1
|
Win KZ, Pimkhaokham A, Kaboosaya B. Comparing Bone Graft Success, Implant Survival Rate, and Marginal Bone Loss: A Retrospective Study on Materials and Influential Factors. J ORAL IMPLANTOL 2024; 50:300-307. [PMID: 38686547 DOI: 10.1563/aaid-joi-d-23-00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Bone grafting serves to restore the alveolar bone defect, providing adequate alveolar bone essential for long-term implant survival. This retrospective study aimed to evaluate the success rate of guided bone regeneration (GBR) bone grafting and investigate the survival rate of implants and the degree of marginal bone loss (MBL) around implants. Furthermore, the influence of confounding factors such as patient conditions, bone graft properties, and implant characteristics was assessed. This study was carried out on treatment outcomes of patients with implants between January 2007 and December 2016, using various graft materials, including autograft, allograft, and xenograft. In a mean follow-up of 70 months (range: 3-10 years), the overall success rate of bone graft (n = 80) was 100%, and the overall survival rate of implant (n = 107) was 97.2% (autograft: 100%, allograft: 100%, and xenograft: 92.9%; P = .03). Mean MBL up to 3 years after implant installation were similar among graft materials, with 0.84 ± 0.48 mm in autograft, 0.73 ± 0.42 mm in allograft, and 1.01 ± 0.59 mm in xenograft (P = .14). Posterior mandibular location had a significant influence on implant survival (P = .003). A significant association of MBL with several factors, including age >60 years (P = .03), both diabetes and hypertension (P = .02), without receiving adjunctive membrane (P = .04), loading within 3-6 months (P < .001), and screw-retained crown (P = .008), was confirmed. Our data substantiated that implant rehabilitation with GBR using autograft and allograft provides the most predictable results. The factors above should be carefully considered with xenograft to enhance long-term clinical outcomes.
Collapse
Affiliation(s)
- Kaung Zaw Win
- Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Chulalongkorn University, Thailand
| |
Collapse
|
2
|
Ko HH, Chou CH, Cheng SJ. The dental implant survival rate in 18 patients with post-operation revolutionary jaw reconstruction using free fibular flap, dental implants, and overdentures. J Dent Sci 2024; 19:1819-1826. [PMID: 39035273 PMCID: PMC11259673 DOI: 10.1016/j.jds.2024.05.021] [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: 05/03/2024] [Revised: 05/15/2024] [Indexed: 07/23/2024] Open
Abstract
Background/purpose This retrospective study assessed the risks and complications associated with dental implants after jaw surgery and radiotherapy for large defects, highlighting challenges for reconstructive surgeons and prosthetic dentists. Materials and methods From 2002 to 2008, National Taiwan University's Department of Maxillofacial Surgery used preoperative stereolithographic models and microvascular flaps for mandibular reconstruction in 18 patients with defects from ameloblastoma or advanced gingival cancer. They received free fibular flap grafts, followed by 46 osseointegrated dental implants. Patient outcomes, monitored for up to 60 months, were assessed through clinical and radiographic evaluations of implant success. Results The overall survival rate of dental implants following tumor surgery and radiotherapy was 84.8%. Seven implants failed due to peri-implantitis (3), tumor recurrence (2), and osteoradionecrosis (ORN) (2). The ameloblastoma group did not contribute to implant failure, with 4 implant failures in the stage III gingival cancer group, and 3 implant failures in the stage IV gingival cancer group. Conclusion Following segmental mandibulectomy for mandible lesions, free fibular bone graft reconstruction restored mandible continuity, while subsequent dental implantation and overdenture fabrication restored occlusion and aesthetics for patients. Besides considering treatment strategies for ameloblastoma groups, similar approaches can be extended to oral cancer patients undergoing post-operative reconstruction. However, additional considerations (peri-implant soft tissue condition, tumor recurrence, ORN, etc.) are necessary for oral cancer patients predisposed to dental implant failure post-surgery.
Collapse
Affiliation(s)
- Hui-Hsin Ko
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Chia-Hsuan Chou
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital Yulin Branch, Yulin, Taiwan
| | - Shih-Jung Cheng
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
- School of Dentistry, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
3
|
Sriram S, Njoroge MW, Lopez CD, Zhu L, Heron MJ, Zhu KJ, Yusuf CT, Yang R. Optimal Treatment Order With Fibula-Free Flap Reconstruction, Oncologic Treatment, and Dental Implants: A Systematic Review and Meta-Analysis. J Craniofac Surg 2024; 35:1065-1073. [PMID: 38666786 DOI: 10.1097/scs.0000000000010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/05/2024] [Indexed: 06/04/2024] Open
Abstract
Head and neck cancer (HNC) patients benefit from craniofacial reconstruction, but no clear guidance exists for rehabilitation timing. This meta-analysis aims to clarify the impact of oncologic treatment order on implant survival. An algorithm to guide placement sequence is also proposed in this paper. PubMed, Embase, and Web of Science were searched for studies on HNC patients with ablative and fibula-free flap (FFF) reconstruction surgeries and radiotherapy (RTX). Primary outcomes included treatment sequence, implant survival rates, and RTX dose. Of 661 studies, 20 studies (617 implants, 199 patients) were included. Pooled survival rates for implants receiving >60 Gy RTX were significantly lower than implants receiving < 60 Gy (82.8% versus 90.1%, P =0.035). Placement >1 year after RTX completion improved implant survival rates (96.8% versus 82.5%, P =0.001). Implants receiving pre-placement RTX had increased survival with RTX postablation versus before (91.2% versus 74.8%, P <0.001). One hundred seventy-seven implants were placed only in FFF with higher survival than implants placed in FFF or native bone (90.4% versus 83.5%, P =0.035). Radiotherapy is detrimental to implant survival rates when administered too soon, in high doses, and before tumor resection. A novel evidence-based clinical decision-making algorithm was presented for utilization when determining the optimal treatment order for HNC patients. The overall survival of dental prostheses is acceptable, reaffirming their role as a key component in rehabilitating HNC patients. Considerations must be made regarding RTX dosage, timing, and implant location to optimize survival rates and patient outcomes for improved functionality, aesthetics, and comfort.
Collapse
Affiliation(s)
- Shreya Sriram
- Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Mao C, Yu W, Li G, Xu Z, Gong Y, Jin M, Lu E. Effects of immediate loading directionality on the mechanical sensing protein PIEZO1 expression and early-stage healing process of peri-implant bone. Biomed Eng Online 2024; 23:36. [PMID: 38504231 PMCID: PMC10953093 DOI: 10.1186/s12938-024-01223-1] [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: 01/04/2024] [Accepted: 02/23/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The reduced treatment time of dental implants with immediate loading protocol is an appealing solution for dentists and patients. However, there remains a significant risk of early peri-implant bone response following the placement of immediately loaded implants, and limited information is available regarding loading directions and the associated in vivo characteristics of peri-implant bone during the early stages. This study aimed to investigate the effects of immediate loading directionality on the expression of mechanical sensing protein PIEZO1 and the healing process of peri-implant bone in the early stage. METHODS Thirty-two implants were inserted into the goat iliac crest models with 10 N static lateral immediate loading applied, followed by histological, histomorphological, immunohistochemical, X-ray microscopy and energy dispersive X-ray spectroscopy evaluations conducted after 10 days. RESULTS From evaluations at the cellular, tissue, and organ levels, it was observed that the expression of mechanical sensing protein PIEZO1 in peri-implant bone was significantly higher in the compressive side compared to the tensile side. This finding coincided with trends observed in interfacial bone extracellular matrix (ECM) contact percentage, bone mass, and new bone formation. CONCLUSIONS This study provides a novel insight into the immediate loading directionality as a potential influence factor for dental implant treatments by demonstrating differential effects on the mechanical sensing protein PIEZO1 expression and related early-stage healing processes of peri-implant bone. Immediate loading directions serve as potential therapeutic influence factors for peri-implant bone during its early healing stage.
Collapse
Affiliation(s)
- Chuanyuan Mao
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Weijun Yu
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Guanglong Li
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Ziyuan Xu
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yuhua Gong
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
| | - Min Jin
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
| | - Eryi Lu
- Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
| |
Collapse
|
5
|
Ganta GK, Mosca RC, Varsani R, Murthy VR, Cheruvu K, Lu M, Arany PR. Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review. Dent J (Basel) 2023; 12:8. [PMID: 38248216 PMCID: PMC10814723 DOI: 10.3390/dj12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The popularity of implants is increasing with the aging population requiring oral-dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
Collapse
Affiliation(s)
- Gopala Krishna Ganta
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
- Intercare Community Health Network, Bangor, MI 49013, USA
| | - Rodrigo Crespo Mosca
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Ridham Varsani
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Venkata Ramana Murthy
- Department of Maxillofacial Surgery, Anil Nirukonda Dental College, Visakhapatnam 531162, India
| | - Kamala Cheruvu
- Department of Orthodontics, Gandhi Institute of Technology and Management Dental College, Visakhapatnam 530045, India
| | - Michael Lu
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Praveen R. Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| |
Collapse
|
6
|
El Ebiary SO, Atef M, Abdelaziz MS, Khashaba M. Guided immediate implant with and without using a mixture of autogenous and xeno bone grafts in the dental esthetic zone. A randomized clinical trial. BMC Res Notes 2023; 16:331. [PMID: 37957760 PMCID: PMC10644537 DOI: 10.1186/s13104-023-06612-8] [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: 10/09/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
PURPOSE This in vivo study aims to assess the pink esthetic score in the anterior maxilla after computer-guided immediate implant installation and fully digital immediate temporalization with and without grafting the jumping gap with a mixture of 1:1 autogenous and xenograft particulates. MATERIALS AND METHODS Twenty-four patients with non-restorable upper anterior teeth in the aesthetic zone have undergone a traumatic extraction for the non-restorable tooth followed by immediate implant placement using a 3D-printed surgical guide according to prosthetically driven implant placement. The patients were divided into two groups. The study group received the dental implant after grafting the jumping gap with 1:1 autogenous and xenograft particulates, while the control group received the dental implant without grafting the jumping gap. Each patient received a digitally fabricated, immediate, nonfunctional temporary prosthesis. The esthetic outcome was compared between the two groups using the pink esthetic score at implant insertion and after 6 months of follow-up. Statistical comparisons were carried out between the studied groups using the Mann-Whitney U test. RESULTS Immediately postoperatively, there was no statistically significant difference between the median PES in the two groups (P-value = 0.746). After six months, the study group showed a statistically significantly higher median PES than the control group (P-value = 0.048). CONCLUSIONS Grafting the jumping distance in the immediate implant protocol helps achieve a better esthetic outcome. CLINICAL RELEVANCE The use of immediate guided implant placement along with grafting the jumping gap followed by immediate digital temporalization guarantees a better esthetic outcome while preserving time, cost, and the number of clinical visits. TRIAL REGISTRATION The study was registered on clinicaltrials.gov with registration number NCT04096209. (19/9/2019).
Collapse
Affiliation(s)
- Sherine Osama El Ebiary
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Mohammed Atef
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Medhat Sameh Abdelaziz
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, Future University in Egypt, Fifth Settlement, End of 90 street, New Cairo, Cairo, Egypt.
| | - Mohammed Khashaba
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| |
Collapse
|
7
|
Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
Collapse
|
8
|
Donos N, Asche NV, Akbar AN, Francisco H, Gonzales O, Gotfredsen K, Haas R, Happe A, Leow N, Navarro JM, Ornekol T, Payer M, Renouard F, Schliephake H. Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1-The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021; 32 Suppl 21:85-92. [PMID: 34642977 DOI: 10.1111/clr.13809] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading. MATERIALS AND METHODS The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant-supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single-tooth implants. The third systematic review was on the long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations. RESULTS Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.
Collapse
Affiliation(s)
- Nikos Donos
- Centre for Oral Clinical Research, Barts and The London, School of Medicine and Dentistry, Queen Mary University of London (QMUL, London, UK
| | - Nele Van Asche
- Centre for Periodontology and Oral Implants, KULeuven, Leuven, Belgium
| | - Aron Naim Akbar
- Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
| | - Helena Francisco
- Departamento de Cirurgia Oral e Implantologia, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Oscar Gonzales
- Department of Periodontology, Complutense University of Madrid, Madrid, Spain.,Department of Periodontology and Periodontal-Prosthesis, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus Gotfredsen
- Oral Rehabilitation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Robert Haas
- Academy for Oral Implantology, Vienna, Austria
| | - Arndt Happe
- Department of Prosthetic Dentistry, University Ulm Center of Dentistry, Germany and Private Practice, Münster, Germany
| | - Natalie Leow
- Periodontology Unit, UCL-Eastman Dental Institute, London, UK
| | | | - Turker Ornekol
- Cosmodent Center for Dentistry and Dental Implants, Istanbul, Turkey
| | - Michael Payer
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University of Graz, Graz, Austria
| | | | - Henning Schliephake
- Department of Oral & Maxillofacial Surgery, University Medicine-Augusta-University, Göttingen, Germany
| |
Collapse
|