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Ashurko I, Samsonov A, Galyas A, Petukhova M, Tarasenko S, Unkovskiy A. Rehabilitation Using Implants with Sloped Platform Edge vs. Standard Platform with Guided Bone Regeneration: A Randomized Control Clinical Trial. Dent J (Basel) 2024; 12:205. [PMID: 39056992 PMCID: PMC11275355 DOI: 10.3390/dj12070205] [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: 03/25/2024] [Revised: 06/08/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
The purpose of this study was to evaluate the vertical bone loss after using different techniques: sloped implants or standard implants with guided bone regeneration. Patients with tooth gap and horizontal bone deficiency were randomly allocated to the test group (implants with sloped platform-SLP) and control group (standard design implants with guided bone regeneration-GBR). The primary outcome was bone loss (6 months after finishing the prosthetic treatment). Secondary outcomes included the following: patient-reported outcome measures (PROMs), post-operative edema, keratinized mucosa width, and pink aesthetic score (PES). The average bone loss at 6 months was 0.23 ± 0.15 mm and 1.03 ± 0.37 mm in the SLP and GBR groups, respectively. The SLP group was characterized by lower pain intensity the first 7 days (p < 0.001), lower post-operative edema (p < 0.001), lower consumption of NSAIDs on days 1, 3, 5, and 7 (p = 0.002, <0.001, <0.001, and 0.008), and lower total OHIP-14 (p = 0.047) on day 7. The keratinized mucosa width was 3.7 (3.4-4.0) mm and 2 (1.4-2.0) mm in the SLP and GBR groups, respectively. The preservation of the mesial, distal papillae, and the level of soft tissue correspondence were significantly higher in the SLP group (p = 0.003, 0.038, <0.001). In the SLP group, more natural color and better texture of soft tissues were found (p = 0.048, p = 0.041). The use of implants with a sloped platform resulted in superior outcomes compared to the standard-design implants with GBR.
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Affiliation(s)
- Igor Ashurko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
| | - Andrey Samsonov
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
| | - Anna Galyas
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
| | - Marina Petukhova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
| | - Svetlana Tarasenko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
| | - Alexey Unkovskiy
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (I.A.); (A.S.); (A.G.); (S.T.)
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
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Wang S, Duan S, Chen R, Wang Z, Tang Y. Immediate loading in partially edentulous patients with fixed implant-supported restorations cases report. FRONTIERS IN ORAL HEALTH 2024; 5:1369494. [PMID: 38774040 PMCID: PMC11106488 DOI: 10.3389/froh.2024.1369494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 05/24/2024] Open
Abstract
Objectives This article reports on four rare cases involving multiple trauma-induced adjacent missing anterior teeth in the maxillary or mandibular region. These cases were successfully treated using a 4-axial implant-based alternative insert and an immediate loading protocol. Material and methods This series of cases was summarized by retrospective study that 4 patients who received a total of 20 immediately loaded implants. These patients had suffered from trauma-induced loss of 8-9 adjacent anterior teeth. The 4-axial-implants were inserted with the assistance of digital pioneer drill guides. The surgical procedure involved alveolar bone trimming or ultrasonic osteotomy, eliminating the need for traditional large-area bone augmentation. Pre- and post-operative CBCT was matched using DTX Studio Implant software, the deviation of implant between actual position and preoperative design was measured and compared using SPSS software package. Results The average follow-up duration 48 months after implant prostheses, the cumulative retention rate of the implants was 100%, the marginal bone loss averaged 0.53 mm (SD 0.15 mm), and buccal plate bone loss averaged 0.62 mm (SD 0.41 mm). Conclusions This retrospective clinical report demonstrates the successful treatment of several patients with multiple adjacent maxillary or mandibular anterior teeth using four implant-supported screws to fix the frame and employing immediate loading. The approach resulted in long-term stable clinical outcomes. Moreover, the method not only shortens the period of edentulism but also facilitates easy disassembly, maintenance, and cleaning. Consequently, it emerges as a highly favorable clinical option for patients suffering from extensive tooth loss.
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Affiliation(s)
- Shuang Wang
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Siyi Duan
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Rui Chen
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Zijian Wang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Yulong Tang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Aliberti SM, Funk RHW, De Stefano M, Hoffmann T, Capunzo M. An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study. Clin Exp Dent Res 2024; 10:e2836. [PMID: 38450945 PMCID: PMC10918715 DOI: 10.1002/cre2.836] [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: 08/24/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure. MATERIALS AND METHODS The study used the hybrid method of SWOT-AHP. RESULTS Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight. CONCLUSIONS This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.
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Affiliation(s)
- Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Richard H. W. Funk
- Institute of AnatomyTechnische Universität (TU) DresdenDresdenGermany
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Marco De Stefano
- Department of Industrial EngineeringUniversity of SalernoSalernoItaly
| | - Thomas Hoffmann
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
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Jia P, Tang Y, Niu L, Qiu L. Clinical and radiographic outcomes of a combined surgery approach to treat peri-implantitis. Int J Oral Maxillofac Surg 2024; 53:333-342. [PMID: 38154998 DOI: 10.1016/j.ijom.2023.11.013] [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: 01/12/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/30/2023]
Abstract
Peri-implant infra-bony defects are difficult to treat, and data on the management of peri-implantitis are lacking. The aim of this study was to evaluate the effect of a combined surgical approach to manage peri-implantitis: implantoplasty with xenogeneic bone grafting and a concentrated growth factor membrane. Two independent examiners analysed the medical records and radiographs taken before surgery and at the last follow-up. Data were analysed at the implant level; some patient-level data (age, sex, smoking habit) were also considered. Linear regression analysis with generalized estimating equations (GEE) was used to explore the effect of variables of interest (including marginal bone level (MBL)) on implantitis treatment success and resolution rates. The effect of the prosthesis type on postoperative clinical and radiographic parameters was also explored by GEE, with adjustment for age, sex, tooth site, location, follow-up duration, and implant length (model IV including all). Thirty patients with 72 implants were investigated. The implant survival rate was 100% over a mean observation period of 3.3 years (range 2-11 years). The treatment success rate (bone loss <0.5 mm, no bleeding on probing (BOP), no suppuration, probing depth (PD) < 5 mm) was higher in females than males (50% vs 19.0%; P = 0.008). At the last postoperative follow-up, the MBL (1.51 ± 1.07 vs 4.01 ± 1.13 mm), PD (3.61 ± 0.84 vs 6.54 ± 1.01 mm), and BOP (23.38 ± 23.18% vs 79.17 ± 15.51%) were significantly reduced when compared to pre-surgery values (all P < 0.001). Furthermore, a significantly higher PD reduction (β = -1.10 mm, 95% confidence interval -1.97 to -0.23 mm, P = 0.014) was observed for implants with a single crown than a full-arch prosthesis (GEE model IV). Preliminary clinical and radiographic data indicate that implantoplasty in combination with surgery could be an effective treatment option for peri-implantitis.
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Affiliation(s)
- P Jia
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Y Tang
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Niu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - L Qiu
- Fourth Division, Peking University School and Hospital of Stomatology, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China; Research Center of Engineering and Technology for Digital Dentistry of the Ministry of Health, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
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Durrani F, Karthickraj SM, Imran F, Ahlawat S, Kumari E, Vani SUG. Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla. J Indian Soc Periodontol 2024; 28:106-112. [PMID: 38988954 PMCID: PMC11232800 DOI: 10.4103/jisp.jisp_436_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 07/12/2024] Open
Abstract
Objective The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla. Materials and Methods Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications. Results The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8). Conclusion Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.
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Affiliation(s)
- Farhan Durrani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S M Karthickraj
- Reader, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Fouzia Imran
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shweta Ahlawat
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ekta Kumari
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S U Gokila Vani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Sharaf MA, Jiang J, Wang S, Xiao P, Xu A, He F. Clinical and patient-centered outcomes following rehabilitation of atrophic edentulous maxilla using six implants placed simultaneously with bilateral maxillary sinus augmentation: A retrospective case series. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101480. [PMID: 37105492 DOI: 10.1016/j.jormas.2023.101480] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES To evaluate treatment success, patient satisfaction, and oral health-related quality of life (OHRQoL) after rehabilitation of atrophic edentulous maxilla (AEM) with six implants placed simultaneously with bilateral maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS The selected patients were fully edentulous with atrophic maxillary posterior residual ridges and rehabilitated with six implants placed simultaneously with bilateral MSFA and immediate All-on-4 provisional fixed prosthesis (PFP). After 7-12 months of implant surgery, all patients have received an All-on-6 definitive fixed prosthesis (DFP). After at least one year of function with DFP, clinical and radiographic examinations were performed. Patient satisfaction was assessed through a visual analog scale (VAS). The OHRQoL before treatment (T0), during provisional (T1), and after definitive prosthesis (T2) was evaluated using OHI-14. RESULTS 20 maxillary edentulous patients were rehabilitated with 120 implants, 20 immediate All-on-4 PFP, and 20 All-on-6 DFP. Of those, 12 patients have passed at least a year follow-up after DFP insertion and were eligible to be included in the assessment of treatment success. After a mean of 20 (12-36) months follow-up, the implant and prosthesis survival rates were 100%. The success rate at the implant level was 98.6%. The mean marginal bone loss (MBL) was 0.09 ± 0.06 mm. No prosthetic or postoperative complications, and the mean general satisfaction was (91.75 ± 7.06). There was a significant improvement in all OHIP-14 domains during the final All-on-6 prosthesis (T2) (P < 0.01). CONCLUSIONS Rehabilitation of atrophic edentulous maxilla using six implants with simultaneous bilateral MSFA and immediate All-on-4 PFP is a successful treatment approach associated with minimal postoperative complications and significant improvement in OHRQoL.
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Affiliation(s)
- Mufeed Ahmed Sharaf
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China; Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Jimin Jiang
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China
| | - Siyuan Wang
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China
| | - Pei Xiao
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China
| | - Antian Xu
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China
| | - Fuming He
- Department of Oral Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang 310006, China.
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Avila-Ortiz G, Vegh D, Mukaddam K, Galindo-Moreno P, Pjetursson B, Payer M. Treatment alternatives for the rehabilitation of the posterior edentulous maxilla. Periodontol 2000 2023; 93:183-204. [PMID: 37486029 DOI: 10.1111/prd.12507] [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: 01/29/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023]
Abstract
Rehabilitation of the edentulous maxilla with implant-supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability and surgical access, among other factors. This review addresses several treatment options to replace missing teeth in posterior maxillary segments, namely the placement of standard implants in conjunction with maxillary sinus floor augmentation, short implants, tilted implants, and distal cantilever extensions. Pertinent technical information and a concise summary of relevant evidence on the reported outcomes of these different therapeutic approaches are presented, along with a set of clinical guidelines to facilitate decision-making processes and optimize the outcomes of therapy.
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Affiliation(s)
- Gustavo Avila-Ortiz
- Private Practice, Gonzalez + Solano Atelier Dental, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Dániel Vegh
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Khaled Mukaddam
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
- University Center of Dental Medicine, Department of Oral Surgery, University of Basel, Basel, Switzerland
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, University of Iceland, Reykjavik, Iceland
| | - Michael Payer
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
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Yuan X, Liu Y, Yang Y, Ren M, Luo L, Zheng L, Liu Y. Effect of short implant crown-to-implant ratio on stress distribution in anisotropic bone with different osseointegration rates. BMC Oral Health 2023; 23:683. [PMID: 37730562 PMCID: PMC10512631 DOI: 10.1186/s12903-023-03379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE This study aimed to provide evidence for the clinical application of single short implants by establishing an anisotropic, three-dimensional (3D) finite element mandible model and simulating the effect of crown-to-implant ratio (CIR) on biomechanics around short implants with different osseointegration rates. METHODS Assuming that the bone is transversely isotropic by finite element method, we created four distinct models of implants for the mandibular first molar. Subsequently, axial and oblique forces were applied to the occlusal surface of these models. Ultimately, the Abaqus 2020 software was employed to compute various mechanical parameters, including the maximum von Mises stress, tensile stress, compressive stress, shear stress, displacement, and strains in the peri-implant bone tissue. RESULTS Upon establishing consistent osseointegration rates, the distribution of stress exhibited similarities across models with varying CIRs when subjected to vertical loads. However, when exposed to inclined loads, the maximum von Mises stress within the cortical bone escalated as the CIR heightened. Among both loading scenarios, notable escalation in the maximum von Mises stress occurred in the model featuring a CIR of 2.5 and an osseointegration rate of 25%. Conversely, other models displayed comparable strength. Notably, stress and strain values uniformly increased with augmented osseointegration across all models. Furthermore, an increase in osseointegration rate correlated with reduced maximum displacement for both cortical bone and implants. CONCLUSIONS After fixing osseointegration rates, the stress around shorter implants increased as the CIR increased under inclined loads. Thus, the effect of lateral forces should be considered when selecting shorter implants. Moreover, an implant failure risk was present in cases with a CIR ≥ 2.5 and low osseointegration rates. Additionally, the higher the osseointegration rate, the more readily the implant can achieve robust stability.
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Affiliation(s)
- Xi Yuan
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000, China
| | - Yuchen Liu
- Dalian University of Technology, Dalian, 116000, China
| | - Yunhe Yang
- Dalian Stomatological Hospital, Dalian, 116000, China
| | - Mingfa Ren
- Dalian University of Technology, Dalian, 116000, China
| | - Lailong Luo
- Dalian University of Technology, Dalian, 116000, China
| | - Lang Zheng
- Dalian University, Dalian, 116000, China
| | - Yang Liu
- Department of Prosthodontics, Dalian Stomatological Hospital, 935 Changjiang Road, Shahekou District, Dalian, 116000, China.
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Qin S, Gao Z. Comparative evaluation of short or standard implants with different prosthetic designs in the posterior mandibular region: a three-dimensional finite element analysis study. Comput Methods Biomech Biomed Engin 2023; 26:1499-1509. [PMID: 36125258 DOI: 10.1080/10255842.2022.2124859] [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: 06/05/2022] [Revised: 08/29/2022] [Accepted: 09/11/2022] [Indexed: 11/03/2022]
Abstract
The purpose of this study is to evaluate the stress distribution of splinted or nonsplinted restorations supported by 2 short or 2 standard dental implants in the mandibular molar region using three-dimensional finite element analysis. Two standard implants (4.8 × 10mm) were placed in the mandibular molar area. Two short implants (4.8 × 6 mm) were located in the mandibular molar atrophied area. Implant-supported prostheses were simulated with splinted or nonsplinted crowns design. Vertical load of 200 N and oblique load of 100 N were applied on the central fossa and the buccal cusps. Evaluation of stress distribution in implants and peri-implant cortical bone using the finite element analysis software (Ansys, Version 2020, R2), a multipurpose computer design program. The maximum principal stress of cortical bone around the implants was higher in nonsplinted crowns when compared to splinted crowns. The stress concentration of cortical bone surrounding implants increased as the implant length decreased either splinted crowns or nonsplinted crowns. The short implants with nonsplinted crowns showed lower stresses when compared to standard implants with nonsplinted crowns. The results suggest that the nonsplinted prostheses supported by short dental implants might be considered in the molar area of the atrophic mandible.
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Affiliation(s)
- Siqi Qin
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi Gao
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Radiographic outcomes of lateral sinus floor elevation with and without bone window repositioning: one-year results of a randomized controlled trial. Int J Oral Maxillofac Surg 2023; 52:255-263. [PMID: 35786525 DOI: 10.1016/j.ijom.2022.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/22/2021] [Accepted: 01/12/2022] [Indexed: 01/11/2023]
Abstract
The objective of this study was to perform a comparative evaluation of the radiographic outcomes of lateral sinus floor elevation with and without bone window repositioning (BLSFE and LSFE, respectively) when applied concomitantly with implant placement. A randomized controlled clinical trial was conducted between February 1, 2016 and May 1, 2017 including 26 individuals with at least one missing tooth. Participants were randomized 1:1 to undergo BLSFE (10 participants, 16 implants) or LSFE (13 participants, 19 implants). Bovine-derived xenograft was used in both groups and the implants were inserted concomitantly. In the BLSFE group, the antrostomy was covered with a repositioned bone window and then with a concentrated growth factors (CGF) membrane. In the LSFE group, the antrostomy was covered with a CGF membrane. Panoramic radiographs were taken before surgery (T0), immediately postoperative (T1), and at 12 months postoperative (6 months after loading) (T2). Marginal bone loss (MBL), apical bone gain, augmented alveolar bone height, and intra-sinus bone augmentation were evaluated on panoramic radiographs at T2. A linear regression analysis with generalized estimating equation models was performed. The implant survival rate was 100% at 1 year after implant surgery. The residual alveolar bone height at T0 was comparable in the BLSFE and LSFE groups (3.58 ± 1.49 mm vs 4.12 ± 1.61, P = 0.32), as was the alveolar bone height at T1 (13.61 ± 1.82 mm vs 12.38 ± 1.82 mm, P = 0.06). At T2, significantly higher alveolar bone height, intra-sinus bone augmentation, and apical bone gain, and lower distal MBL were observed in the BLSFE group when compared to the LSFE group, with adjusting for covariates (β = 2.44, 95% CI 1.42-3.46, P < 0.0001; β = 2.38, 95% CI 1.35-3.41, P < 0.0001; β = 2.33, 95% CI 1.23-3.42, P < 0.0001; and β = -0.43, 95% CI -0.83 to -0.02, P = 0.038, respectively). No significant difference was observed for mesial MBL or apical bone resorption at T2. Lateral sinus floor elevation with bone window repositioning may result in higher bone augmentation after 1 year than the traditional approach. Further research is needed to elucidate the effect of lateral sinus floor elevation with bone window repositioning.
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Barausse C, Pistilli R, Canullo L, Bonifazi L, Ferri A, Felice P. A 5-year randomized controlled clinical trial comparing 4-mm ultrashort to longer implants placed in regenerated bone in the posterior atrophic jaw. Clin Implant Dent Relat Res 2022; 24:4-12. [PMID: 35019219 DOI: 10.1111/cid.13061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/27/2021] [Accepted: 12/10/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Short implants (up to 5-mm long) have shown good results when compared to longer implants placed in augmented bone. PURPOSE To evaluate if 4-mm ultrashort implants could also be an alternative to bone augmentation in the severely atrophic posterior jaws. The primary aim of the study was to compare implant survival rates between study groups. MATERIALS AND METHODS Eighty partially edentulous patients with posterior atrophic jaws (5-6 mm of bone above the mandibular canal and 4-5 mm below the maxillary sinus) were included: 40 patients in the maxilla and 40 in mandible. The patients were randomized to receive one to three 4-mm ultrashort implants or one to three implants at least 10-mm long in augmented bone. Results are reported 5 years after loading with the following outcome measures: implant and prosthetic failures, complications and peri-implant marginal bone level changes. RESULTS Thirty-two complications were reported for the control group in 18 patients versus 13 complications in 10 patients in the test group, the difference being not statistically significant (p = 0.103). In the augmented group, 12 implants failed in 6 patients versus 7 short implants in 6 cases, and 9 prostheses failed in the control group while 4 in the test one, without statistically significant differences (p = 1.000 and 0.363, respectively). At 5 years after loading, short implants lost on average 0.58 ± 0.40 mm of peri-implant marginal bone and long implants 0.99 ± 0.58 mm, the difference was statistically significant (p = 0.006). CONCLUSION Four-millimeter ultrashort implants showed similar if not better results when compared to longer implants placed in augmented jaws 5 years after loading. For this reason, their use could be in specific cases preferable to bone augmentation since the treatment is less invasive, faster, cheaper and associated with less morbidity. However, longer follow-ups and larger trials are needed.
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Affiliation(s)
- Carlo Barausse
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy.,Postgraduate School of Oral Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Luigi Canullo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Bonifazi
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
| | - Agnese Ferri
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
| | - Pietro Felice
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
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Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [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] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
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Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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Iezzi G, Perrotti V, Felice P, Barausse C, Piattelli A, Del Fabbro M. Are <7‐mm long implants in native bone as effective as longer implants in augmented bone for the rehabilitation of posterior atrophic jaws? A systematic review and meta‐analysis. Clin Implant Dent Relat Res 2020; 22:552-566. [DOI: 10.1111/cid.12946] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 08/30/2023]
Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Pietro Felice
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Carlo Barausse
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
- Biomaterials Engineering Catholic University of San Antonio de Murcia (UCAM) Murcia Spain
- Fondazione Villaserena per la Ricerca Città Sant'Angelo Pescara Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
- Dental Clinic IRCCS Orthopedic Institute Galeazzi Milan Italy
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CT-based dentulous mandibular alveolar ridge measurements as predictors of crown-to-implant ratio for short and extra short dental implants. Sci Rep 2020; 10:16229. [PMID: 33004827 PMCID: PMC7530749 DOI: 10.1038/s41598-020-73180-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/25/2020] [Indexed: 12/17/2022] Open
Abstract
The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and horizontal dimensions of dentulous posterior mandibles in a sample of 18- to 25-year-olds were measured, and correlations of these dimensions with sex and site were investigated. Mandibular computed tomography scans from 100 subjects were considered. Vertical and horizontal bone and tooth measurements were taken at the sites of the second premolar (PM), and the mesial and distal roots of the first and second molars (M1m, M1d, M2m and M2d, respectively). A hypothetical crown-to-implant ratio (C/I R) was calculated assuming the insertion of short and extra short implants (5, 6 or 7 mm), at 1.5 mm from the inferior alveolar canal, maintaining the position of the existing occlusal plane. All vertical bone dimensions decreased from the PM to the M2d. Width measurements increased from the mesial (PM) to the distal sites (M1m, M1d, M2m and M2d). Males had significantly greater vertical and horizontal measurements than females at all sites. The mean C/I R was higher than 2 for all sizes of implant. The C/I R was lower for the second molar than for the second premolar, while it was similar for the first molar and the second premolar. Males had a higher C/I R than females. Computed tomography can be used to study the anatomical features of alveolar bone, and to predict some clinical aspects of prosthetic rehabilitation with implants, such as the crown-to-implant ratio in conditions of serious bone atrophy.
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