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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [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: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Dignam P, Elshafey M, Jeganathan A, Foo M, Park JS, Ratnaweera M. Prevalence and Factors Influencing Post-Operative Complications following Tooth Extraction: A Narrative Review. Int J Dent 2024; 2024:7712829. [PMID: 38756385 PMCID: PMC11098612 DOI: 10.1155/2024/7712829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/08/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Background Complications from dental extractions may result in multiple post-operative visits and adversely affect the patient's life. Preventing complications may decrease post-operative morbidity for the individual as well as lower societal costs, such as lost time from work and healthcare costs. Objectives This narrative review aims to assess the prevalence and factors influencing post-operative complications following tooth extraction, helping clinicians minimise the risk. Data Sources. Cross-sectional studies. Study Eligibility and Participants. Patients undergoing dental extractions. Our exclusion criteria included in vitro studies, animal studies, terminally ill patients, and tooth loss not due to dental extraction. Literature was collected from "PubMed" and "Web of Science" through search criteria based on the "PICO" framework. Twenty articles were used to formulate a prevalence table, and 156 articles were included for the factors influencing complications. Study Appraisal and Synthesis Methods. This narrative review was reported using the SANRA (a scale for the quality assessment of narrative review articles) checklist. Due to the scope of our narrative review and its associated objectives, the quality of cross-sectional studies (AXIS) will be conducted from the studies outlining the prevalence. Results Alveolar osteitis appears to be the most prevalent post-operative complication following tooth extraction. Predisposing factors can be significant in their ability to alter the risk of postoperative complications, and clinicians should provide patient-centred care to mitigate this risk. Limitations. Due to the breadth of context, a systematic review was not feasible, as it may have introduced heterogeneity. Conclusion This narrative review has highlighted an array of factors which can influence the prevalence of post-operative complications. Future research would benefit from individually reporting post-operative complications, reducing the heterogeneity in definitions of the complications, and including greater detail on the predisposing factors studied.
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Affiliation(s)
- Peter Dignam
- UWA Dental School, The University of Western Australia, Nedlands, Australia
| | - Mariam Elshafey
- UWA Dental School, The University of Western Australia, Nedlands, Australia
| | - Aparna Jeganathan
- UWA Dental School, The University of Western Australia, Nedlands, Australia
| | - Magdalen Foo
- UWA Dental School, The University of Western Australia, Nedlands, Australia
| | - Joon Soo Park
- UWA Dental School, The University of Western Australia, Nedlands, Australia
- International Research Collaborative—Oral Health and Equity, School of Allied Health, The University of Western Australia, Crawley, Australia
- School of Engineering, Information Technology and Physical Sciences, Federation University Australia, Victoria, Ballarat, Australia
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Bogner MS, Chambas V, Veyrune JL, Faulks D, Hennequin M. Oral implant rehabilitation under general anesthesia for patients with cognitive and physical disabilities: A 14-year cohort study. J Prosthet Dent 2024:S0022-3913(24)00012-X. [PMID: 38296761 DOI: 10.1016/j.prosdent.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/02/2024]
Abstract
STATEMENT OF PROBLEM Oral rehabilitation with implants is an alternative to the provision of removable dentures in all patients for whom missing teeth require replacement. However, individuals with cognitive, mental health issues, and/or physical disabilities are often excluded from implant-supported prostheses because of the high perceived risk of failure linked to poor oral health, presence of parafunction, or systemic conditions. PURPOSE The purpose of this cohort study was to describe the protocols, outcomes, and survival rates of oral rehabilitation with implant-supported prostheses in patients with cognitive and physical disabilities treated under general anesthesia (GA) in a French unit of Special Care Dentistry. MATERIAL AND METHODS A retrospective cohort study was conducted on patient files. Data collected included demographics and information about the surgical and prosthetic phases of rehabilitation. Clinical and radiological reports were retrieved to establish the survival, success, and failure rates of implant placement according to the Health Scale for Dental Implants (HDSI) classification. RESULTS A total of 298 dental implants had been placed under GA in 57 patients between January 2007 and August 2021. The prevalence of technical and biological postoperative complications was found to be 14% and 13% respectively. Thirty implants were determined to be failures. The estimated survival time in the population studied for loaded implants was 144.7 months [138.0; 151.3]. The cumulative survival rate was estimated to be 86% at 157 months. CONCLUSIONS Implant-supported prostheses were found to be effective, and oral rehabilitation carried out under the conditions described was determined to be stable.
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Affiliation(s)
- Marie-Sophie Bogner
- Specialist Dentist, University of Clermont Auvergne (UCA), Centre for Research in Clinical Dentistry (CROC), BP 10448, Clermont-Ferrand, France; Department of Sedation & Special Care Dentistry, Guy´s & St Thomas´ NHS Foundation Trust, London, United Kingdom.
| | - Vivien Chambas
- Specialist, Private Practitioner, University of Clermont Auvergne (UCA), Centre for Research in Clinical Dentistry (CROC), BP 10448, Clermont-Ferrand, France
| | - Jean-Luc Veyrune
- Professor, University of Clermont Auvergne (UCA), Centre for Research in Clinical Dentistry (CROC), BP 10448, Clermont-Ferrand, France; CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Denise Faulks
- Specialist, Consultant, University of Clermont Auvergne (UCA), Centre for Research in Clinical Dentistry (CROC), BP 10448, Clermont-Ferrand, France; CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
| | - Martine Hennequin
- Professor, University of Clermont Auvergne (UCA), Centre for Research in Clinical Dentistry (CROC), BP 10448, Clermont-Ferrand, France; CHU Clermont-Ferrand, Service d'Odontologie, CHU Estaing, Clermont-Ferrand, France
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Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
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Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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5
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Schliephake H. The role of systemic diseases and local conditions as risk factors. Periodontol 2000 2022; 88:36-51. [PMID: 35103330 DOI: 10.1111/prd.12409] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Henning Schliephake
- Department of Oral Maxillofacial Surgery, University Medicine George-Augusta-University, Göttingen, Germany
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6
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Esimekara JFO, Perez A, Courvoisier DS, Scolozzi P. Dental implants in patients suffering from autoimmune diseases: A systematic critical review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e464-e473. [PMID: 35033725 DOI: 10.1016/j.jormas.2022.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE This systematic review aimed to evaluate complications and survival rates of dental implants placed in patients suffering from autoimmune diseases. MATERIALS AND METHODS A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines (PRISMA), using Google scholar and PubMed electronic databases with a stop date of September 2021. The eligibility criteria included all full text human studies in the English language literature reporting on patients with autoimmune diseases treated with dental implants. RESULTS Fifty-five studies reporting on nine distinct autoimmune diseases were analyzed: 17 on Sjögren's syndrome (SS), 11 on oral lichen planus (OLP), 8 on Type 1 diabetes, 6 on rheumatoid arthritis (RA), 4 on systemic scleroderma (SSc), 3 on Crohn's disease (CD), 3 on systemic lupus erythematosus (SLE), 2 on mucous membrane pemphigoid (MMB) and 1 on pemphigus vulgaris (PV). Despite the heterogeneity and methodological limitations of most of the studies, results showed that dental implant survival rates were comparable to those reported in the general population. However, patients with secondary SS or erosive OLP were more susceptible to developing peri-mucositis and increased marginal bone loss. CONCLUSION This review suggested that dental implants may be considered as a safe and viable therapeutic option in the management of edentulous patients suffering from autoimmune diseases. Nevertheless, scrupulous maintenance of oral hygiene and long-term follow-up emerge as being the common determinants for uneventful dental implant treatment.
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Affiliation(s)
| | - Alexandre Perez
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Unit of Oral Surgery and Implantology, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
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Lee CH, Mukundan A, Chang SC, Wang YL, Lu SH, Huang YC, Wang HC. Comparative Analysis of Stress and Deformation between One-Fenced and Three-Fenced Dental Implants Using Finite Element Analysis. J Clin Med 2021; 10:jcm10173986. [PMID: 34501431 PMCID: PMC8432445 DOI: 10.3390/jcm10173986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/24/2021] [Accepted: 08/31/2021] [Indexed: 01/03/2023] Open
Abstract
Finite element analysis (FEA) has always been an important tool in studying the influences of stress and deformation due to various loads on implants to the surrounding jaws. This study assessed the influence of two different types of dental implant model on stress dissipation in adjoining jaws and on the implant itself by utilizing FEA. This analysis aimed to examine the effects of increasing the number of fences along the implant and to compare the resulting stress distribution and deformation with surrounding bones. When a vertical force of 100 N was applied, the largest displacements found in the three-fenced and single-fenced models were 1.7469 and 2.5267, respectively, showing a drop of 30.8623%. The maximum stress found in the three-fenced and one-fenced models was 13.518 and 22.365 MPa, respectively, showing a drop of 39.557%. Moreover, when an oblique force at 35° was applied, a significant increase in deformation and stress was observed. However, the three-fenced model still had less stress and deformation compared with the single-fenced model. The FEA results suggested that as the number of fences increases, the stress dissipation increases, whereas deformation decreases considerably.
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Affiliation(s)
- Chia-Hsuan Lee
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
| | - Arvind Mukundan
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI), and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chiayi 62102, Taiwan;
| | - Szu-Chien Chang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
| | - Yin-Lai Wang
- Gentle Dental Clinic, No. 400, Baotai Rd., Fengshan Dist., Kaohsiung City 80284, Taiwan;
| | - Shu-Hao Lu
- Topology Medical Consultant Co., 12F., No. 812, Xinsheng Rd., Qianzhen Dist., Kaohsiung City 80284, Taiwan;
| | - Yu-Cheng Huang
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Kaohsiung City 80284, Taiwan; (C.-H.L.); (S.-C.C.)
- Correspondence: (Y.-C.H.); (H.-C.W.)
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI), and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chiayi 62102, Taiwan;
- Correspondence: (Y.-C.H.); (H.-C.W.)
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Mozzati M, Gallesio G, Menicucci G, Manzella C, Tumedei M, Del Fabbro M. Dental Implants with a Calcium Ions-Modified Surface and Platelet Concentrates for the Rehabilitation of Medically Compromised Patients: A Retrospective Study with 5-Year Follow-Up. MATERIALS 2021; 14:ma14112718. [PMID: 34064086 PMCID: PMC8196782 DOI: 10.3390/ma14112718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/07/2023]
Abstract
Background: Platelet concentrates are biological, autologous products obtained from the patient’s whole blood, consisting of a supraphysiological concentration of platelets and growth factors, that have proved beneficial in different applications in the medical and dental fields. They are used in several medical and dental applications to enhance tissue healing. Previous evidence shows that platelet concentrates may be beneficial in patients with compromised systemic conditions, in which the healing process is impaired. Aim: To evaluate the 5-year clinical outcome of implant treatment using acid-etched implants with calcium ions-modified surface in association with plasma rich in growth factors, in patients with systemic diseases of a different nature. Methods: Charts of 99 medically compromised patients, who had received a total of 224 dental implants from January 2013 to June 2013, were retrospectively evaluated. Patients were divided into four groups, according to their condition: diabetes (n = 39 patients), osteoporosis (n = 36), lupus erythematosus systemic (n = 5), rheumatoid arthritis (n = 19). The main outcomes were implant survival, marginal bone level (MBL) change and complications throughout follow-up. Results: Mean follow-up was 63.06 ± 1.90 months (range 60.1 to 66.4 months). In total, eight implants failed in 6 diabetic patients and 4 in 3 patients with rheumatoid arthritis. Overall 5-year implant survival was 94.6%. In total, 30 complications occurred in 24 patients, mostly transient, and no severe adverse event occurred. Overall MBL change was 0.45 ± 0.12 mm, with no significant differences among groups. Conclusions: In the present sample of medically compromised patients, rehabilitation with calcium ions-modified surface implants associated with plasma rich in growth factors proved to be a safe and effective treatment. The satisfactory results achieved after 5-year follow-up are comparable to those historically reported for healthy patients.
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Affiliation(s)
- Marco Mozzati
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giorgia Gallesio
- Private Practitioner, SIOM Oral Surgery and Implantology Center, 10126 Turin, Italy; (M.M.); (G.G.)
| | - Giulio Menicucci
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Carlo Manzella
- Prosthodontic Department, School of Dentistry, University of Turin, 10124 Turin, Italy; (G.M.); (C.M.)
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti, 66100 Chieti, Italy;
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- IRCCS Orthopedic Institute Galeazzi, Dental Clinic, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950
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Dental Implant Failure Rate and Marginal Bone Loss in Transplanted Patients: A Systematic Review and Meta-Analysis. TRANSPLANTOLOGY 2020. [DOI: 10.3390/transplantology1020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This systematic review investigates the failure rate and marginal bone loss (MBL) of dental implants placed in patients undergoing solid-organ transplant (SOT) compared to healthy controls. Three databases (PubMed, Web of Sciences, and the Cochrane Library) were searched up to June 2020 (PROSPERO CRD42019124896). Case-control and cohort studies reporting data failure rate and marginal bone loss (MBL) of dental implants placed in SOT patients were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Four case-control studies fulfilled the inclusion criteria; all had low risk of bias. Meta-analyses revealed consistently lower implant failure rate than control populations at patient and implant levels. SOT patients had a significant difference of −18% (p-value < 0.001) MBL compared to healthy patients. SOT status poses no serious threat to implant survival. Overall, this group of patients presented lower levels of dental implant failure rate and marginal bone loss compared to otherwise healthy patients. Further intervention trials with larger sample size and longer follow-ups are necessary to confirm these summarized results.
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Halpern LR, Adams DR. Medically Complex Dental Implant Patients: Controversies About Systemic Disease and Dental Implant Success/Survival. Dent Clin North Am 2020; 65:1-19. [PMID: 33213704 DOI: 10.1016/j.cden.2020.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Advances in dental implant therapy have created choices to enhance the expectations of dental practitioners and their patients with respect to oral rehabilitation at any age after childhood and regardless of, in most cases, medical disabilities. The medical status of the patient however can significantly influence the success rate of dental implant therapy. This article applies the hierarchy of scientific evidence ranging from case reports, retrospective, prospective cohort investigations, systematic reviews, and meta-analyses criteria in order to determine whether dental implant placement in medically compromised patients yields any detrimental sequelae.
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Affiliation(s)
- Leslie R Halpern
- Oral and Maxillofacial Surgery, University of Utah School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA.
| | - David R Adams
- Oral and Maxillofacial Surgery, University of Utah School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA
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11
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Diep GK, Ramly EP, Alfonso AR, Berman ZP, Rodriguez ED. Enhancing Face Transplant Outcomes: Fundamental Principles of Facial Allograft Revision. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2949. [PMID: 32983759 PMCID: PMC7489753 DOI: 10.1097/gox.0000000000002949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/08/2020] [Indexed: 11/25/2022]
Abstract
Facial transplantation (FT) has become a feasible reconstructive solution for patients with devastating facial injuries. Secondary revisions to optimize functional and aesthetic outcomes are to be expected, yet the optimal timing and approach remain to be determined. The purpose of this study was to analyze all facial allograft revisions reported to date, including the senior author's experience with 3 FTs. Methods A literature review was performed, with 2 reviewers independently conducting title and abstract screening, followed by a full-text review. All articles mentioning FT revision surgeries were evaluated. The medical records of the senior author's 3 FT recipients were additionally reviewed. Results Initially, 721 articles were captured and 37 were included in the final analysis. Thirty-two FTs were reported to have involved posttransplant allograft revisions, with FT recipients undergoing a mean of 4.8 ± 4.6 revision procedures. The mean duration between FT and the first revision procedure was 149 ± 179 days. A wide spectrum of revisions was identified and categorized as involving the soft tissues, craniofacial skeleton, dentition, oronasal cavity, salivary glands, facial nerve, or ocular region. In the senior author's experience, when indicated, posttransplant occlusal changes and integrity of the donor-recipient intraoral interface were successfully addressed with secondary procedures without allograft compromise or loss. Conclusions The worldwide experience shows that secondary procedures are nearly ubiquitous after FT and can be safely performed at various timepoints. The authors thereby establish 5 distinct categories of facial allograft revisions and define 7 critical principles to optimize posttransplant procedures.
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Affiliation(s)
- Gustave K Diep
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Elie P Ramly
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Allyson R Alfonso
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Zoe P Berman
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
| | - Eduardo D Rodriguez
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, N.Y
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12
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Razmara F, Khayamzadeh M, Shabankare G. Applying dental implant therapy in patients with oral lichen planus: a review of literature. Int J Implant Dent 2020; 6:21. [PMID: 32458407 PMCID: PMC7250998 DOI: 10.1186/s40729-020-00216-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Lichen planus (LP) is a violent, paranormal inflammatory disease that can affect the skin or any lining of the mucous membrane. LPs are a branch of immune-mediated inflammatory disease (IMID) that collaborates with the function and structure of the immune system that are precipitated through various etiological infectious agents. Oral lichen planus (OLP) is one of the most common kinds of IMID. These traumas might limit the normal life of patients and, in some cases, can be treated spontaneously. In patients who are affected by OLP, the dental clinicians must be capable of the proper diagnosis of the disorder. Dental implants are progressively applied for the treatment of partial or complete edentulism. Implant rehabilitation in OLP patients is one of the main challenges for patients and dental clinicians. There is not enough knowledge about this condition, and also medical documents are limited. In this study, by conducting a comprehensive review of literature, we tried to collect related data around the safety and success rate of implant rehabilitation in patients who suffer from OLP disorder. There proved to be no relation between implant survival rate and OLP diseases, but it is proven that some factors such as bone quality and fracture resistance, parafunctional habits, and resection of the marginal mandible could powerfully affect it. For evaluation of the advantages and disadvantages of applying implants in patients with OLP disorders, implementation of controlled studies is required.
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Affiliation(s)
- Farnoosh Razmara
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khayamzadeh
- Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
| | - Ghazal Shabankare
- School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
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13
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Sohn JB, Lee H, Han YS, Jung DU, Sim HY, Kim HS, Oh S. When do we need more than local compression to control intraoral haemorrhage? J Korean Assoc Oral Maxillofac Surg 2020; 45:343-350. [PMID: 31966979 PMCID: PMC6955419 DOI: 10.5125/jkaoms.2019.45.6.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/05/2019] [Accepted: 10/28/2019] [Indexed: 11/07/2022] Open
Abstract
Objectives The aims of this study were to determine the effectiveness of local compression in patients presenting to the emergency room with intraoral bleeding and to identify when complex haemostatic measures may be required. Materials and Methods Five hundred forty patients who had experienced intraoral haemorrhage were retrospectively reviewed. The outcome variable was the haemostasis method used, i.e., simple (local compression with gauze) or complex (an alternative method after local compression has failed). Predictor variables were sex, age, American Society of Anesthesiologists (ASA) class, hepatic cirrhosis, bleeding disorder, use of antithrombotic agents, and site/cause of haemorrhage. Results The mean patient age was 48.9±23.9 years, 53.5% were male, 42.8% were ASA class II or higher, and 23.7% were taking antithrombotic agents. Local compression was used most often (68.1%), followed by local haemostatic agents, sutures, systemic tranexamic acid or blood products, and electrocautery. The most common site of bleeding was the gingiva (91.7%), and the most common cause was tooth extraction (45.7%). Risk factors for needing a complex haemostasis method were use of antithrombotic agents (odds ratio 2.047, P=0.009) and minor oral surgery (excluding extraction and implant procedures; odds ratio 6.081, P=0.001). Conclusion A haemostasis method other than local compression may be needed in patients taking antithrombotic agents or having undergone minor oral surgery.
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Affiliation(s)
- Jun-Bae Sohn
- Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center, Seoul, Korea
| | - Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center, Seoul, Korea
| | - Yoon-Sic Han
- Department of Oral and Maxillofacial Surgery, Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center, Seoul, Korea
| | - Da-Un Jung
- Section of Dentistry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hye-Young Sim
- Section of Dentistry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hee-Sun Kim
- Section of Dentistry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Medical Research Collaborating Center, SMG-SNU Boramae Medical Center, Seoul, Korea
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14
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Padhye NM, Padhye AM, Bhatavadekar NB. Osseodensification -- A systematic review and qualitative analysis of published literature. J Oral Biol Craniofac Res 2019; 10:375-380. [PMID: 31737477 DOI: 10.1016/j.jobcr.2019.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
The recently introduced technique of osseodensification for dental implant involves the use of special drills (Densah) run in a counter-clockwise direction at the osteotomy site. It is claimed that this causes expansion of the osteotomy site, and increases density of the bone in immediate vicinity of the osteotomy. We reviewed published papers on the primary stability attained using this drilling technique. As a secondary finding, the bone to implant contact (BIC) and the bone area fraction occupancy (BAF) was also compared between the conventional drilling protocol and the osseodensification protocol, among these articles. A Systematic search was performed in PubMed-Medline, Embase and Google Scholar for clinical/animal studies up to November 2018. A total of 12 articles, from a database of 132 articles, consisting of 8 animal histologic studies, 2 human based clinical studies, 1 case series and 1 case report were assessed. 10/12 articles measured the insertion torque values, 7/12 articles measured the BIC and 6/12 articles estimated the BAF between the two techniques. Quality assessment of 8 studies performed using ARRIVE guidelines showed that 6/8 studies had a high score. An average increase in the insertion torque, BIC and BAF was noted in the osseodensification group as compared to the conventional drilling group. Since most of these studies are non-clinical, it can be inferred that osseodensification is an efficient way to enhance primary stability of implants in low density bone in an animal model. However, extrapolation to long term clinical success cannot be ascertained until further evidence becomes available.
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Affiliation(s)
| | - Ashvini Mukul Padhye
- Professor & Head of Department of Periodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Neel B Bhatavadekar
- Clarus Dental Specialties, Pune. Adjunct Faculty, University of North Carolina at Chapel Hill, USA
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15
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Abou-Ayash S, Enkling N, Srinivasan M, Haueter M, Worni A, Schimmel M. Evolution of in vivo assessed retention forces in one-piece mini dental implant-retained mandibular overdentures: 5-Year follow-up of a prospective clinical trial. Clin Implant Dent Relat Res 2019; 21:968-976. [PMID: 31313455 DOI: 10.1111/cid.12816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/19/2019] [Accepted: 06/20/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND The evolution of retention forces in one-piece mini dental implants (MDIs) retaining implant overdentures (IODs) is of major importance, as the male parts cannot be exchanged, due to the implant design. PURPOSE To report the evolution of retention forces of one-piece MDIs, retaining mandibular IODs with ball/ O-ring attachments during 5 years assessed in vivo. MATERIALS AND METHODS Four MDIs were installed in the interforaminal region and immediately loaded using the existing mandibular complete denture. Directly post-op, at the 1-year and the 5-year follow-up, the retention forces were assessed with a validated strain gauge at each implant site separately. RESULTS At the male part, changes could only be observed at implant site 34: During the first year, there was a statistically significant increase, whereas the retention forces were decreased at the 5-year follow-up. At the female part, retention forces decreased significantly over time. Baseline values could be reestablished by exchanging the O-rings. The changes of the retention forces were more obvious in the posterior, compared to the anterior implants. CONCLUSIONS Retention forces at the female part decrease significantly over time, when retaining mandibular IODs by MDIs with ball/ O-ring attachments. Baseline values can be reestablished by exchanging the O-rings. At the male part, changes of retention forces depend on the implant location.
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Affiliation(s)
- Samir Abou-Ayash
- Section for Digital Implant- and Reconstructive Dentistry (DIRecD), Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Norbert Enkling
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Department of Prosthodontics, University of Bonn, Bonn, Germany
| | - Murali Srinivasan
- Clinic for General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Marius Haueter
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | | | - Martin Schimmel
- Division of Gerodontology, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
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16
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Wang M, Li Y, Li J, Fan L, Yu H. The risk of moderate‐to‐severe post‐operative pain following the placement of dental implants. J Oral Rehabil 2019; 46:836-844. [PMID: 31074878 DOI: 10.1111/joor.12815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Meijie Wang
- Department of Prosthetics, West China School of Stomatology Sichuan University Sichuan China
| | - Yiyuan Li
- Department of Prosthetics, West China School of Stomatology Sichuan University Sichuan China
| | - Junying Li
- Department of Prosthetics, West China School of Stomatology Sichuan University Sichuan China
| | - Linli Fan
- Department of Prosthetics, West China Hospital of Stomatology Sichuan University Sichuan China
| | - Haiyang Yu
- Department of Prosthetics, West China School of Stomatology Sichuan University Sichuan China
- Department of Prosthetics, West China Hospital of Stomatology Sichuan University Sichuan China
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17
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Abstract
There are few absolute contraindications to dental implant placement. Relative contraindications include cognitive decline, American Society of Anesthesiology patient status IV or higher categories, or medical conditions that may jeopardize the life or lifespan of the patient. Precautions for placing dental implants should be viewed with respect to the evidence-based exposures that can contribute to risk of failure, including but not limited to local, behavioral, and medical factors. Risk for dental implant failure increases in association with (1) past history of periodontal disease, (2) bruxism, (3) smoking, and (4) radiation therapy.
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Affiliation(s)
- Amritpal S Kullar
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, Oral Radiology, MN324 College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40356-0297, USA.
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18
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Hernández G, Paredes V, López-Pintor RM, de Andrés A, de Vicente JC, Sanz M. Implant treatment in immunosuppressed renal transplant patients: A prospective case-controlled study. Clin Oral Implants Res 2019; 30:524-530. [PMID: 30980770 DOI: 10.1111/clr.13437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this clinical study was to evaluate long-term outcomes of implant therapy in a cohort of immunosuppressed renal transplant patients compared with a matched control group. MATERIAL AND METHODS Pharmacologically immunosuppressed renal transplant patients received dental implant treatment between 2001 and 2011. Periodontal, clinical and radiographic parameters were prospectively measured with a mean follow-up of 116.8 months (range from 84 to 192 months). A matched controlled non-transplant sample receiving similar implant treatment in the same time was included as a control group. RESULTS Implant survival rate was over 98% in both test and control groups (100% and 98.84%, respectively). Peri-implant mucositis was diagnosed in 46.80% of the implants in the study group and in 48.80% in the control group. Peri-implantitis occurred in 5.10% of the implants in the study group and in 8.10% of the controls. Wound healing and post-operative pain were similar in both groups. CONCLUSIONS Despite the limitations of this study, pharmacological immunosuppression in renal transplant patients did not affect implant outcomes. Renal transplant patients should be carefully controlled periodically after implant treatment. CLINICAL IMPLICATIONS The results from this investigation justify the use of dental implants for the dentalrehabilitation of immunosuppressed patients after renal transplantation provided they follow the necessarylong-term monitoring and regular maintenance of their oral and systemic health.
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Affiliation(s)
- Gonzalo Hernández
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Víctor Paredes
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Amado de Andrés
- Department of Nephrology, Hospital 12 de octubre, Madrid, Spain
| | - Juan Carlos de Vicente
- Department of Oral and Maxillofacial Surgery, Hospital of Asturias, School of Medicine and Dentistry, Oviedo University, Oviedo, Spain
| | - Mariano Sanz
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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19
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Abukaraky A, Hamdan AA, Ameera MN, Nasief M, Hassona Y. Quality of YouTube TM videos on dental implants. Med Oral Patol Oral Cir Bucal 2018; 23:e463-e468. [PMID: 29924766 PMCID: PMC6051691 DOI: 10.4317/medoral.22447] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 05/03/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients search YouTube for health-care information. PURPOSE To examine what YouTube offers patients seeking information on dental implants, and to evaluate the quality of provided information. MATERIAL AND METHODS A systematic search of YouTube for videos containing information on dental implants was performed using the key words Dental implant and Tooth replacement. Videos were examined by two senior Oral and Maxillofacial Surgery residents who were trained and calibrated to perform the search. Initial assessment was performed to exclude non- English language videos, duplicate videos, conference lectures, and irrelevant videos. Included videos were analyzed with regard to demographics and content's usefulness. Information for patients available from the American Academy of Implant Dentistry, European Association of Osseointegration, and British Society of Restorative Dentistry were used for benchmarking. RESULTS A total of 117 videos were analyzed. The most commonly discussed topics were related to procedures involved in dental implantology (76.1%, n=89), and to the indications for dental implants (58.1%, n=78). The mean usefulness score of videos was poor (6.02 ±4.7 [range 0-21]), and misleading content was common (30.1% of videos); mainly in topics related to prognosis and maintenance of dental implants. Most videos (83.1%, n=97) failed to mention the source of information presented in the video or where to find more about dental implants. CONCLUSIONS Information about dental implants on YouTube is limited in quality and quantity. YouTube videos can have a potentially important role in modulating patients attitude and treatment decision regarding dental implants.
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Affiliation(s)
- A Abukaraky
- Oral Medicine and Special Care Dentistry, Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontology, School of Dentistry- The University of Jordan, Queen Rania Street, 11942,
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20
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Podaropoulos L. Increasing the Stability of Dental Implants: the Concept of Osseodensification. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Summary
One of the most important factors that affect osseointegration is the primary stability of the implant. Dental implants inserted at the posterior region of the maxilla exhibit the lowest success rates as the low density bone in this area often jeopardize rigid fixation of the implant. Many surgical techniques have been developed to increase the primary stability of an implant placed in low density bone, such as bicortical fixation of the implant, undersized preparation of the implant bed and bone condensation by the use of osteotomes. A new promising technique, named osseodensification, has been recently developed that creates an autograft layer of condensed bone at the periphery of the implant bed by the aid of specially designed burs rotating in a clockwise and anti-clockwise direction. The purpose of this review is to emphasize that implant primary stability is strongly influenced by the surgical technique, to quote and briefly analyse the various surgical procedures laying weight to osseodensification procedure.
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Affiliation(s)
- Leonidas Podaropoulos
- Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian, University of Athens , Greece
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21
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Shi Q, Xu J, Zhang T, Zhang B, Liu H. Post-operative Bleeding Risk in Dental Surgery for Patients on Oral Anticoagulant Therapy: A Meta-analysis of Observational Studies. Front Pharmacol 2017; 8:58. [PMID: 28228727 PMCID: PMC5296357 DOI: 10.3389/fphar.2017.00058] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/26/2017] [Indexed: 01/19/2023] Open
Abstract
Background and Objective: Minor dental surgery is invasive and hemorrhagic. Thus, in patients treated with anticoagulants, the bleeding risk related to these invasive procedures is concerning. The aim of this meta-analysis is to evaluate this risk by comparing the post-operative bleeding rates of oral anticoagulation treatment (OAT) patients (without interrupted or altered anticoagulant intake) with non-OAT patients. Methods: PubMed, Embase and the Cochrane Library were searched for eligible studies that compared the post-operative (following minor dental surgery) bleeding rates of OAT patients without interrupted or altered therapy with those of non-OAT patients. Relative risk (RR) and 95% confidence interval (CI) were calculated. Subgroup analyses were used to identify the association between the bleeding rate and different dental surgeries or anticoagulants. Results: Thirty two full text articles were assessed for eligibility and 20 studies were excluded according to the selection criteria. Finally, 12 studies and a total of 2102 OAT patients and 2271 non-OAT patients were included. A pooled analysis indicated that the post-operative bleeding risk in OAT patients is higher than that of non-OAT patients (RR: 2.794, 95% CI: 1.722-4.532, P = 0.000). The pooled RRs in the dental implant surgery and dental extraction subgroups were 2.136 (95% CI: 0.825-5.531, P = 0.118) and 2.003 (95% CI: 0.987-4.063, P = 0.054), respectively. As for the different oral anticoagulants, the pooled RR in the subgroup of new oral anticoagulants (NOACs) was 1.603 (95% CI: 0.430-5.980, P = 0.482), while the pooled RR in the vitamin K antagonists subgroup was 3.067 (95% CI: 1.838-5.118, P = 0.000). Conclusion: Under current evidence, OAT patients were under a higher post-operative bleeding risk than the non-OAT patients following minor dental surgery. For the dental implant surgeries and dental extractions, our study failed to demonstrate a higher risk of bleeding in the OAT patients compared with the non-OAT patients. Besides, The NOACs might be safer than the vitamin K antagonists in dental implant surgery. However, more well-designed studies are required for future research.
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Affiliation(s)
- Quan Shi
- Institute of Stomatology, Chinese PLA General Hospital Beijing, China
| | - Juan Xu
- Institute of Stomatology, Chinese PLA General Hospital Beijing, China
| | - Tong Zhang
- Institute of Stomatology, Chinese PLA General Hospital Beijing, China
| | - Bin Zhang
- Institute of Stomatology, Chinese PLA General Hospital Beijing, China
| | - Hongchen Liu
- Institute of Stomatology, Chinese PLA General Hospital Beijing, China
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22
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Rodriguez LC, Saba JN, Meyer CA, Chung K, Wadhwani C, Rodrigues DC. A finite element analysis of novel vented dental abutment geometries for cement-retained crown restorations. Clin Exp Dent Res 2016; 2:136-145. [PMID: 29744160 PMCID: PMC5839249 DOI: 10.1002/cre2.33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/23/2016] [Accepted: 03/30/2016] [Indexed: 01/01/2023] Open
Abstract
Recent literature indicates that the long-term success of dental implants is, in part, attributed to how dental crowns are attached to their associated implants. The commonly utilized method for crown attachment - cementation, has been criticized because of recent links between residual cement and peri-implant disease. Residual cement extrusion from crown-abutment margins post-crown seating is a growing concern. This study aimed at (1) identifying key abutment features, which would improve dental cement flow characteristics, and (2) understanding how these features would impact the mechanical stability of the abutment under functional loads. Computational fluid dynamic modeling was used to evaluate cement flow in novel abutment geometries. These models were then evaluated using 3D-printed surrogate models. Finite element analysis also provided an understanding of how the mechanical stability of these abutments was altered after key features were incorporated into the geometry. The findings demonstrated that the key features involved in improved venting of the abutment during crown seating were (1) addition of vents, (2) diameter of the vents, (3) location of the vents, (4) addition of a plastic screw insert, and (5) thickness of the abutment wall. This study culminated in a novel design for a vented abutment consisting of 8 vents located radially around the abutment neck-margin plus a plastic insert to guide the cement during seating and provide retrievability to the abutment system.Venting of the dental abutment has been shown to decrease the risk of undetected residual dental cement post-cement-retained crown seating. This article will utilize a finite element analysis approach toward optimizing dental abutment designs for improved dental cement venting. Features investigated include (1) addition of vents, (2) diameter of vents, (3) location of vents, (4) addition of plastic screw insert, and (5) thickness of abutment wall.
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Affiliation(s)
- Lucas C. Rodriguez
- Department of BioengineeringUniversity of Texas at DallasRichardsonTexasUSA
| | - Juliana N. Saba
- Department of BioengineeringUniversity of Texas at DallasRichardsonTexasUSA
| | - Clark A. Meyer
- Department of BioengineeringUniversity of Texas at DallasRichardsonTexasUSA
| | - Kwok‐Hung Chung
- Department of Restorative DentistryUniversity of WashingtonSeattleWashingtonUSA
| | - Chandur Wadhwani
- Department of Restorative DentistryUniversity of WashingtonSeattleWashingtonUSA
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23
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Manor Y, Simon R, Haim D, Garfunkel A, Moses O. Dental implants in medically complex patients—a retrospective study. Clin Oral Investig 2016; 21:701-708. [DOI: 10.1007/s00784-016-1937-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/08/2016] [Indexed: 12/28/2022]
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Kalavrezos N, Scully C. Mouth cancer for clinicians part 13: life after mouth cancer treatment. ACTA ACUST UNITED AC 2016; 43:672-4, 677-8, 681-2, 684-6. [DOI: 10.12968/denu.2016.43.7.672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicholas Kalavrezos
- Maxillofacial and Reconstructive Surgeon of The Head, Face and Neck, University College London Hospital and The Harley Street Clinic. Assistant Secretary, European Association of Cranio-Maxillofacial Surgery, UCL, London, UK
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25
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Marković A, Đinić A, Calvo Guirado JL, Tahmaseb A, Šćepanović M, Janjić B. Randomized clinical study of the peri-implant healing to hydrophilic and hydrophobic implant surfaces in patients receiving anticoagulants. Clin Oral Implants Res 2016; 28:1241-1247. [DOI: 10.1111/clr.12948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Aleksa Marković
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Ana Đinić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - José Luis Calvo Guirado
- Department of Research; International Dentistry Research Cathedra; UCAM Universidad Catolica San Antonio de Murcia; Murcia Spain
| | - Ali Tahmaseb
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
| | - Miodrag Šćepanović
- Department of Prosthodontics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Bojan Janjić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
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26
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Oral rehabilitation of patients with Chediak-Higashi syndrome using zygoma and root form implant-supported fixed prostheses: A report of two patients. J Prosthet Dent 2016; 116:831-835. [PMID: 27492987 DOI: 10.1016/j.prosdent.2016.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 11/23/2022]
Abstract
Chediak-Higashi syndrome (CH-S) is a rare genetic immunodeficiency disorder. Fewer than 500 individuals with CH-S have been reported worldwide in the past 20 years. The dental management of patients in whom CH-S has been diagnosed has been rarely reported and only in the form of a case report. All reports addressed the severe periodontal disease found in those patients, and most studies concluded that periodontal treatment had an unfavorable prognosis. As a result, complete edentulism at an early age because of severe periodontal disease is expected. The purpose of this report was to present 2 patients with CH-S seeking oral rehabilitation after early tooth loss and severe bone resorption as a manifestation of severe periodontal disease. The treatment used bilateral zygoma implants and an all-on-4 concept. The complications encountered and management with a 5-year post-surgery follow-up are also presented.
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27
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Neves J, de Araújo Nobre M, Oliveira P, Martins Dos Santos J, Malo P. Risk Factors for Implant Failure and Peri-Implant Pathology in Systemic Compromised Patients. J Prosthodont 2016; 27:409-415. [PMID: 27348845 DOI: 10.1111/jopr.12508] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To identify the possible risk factors for implant failure and peri-implant pathology in a population of systemically compromised patients. MATERIALS AND METHODS This retrospective clinical study included a total of 721 systemically compromised patients (422 women, 299 men), with an average age of 51 years (range: 20 to 87) rehabilitated with dental implants. The average follow-up time was 7.3 years. The patients' demographic variables (age and gender) and clinical variables (implant location, type of implant surface, and systemic conditions) were recorded. Outcome measures were implant failure and peri-implant pathology. Binary logistic regression models were performed to investigate the effect of the patients' demographic and clinical characteristics on the dependent variables implant failure and peri-implant pathology. A linear regression model was performed to correlate the patient's characteristics with the number of failed implants. Odds ratios (OR) with 95% confidence intervals and corresponding levels of significance were estimated for each variable. RESULTS Multivariate logistic regression disclosed increased age (patients over 40 years of age) as a risk factor for implant failure (OR = 2.63) and hepatitis as a risk factor for peri-implant pathology (OR = 3.74). Multivariate linear regression disclosed rheumatologic and cardiac diseases to be correlated with a higher number of failed implants. CONCLUSIONS Within the limitations of this study, the results suggest no absolute contraindications for implant rehabilitation in a population of systemically compromised patients. Nevertheless, this study suggests that increasing age, rheumatological condition, cardiovascular condition, and hepatitis should be considered when performing implant-supported rehabilitations due to their negative influence on the outcome.
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Affiliation(s)
- Joana Neves
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal.,Oral Hygiene Department, Maló Clinic, Lisbon, Portugal
| | | | - Pedro Oliveira
- Center for Interdisciplinary Research Egas Moniz, Campus Universitário, Caparica, Portugal
| | | | - Paulo Malo
- Department of Oral Surgery, Maló Clinic, Lisbon, Portugal
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Al Subaie AE, Eimar H, Abdallah MN, Durand R, Feine J, Tamimi F, Emami E. Anti-VEGFs hinder bone healing and implant osseointegration in rat tibiae. J Clin Periodontol 2015; 42:688-96. [PMID: 26073407 DOI: 10.1111/jcpe.12424] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 01/12/2023]
Abstract
AIM To assess the effect of anti-vascular endothelial growth factors (VEGF) on bone healing (defect volume) and implant osseointegration (bone-implant contact per cent) in rat tibia. MATERIALS AND METHODS In Sprague-Dawley rats (n = 36), a unicortical defect was created in the right tibia and a titanium implant was placed in the left tibia of each rat. Rats were assigned into three groups and received either anti-vascular endothelial growth factor neutralizing antibody, Ranibizumab or saline (control). Two weeks following surgery, rats were euthanized and bone samples were retrieved. Bone healing and osseointegration were assessed using micro-CT and histomorphometry. One-way anova followed by the Tukey's test was used for data analyses. RESULTS The volume of the bone defects in the anti-VEGF group (2.48 ± 0.33 mm(3) ) was larger (p = 0.026) than in the controls (2.11 ± 0.36 mm(3) ) as measured by μ-CT. Bone-implant contact percent in the anti-VEGF (19.9 ± 9.4%) and Ranibizumab (21.7 ± 9.2%) groups were lower (p < 0.00) than in the control group (41.8 ± 12.4%). CONCLUSIONS The results of this study suggest that drugs that inhibit the activity of vascular endothelial growth factor (i.e. anti-VEGF) may hinder bone healing and implant osseointegration in rat tibiae.
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Affiliation(s)
- Ahmed Ebraheem Al Subaie
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Hazem Eimar
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | - Robert Durand
- College of Dentistry, University of Dammam, Dammam, Saudi Arabia
| | - Jocelyne Feine
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Faleh Tamimi
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, University of Montreal, Montreal, QC, Canada
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von Salis-Soglio M, Stübinger S, Sidler M, Klein K, Ferguson SJ, Kämpf K, Zlinszky K, Buchini S, Curno R, Péchy P, Aronsson BO, von Rechenberg B. A novel multi-phosphonate surface treatment of titanium dental implants: a study in sheep. J Funct Biomater 2014; 5:135-57. [PMID: 25215424 PMCID: PMC4192609 DOI: 10.3390/jfb5030135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/20/2014] [Accepted: 09/02/2014] [Indexed: 01/18/2023] Open
Abstract
The aim of the present study was to evaluate a new multi-phosphonate surface treatment (SurfLink®) in an unloaded sheep model. Treated implants were compared to control implants in terms of bone to implant contact (BIC), bone formation, and biomechanical stability. The study used two types of implants (rough or machined surface finish) each with either the multi-phosphonate Wet or Dry treatment or no treatment (control) for a total of six groups. Animals were sacrificed after 2, 8, and 52 weeks. No adverse events were observed at any time point. At two weeks, removal torque showed significantly higher values for the multi-phosphonate treated rough surface (+32% and +29%, Dry and Wet, respectively) compared to rough control. At 52 weeks, a significantly higher removal torque was observed for the multi-phosphonate treated machined surfaces (+37% and 23%, Dry and Wet, respectively). The multi-phosphonate treated groups showed a positive tendency for higher BIC with time and increased new-old bone ratio at eight weeks. SEM images revealed greater amounts of organic materials on the multi-phosphonate treated compared to control implants, with the bone fracture (from the torque test) appearing within the bone rather than at the bone to implant interface as it occurred for control implants.
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Affiliation(s)
- Marcella von Salis-Soglio
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stefan Stübinger
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Michéle Sidler
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Karina Klein
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stephen J Ferguson
- Institute for Biomechanics, ETH Zürich, Vladimir-Prelog-Weg 1-5/10, Zürich 8093, Switzerland.
| | - Käthi Kämpf
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Katalin Zlinszky
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Sabrina Buchini
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Richard Curno
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Péter Péchy
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | | | - Brigitte von Rechenberg
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
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Gómez-de Diego R, Mang-de la Rosa MDR, Romero-Pérez MJ, Cutando-Soriano A, López-Valverde-Centeno A. Indications and contraindications of dental implants in medically compromised patients: update. Med Oral Patol Oral Cir Bucal 2014; 19:e483-9. [PMID: 24608222 PMCID: PMC4192572 DOI: 10.4317/medoral.19565] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 09/20/2013] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to review the current scientific literature in order to analyse the indications and contraindications of dental implants in medically compromised patients. A reference research was carried out on PubMed using the key words “implant” AND (oral OR dental) AND (systemic disease OR medically compromised), in articles published between 1993 and 2013. The inclusion criteria were the following: clinical studies in which, at least, 10 patients were treated, consensus articles, reviewed articles and meta-analysis performed in humans treated with dental implants, and which included the disease diagnosis. A total of 64 articles were found, from which 16 met the inclusion criteria.
Cardiac systemic diseases, diabetic endocrine pathologies or controlled metabolic disorders do not seem to be a total or partial contraindication to the placement of dental implants. Tobacco addiction, and head and neck radiotherapy are correlated to a higher loss of dental implants. Patients suffering from osteoporosis undergoing biphosphonates therapy show an increased risk of developing bone necrosis after an oral surgery, especially if the drugs are administered intravenously or they are associated to certain concomitant medication.
Key words:Dental implants, medically compromised patient, systemic diseases.
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Affiliation(s)
- Rafael Gómez-de Diego
- Departamento Cirugía, Universidad de Salamanca, Avda. Alfonso X El Sabio S/N, 37007 Salamanca, Spain,
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Gaviria L, Salcido JP, Guda T, Ong JL. Current trends in dental implants. J Korean Assoc Oral Maxillofac Surg 2014; 40:50-60. [PMID: 24868501 PMCID: PMC4028797 DOI: 10.5125/jkaoms.2014.40.2.50] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/02/2014] [Indexed: 01/09/2023] Open
Abstract
Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants.
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Affiliation(s)
- Laura Gaviria
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - John Paul Salcido
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Teja Guda
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Joo L Ong
- Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, TX, USA
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Nakagawa A, Shitara N, Ayukawa Y, Koyano K, Nishimura K. Implant treatment followed by living donor lung transplant: A follow-up case report. J Prosthodont Res 2014; 58:127-31. [DOI: 10.1016/j.jpor.2013.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/08/2013] [Accepted: 11/21/2013] [Indexed: 10/25/2022]
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Altin N, Ergun S, Katz J, Sancakli E, Koray M, Tanyeri H. Implant-Supported Oral Rehabilitation of a Patient with Pemphigus Vulgaris: A Clinical Report. J Prosthodont 2013; 22:581-586. [DOI: 10.1111/jopr.12050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2013] [Indexed: 10/27/2022] Open
Affiliation(s)
- Nazlı Altin
- Department of Oral Surgery; Istanbul University, Faculty of Dentistry; Istanbul Turkey
| | - Sertan Ergun
- Associate Professor, Department of Oral Surgery; Istanbul University, Faculty of Dentistry; Istanbul Turkey
| | - Joseph Katz
- Professor, Department of Oral and Maxillofacial Diagnostic Sciences University of Florida; College of Dentistry; Gainesville FL
| | - Erkan Sancakli
- Associate Professor, Department of Prosthodontics; Istanbul University, Faculty of Dentistry; Istanbul Turkey
| | - Meltem Koray
- Department of Oral Surgery; Istanbul University, Faculty of Dentistry; Istanbul Turkey
| | - Hakkı Tanyeri
- Professor, Department of Oral Surgery; Istanbul University, Faculty of Dentistry; Istanbul Turkey
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Tanaka TI, Chan HL, Tindle DI, Maceachern M, Oh TJ. Updated clinical considerations for dental implant therapy in irradiated head and neck cancer patients. J Prosthodont 2013; 22:432-8. [PMID: 23388045 DOI: 10.1111/jopr.12028] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2012] [Indexed: 11/29/2022] Open
Abstract
An increasing number of reports indicate successful use of dental implants (DI) during oral rehabilitation for head and neck cancer patients undergoing tumor surgery and radiation therapy. Implant-supported dentures are a viable option when patients cannot use conventional dentures due to adverse effects of radiation therapy, including oral dryness or fragile mucosa, in addition to compromised anatomy; however, negative effects of radiation, including osteoradionecrosis, are well documented in the literature, and early loss of implants in irradiated bone has been reported. There is currently no consensus concerning DI safety or clinical guidelines for their use in irradiated head and neck cancer patients. It is important for health care professionals to be aware of the multidimensional risk factors for these patients when planning oral rehabilitation with DIs, and to provide optimal treatment options and maximize the overall treatment outcome. This paper reviews and updates the impact of radiotherapy on DI survival and discusses clinical considerations for DI therapy in irradiated head and neck cancer patients.
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Affiliation(s)
- Takako Imai Tanaka
- Department of Biomedical & Diagnostic Sciences, University of Detroit Mercy School of Dentistry, Detroit, MI, USA.
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Diz P, Scully C, Sanz M. Dental implants in the medically compromised patient. J Dent 2013; 41:195-206. [PMID: 23313715 DOI: 10.1016/j.jdent.2012.12.008] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 12/03/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE It has been suggested that some local and systemic factors could be contraindications to dental implant treatment. The objective of this paper was to evaluate whether success and survival rates of dental implants are reduced in the medically compromised patient. DATA/SOURCES An extensive literature search was conducted using PubMed/Medline, Scopus, Scirus and Cochrane databases up to November 8, 2012. CONCLUSIONS There are very few absolute medical contraindications to dental implant treatment, although a number of conditions may increase the risk of treatment failure or complications. The degree of systemic disease-control may be far more important that the nature of the disorder itself, and individualized medical control should be established prior to implant therapy, since in many of these patients the quality of life and functional benefits from dental implants may outweigh any risks.
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Affiliation(s)
- Pedro Diz
- Grupo de Investigación en Odontología Médico-Quirúrgica (OMEQUI), School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
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Borzabadi-Farahani A. Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants. J ORAL IMPLANTOL 2012; 38:779-91. [DOI: 10.1563/aaid-joi-d-11-00022] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The use of implant-supported restorations in patients with hypodontia remains challenging and requires a multistage treatment that begins in late mixed dentition and continues into late adolescence. The aim of this article is to review the role of orthodontics in endosseous implant rehabilitation of patients with hypodontia. The MEDLINE, Web of Science, Scopus, Cochrane databases, and necessary scientific textbooks were searched for relevant studies and reviews, and as far as possible, they were only included if they had been cited at least once in the literature. Dental implants are susceptible to overloading as the periodontal ligament is absent and the proprioceptive nerve endings are either lacking or very limited. Patients with hypodontia may present with skeletal features such as short and retrognathic maxilla, prognathic mandible, and shorter lower anterior facial height, and they sometimes need orthognathic correction as part of their overall treatment. Dental problems vary and include bimaxillary retroclination of incisors, spacing, centerline discrepancies, microdontia, hypoplastic enamels, ankylosis of the retained primary teeth, overeruptions, and volume deficiencies of alveolar ridges. The challenges mentioned, as well as bone volume deficiencies, compromise the successful placement of implants. Orthodontic strategies and techniques, such as uprighting mechanics, extrusion/intrusion, delayed space opening, and orthodontic implant site-switching, can be used to create, preserve, or augment the implant site. After orthodontic site development, the final planned position of the teeth should be maintained with a rigid bonded retainer; overlooking this stage may compromise the implant site and require orthodontic retreatment.
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Affiliation(s)
- Ali Borzabadi-Farahani
- Craniofacial Orthodontics, Children's Hospital Los Angeles, and Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles
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Local Delivery of the Hemostatic Agent Tranexamic Acid in Chronically Anticoagulated Patients. J Craniofac Surg 2012; 23:e648-52. [DOI: 10.1097/scs.0b013e318271055d] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Liddelow G, Klineberg I. Patient-related risk factors for implant therapy. A critique of pertinent literature. Aust Dent J 2012; 56:417-26; quiz 441. [PMID: 22126353 DOI: 10.1111/j.1834-7819.2011.01367.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Treatment planning for dental implants involves the assessment of patient-related risk factors prior to formulation of a treatment plan. The aim of this review was to assess relevant literature and provide evidence-based information on the successful surgical placement of dental implants. METHODS An electronic search of Medline, PubMed and the Cochrane Databases of Systematic Reviews was undertaken using a combination of MeSH terms and keywords. A handsearch was also performed and cross-referenced with articles cited in papers selected. The primary study parameter was implant failure. RESULTS Forty-three studies were selected based on specific inclusion criteria. Many studies contain confounding variables, numbers in subcategories are often too small for meaningful statistical analysis, and follow-up times vary and are often short-term. CONCLUSIONS There are many risk factors which the clinician is required to know and understand to advise patients, and consider in planning and treatment provision. Consistent evidence exists to show an increased failure rate with smokers, a history of radiotherapy and local bone quality and quantity. Weaker evidence exists to show a higher incidence of peri-implant disease in patients with a history of periodontitis-related tooth loss. Lack of evidence precludes definitive guidelines for patients with autoimmune disorders where expert opinion recommends caution. Osteoporotic patients show acceptable survival rates; however patients on oral bisphosphonates show a small incidence but high morbidity from osteonecrosis of the jaw. Emerging evidence suggests that there is a correlation between genetic traits and disruption of osseointegration.
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Affiliation(s)
- G Liddelow
- The Brånemark Centre, Perth, Western Australia
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40
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Sun DC, Li DH, Ji HC, Rao GZ, Liang LH, Ma AJ, Xie C, Zou GK, Song YL. In vitro culture and characterization of alveolar bone osteoblasts isolated from type 2 diabetics. Braz J Med Biol Res 2012; 45:502-9. [PMID: 22473318 PMCID: PMC3854304 DOI: 10.1590/s0100-879x2012007500054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 03/23/2012] [Indexed: 11/22/2022] Open
Abstract
In order to understand the mechanisms of poor osseointegration following dental implants in type 2 diabetics, it is important to study the biological properties of alveolar bone osteoblasts isolated from these patients. We collected alveolar bone chips under aseptic conditions and cultured them in vitro using the tissue explants adherent method. The biological properties of these cells were characterized using the following methods: alkaline phosphatase (ALP) chemical staining for cell viability, Alizarin red staining for osteogenic characteristics, MTT test for cell proliferation, enzyme dynamics for ALP contents, radio-immunoassay for bone gla protein (BGP) concentration, and ELISA for the concentration of type I collagen (COL-I) in the supernatant. Furthermore, we detected the adhesion ability of two types of cells from titanium slices using non-specific immunofluorescence staining and cell count. The two cell forms showed no significant difference in morphology under the same culture conditions. However, the alveolar bone osteoblasts received from type 2 diabetic patients had slower growth, lower cell activity and calcium nodule formation than the normal ones. The concentration of ALP, BGP and COL-I was lower in the supernatant of alveolar bone osteoblasts received from type 2 diabetic patients than in that received from normal subjects (P < 0.05). The alveolar bone osteoblasts obtained from type 2 diabetic patients can be successfully cultured in vitro with the same morphology and biological characteristics as those from normal patients, but with slower growth and lower concentration of specific secretion and lower combining ability with titanium than normal ones.
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Affiliation(s)
- Dao-Cai Sun
- Department of Implant Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Gu L, Yu YC. Clinical Outcome of Dental Implants Placed in Liver Transplant Recipients After 3 Years: A Case Series. Transplant Proc 2011; 43:2678-82. [DOI: 10.1016/j.transproceed.2011.06.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Revised: 05/05/2011] [Accepted: 06/03/2011] [Indexed: 01/13/2023]
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Kosyfaki P, Att W, Strub JR. The dental patient on oral anticoagulant medication: a literature review. J Oral Rehabil 2010; 38:615-33. [PMID: 21073495 DOI: 10.1111/j.1365-2842.2010.02184.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Specific diseases and medications may considerably influence the delivery of oral care and the course of dental therapy. The purpose of this literature review is to examine the relationship between oral anticoagulant medication and dental treatment. Electronic and manual searches were conducted for clinical studies in the English literature for the years 1988-2010. The review process provided a total of 110 pertinent literature references, out of which 38 studies dealt with oral anticoagulants and dental treatment. Different treatment strategies relative to dental periprocedural anticoagulation regimens have been identified, and their accompanying thromboembolic and bleeding risks are being presented and discussed. Regarding to what extent a safe and successful dental treatment in patients on anticoagulant medication is feasible, the level of evidence is lacking. Until high-level data are provided, an individualised treatment approach after consultation with the physician of the patient is highly recommended.
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Affiliation(s)
- P Kosyfaki
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany.
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Lutz R, Srour S, Nonhoff J, Weisel T, Damien CJ, Schlegel KA. Biofunctionalization of titanium implants with a biomimetic active peptide (P-15) promotes early osseointegration. Clin Oral Implants Res 2010; 21:726-34. [PMID: 20636727 DOI: 10.1111/j.1600-0501.2009.01904.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The early stages of peri-implant bone formation play an essential role in the osseointegration and long-term success of dental implants. By incorporating bioactive coatings, this biofunctionalization of implant surfaces may enhance the attachment of the implant to the surrounding bone and stimulate bone regeneration. MATERIAL AND METHODS To demonstrate faster osseointegration, the surfaces of dental implants were grit-blasted and acid-etched. They were then coated with hydroxyapatite (HA) and experimental implants were further coated with a biomimetic active peptide (P-15) in one of two concentrations. These biofunctionalized samples and controls with no peptide were placed in the forehead region of 12 adult pigs. Six animals were evaluated for a period of 14 or 30 days. RESULTS Histomorphometric analysis demonstrated that the implants with the high concentration of P-15 had significantly higher percentage of bone-to-implant contact (BIC) at 14 (P=0.018) and 30 (P=0.015) days compared with the other groups. Both concentrations of P-15 showed increased peri-implant bone density compared to the control group at 30 days. CONCLUSION Biofunctionalization of the implant surface with a biomimetic active peptide leads to significantly increased BIC rates at 14 and 30 days and higher peri-implant bone density at 30 days.
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Affiliation(s)
- R Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
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Krennmair G, Seemann R, Piehslinger E. Dental implants in patients with rheumatoid arthritis: clinical outcome and peri-implant findings. J Clin Periodontol 2010; 37:928-36. [DOI: 10.1111/j.1600-051x.2010.01606.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Abstract
OBJECTIVE Because of increasing health awareness, many Nigerian patients are demanding that their lost tooth/teeth be replaced with dental implants. This study reports the pattern and distribution of implant replacement of lost tooth/teeth in a private dental practice in Lagos, Nigeria. METHODS A retrospective review of implant replacement of lost tooth/teeth over a period of 6 years at Schubbs Private Dental Clinic, Lagos, was carried out. Data analysis included age, sex, occupation, habits and medical condition of patients, augmentation procedure, technique of implant placement (immediate vs conventional loading) tooth/teeth replaced, and follow-up period. RESULTS A total of 227 implants (Bicon, Boston, MA) with complete superstructure were placed in 121 patients(males = 68, females = 53; age range: 15-74 years). Majority of the patients were of high socioeconomic class. Ten (8.3%) patients had immediate implants and 111 (91.7%) undergone 2-stage implant procedures. The highest number (39.2%) of implants was placed in the molar region, and the replacement of the canines was the lowest (3.1%). Success rate over a period of 6 years was 96%. Of the 9 (4%) implants that failed, 2 were repeated and remained functional till date. CONCLUSIONS Dental implant therapy as a means of tooth replacement is gaining popularity among Nigerian social upper class. Success rate in this series is comparable with previous reports from Europe and America.
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46
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Javed F, Romanos GE. Impact of Diabetes Mellitus and Glycemic Control on the Osseointegration of Dental Implants: A Systematic Literature Review. J Periodontol 2009; 80:1719-30. [DOI: 10.1902/jop.2009.090283] [Citation(s) in RCA: 215] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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47
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Madrid C, Sanz M. What influence do anticoagulants have on oral implant therapy? A systematic review. Clin Oral Implants Res 2009; 20 Suppl 4:96-106. [DOI: 10.1111/j.1600-0501.2009.01770.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Torres J, Tamimi F, Garcia I, Herrero A, Rivera B, Sobrino JA, Hernández G. Dental implants in a patient with Paget disease under bisphosphonate treatment: A case report. ACTA ACUST UNITED AC 2009; 107:387-92. [PMID: 19217014 DOI: 10.1016/j.tripleo.2008.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 11/17/2008] [Accepted: 11/17/2008] [Indexed: 11/26/2022]
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49
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Zitzmann NU, Margolin MD, Filippi A, Weiger R, Krastl G. Patient assessment and diagnosis in implant treatment. Aust Dent J 2008; 53 Suppl 1:S3-10. [DOI: 10.1111/j.1834-7819.2008.00036.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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