus prevalence and widths were analyzed statistically relative to age, gender, and molar relationship. RESULTS Prevalence of type 1 alveolus was 78.9% in maxillary central incisors, 15.1% in maxillary lateral incisors, 24.1% in mandibular central incisors, and 5.0% in mandibular lateral incisors. Type 2 alveolus was commonly observed in the maxillary lateral incisors (82.2%), mandibular central incisors (66.2%), and mandibular lateral incisors (87.9%). Prevalence of type 3 and 4 alveoli ranged from 0.0 to 9.4%. As for maxillary central incisors, type 1 was the widest both at the alveolar crest (7.77 ± 0.58 mm) and apical area (9.05 ± 1.86 mm), while type 3 had the lowest width at the apical region (4.08 ± 0.51 mm). Among maxillary central incisors, prevalence of type 1 tended to decrease with age. At all maxillary and mandibular incisor sites, alveolus widths were significantly thicker in males than in females. At maxillary lateral incisor and mandibular incisor sites, prevalence of alveolus type was significantly different among three molar relationships. CONCLUSION A 4-type classification system was suggested for alveolus morphology in incisive region. Identification of alveolus type might aid in the corresponding treatment.
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Affiliation(s)
- Li-Qi Zhang
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Ya-Ning Zhao
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Ya-Qiong Zhang
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Deng-Gao Liu
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
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15
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Coli P, Jemt T. Are marginal bone level changes around dental implants due to infection? Clin Implant Dent Relat Res 2021; 23:170-177. [PMID: 33463079 DOI: 10.1111/cid.12971] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant. Reduction of marginal bone levels in association with bleeding on probing have been claimed to be a sign of pathology and an indication of treatment needs. PURPOSE To assess the available evidence that peri-implant bone loss is caused by infection. MATERIALS AND METHODS This article is a narrative review on the interpretation of marginal bone level changes around dental implants as a consequence of infection. RESULTS AND CONCLUSIONS There is evidence that plaque accumulation induces an inflammatory reaction in the peri-implant soft tissues and that resumption of plaque control measures results in the reduction of the inflammation. Since plaque is always present in the oral cavity, a cause-effect relationship between plaque accumulation and peri-implantitis, defined as inflammation of the peri-implant soft tissues associated with marginal bone loss has been difficult to validate and has not been proven so far. There is no evidence of the mechanisms involved in the tissue reactions resulting in the conversion from a state of an inevitable inflammation contained in the soft tissues to a state of inflammation involving the loss of peri-implant marginal bone. There is today no consensus whether implants should be expected to be surrounded by tissues which are completely free from inflammation, or that an "immune-driven", chronic, subclinical inflammation should be expected at the foreign body implant. The infectious origin theory appears to be mainly supported by ligature-induced experimental peri-implantitis investigations in animal models that suffer of several methodological problems, and therefore, provide misleading information with regards to human clinical applications in large, routine populations.
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Affiliation(s)
- Pierluigi Coli
- Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
| | - Torsten Jemt
- Brånemark Clinic, Public Dental Health Care Service, Gothenburg, Västra Götaland, Sweden
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16
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Klinge A, Tranaeus S, Becktor J, Winitsky N, Naimi-Akbar A. The risk for infraposition of dental implants and ankylosed teeth in the anterior maxilla related to craniofacial growth, a systematic review. Acta Odontol Scand 2021; 79:59-68. [PMID: 32835562 DOI: 10.1080/00016357.2020.1807046] [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] [Indexed: 12/30/2022]
Abstract
BACKGROUND The aim of the study was to evaluate a potential association between individuals with different craniofacial types or other exposures, and the risk of infraposition due to continued growth/eruption of adjacent teeth in the anterior maxilla. MATERIALS AND METHODS This is a systematic review in which primary studies as well as other systematic reviews are scrutinised. A search of PubMed (Medline), Scopus, Web of science and Health technology assessment (HTA) organisations and a complementary handsearch was carried out. Selected studies were read in full-text by several reviewers. The quality of the included primary studies was assessed using a protocol for assessment of risk of bias in exposure studies. RESULTS The literature search resulted in 3,296 publications. Title and abstract screening yielded 25, whereof one systematic review, potential publications allocated for full-text inspection. The quality assessment resulted in a total of seven studies with a low/moderate risk of bias and four studies with a high risk of bias. CONCLUSION In conclusion, a long-term risk for infraposition of dental implants, or ankylosed teeth, among natural teeth can be observed in some cases. The predisposing factors are still not fully understood since the current scientific evidence is very limited.
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Affiliation(s)
- Anna Klinge
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Sofia Tranaeus
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden
| | - Jonas Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
| | - Nicole Winitsky
- Folktandvården Eastmaninstitutet. Public Dental Health, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, Malmö, Sweden
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden
- Folktandvården Eastmaninstitutet. Public Dental Health, Stockholm, Sweden
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Cosola S, Marconcini S, Boccuzzi M, Menchini Fabris GB, Covani U, Peñarrocha-Diago M, Peñarrocha-Oltra D. Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186920. [PMID: 32971869 PMCID: PMC7557536 DOI: 10.3390/ijerph17186920] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022]
Abstract
Background: to assess the radiological marginal bone loss between bone-level or tissue-level dental implants through a systematic review of literature until September 2019. Methods: MEDLINE, Embase and other database were searched by two independent authors including only English articles. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis counting a total of 1161 patients (mean age 54.4 years) and 2933 implants, 1427 inserted at Tissue-level (TL) and 1506 inserted at Bone-level (BL). The survival rate and the success rate were more than 90%, except for 2 studies with a success rate of 88% and 86.2%. No studies reported any differences between groups in term of success and survival rates. Three studies showed that BL-implants had statistically less marginal bone loss (p < 0.05). Only one study reported statistically less marginal bone loss in TL-implants (p < 0.05). Conclusion: In the most part of the studies, differences between implant types in marginal bone loss were not statistically significant after a variable period of follow-up ranged between 1 and 5 years.
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Affiliation(s)
- Saverio Cosola
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Correspondence:
| | - Simone Marconcini
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Michela Boccuzzi
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Giovanni Battista Menchini Fabris
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
- Department of Stomatology, University of Studies Guglielmo Marconi, 44, 00193 Roma, Italy
| | - Ugo Covani
- Tuscan Stomatologic Institute, via Aurelia, 335, 55041 Lido di Camaiore, Italy; (S.M.); (M.B.); (G.B.M.F.); (U.C.)
| | - Miguel Peñarrocha-Diago
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
| | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 13, 46010 Valencia, Spain; (M.P.-D.); (D.P.-O.)
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Is Peri-Implant Probing Causing Over-Diagnosis and Over-Treatment of Dental Implants? J Clin Med 2019; 8:jcm8081123. [PMID: 31362381 PMCID: PMC6722911 DOI: 10.3390/jcm8081123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 12/23/2022] Open
Abstract
Pocket probing depth (PPD) and bleeding on probing (BOP) measurements are useful indices for the assessment of periodontal conditions. The same periodontal indices are commonly recommended to evaluate the dental implant/tissue interface to identify sites with mucositis and peri-implantitis, which, if not treated, are anticipated to lead to implant failure. The aim of the present narrative review is to discuss the available literature on the effectiveness of probing at dental implants for identification of peri-implant pathology. There is substantial clinical evidence that PPD and BOP measurements are very poor indices of peri-implant tissue conditions and are questionable surrogate endpoints for implant failure. On the contrary, the literature suggests that frequent disturbance of the soft tissue barrier at implants may instead induce inflammation and bone resorption. Moreover, over-diagnosis and subsequent unnecessary treatment may lead to iatrogenic damage to the implant-tissue interface. Despite this, the recommendations from recent consensus meetings are still promoting the use of probing at dental implants. For evaluation of implants, for instance at annual check-ups, the present authors recommend a clinical examination that includes (i) a visual inspection of the peri-implant tissues for the assessment of oral hygiene and the detection of potential redness, swelling, (ii) palpation of the peri-implant tissues for assessment of the potential presence of swelling, bleeding, suppuration. In addition, (iii) radiography is recommended for the assessment of crestal bone level for comparison with previous radiographs to evaluate potential progressive bone loss even if there is a need for more scientific evidence of the true value of the first two clinical testing modes.
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Priest G. The treatment dilemma of missing maxillary lateral incisors-Part II: Implant restoration. J ESTHET RESTOR DENT 2019; 31:319-326. [PMID: 31033174 DOI: 10.1111/jerd.12483] [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: 12/09/2018] [Revised: 03/09/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This second of a two-part series reviews the single dental implant as the most current treatment alternative for replacement of a missing or lost maxillary lateral incisor. Assessments of dental maturity for implant placement, implant space requirements, surgical and restorative influence on soft tissue profiles, and implant success are reviewed. OVERVIEW Recent data indicates that implant success rates are high, and esthetics and soft tissue profiles appear to be stable for maxillary lateral incisor implants. Implant placement should be assessed by dental maturity of the specific patient as opposed to chronological age, and implant spacing should be developed and assessed by all team members. CONCLUSIONS Implant replacement of a missing lateral incisor is a predictable treatment mode if implant placement is deferred until dental maturity and then accurately placed in a well-developed site. Treatment involves more complicated planning and execution from team members than other alternatives, but innovations in techniques and materials render it a favorable alternative for lateral incisor replacement. CLINICAL SIGNIFICANCE Implant restoration of a missing or lost maxillary lateral incisor is surgically and restoratively more complex than space closure or a resin-bonded fixed dental prosthesis but demonstrates high success rates and high esthetic potential when team members follow strict treatment protocols.
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