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Kumar VV, Venkat S, Jacob PC, Khemeria G. Rehabilitation of Reconstructed Maxilla Using Denture-Guided Epithelial Regeneration in DCIA Flap: 10-Year Follow-Up. J Maxillofac Oral Surg 2024; 23:639-643. [PMID: 38911398 PMCID: PMC11189883 DOI: 10.1007/s12663-023-01900-z] [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: 01/02/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
This 10-year follow-up report describes the interdisciplinary comprehensive management of a patient with aneurysmal bone cyst of the maxilla in a 24-year-old patient. The treatment included resection and primary reconstruction with vascularized deep circumflex iliac artery-based composite free flap, implant placement, and peri-implant soft tissue management using denture-guided epithelial regeneration with interim dentures. Definitive management was done using implant-supported cast partial dentures, and the patient followed up for 10 years.
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Affiliation(s)
- Vinay V. Kumar
- Oral Rehabilitation Center, 9 Osborne Road, Sivanchetti Gardens, Bengaluru, KA 560042 India
- Department of Surgical Sciences, Odontology and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Sainath Venkat
- Department of Maxillofacial Prosthetics, Sri Shankara Cencer Hospital and Research Center, Bengaluru, 560004 India
| | - P. C. Jacob
- Ora Care Dental Clinic, Coles Road, Bengaluru, 560005 India
| | - Gaurav Khemeria
- Oral Rehabilitation Center, 9 Osborne Road, Sivanchetti Gardens, Bengaluru, KA 560042 India
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2
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Wang Q, Zhang T. Application of an ultrasonic bone knife combined with a dental electric motor in the extraction of mandibular middle and low impacted teeth. BMC Oral Health 2024; 24:18. [PMID: 38178077 PMCID: PMC10768189 DOI: 10.1186/s12903-023-03788-0] [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: 05/20/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVE To investigate the clinical application of an ultrasonic bone knife (UBK) combined with a dental electric motor (DEM) in the extraction of mandibular middle and low impacted teeth. METHODS From January 2022 to May 2023,200 patients with wisdom teeth were randomly divided into three groups: experimental group A (UBK combined with DEM), experimental group B (UBK combined with high-speed turbine mobile phone (HSTMP)), and the control group (bone chisel split crown (BCSC)). The operation time, psychological state during operation, pain, swelling, limitation of mouth opening and other complications on the first, second and third days after operation were recorded. RESULTS The operation time of experimental group A (EAG) (12.95 ± 2.12) minutes was shorter than that of experimental group B (EBG) (17.06 ± 2.25) minutes and the control group (CG) (23.43 ± 2.18) minutes, and the difference was statistically significant (P < 0.05). The psychological state of the EAG was significantly lower than that of the EBG and CG (P < 0.05). The postoperative pain, swelling, limitation of mouth opening and complications in the EAG were significantly lower than those in the EBG and CG (P < 0.05). CONCLUSION UBK combined with DEM in the extraction of mandibular middle and low obstructed teeth has good results, good prognosis, high safety, short operation time, better psychological status of patients, low postoperative pain, swelling, mouth opening restriction and complication rate, and is currently the preferred extraction method.
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Affiliation(s)
- Qian Wang
- School of Stomatology, Jinan University, Guangzhou, 510000, China
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Zhongshan City, Zhongshan, 528400, China
| | - Tonghan Zhang
- School of Stomatology, Jinan University, Guangzhou, 510000, China.
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Zhongshan City, Zhongshan, 528400, China.
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3
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Bhargava N, Perrotti V, Caponio VCA, Matsubara VH, Patalwala D, Quaranta A. Comparison of heat production and bone architecture changes in the implant site preparation with compressive osteotomes, osseodensification technique, piezoelectric devices, and standard drills: an ex vivo study on porcine ribs. Odontology 2023; 111:142-153. [PMID: 35852778 PMCID: PMC9810586 DOI: 10.1007/s10266-022-00730-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/05/2022] [Indexed: 01/07/2023]
Abstract
This study aimed at investigating differences in heat generation and bone architecture following four different implant site preparation techniques: compressive osteotomes, conventional drills, osseodensification (OD mode with osseodensification drills), and piezoelectric systems. Porcine rib bones were used as a model for implant surgery. Thermocouples were employed to measure temperature changes, and micro-CT to assess the bone architecture. The primary stability and insertion torque values of the implants placed in the differently prepared sites were assessed. The temperature changes were higher with Piezo. The average primary stability using the ISQ scale was the greatest for drills (76.17 ± 0.90) and the lowest for osteotomes (71.50 ± 11.09). Insertion torque was significantly higher with the osseodensification method (71.67 ± 7.99 Ncm) in comparison to drills, osteotomes, and piezo. Osteotomes showed the highest bone to implant contact percentage (39.83 ± 3.14%) and average trabecular number (2.02 ± 0.21 per mm), while drills exhibited the lowest (30.73 ± 1.65%; 1.37 ± 0.34 per mm). Total implant site bone volume was the highest with osseodensification (37.26 ± 4.13mm3) and the lowest for osteotomes (33.84 ± 3.84mm3). Statistical analysis showed a high primary stability and decrease in temperature during implant site preparation with osseodensification technique. The results support the use of osseodensification technique for implant site preparation.
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Affiliation(s)
- Nishith Bhargava
- Dental School, University of Western Australia, Perth, WA, Australia
| | - Vittoria Perrotti
- Deptartment of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti-Pescara, Via dei Vestini, 31, 66100, Chieti, Italy.
| | | | | | - Diana Patalwala
- Centre for Microscopy, Characterization and Analysis, The University of Western Australia, Perth, WA, Australia
| | - Alessandro Quaranta
- School of Dentistry, University of Sydney, Sydney, NSW, Australia
- Scientific and Education Director, Smile Specialists Suite, Newcastle-Sydney, NSW, Australia
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Arakji H, Osman E, Aboelsaad N, Shokry M. Evaluation of implant site preparation with piezosurgery versus conventional drills in terms of operation time, implant stability and bone density (randomized controlled clinical trial- split mouth design). BMC Oral Health 2022; 22:567. [PMID: 36463145 PMCID: PMC9719637 DOI: 10.1186/s12903-022-02613-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation. METHODS Twelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months. RESULTS a significant difference in terms of time of surgery (p < 0.005) and in implant stability at 4 months (p = 0.024) on the study side, while a non-statistical significance in terms of bone density was detected (p = 0.468). CONCLUSION The piezoelectric implant site drilling protocol seemed to be a reliable and repeatable technique. Despite the limited sample size and lengthier operative time, the piezoelectric inserts enhanced bone quality and implant stability. Clinical trial registration Current Controlled Trials (ClinicalTrials.gov) https://clinicaltrials.gov/ct2/show/NCT05512273 ; the date of registration: 23/08/2022. Retrospectively registered.
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Affiliation(s)
- Hani Arakji
- grid.18112.3b0000 0000 9884 2169Oral Surgical Sciences Department, Faculty of Dentistry, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, Lebanon
| | - Essam Osman
- grid.18112.3b0000 0000 9884 2169Oral Rehabilitation Sciences Department, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Nayer Aboelsaad
- grid.18112.3b0000 0000 9884 2169Oral Surgical Sciences Department, Faculty of Dentistry, Beirut Arab University, Riad El Solh, P.O. Box 11-5020, Beirut, Lebanon
| | - Mohamed Shokry
- grid.7155.60000 0001 2260 6941Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Elian S, Salem A. The impact of zero insertion torque on flapless immediate implant placement in the maxilla (5 years follow up clinical study). JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2022024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: The achievement of good osseointegration in immediate implant placement can occur in the presence adequate primary stability. The insertion torque varies between cases depending on many factors. Aim: To assess clinically the impact of zero insertion torque on the survival of immediate implant placement in the maxilla for more than 5 years follow-up. Methods: A flapless immediate 2018 implants were in the maxilla in non-restorable single rooted teeth osteotomy site. The insertion torque of the implant was measured clinically by an integrated software. Results: The final insertion torque for 42 implants out of 2018 placed in fresh extraction sockets in the maxilla was zero (no primary stability). Their survival rate was 83.3%. Conclusions: The lack of certain conditions during immediate implant surgical installation and healing had the major effects on success. The loss of torque during immediate implant placement to zero may jeopardize the survival of the implants, but it may not be statistically significant with their failure and loss. The implant primary stability is not an absolute prerequisite to osseointegration; however, it may affect the implant survival rate.
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Schierano G, Baldi D, Peirone B, Mauthe von Degerfeld M, Navone R, Bragoni A, Colombo J, Autelli R, Muzio G. Biomolecular, Histological, Clinical, and Radiological Analyses of Dental Implant Bone Sites Prepared Using Magnetic Mallet Technology: A Pilot Study in Animals. MATERIALS 2021; 14:ma14226945. [PMID: 34832347 PMCID: PMC8618607 DOI: 10.3390/ma14226945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/05/2021] [Accepted: 11/12/2021] [Indexed: 02/07/2023]
Abstract
Background. A new instrumentation exploiting magneto-dynamic technology (mallet) proposed for implant site preparation was investigated. Methods. In the tibias of three minipigs, two sites were prepared by mallet and two by drill technique. Primary stability (ISQ) was detected after implant positioning (T0) and at 14 days (T14). X-rays and computed tomography were performed. At T14, bone samples were utilized for histological and biomolecular analyses. Results. In mallet sites, histological evaluations evidenced a significant increase in the newly formed bone, osteoblast number, and a smaller quantity of fibrous tissue. These results agree with the significant BMP-4 augmentation and the positive trend in other osteogenic factors (biological and radiological investigations). Major, albeit IL-10-controlled, inflammation was present. For both techniques, at T14 a significant ISQ increase was evidenced, but no significant difference was observed at T0 and T14 between the mallet and drill techniques. In mallet sites, lateral bone condensation was observed on computed tomography. Conclusions. Using biological, histological, clinical, and radiological analyses, this study first shows that the mallet technique is effective for implant site preparation. Based on its ability to cause osseocondensation and improve newly formed bone, mallet technology should be chosen in all clinical cases of poor bone quality.
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Affiliation(s)
- Gianmario Schierano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Via Nizza 230, 10126 Torino, Italy
- Correspondence: ; Tel.: +39-(0)11-6331531/1532; Fax: +39-(0)11-6331513
| | - Domenico Baldi
- Department of Surgical Science (DISC), Division of Prosthetic Dentistry, University of Genoa, 16132 Genoa, Italy; (D.B.); (J.C.)
| | - Bruno Peirone
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, Grugliasco, 10095 Torino, Italy; (B.P.); (M.M.v.D.)
| | - Mitzy Mauthe von Degerfeld
- Department of Veterinary Sciences, University of Turin, Largo Paolo Braccini 2, Grugliasco, 10095 Torino, Italy; (B.P.); (M.M.v.D.)
| | - Roberto Navone
- Department of Medical Science, University of Turin, Via Santena 5, 10126 Torino, Italy; (R.N.); (A.B.)
| | - Alberto Bragoni
- Department of Medical Science, University of Turin, Via Santena 5, 10126 Torino, Italy; (R.N.); (A.B.)
| | - Jacopo Colombo
- Department of Surgical Science (DISC), Division of Prosthetic Dentistry, University of Genoa, 16132 Genoa, Italy; (D.B.); (J.C.)
| | - Riccardo Autelli
- Department of Clinical and Biological Sciences, University of Turin, Corso Raffaello 30, 10125 Torino, Italy; (R.A.); (G.M.)
| | - Giuliana Muzio
- Department of Clinical and Biological Sciences, University of Turin, Corso Raffaello 30, 10125 Torino, Italy; (R.A.); (G.M.)
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Godoy-Reina I, Moreu-Burgos G, González-Jaranay M. Stability and marginal bone loss in implants placed using piezoelectric osteotomy versus conventional drilling: systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2021; 26:e226-e237. [PMID: 33247573 PMCID: PMC7980295 DOI: 10.4317/medoral.24146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
Background The main objective of this systematic review was to compare primary and secondary implant stability between placement with piezoelectric osteotomy and conventional drilling, comparing marginal bone losses as a secondary objective.
Material and Methods An electronic search was conducted using PubMed (MEDLINE), Scopus, and Cochrane Library (Wiley) databases, besides a manual search.
Results A total of 153 articles were retrieved, 39 from Pubmed, 44 from Scopus, and 70 from the Cochrane Library. After removing duplicates, 112 articles (1 from the manual search) were screened, and 9 were finally selected for qualitative and statistical analyses.
Conclusions Piezoelectric surgery is a predictable alternative to conventional drilling for dental implant placement. Medium/long-term survival rates and marginal bone losses are similar between piezoelectric osteotomy and conventional drilling, and there is no difference in ISQ values for primary stability. However, implants placed with ultrasound showed a lower decrease in implant stability quotient (ISQ) during the osseointegration period and a higher ISQ value for secondary stability. This study contributes further information on peri-implant bone tissue at 3 and 6 months after implant placement with piezoelectric osteotomy or conventional drilling and provides an updated meta-analysis of comparative studies. Key words:Piezosurgery, piezoelectric surgery, conventional drill, implant site preparation, dental implant, implant stability, marginal bone loss.
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Affiliation(s)
- I Godoy-Reina
- Department of Stomatology Faculty of Dentistry, University of Granada Campus Universitario de Cartuja Colegio Máximo s/n, E-18071 Granada, Spain +
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Bone Healing Evaluation Following Different Osteotomic Techniques in Animal Models: A Suitable Method for Clinical Insights. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Osteotomy is a common step in oncological, reconstructive, and trauma surgery. Drilling and elevated temperature during osteotomy produce thermal osteonecrosis. Heat and associated mechanical damage during osteotomy can impair bone healing, with consequent failure of fracture fixation or dental implants. Several ex vivo studies on animal bone were recently focused on heating production during osteotomy with conventional drill and piezoelectric devices, particularly in endosseous dental implant sites. The current literature on bone drilling and osteotomic surface analysis is here reviewed and the dynamics of bone healing after osteotomy with traditional and piezoelectric devices are discussed. Moreover, the methodologies involved in the experimental osteotomy and clinical studies are compared, focusing on ex vivo and in vivo findings.
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Study of Treatment Methods for Surrounding Soft Tissues of Implants Following Mandibular Reconstructions with Fibula-Free Flaps. Dent J (Basel) 2020; 8:dj8030067. [PMID: 32635391 PMCID: PMC7559181 DOI: 10.3390/dj8030067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 11/24/2022] Open
Abstract
In maxillofacial reconstruction implant treatment, unsatisfactory soft tissue treatment of the area around the implant may lead to inflammation. As a result, appropriate soft tissue treatment is critical. To the best of our knowledge, there are no studies that compare the different tissue treatment methods available. Hence, in this study, we compare three soft tissue treatment methods around implants after mandibular reconstruction is achieved with a fibula-free flap. Out of 33 patients who underwent mandible reconstruction using fibula-free flaps between 2006 and 2015, 5 were selected for this study. A total of 17 implants were used for treatment by the final prosthetics of the five patients. Three soft tissue treatment methods with free gingival graft (FGG) were evaluated, namely, installing a splint in a modified abutment to protect the wounded area during a palatal mucosa transplant (method 1), installing a splint or dentures to a locator abutment (method 2), and the use of screw-in fixed dentures (method 3). The method that could guarantee the widest keratinized mucosa was the screw-in fixed denture method. The results of our study indicated that employing screw-in fixed dentures for FGG may be a useful soft tissue treatment for mandible reconstruction implants.
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Lajolo C, Valente NA, Romandini WG, Petruzzi M, Verdugo F, D'Addona A. Bone heat generated using conventional implant drills versus piezosurgery unit during apical cortical plate perforation. J Periodontol 2019. [PMID: 29520833 DOI: 10.1002/jper.17-0502] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The apical portion of the implant osteotomy receives less irrigation and cooling during surgical preparation. High bone temperature, above the critical 10°C threshold, may impair osseointegration, particularly around dense cortical bone. The aim of this study was to evaluate the apical cortical plate temperature increase with two different devices and pressure loads in a porcine rib ex vivo model. METHODS A total of 24 implant sites were prepared on porcine ribs, divided into 4 groups of 6 samples each, according to the device used (conventional drill system or piezosurgery) and pressure load applied (1,000 g or 1,500 g). A rubber dam was used to isolate the apical cortical plate from the cooling effect of irrigation. Temperature variation measurements were taken using an infrared thermometer. RESULTS The piezosurgery unit was two times more likely to increase the osteotomy temperature by 10°C (OR = 2; 95% CI 1.136, 3.522; P < 0.05). The average temperature increase was 0.07°C (SD = 0.10) for group 1 (drill system 1,000 g); 0.22°C (SD = 0.26) for group 2 (drill system 1,500 g); 9.18°C (SD = 4.51) for group 3 (piezosurgery 1,000 g); and 8.17°C (SD = 6.12) for group 4 (piezosurgery 1,500 g). The piezosurgery site preparation had significantly higher temperature increase than did the conventional drill site preparation (P < 0.05). There was no statistically significant difference in temperature change between the two pressure loads applied (P = 0.78). Temperature increases exceeded the critical 10°C threshold in half of the samples prepared with the piezoelectric device. CONCLUSIONS Bone overheating using a piezosurgery unit is a potential risk during implant site preparation. The piezosurgical device resulted in significantly higher temperatures than did conventional drilling at the apical cortical portion of the osteotomy. The temperature increase was often higher than the critical 10°C threshold.
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Affiliation(s)
- Carlo Lajolo
- Department of Oral Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Nicola Alberto Valente
- Department of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Rome, Italy.,Unit of Oral Surgery and Implantology, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
| | | | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - Fernando Verdugo
- Department of Periodontics, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Antonio D'Addona
- Department of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Rome, Italy.,Department of Periodontics, Catholic University of the Sacred Heart, Rome, Italy
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García-Moreno S, González-Serrano J, López-Pintor R, Pardal-Peláez B, Hernández G, Martínez-González J. Implant stability using piezoelectric bone surgery compared with conventional drilling: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2018; 47:1453-1464. [DOI: 10.1016/j.ijom.2018.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 01/14/2023]
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Lajolo C, Valente NA, Romandini WG, Petruzzi M, Verdugo F, D'Addona A. Reply from authors: RE: Bone heat generated using conventional implant drills versus piezosurgery unit during apical cortical plate perforation. J Periodontol 2018; 89:1163-1164. [PMID: 30118190 DOI: 10.1002/jper.18-0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/06/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Carlo Lajolo
- Department of Oral Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Nicola Alberto Valente
- Department of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Rome, Italy.,Unit of Oral Surgery and Implantology, University Hospital of Geneva, University of Geneva, Geneva, Switzerland
| | | | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Bari, Italy
| | - Fernando Verdugo
- Department of Periodontics, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Antonio D'Addona
- Department of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Rome, Italy.,Department of Periodontics, Catholic University of the Sacred Heart, Rome, Italy
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Sendyk DI, de Oliveira NK, Pannuti CM, da Graça Naclério-Homem M, Wennerberg A, Deboni MCZ. Conventional Drilling Versus Piezosurgery for Implant Site Preparation: A Meta-Analysis. J ORAL IMPLANTOL 2018; 44:400-405. [PMID: 29583059 DOI: 10.1563/aaid-joi-d-17-00091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate if the stability of dental implants varies between dental implants placed by piezosurgery compared with those placed by conventional drilling. An electronic search in MEDLINE, SCOPUS, and the Cochrane Library was undertaken until August 2016 and was supplemented by manual searches and by unpublished studies at OpenGray. Only randomized controlled clinical trials that reported implant site preparation with piezosurgery and with conventional drilling were considered eligible for inclusion in this review. Meta-analyses were performed to evaluate the impact of piezosurgery on implant stability. Of 456 references electronically retrieved, 3 were included in the qualitative analysis and quantitative synthesis. The pooled estimates suggest that there is no significant difference between piezosurgery and conventional drilling at baseline (weighted mean differences [WMD]: 2.20; 95% confidence interval [CI]: -5.09, 9.49; P = .55). At 90 days, the pooled estimates revealed a statistically significant difference (WMD: 3.63; 95% CI: 0.58, 6.67, P = .02) favoring piezosurgery. Implant stability may be slightly improved when osteotomy is performed by a piezoelectric device. More randomized controlled clinical trials are needed to confirm these findings.
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Affiliation(s)
- Daniel Isaac Sendyk
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Natacha Kalline de Oliveira
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio Mendes Pannuti
- 2 Department of Stomatology, Division of Periodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Ann Wennerberg
- 3 Department of Prosthodontics, Faculty of Dentistry, Malmö University, Malmö, Sweden
| | - Maria Cristina Zindel Deboni
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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Troedhan A, Mahmoud ZT, Wainwright M, Khamis MM. Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/2455-4634.000028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Kumar VV, Ebenezer S, Kämmerer PW, Jacob PC, Kuriakose MA, Hedne N, Wagner W, Al-Nawas B. Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial. J Craniomaxillofac Surg 2016; 44:1849-1858. [PMID: 27697397 DOI: 10.1016/j.jcms.2016.08.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/20/2016] [Accepted: 08/29/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). RESULTS 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. CONCLUSION The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant-loading phase and tend to decrease over time under appropriate management.
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Affiliation(s)
- Vinay V Kumar
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India; Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
| | - Supriya Ebenezer
- Department of Periodontics, M. R. Ambedkar Dental College & Hospital, Bangalore, India.
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Rostock University, Rostock, Germany.
| | - P C Jacob
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Moni A Kuriakose
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Naveen Hedne
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
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