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Darriba I, Seidel A, Moreno F, Botelho J, Machado V, Mendes JJ, Leira Y, Blanco J. Influence of low insertion torque values on survival rate of immediately loaded dental implants: A systematic review and meta-analysis. J Clin Periodontol 2023; 50:158-169. [PMID: 36217696 PMCID: PMC10092009 DOI: 10.1111/jcpe.13733] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 01/18/2023]
Abstract
AIM The aim was to systematically evaluate the effect of low insertion torque values on the survival rate of immediately loaded dental implants. MATERIALS AND METHODS The protocol was registered with PROSPERO (ID CRD42020189499). An electronic search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until June 2022 in English and Spanish. Studies analysing the failure or survival rate of immediately loaded dental implants according to different insertion torque values were included. RESULTS Five-hundred seventy-three articles were assessed for eligibility, of which seven articles, four randomized clinical trials (RCTs), one controlled clinical trial, and two prospective case series studies were included in the qualitative analysis. The RCTs were classified as having low risk of bias and the non-RCTs as having moderate and serious risk of bias. The mean survival rate for implants with low insertion toque (≤35 Ncm) was 96% (p > .001, 95% confidence interval [CI]: 0.91-0.98) and that for implants with medium or high insertion torque (>35 Ncm) was 92% (p > .001, 95% CI: 0.86-0.96) (incidence rate ratio [IRR] = 1.05, 95% CI: 0.79-1.39, p = .175, I2 = 0.0%). Splinted implants with insertion torque >20 Ncm and single implants with insertion torque >35 Ncm had a higher survival rate than implants with lower insertion torque values (IRR = 1.05, 95% CI: 0.78-1.43, p = .956, I2 = 0.0%, and RR = 0.92, 95% CI: 0.48-1.75, p = .799, I2 = 0.0%, respectively). Different insertion torque values achieved equivalent outcomes. The mean follow-up was 24 months. CONCLUSIONS Low insertion torque values have no significant effect on survival rates of immediate loading implants at a mean follow-up of 24 months.
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Affiliation(s)
- Iria Darriba
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Anna Seidel
- Department of Prosthodontics, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Federico Moreno
- Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London, UK
| | - João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - José João Mendes
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal.,Evidence-Based Hub, CRU, CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Portugal
| | - Yago Leira
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain.,Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London, UK.,Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela, University Clinical Hospital, Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Odontology and Medicine, University of Santiago de Compostela and Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
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Wang J, Zhang Z, Deng F. Marginal bone level change during sequential loading periods of partial edentulous rehabilitation using immediately loaded self-tapping implants: a 6.5-year retrospective study. J Adv Prosthodont 2022; 14:133-142. [PMID: 35855320 PMCID: PMC9259351 DOI: 10.4047/jap.2022.14.3.133] [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: 12/27/2021] [Revised: 05/11/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE A large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points. MATERIALS AND METHODS The patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05). RESULTS Overall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05). CONCLUSION Slight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.
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Affiliation(s)
- Jing Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Gotfredsen K, Hosseini M, Rimborg S, Özhayat E. Patient's perception of timing concepts in implant dentistry: A systematic review. Clin Oral Implants Res 2021; 32 Suppl 21:67-84. [PMID: 34642992 DOI: 10.1111/clr.13861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/16/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023]
Abstract
Protocols for implant dentistry, most frequently include periods until healing of the extraction sockets and osseointegration of the implant. Deductional thinking imply that patients would prefer if treatment time in implant dentistry were reduced. AIM What is the patient perception of immediate or early implant placement or loading in comparison with traditional, delayed placement, and/or loading assessed by patient-reported outcome measures, as evidenced in randomized controlled clinical trials or prospective controlled studies? MATERIAL AND METHODS A systematic review was performed following the PRISMA guidelines with a literature search up to June 30. All hits were imported into Rayyan online software and analyzed by two authors for eligibility. Cochrane RoB2.0 and Newcastle-Ottawa Scale were used to evaluate risk of bias in the individual studies. RESULTS Of the initially 1439 articles, 76 underwent full-text analysis and finally 40 articles, representing 35 cohort studies, were included. The quality evaluation demonstrated some concerns among most of the studies. CONCLUSION a) There is no strong evidence to support that the time for implant placement or loading of implant-supported single or short-span reconstructions or overdentures influence patients´ discomfort, satisfaction with function or esthetics or overall satisfaction with the implant treatment. b) There is some evidence that studies including edentulous patients rehabilitated with implant-supported full-arch FDPs demonstrate more satisfied patients with immediate than for the early or delayed loaded implant reconstructions after short time, but the difference is not clear one year after treatment.
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Affiliation(s)
- Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susie Rimborg
- Faculty Library of Natural- and Health Sciences, Copenhagen University Library, Copenhagen University, Copenhagen, Denmark
| | - Esben Özhayat
- Section of Public Health Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Aiquel LL, Pitta J, Antonoglou GN, Mischak I, Sailer I, Payer M. Does the timing of implant placement and loading influence biological outcomes of implant-supported multiple-unit fixed dental prosthesis-A systematic review with meta-analyses. Clin Oral Implants Res 2021; 32 Suppl 21:5-27. [PMID: 34642990 PMCID: PMC9292924 DOI: 10.1111/clr.13860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/23/2021] [Accepted: 06/10/2021] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple-unit implant-supported fixed dental prosthesis (FDPs). MATERIAL AND METHODS A literature search was performed by three independent reviewers for studies reporting on ≥10 patients with FPDs supported by ≥two implants over ≥3 years of follow-up. Data were analyzed on implant survival and biological complications as primary outcomes and biological events, including changes in peri-implant marginal bone level (MBL), probing depth, soft-tissue level, and health condition as secondary outcomes. RESULTS 7002 titles were identified, 360 full-texts were screened, and 14 studies were included. These comprised 6 randomized controlled studies (RCTs), 5 cohort studies, and 3 case series with identifiable implant placement and loading protocols in five of 09 possible combinations. All groups but one (IPIL) showed implant survival rates >90%. A meta-analysis based on 3 RCTs found no differences in survival rate between DPIL and DPDL (p = .227). CONCLUSIONS High survival rates for all studied implant placement and loading combinations were shown for FPDs over ≥3 years of follow-up. When a delayed implant placement protocol is applied, immediate or delayed loading demonstrated similar survival rates. The heterogeneity of the data did not allow to draw any further conclusions on the occurrence of biological complications related to timing of implant placement/loading.
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Affiliation(s)
- Louise Leite Aiquel
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - João Pitta
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Georgios N. Antonoglou
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - Irene Mischak
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
| | - Irena Sailer
- Division of Fixed Prosthodontics and BiomaterialsUniversity Clinics for Dental MedicineUniversity of GenevaGenevaSwitzerland
| | - Michael Payer
- Department of Oral Surgery and OrthodonticsUniversity Clinic of Dental Medicine and Oral HealthMedical University of GrazGrazAustria
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Kim YY, Song YW, Kim MJ, Cha JK, Park JM, Kim JH, Jung UW. Immediate loading of fixed partial prostheses reconstructed using either tapered or straight implants in the posterior area: A randomized clinical trial. Clin Implant Dent Relat Res 2021; 23:703-715. [PMID: 34378853 DOI: 10.1111/cid.13039] [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: 04/12/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND In immediately loaded implants within 72 h after the implant placement in the unilaterally and partially edentulous ridge, primary stability is considered critical, which can be influenced by the design of the implant fixture. PURPOSE To determine the outcomes at 1 year after the immediate loading of multiunit fixed partial prostheses over either tapered implants (TIs) or straight implants (SIs) in the posterior region. MATERIALS AND METHODS Forty-eight patients (24 patients, 52 implants in TI group; 24 patients, 50 implants in SI group) were included for the study. Except for the one SI group patient whose two implants showed the insertion torque less than 30 Ncm, provisional prostheses designed and fabricated from intraoral scan data obtained immediately after implant surgery were delivered to rest of the 47 subjects at 3-7 days. After a year, the survival rate was estimated by intention-to-treat (ITT) and per-protocol (PP) analyses, and marginal bone loss (MBL) and implant stability were also analyzed statistically (p < 0.05). RESULTS Survival rate at implant level in TI group was 96.2%, and that of SI group in the ITT analysis was 86.0%. Intergroup difference, however, was not statistically significant (p > 0.05). Insertion torque was significantly higher in TI group than SI group (47.12 ± 6.37 Ncm vs. 41.60 ± 9.77 Ncm; p < 0.05). MBLs of both groups were less than 0.1 mm at 1-year follow-up and was similar between two groups (p > 0.05). CONCLUSIONS Immediate loading of fixed partial prostheses after TI and SI placement showed reliable outcomes in the partially edentulous posterior ridge. In terms of the initial mechanical stability, the performance was superior for TIs than for SIs.
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Affiliation(s)
- Yoo-Yeon Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Man Park
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jee-Hwan Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
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Vogl S, Stopper M, Hof M, Theisen K, Wegscheider WA, Lorenzoni M. Immediate occlusal vs nonocclusal loading of implants: A randomized prospective clinical pilot study and patient centered outcome after 36 months. Clin Implant Dent Relat Res 2019; 21:766-774. [PMID: 31062517 PMCID: PMC6767417 DOI: 10.1111/cid.12770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 11/30/2022]
Abstract
Background Immediate provisionalization reduces chair time and improves patient comfort. Purpose To analyze immediate functional loading vs nonfunctional loading with restorations in the posterior mandible for marginal bone defects, implant success/survival, and patient satisfaction. Materials and Methods A randomized controlled clinical trial was designed to assess these parameters based on 20 adult patients who underwent implant surgery, followed by immediate delivery of screw‐retained or cemented single or splinted restorations in full occlusal contact or in infraocclusion (test and control group). A questionnaire with visual analog scales was used to assess patient satisfaction. Results Following 36‐month data were evaluable for 9 patients (21 implants) in the study group (immediate functional loading) and for 10 patients (31 implants) in the control group (immediate nonfunctional loading). One implant in the control group was lost, hence the overall implant survival and success rate was 98.2%. Marginal bone defects were consistent with previous studies and comparable in both groups. Periotest values did not significantly change from baseline and the 12‐month follow‐up (Friedmann test). Patient satisfaction was high and did not involve any significant intergroup differences (Mann‐Whitney U‐test). Conclusions Both types of immediate provisional restorations are viable in selected patients. Larger randomized controlled trials are needed to establish immediate functional loading as a standard treatment for partially edentulous jaws.
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Affiliation(s)
- Susanne Vogl
- Division of Operative dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Marlene Stopper
- Division of Operative dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Markus Hof
- Department of Oral Surgery, Dental Clinics, Faculty of Medicine at the Sigmund Freud University, Vienna, Austria
| | - Kerstin Theisen
- Division of Operative dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Walther A Wegscheider
- Division of Operative dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Martin Lorenzoni
- Division of Operative dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
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