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Zhang Y, Wen G, Dong W. Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:196. [PMID: 38443497 DOI: 10.1007/s00784-024-05588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. MATERIALS AND METHODS A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. RESULTS Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. CONCLUSION The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. CLINICAL RELEVANCE Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.
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Affiliation(s)
- Yan Zhang
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Guochen Wen
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Wei Dong
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China.
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2
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Abyzova E, Dogadina E, Rodriguez RD, Petrov I, Kolesnikova Y, Zhou M, Liu C, Sheremet E. Beyond Tissue replacement: The Emerging role of smart implants in healthcare. Mater Today Bio 2023; 22:100784. [PMID: 37731959 PMCID: PMC10507164 DOI: 10.1016/j.mtbio.2023.100784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
Smart implants are increasingly used to treat various diseases, track patient status, and restore tissue and organ function. These devices support internal organs, actively stimulate nerves, and monitor essential functions. With continuous monitoring or stimulation, patient observation quality and subsequent treatment can be improved. Additionally, using biodegradable and entirely excreted implant materials eliminates the need for surgical removal, providing a patient-friendly solution. In this review, we classify smart implants and discuss the latest prototypes, materials, and technologies employed in their creation. Our focus lies in exploring medical devices beyond replacing an organ or tissue and incorporating new functionality through sensors and electronic circuits. We also examine the advantages, opportunities, and challenges of creating implantable devices that preserve all critical functions. By presenting an in-depth overview of the current state-of-the-art smart implants, we shed light on persistent issues and limitations while discussing potential avenues for future advancements in materials used for these devices.
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Affiliation(s)
- Elena Abyzova
- Tomsk Polytechnic University, Lenin ave. 30, Tomsk, Russia, 634050
| | - Elizaveta Dogadina
- Tomsk Polytechnic University, Lenin ave. 30, Tomsk, Russia, 634050
- Institute of Orthopaedic & Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | | | - Ilia Petrov
- Tomsk Polytechnic University, Lenin ave. 30, Tomsk, Russia, 634050
| | | | - Mo Zhou
- Institute of Orthopaedic & Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
| | - Chaozong Liu
- Institute of Orthopaedic & Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Stanmore, HA7 4LP, UK
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3
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Lops D, Romeo E, Mensi M, Troiano G, Zhurakivska K, Del Fabbro M, Palazzolo A. CAD/CAM Abutments in the Esthetic Zone: A Systematic Review and Meta-Analysis of Soft Tissue Stability. J Clin Med 2023; 12:jcm12113847. [PMID: 37298041 DOI: 10.3390/jcm12113847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Computer-aided design and computer-aided manufacturing customized abutments are increasingly used in everyday clinical practice. Nevertheless, solid scientific evidence is currently lacking regarding their potential advantages in terms of soft tissue stability. The main aim of this systematic review and meta-analysis was to compare the soft tissue outcomes of prefabricated versus customized (CAD/CAM) abutments. The present review was registered with PROSPERO (CRD42020161875) and the protocol was developed according to the PRISMA statement. An electronic search was performed on three databases (PubMed, Embase and Cochrane Central) up to May 2023. Data extraction was followed by qualitative and quantitative analysis of the included studies. Three randomized controlled clinical trials and three controlled clinical trials (number of patients = 230; number of dental implants = 230) with a follow-up of between 12 and 36 months were included. No significant differences were observed between prefabricated versus customized (CAD/CAM) abutments regarding midfacial mucosal recession, interproximal papillae and pink aesthetic score (PES) after 12 months. Conclusion: The potential benefits of CAD/CAM abutments on soft tissues should be better clarified in future investigations. The usage of customized CAD/CAM abutments in everyday clinical practice should be based on a careful case-by-case evaluation (CRD42020161875).
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Affiliation(s)
- Diego Lops
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
| | - Eugenio Romeo
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
| | - Magda Mensi
- Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Antonino Palazzolo
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
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Histologic Evaluation of Soft Tissues around Dental Implant Abutments: A Narrative Review. MATERIALS 2022; 15:ma15113811. [PMID: 35683109 PMCID: PMC9181750 DOI: 10.3390/ma15113811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 01/28/2023]
Abstract
The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans. The aim of this review paper was to analyze the literature focusing on histological clinical studies in humans which have examined different materials or different surface treatments and their effects on peri-implant soft tissues. The research was conducted according to the following PICO question: “Do different implant/abutment materials affect peri-implant soft tissues adhesion and health?”. Nine articles were analyzed in this review. The results of this review show the influence of different abutment materials on the peri-implant soft tissues, and the need of further research regarding the effect that abutment materials, surface treatments, and surface properties have on soft tissues.
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A Novel Approach to Immediate Implants: The CastleWall Surgical Technique. Dent J (Basel) 2022; 10:dj10040062. [PMID: 35448056 PMCID: PMC9027629 DOI: 10.3390/dj10040062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: The purpose of this study was to investigate the volumetric stability around immediate implants, in which a 360-degree socket-shield was retained using the CastleWall Surgical Technique (CWST). Material and methods: This retrospective study examined the results of the CWST used for 25 consecutive patients, involving 31 immediate implants. Silicone impressions taken prior to extraction, and at a review appointment were converted to STL files and compared. The median follow-up time was 14.2 ± 5.5 months. Volumetric changes and gingival recession on both buccal and lingual sites were measured. Papillary height changes were also evaluated from available photographs taken before and after treatment. Patients in the study completed a Visual Analogue Scale (VAS) for evaluation of post-operative discomfort and overall satisfaction with this procedure. Results: All implants integrated successfully without complications. Mean loss of buccal and lingual tissue was 0.30 ± 0.32 mm and 0.17 ± 0.27 mm, respectively. Mean recession at the mid-buccal and mid-lingual gingival margin was 0.66 ± 0.64 mm and 0.87 ± 0.84 mm, respectively. Mean recession of the mesial and distal papilla was 0.26 ± 0.55 mm and 0.29 ± 0.52 mm, respectively. Patients reported 97.74 ± 5.60% satisfaction with this procedure using the Visual Analogue Scale (VAS), with minimal post-operative discomfort. Conclusions: The results of this study showed excellent soft tissue stability and aesthetics were achieved using the CWST, with minimal postoperative pain. The other main advantage of retaining a 360-degree socket-shield, is there is more available surface area to lock the implant to the shield to prevent shield migration over time.
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Orchestrating soft tissue integration at the transmucosal region of titanium implants. Acta Biomater 2021; 124:33-49. [PMID: 33444803 DOI: 10.1016/j.actbio.2021.01.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 12/20/2022]
Abstract
Osseointegration at the bone-implant interface and soft tissue integration (STI) at the trans-mucosal region are crucial for the long-term success of dental implants, especially in compromised patient conditions. The STI quality of conventional smooth and bio-inert titanium-based implants is inferior to that of natural tissue (i.e. teeth), and hence various surface modifications have been suggested. This review article compares and contrasts the various modification strategies (physical, chemical and biological) utilized to enhance STI of Ti implants. It also details the STI challenges associated with conventional Ti-based implants, current surface modification strategies and cutting-edge nano-engineering solutions. The topographical, biological and therapeutic advances achievable via electrochemically anodized Ti implants with TiO2 nanotubes/nanopores are highlighted. Finally, the status and future directions of such nano-engineered implants is discussed, with emphasis on bridging the gap between research and clinical translation.
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7
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Guo T, Gulati K, Arora H, Han P, Fournier B, Ivanovski S. Race to invade: Understanding soft tissue integration at the transmucosal region of titanium dental implants. Dent Mater 2021; 37:816-831. [PMID: 33676764 DOI: 10.1016/j.dental.2021.02.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/03/2021] [Accepted: 02/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The success of a dental implant system not only depends on appropriate osseointegration at the bone-implant interface, but also on robust soft-tissue integration (STI)/muco-integration at the transmucosal region. However, numerous studies have reported that the STI quality of conventional smooth and bio-inert titanium-based transmucosal components is significantly inferior to that of natural teeth, which may compromise the long-term success of implant restorations. In this review article, we discuss the structural and histological characteristics of peri-implant tissues; compare the roles of various cells residing in the transmucosal region and explore the material-based challenges that must be addressed to achieve early establishment and long-term maintenance of STI. METHODS This extensive review article critically compares and contrasts the findings from articles published in the domain of 'soft-tissue integration around Ti dental implants'. RESULTS Histological characteristics, including poorer epithelial attachment and absence of direct collagen-implant/abutment integration, are responsible for the inferior STI strength around dental implants/abutments. Furthermore, various cellular functions during STI establishment and maturation at the abutment-mucosa interface must be modulated to achieve early STI. Moreover, we discuss and detail the challenges of achieving robust STI, including the presence of oral bacterial milieu, as well as material and corrosion related issues. Finally, research challenges towards achieving and maintaining robust STI are discussed, targeting the future directions to enhance the long-term survival of implant restorations. SIGNIFICANCE Based on its histological characteristics, STI on current implant/abutment surfaces is suboptimal compared to the periodontal attachment found at teeth, making implants potentially more susceptible to disease initiation and progression. To obtain stable STI at the trasmucosal region, it is essential for future studies to design customized implant systems, with enhanced surface bioactivity and tailorable therapeutic capacity, which can improve the long-term success of implant restorations, especially in compromised conditions.
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Affiliation(s)
- Tianqi Guo
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia
| | - Karan Gulati
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia.
| | - Himanshu Arora
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia
| | - Pingping Han
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia
| | - Benjamin Fournier
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia; Universite de Paris, Dental Faculty Garanciere, Oral Biology Department, Centre of Reference for Oral and Dental Rare Diseases, Paris, France; Centre de Recherche des Cordeliers, Universite de Paris, Sorbonne Universite, INSERM UMRS 1138, Molecular Oral Pathophysiology, Paris, France
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Herston QLD 4006, Australia.
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8
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Wang ICI, Barootchi S, Tavelli L, Wang HL. The peri-implant phenotype and implant esthetic complications. Contemporary overview. J ESTHET RESTOR DENT 2021; 33:212-223. [PMID: 33459483 DOI: 10.1111/jerd.12709] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To provide a contemporary and comprehensive overview of the hard and soft tissue biological structures surrounding an osseointegrated dental implant (peri-implant referred to as the peri-implant phenotype), in the context of peri-implant esthetic complications. OVERVIEW The individual components of the peri-implant phenotype (keratinized mucosa width, mucosal thickness, supracrestal tissue height, and the peri-implant buccal bone) have been linked to different aspects of implant esthetics, as well as health-related aspects. At the time of implant therapy, respecting the biology of the peri-implant hard and soft tissues, and anticipating their remodeling patterns can alleviate future esthetic complications. CONCLUSIONS While the current literature may not allow for a point-by-point evidence based-recommendation for the required amount of each peri-implant structure, bearing in mind the proposed values for the components of the peri-implant phenotype, at the time of and prior to implant therapy can lead to more predictable treatment outcomes, and the avoidance of esthetic complications. CLINICAL SIGNIFICANCE Knowledge of hard and soft tissue components surrounding and osseointegrated dental implant, and their underlying biological remodeling process is crucial for carrying out a successful therapy and alleviating possible future esthetic challenges.
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Affiliation(s)
- I-Ching Izzie Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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9
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Dhamija R, Shetty V, Vineeth K, Nagaraju R, Rao RS. Socket preservation with demineralized freeze-dried bone allograft and platelet-rich fibrin for implant site development: A randomized controlled trial. J Indian Prosthodont Soc 2020; 20:304-311. [PMID: 33223701 PMCID: PMC7654195 DOI: 10.4103/jips.jips_2_20] [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: 01/05/2020] [Revised: 05/27/2020] [Accepted: 06/22/2020] [Indexed: 11/20/2022] Open
Abstract
Aim: This in vivo study compared clinical, histological, and radiological differences in bone formation in human extraction sockets grafted with demineralized freeze-dried bone allograft (DFDBA) and platelet-rich fibrin (PRF), with nongrafted sockets and bone–implant contact (BIC) at 3 and 6 months after implant placement. Settings and Design: Randomised controlled trial. Materials and Methods: The study comprised thirty posterior teeth sockets in either arch in patients ranging from 25 to 60 years. The patients were divided into two equal groups – Group I: control group wherein no graft was placed and the extraction socket was left to heal normally and Group II: test group in which DFDBA and PRF were placed after extraction. 12–16 weeks after extraction, a trephine biopsy was done just prior to implant placement, followed by implant placement. Cone-beam computed tomography (CBCT) at 3 and 6 months after implant placement was done to assess BIC. Statistical Analysis Used: Descriptive and Inferential statistical analysis was done. Parametric test: Independent t-test was used for intergroup analysis and dependent t-test for intra-group analysis. Results: Lower buccal bone levels were seen in the control group versus test group at all intervals though moderately significant. Lingual bone levels significantly reduced at all the three intervals for the control group as compared to the test group. Ridge width in both groups reduced in a time span of 6–7 months without any significant difference. Better bone conversion was noted in the preserved sockets. The preserved sockets also showed better BIC 3 months after implant placement and loading. Conclusion: Indigenously developed DFDBA material shows promising results as an osteoinductive material.
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Affiliation(s)
- Ridhima Dhamija
- Department of Prosthodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Vibha Shetty
- Department of Prosthodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - K Vineeth
- Department of Oral and Maxillofacial Surgery, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Rakesh Nagaraju
- Department of Oral Medicine and Radiology, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Roopa S Rao
- Department of Oral and Maxillofacial Pathology, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
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Srivastava G, Panda S, Panda S, Padhiary SK, Das SS, Fabbro MD. Reproducibility and validity of anterior implant esthetic indices: A review. J Indian Soc Periodontol 2020; 24:301-308. [PMID: 32831501 PMCID: PMC7418544 DOI: 10.4103/jisp.jisp_528_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/01/2020] [Accepted: 03/18/2020] [Indexed: 11/15/2022] Open
Abstract
Background: The purpose of this review was to narrate about the reproducibility and validity of different indices evaluating esthetic aspects in anterior single implant-supported restorations. Materials and Methods: An electronic search of Medline, Scopus, Embase, Cochrane Central, and Web of Science databases was performed using the keywords “dental implants,” “anterior esthetics,” “esthetic score,” and “esthetic index.” Besides, a manual search of dental implant journals was carried out. Results: The electronic search revealed 932 titles. After further review, 14 articles fulfilled the eligibility criteria and were included in this review. Because of the heterogeneity of the study designs, interventions, and parameters used for assessment of esthetics, no meta-analysis could be performed. Conclusion: Many indices have been proposed for the evaluation of the esthetic aspects of single implant-supported reconstructions in the anterior maxilla. All of them have some advantages and drawbacks that this review pointed out. The evidence level of studies used for the validation of these indices is poor. It is necessary to achieve a consensus on the tools for assessment of the esthetic aspect and perform evidence-based studies to validate an appropriate index.
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Affiliation(s)
- Gunjan Srivastava
- Department of Prosthodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Swagatika Panda
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Subrat Kumar Padhiary
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Sitansu Sekhar Das
- Department of Prosthodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Sun C, Zhao J, Liu Z, Tan L, Huang Y, Zhao L, Tao H. Comparing conventional flap‐less immediate implantation and socket‐shield technique for esthetic and clinical outcomes: A randomized clinical study. Clin Oral Implants Res 2019; 31:181-191. [PMID: 31680339 DOI: 10.1111/clr.13554] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/15/2019] [Accepted: 10/19/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Cong Sun
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Jinxiu Zhao
- Department of Stomatology People's Hospital of Gaomi Gaomi China
| | - Zhi Liu
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Lei Tan
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - YaLi Huang
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Liang Zhao
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Hong Tao
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
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12
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Garabetyan J, Malet J, Kerner S, Detzen L, Carra MC, Bouchard P. The relationship between dental implant papilla and dental implant mucosa around single‐tooth implant in the esthetic area: A retrospective study. Clin Oral Implants Res 2019; 30:1229-1237. [DOI: 10.1111/clr.13536] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/27/2019] [Accepted: 09/06/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Julia Garabetyan
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
| | - Jacques Malet
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
| | - Stéphane Kerner
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
| | - Laurent Detzen
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
| | - Maria Clotilde Carra
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
- Inserm Population‐based Epidemiologic Cohorts UnitUMS 011 Villejuif France
| | - Philippe Bouchard
- Department of Periodontology U.F.R. of Odontology Université de Paris Paris France
- Department of Periodontology Service d’odontologie AP‐HPRothschild Hospital Paris France
- Laboratory Orofacial Pathologies, Imaging and Biotherapies EA 2496 Université de Paris Montrouge France
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13
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Chackartchi T, Romanos GE, Sculean A. Soft tissue‐related complications and management around dental implants. Periodontol 2000 2019; 81:124-138. [DOI: 10.1111/prd.12287] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Tali Chackartchi
- Department of Periodontology Faculty of Dental Medicine Hadassah & Hebrew University Jerusalem Israel
| | - Georgios E. Romanos
- Department of Periodontology School of Dental Medicine Stony Brook University Stony Brook New York USA
| | - Anton Sculean
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
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14
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Huynh‐Ba G, Hoders AB, Meister DJ, Prihoda TJ, Mills MP, Mealey BL, Cochran DL. Esthetic, clinical, and radiographic outcomes of two surgical approaches for single implant in the esthetic area: 1‐year results of a randomized controlled trial with parallel design. Clin Oral Implants Res 2019; 30:745-759. [DOI: 10.1111/clr.13458] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 05/18/2018] [Accepted: 07/10/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Guy Huynh‐Ba
- Department of Periodontics University of Texas Health Science Center at San Antonio San Antonio Texas
| | | | | | - Thomas J. Prihoda
- Department of Pathology University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Michael P. Mills
- Department of Periodontics University of Texas Health Science Center at San Antonio San Antonio Texas
| | - Brian L. Mealey
- Department of Periodontics University of Texas Health Science Center at San Antonio San Antonio Texas
| | - David L. Cochran
- Department of Periodontics University of Texas Health Science Center at San Antonio San Antonio Texas
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De Bruyckere T, Eeckhout C, Eghbali A, Younes F, Vandekerckhove P, Cleymaet R, Cosyn J. A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish convexity at the buccal aspect of single implants: A one-year CBCT analysis. J Clin Periodontol 2018; 45:1375-1387. [DOI: 10.1111/jcpe.13006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/20/2018] [Accepted: 08/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas De Bruyckere
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Célien Eeckhout
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Aryan Eghbali
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Faris Younes
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
| | - Paulien Vandekerckhove
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Roberto Cleymaet
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
| | - Jan Cosyn
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
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Cosyn J, Thoma DS, Hämmerle CHF, De Bruyn H. Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients. Periodontol 2000 2018; 73:193-202. [PMID: 28000279 DOI: 10.1111/prd.12163] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In recent years the scientific community has shown a clear interest in the esthetic outcome of implant treatment. The present paper provides an overview of the esthetic ratings that have been used in implant dentistry. A distinction can be made between objective evaluations by clinicians and subjective evaluations by patients. The former mainly include: midfacial and interproximal soft-tissue levels; two-dimensional/three-dimensional soft-tissue alterations; assessment of the color match between the natural dentition, on the one hand, and the peri-implant tissues and the reconstruction, on the other hand; and ordinal indices, such as the pink and white esthetic score. Patient's needs and judgment may differ from objective indicators of implant success and esthetics. As a result, assessing treatment on the basis of patient-reported outcomes measures should be considered important. Validated questionnaires have been used that mainly assess the impact of oral health on the overall well-being of individuals. The esthetic judgment of patients is usually based on nonstandardized questions with varying scoring methods, including visual analog scales, Likert and other category scales and open questions. The heterogeneity in scoring systems between studies may compromise proper comparison of objective and subjective esthetic outcomes between studies and therapeutic concepts.
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Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000 2018; 73:84-102. [PMID: 28000278 DOI: 10.1111/prd.12170] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Implant placement in post-extraction sites of single teeth in the esthetic zone has been a topic of great interest in the field of implant dentistry since 1990. Triggered by the development of guided bone regeneration, the concept of immediate implant placement became quite popular in the 1990s. In the past 12 years, however, the dental community has begun to focus increasingly on the esthetic outcomes of post-extraction implant placement and several studies indicated a significant risk for the development of mucosal recessions with immediate implants. Parallel with this, significant progress has been made in the understanding of tissue biology in terms of hard and soft tissue alterations post extraction, based on preclinical, clinical and radiological studies. This knowledge has helped better to understand the etiology of these esthetic complications with immediate implant placement. The present review first analyzes the various phases of the development of therapeutic strategies over the years for post-extraction implant placement in single tooth sites in the esthetic zone. It presents the current knowledge concerning the terminology with immediate, early and late implant placement, the risk factors for the development of esthetic complications, and the selection criteria for the various treatment options. In the second part, clinical recommendations are given, since a clinician active in this field of implant therapy can use all treatment options depending on the preoperative analysis including a 3D cone beam computed tomography. The selection criteria for all four treatment options are presented and documented with typical case reports to illustrate the current treatment approaches applied in daily practice.
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Arunyanak SP, Pollini A, Ntounis A, Morton D. Clinician assessments and patient perspectives of single-tooth implant restorations in the esthetic zone of the maxilla: A systematic review. J Prosthet Dent 2017; 118:10-17. [PMID: 28385430 DOI: 10.1016/j.prosdent.2016.10.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Esthetic outcomes associated with implant dentistry are important to both clinicians and patients. However, esthetic satisfaction may vary between the 2 groups. In order to evaluate the current publications relating to this topic, the following focused question was developed, "what are the quantitative and qualitative differences between clinician evaluations and patient perspectives in the assessment of single-tooth implant outcomes in the esthetic zone?" PURPOSE The purpose of this systematic review was to identify differences in esthetic satisfaction between clinicians and patients when evaluating single-tooth implant-supported restorations. MATERIAL AND METHODS An electronic search of the Medline database and Cochrane Central Register of Controlled Trials (2000 to 2014) was performed. The search was supplemented by a manual search of specific journals. A quality assessment of full-text articles was performed according to Cochrane Collaboration's tool and Newcastle-Ottawa scale for risk of bias assessment. Information regarding outcomes was collected and compared. RESULTS The search term combinations identified 555 titles. Subsequent to further review, 11 publications, including 2 randomized controlled trials, were selected for inclusion. Because of the heterogeneity of the study designs, study interventions, and esthetic assessment methods, no meta-analysis was performed. The clinicians identified a satisfactory outcome in 51% to 100% for peri-implant soft tissue and 62% to 90% for implant restorations. Patients showed a mean range score of 43% to 93% for peri-implant soft tissue and 81% to 96% for implant restorations. The visual analog scale score of the dentists was always lower than that of the patients. The review identified correlations between subjective and objective assessments for the Pink Esthetic Score (PES), the Papilla Index (PI), the Implant Crown Aesthetic Index (ICAI), and the modified (mod-ICAI) indices. CONCLUSIONS Clinicians are more critical of esthetic outcomes than patients. The PES and the PI correlated with the patients' responses concerning the peri-implant soft tissue. The ICAI and the mod-ICAI showed a correlation of both the peri-implant mucosa and implant-supported crown satisfaction. Thus, a comprehensive and practical index should be developed to assess the esthetic outcomes for single-tooth implant restorations in the esthetic zone.
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Affiliation(s)
- Sirikarn P Arunyanak
- Lecturer, Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; and Former ITI Scholar, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Ky
| | - Adrien Pollini
- Resident, Graduate Prosthodontics, Department of Oral Health and Rehabilitation, School of Dentistry, University of Louisville, Louisville, Ky
| | - Athanasios Ntounis
- Private practice, Fredericksburg, Va; and former Assistant Professor, Department of Oral Health and Rehabilitation, University of Louisville, School of Dentistry, Louisville, Ky
| | - Dean Morton
- Professor and Chair, Department of Prosthodontics, School of Dentistry, Indiana University, Indianapolis, Ind.
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19
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Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol 2000 2016; 73:7-21. [DOI: 10.1111/prd.12185] [Citation(s) in RCA: 253] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Petsos H, Trimpou G, Eickholz P, Lauer HC, Weigl P. The influence of professional competence on the inter- and intra-individual esthetic evaluation of implant-supported crowns in the anterior maxilla. Clin Oral Implants Res 2016; 28:453-460. [PMID: 27009805 DOI: 10.1111/clr.12819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Evaluation of the influence of professional competence on esthetic predictability of implant-supported crowns in the anterior maxilla and identification of objective factors allowing predictable planning for esthetic results. MATERIALS AND METHODS Sixty patients with 82 implants in the esthetic zone were included in this study. Width of keratinized mucosa, biotype, recessions, and papilla index according to Jemt as well as radiological bone loss were assessed. Study casts and photographs were obtained. Each patient as well as people with different level of expertise (laypersons, students and dentists) rated the esthetic satisfaction after final restoration on a scale (1-10). Correlations between esthetic assessments and previously documented clinical parameters were tested. RESULTS The study failed to show a significant relationship between the raters' level of dental expertise and their subjective esthetic evaluation. However, patients rated themselves much more favorable than the three evaluator groups did. A comparison of the clinical parameters with the esthetic evaluation revealed significantly more favorable ratings by the lay group in the presence of a wide attached gingiva (P = 0.021) than by the other groups and by the laypersons (P = 0.002), the dentists (P = 0.003), and students (P = 0.009) in the absence of recessions. The ratio of the implant crown length to the length of the contralateral crown had a negative effect on ratings for all three groups ([laypersons P < 0.001], [students P < 0.001] and [dentists P = 0.001]). The papilla index of the mesial papilla correlated significantly with laypersons' ratings (P = 0.036). CONCLUSION Earlier investigations are confirmed. Width of keratinized mucosa is a risk factor for esthetic predictability of implant-supported crowns in the anterior maxilla in laypersons' ratings. Furthermore, there is an association between the discrepancy of lengths of implant-supported single crowns to their contralateral natural teeth and esthetic satisfaction for all expertise levels.
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Affiliation(s)
- Hari Petsos
- Department of Periodontology, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.,Private Practice, Soest, Germany
| | - Georgia Trimpou
- Department of Prosthodontics, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.,Department of Oral Surgery and Implantology, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Hans-Christoph Lauer
- Department of Prosthodontics, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Paul Weigl
- Department of Prosthodontics, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
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21
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Kolerman R, Nissan J, Rahmanov A, Zenziper E, Slutzkey S, Tal H. Radiological and Biological Assessment of Immediately Restored Anterior Maxillary Implants Combined with GBR and Free Connective Tissue Graft. Clin Implant Dent Relat Res 2016; 18:1142-1152. [PMID: 26996771 DOI: 10.1111/cid.12417] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/22/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiologic and biologic assessment of immediately restored Implants combined with guided bone regeneration (GBR) and free connective tissue graft. METHODS 1-4 year retrospective study involving 34 patients treated with maxillary immediately restored anterior single-implants. Soft tissue dimensions, radiographic bone loss, and biological and prosthetic complications were assessed. RESULTS During the mean follow up period of 29 months the study group presented a mean mesial bone loss of 1.10 ± 0.39 mm (range: 0.5-2.4 mm), and mean distal bone loss of 1.19 ± 0.41 mm (range: 0.4-2.1 mm). Mean periimplant probing depth of 3.49 mm (SD ± 1.06) and 2.35 (SD ± 0.52) for the contralateral tooth (highly significant p < 0.001). Bleeding on probing was present in 29.4% of the examined implant supported crown sites and 10.4% of the contralateral teeth (p < 0.001). CONCLUSIONS Anterior maxillary single-tooth replacement, using GBR and connective tissue graft according to the concept of immediate implant placement, and non-functional restoration is an accepted treatment modality achieving favorable peri-implant soft tissue condition.
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Affiliation(s)
- Roni Kolerman
- Lecturer, Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Joseph Nissan
- Professor, Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arkadi Rahmanov
- Instructor, Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eran Zenziper
- Instructor, Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shimshon Slutzkey
- Instructor, Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Haim Tal
- Professor and head, Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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22
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Cosyn J, Pollaris L, Van der Linden F, De Bruyn H. Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile: one-year results. J Clin Periodontol 2015; 42:398-405. [DOI: 10.1111/jcpe.12384] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Jan Cosyn
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Pharmacy; Dental Medicine; Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - Louis Pollaris
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Filip Van der Linden
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Hugo De Bruyn
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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23
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Huynh-Ba G, Meister DJ, Hoders AB, Mealey BL, Mills MP, Oates TW, Cochran DL, Prihoda TJ, McMahan CA. Esthetic, clinical and patient-centered outcomes of immediately placed implants (Type 1) and early placed implants (Type 2): preliminary 3-month results of an ongoing randomized controlled clinical trial. Clin Oral Implants Res 2015; 27:241-52. [DOI: 10.1111/clr.12577] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Guy Huynh-Ba
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | | | - Ashley B. Hoders
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Brian L. Mealey
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Michael P. Mills
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Thomas W. Oates
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - David L. Cochran
- Department of Periodontics; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Thomas J. Prihoda
- Department of Pathology; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - C. Alex McMahan
- Department of Pathology; University of Texas Health Science Center at San Antonio; San Antonio TX USA
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24
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Clinical use of ridge-splitting combined with ridge expansion osteotomy, sandwich bone augmentation, and simultaneous implantation. Br J Oral Maxillofac Surg 2014; 52:703-8. [DOI: 10.1016/j.bjoms.2014.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 03/30/2014] [Indexed: 11/22/2022]
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25
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Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft. IMPLANT DENT 2014; 23:416-25. [PMID: 25033346 DOI: 10.1097/id.0000000000000122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This randomized controlled clinical pilot trial compared the efficacy of 2 soft tissue grafting methods for correcting esthetic discrepancies associated with definitively restored implant crowns. METHODS Thirteen patients presenting with implants displaying recession, thin biotype, concavity defects, or a combination thereof associated with single crowned dental implants randomly received subepithelial connective tissue grafts (SCTG) in the control group (N = 7) or acellular dermal matrix (ADM) allografts in the test group (N = 6), both under coronally positioned flaps. Data regarding soft tissue, hard tissue, esthetics, and quality of life (QoL) parameters were collected over 6 months. RESULTS Both groups gained tissue thickness (SCTG: 63% and ADM: 105%), reduced concavity measures (SCTG: 82% and ADM: 96%), and improved recessions (SCTG: 40% and ADM: 28%) from baseline to 6 months. Clinicians determined improvement in esthetics for both groups (P = 0.001), unlike patients who did not change their esthetic ratings. No statistical differences were noted for QoL assessment; however, ADM subjects had more eventful wound healing (P = 0.021). CONCLUSIONS Within the limitations of this study, both SCTG and ADM result in increased mucosal thickness, reduction in concavity dimensions, and have a potential for recession reduction on definitively restored dental implants.
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26
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Cosyn J, Cleymaet R, De Bruyn H. Predictors of Alveolar Process Remodeling Following Ridge Preservation in High-Risk Patients. Clin Implant Dent Relat Res 2014; 18:226-33. [PMID: 25041378 DOI: 10.1111/cid.12249] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE (1) To clinically evaluate horizontal remodeling of the alveolar process (hard and soft tissues) following ridge preservation in high-risk patients and (2) to identify predictors of such remodeling. MATERIALS AND METHODS Periodontally healthy nonsmoking patients with a failing tooth in the anterior maxilla (15-25) were selected for a prospective case series. All were in need of a single implant and demonstrated high risk for aesthetic complications given an incomplete buccal bone wall and/or thin-scalloped gingival biotype. Following flapless tooth extraction, ridge preservation was performed using one or more collagen-enriched, bovine-derived block grafts (Geistlich Bio-Oss® Collagen® 100 mg, Geistlich Pharma AG, Wolhusen, Switzerland) without the additional use of membranes or soft tissue grafts. The change in buccopalatal dimension of the alveolar process between baseline (prior to tooth extraction) and 4 months was assessed on the basis of superimposed occlusal slides. Regression analysis was performed to identify predictors of alveolar process remodeling. RESULTS Forty-two patients (21 females, 21 males; mean age 38) met the selection criteria and consented to the treatment. Mean alveolar process remodeling was 14% (SD 7, range 4-30) with minimal remodeling (≤ 10%) in 16 patients (38%) and advanced remodeling (>20%) in 10 patients (24%). A single implant could be installed in all subjects without additional guided bone regeneration. Connective tissue grafting was performed later on in the treatment for aesthetic purposes, hereby compensating for tissue loss at the buccal aspect. Predictors of alveolar process remodeling were tooth location (central incisors and cuspids > laterals incisors and premolars), tooth abscess (p = .025), and buccal bone loss (p = .035). CONCLUSION Alveolar process remodeling seems inevitable yet acceptable following ridge preservation in high-risk patients. Proper case selection may reduce the incidence of advanced remodeling.
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Affiliation(s)
- Jan Cosyn
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Dental Medicine, Department of Periodontology and Oral Implantology, Free University of Brussels (VUB), Brussels, Belgium
| | - Roberto Cleymaet
- Faculty of Medicine and Pharmacy, Dental Medicine, Free University of Brussels (VUB), Brussels, Belgium
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Odontology, Department of Prosthodontics, Malmö University, Malmö, Sweden
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27
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Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 2013; 23 Suppl 6:2-21. [PMID: 23062124 DOI: 10.1111/j.1600-0501.2012.02547.x] [Citation(s) in RCA: 567] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological, technical, and aesthetic complications. The focused question was: What is the survival rate of implants supporting single crowns and implant-supported crowns with a mean follow-up of 5 years and to which extent do biological, technical, and aesthetic complications occur? METHODS A Medline search (2006-2011) was performed for clinical studies focusing on implant-supported SCs with a mean follow-up of at least 5 years. The search was complemented by an additional hand search and the inclusion of 24 studies from a previous systematic review (Jung et al. 2008a). Survival and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5- and 10-year proportions. RESULTS Forty-six studies derived from an initial search count of 1083 titles and the complementary publications from the previous systematic review (Jung et al. 2008a) were selected and the data were extracted. Based on the meta-analysis, survival of implants supporting SCs at 5 years amounted to 97.2% (95% CI: 96.3-97.9%), and at 10 years amounted to 95.2% (95% CI: 91.8-97.2%). The survival of implant-supported SCs was 96.3% (95% CI: 94.2-97.6%) after 5 years and 89.4% (95% CI: 82.8-93.6%) after 10 years. For biological complications, a 5-year cumulative soft tissue complication rate of 7.1% (95% CI: 4.4-11.3%) and a cumulative complication rate for implants with bone loss >2 mm of 5.2% (95% CI: 3.1-8.6%) were calculated. Technical complications reached a cumulative incidence of 8.8% (95% CI: 5.1-15.0%) for screw-loosening, 4.1% (95% CI: 2.2-7.5%) for loss of retention, and 3.5% (95% CI: 2.4-5.2%) for fracture of the veneering material after 5 years. The cumulative 5-year aesthetic complication rate amounted to 7.1% (95% CI: 3.6-13.6%). CONCLUSIONS The outcomes of the meta-analysis demonstrated high implant survival rates for both the single tooth implants and the respective single crowns after 5 and 10 years. However, technical, biological, and aesthetic complications were frequent.
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Affiliation(s)
- Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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Schropp L, Wenzel A, Stavropoulos A. Early, delayed, or late single implant placement: 10-year results from a randomized controlled clinical trial. Clin Oral Implants Res 2013; 25:1359-65. [PMID: 25040354 DOI: 10.1111/clr.12273] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to present the 10-year clinical and radiographic data from a RCT on single-tooth implants placed early, delayed, or late after tooth extraction. MATERIALS AND METHODS Sixty-three patients were randomly allocated to three groups and received an implant on average 10 days (Ea), 3 months (De), or 17 months (La) after tooth extraction. Second-stage surgery was performed after 3 months of submerged healing; metal-ceramic crowns were cemented after one additional month. Standardized periapical radiographs were taken 1 week after implant placement (TP), 1 week (TC) and 1-1.5 year (T1) after crown delivery, and 10 years after implant placement (T10). Pocket depth (PD) and bleeding on probing were registered during controls (TC - T10). RESULTS Two Ea and one De implants failed to osseointegrate. Seven patients (4 Ea, 1 De, and 2 La) were not available at T10 . No significant differences were found among groups regarding implant survival or radiographic peri-implant marginal bone levels (Ea: 1.15 ± 0.77; De: 1.53 ± 1.06; La: 1.42 ± 1.07) at T10 . Similarly, no differences were observed among groups in the number of implants with PD ≥ 5 mm (Ea: 29%; De: 35%; La: 44%) or the average depth of the sites with PD ≥ 5 mm (Ea: 5.4 ± 0.7; De: 6.1 ± 1.4; La: 5.4 ± 0.5) at T10 . Peri-implant mucositis was found in 70% of the cases; peri-implantitis was diagnosed only in two implants (1 De, 1 La) corresponding to 4.3%. CONCLUSION Single-tooth implants placed early or delayed after tooth extraction show high survival rates and limited peri-implant marginal bone resorption or biological complications, similar to what is observed with implants placed according to the conventional (late) protocol.
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Affiliation(s)
- Lars Schropp
- Prosthetic Dentistry, Department of Dentistry, Aarhus University, Aarhus, Denmark; Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark
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29
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Buser D, Chappuis V, Bornstein MM, Wittneben JG, Frei M, Belser UC. Long-term stability of contour augmentation with early implant placement following single tooth extraction in the esthetic zone: a prospective, cross-sectional study in 41 patients with a 5- to 9-year follow-up. J Periodontol 2013; 84:1517-27. [PMID: 23347346 DOI: 10.1902/jop.2013.120635] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Early implant placement with simultaneous contour augmentation is documented with short- and medium-term studies. The long-term stability of contour augmentation is uncertain. METHODS In this prospective, cross-sectional study, 41 patients with an implant-borne single crown were examined twice, in 2006 and 2010. Clinical, radiologic, and esthetic parameters were assessed at both examinations. In addition, a cone beam computed tomographic (CBCT) image was obtained during the second examination to assess the dimensions of the facial bone wall. RESULTS All 41 implants demonstrated ankylotic stability without signs of peri-implant infection at both examinations. The clinical parameters remained stable over time. Satisfactory esthetic outcomes were noted, as assessed by the pink and white esthetic score (PES/WES) indices. Overall, the PES scores were slightly higher than the WES scores. None of the implants developed mucosal recession over time, as confirmed by values of the distance between implant shoulder and mucosal margin and cast measurements. The periapical radiographs yielded stable peri-implant bone levels, with a mean distance between implant shoulder and first visible bone-implant contact value of 2.18 mm. The CBCT analysis demonstrated a mean thickness of the facial bone wall ≈2.2 mm. In two implants (4.9%) no facial bone wall was detectable radiographically. CONCLUSIONS This prospective cross-sectional study demonstrates stable peri-implant hard and soft tissues for all 41 implants examined and satisfactory esthetic outcomes overall. The follow-up of 5 to 9 years confirmed again that the risk for mucosal recession is low with early implant placement. In addition, contour augmentation with guided bone regeneration was able to establish and maintain a facial bone wall in 95% of patients.
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Affiliation(s)
- Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Covani U, Chiappe G, Bosco M, Orlando B, Quaranta A, Barone A. A 10-Year Evaluation of Implants Placed in Fresh Extraction Sockets: A Prospective Cohort Study. J Periodontol 2012; 83:1226-34. [DOI: 10.1902/jop.2012.110583] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Suphanantachat S, Thovanich K, Nisapakultorn K. The influence of peri-implant mucosal level on the satisfaction with anterior maxillary implants. Clin Oral Implants Res 2012; 23:1075-81. [DOI: 10.1111/j.1600-0501.2011.02268.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Supreda Suphanantachat
- Department of Periodontology; Faculty of Dentistry; Chulalongkorn University; Bangkok; Thailand
| | - Ketsuda Thovanich
- Private practice, previously Implantology Unit; Faculty of Dentistry; Chulalongkorn University; Bangkok; Thailand
| | - Kanokwan Nisapakultorn
- Department of Periodontology; Faculty of Dentistry; Chulalongkorn University; Bangkok; Thailand
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Cosyn J, Sabzevar MM, De Bruyn H. Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla: a multivariate analysis. J Clin Periodontol 2012; 39:895-903. [DOI: 10.1111/j.1600-051x.2012.01921.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | - Mehran M. Sabzevar
- Dental Medicine; Free University of Brussels (VUB); Faculty of Medicine and Pharmacy; Brussels; Belgium
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Sanz I, Garcia-Gargallo M, Herrera D, Martin C, Figuero E, Sanz M. Surgical protocols for early implant placement in post-extraction sockets: a systematic review. Clin Oral Implants Res 2012; 23 Suppl 5:67-79. [PMID: 22211306 DOI: 10.1111/j.1600-0501.2011.02339.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the best timing for placing implants after tooth extraction, by comparing early vs. delayed implant placement and evaluating the hard and/or soft tissue ridge dimensional changes and the outcomes related with implant survival and prosthesis success. MATERIAL AND METHODS An online search of the main databases including The National Library of Medicine (MEDLINE via Pubmed), Embase and The Cochrane Central Register of Controlled Trials was conducted up to February 2011. Randomized controlled clinical trials (RCTs), prospective cohort studies and case-control retrospective studies, with a follow-up of at least 1 month after loading of dental implants, comparing: (i) early vs. delayed implant placement, (ii) augmentation vs. no augmentation at implant placement in early placed implants and/or (iii) the comparison of various augmentation procedures at early implant placement, were conducted. A hand search of relevant journals was also performed. Screening of eligible studies, assessment of their methodological quality and data extraction were conducted in duplicate by two independent reviewers. Authors of studies were contacted for clarification or missing information. RESULTS Eight studies were included, although meta-analysis could only be performed with the data from two studies comparing early vs. delayed implant. The percentage of bone height and bone width reduction favoured the early placement, with pooled mean difference between groups of 13.11% (95% CI: from 3.83 to 22.4; P = 0.057) and 19.85% (95% CI: from 13.85 to 25.81) respectively. Implant survival demonstrated a non-significant higher implant survival rate for the early group (RR = 1.02, 95% CI: 0.96-1.1).With regard to patient satisfaction, statistically significant differences between the groups in favour of the early group for overall satisfaction and appearance with the restoration were demonstrated at 2 years, although these differences were lost at 5 years. CONCLUSIONS Placement of dental implants at an early timing after tooth extraction may offer advantages in terms of soft and hard tissue preservation, when compared with a delayed protocol. Nevertheless, well-designed, high quality, randomized clinical trials, are needed, because the available evidence is today limited in terms of available studies and quality.
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Affiliation(s)
- Ignacio Sanz
- ETEP Research Group, University Complutense, Madrid, Spain
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Cosyn J, Eghbali A, Hanselaer L, De Rouck T, Wyn I, Sabzevar MM, Cleymaet R, De Bruyn H. Four modalities of single implant treatment in the anterior maxilla: a clinical, radiographic, and aesthetic evaluation. Clin Implant Dent Relat Res 2012; 15:517-30. [PMID: 22236111 DOI: 10.1111/j.1708-8208.2011.00417.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE To document the outcome of single implants in the anterior maxilla following four routine treatment modalities when performed by experienced clinicians in daily practice using the same implant system and biomaterials. MATERIAL AND METHODS A retrospective study in patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 was conducted. The four treatment modalities practically covered every clinical situation and included standard implant treatment (SIT), immediate implant treatment (IIT), implant treatment in conjunction with guided bone regeneration (GBR), and implant treatment in grafted bone (BGR) harvested from the chin. All implants were installed via flap surgery. Patients were clinically and radiographically examined. Complications were registered and the aesthetic outcome (pink esthetic score [PES] and white esthetic score [WES]) was rated. A blinded clinician who had not been involved in the treatment performed all evaluations. Patient's aesthetic satisfaction was also registered. RESULTS One hundred four out of 115 eligible patients (44 SIT, 28 IIT, 18 GBR, and 14 BGR) received at least one single NobelReplace tapered TiUnite® (Nobel Biocare, Göteborg, Sweden) implant in the anterior maxilla and were available for evaluation. Clinical parameters (implant survival: 93%, mean plaque level: 24%, mean bleeding on probing: 33%, and mean probing depth: 3.2 mm) and mean bone level (1.19 mm) did not differ significantly between treatment modalities. Postoperative complications were more common following GBR/BGR (>61%) when compared with SIT/IIT (<18%) (p < .001). BGR was in 4/14 patients associated with permanent sensory complications at the donor site. Technical complications occurred in 9/104 patients. SIT and IIT showed similar soft tissue aesthetics (PES: 10.07 and 10.88, respectively), however major alveolar process deficiency was common (>15%). PES was 9.65 for GBR. BGR showed inferior soft tissue aesthetics (PES: 9.00; p = .045) and shorter distal papillae were found following GBR/BGR (p = .009). Periodontal disease (odds ratio [OR]: 13.0, p < .001), GBR/BGR (OR: 4.3, p = .004), and a thin-scalloped gingival biotype (OR: 3.7, p = .011) increased the risk for incomplete distal papillae. WES was 7.98 for all patients considered. Poor agreement was found between objective and subjective aesthetic ratings. CONCLUSIONS All treatment modalities were predictable from a clinical and radiographic point of view. However, advanced reconstructive surgery, especially BGR, increased the risk for complications and compromised aesthetics. Research is required on the prevention and minimally invasive treatment of buccal bone defects at the time of tooth loss to avoid complex therapy.
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Affiliation(s)
- Jan Cosyn
- University of Ghent, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent, Belgium.
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Covani U, Ricci M, D'Ambrosio N, Quaranta A, Barone A. Changes in soft tissues around immediate full-arch rehabilitations: a prospective study. Clin Oral Implants Res 2012; 24 Suppl A100:122-6. [DOI: 10.1111/j.1600-0501.2011.02394.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/23/2011] [Accepted: 11/20/2011] [Indexed: 11/28/2022]
Affiliation(s)
- U. Covani
- Department of Surgery; University of Pisa; Pisa, Italy
| | - M. Ricci
- University of Genova; Genova, Italy
| | | | - A. Quaranta
- Department of Dentistry; University of Rome “La Sapienza”; Rome, Italy
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Raes F, Cosyn J, Crommelinck E, Coessens P, De Bruyn H. Immediate and conventional single implant treatment in the anterior maxilla: 1-year results of a case series on hard and soft tissue response and aesthetics. J Clin Periodontol 2011; 38:385-94. [DOI: 10.1111/j.1600-051x.2010.01687.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Buser D, Wittneben J, Bornstein MM, Grütter L, Chappuis V, Belser UC. Stability of contour augmentation and esthetic outcomes of implant-supported single crowns in the esthetic zone: 3-year results of a prospective study with early implant placement postextraction. J Periodontol 2010; 82:342-9. [PMID: 20831371 DOI: 10.1902/jop.2010.100408] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Early implant placement is one of the treatment options after tooth extraction. Implant surgery is performed after a healing period of 4 to 8 weeks and combined with a simultaneous contour augmentation using the guided bone regeneration technique to rebuild stable esthetic facial hard- and soft-tissue contours. METHODS In this prospective study, 20 patients were treated with an implant-born single crown and followed for 3 years. Clinical, radiologic, and esthetic parameters were recorded to assess treatment outcomes. RESULTS At the 3-year examination, all 20 implants were successfully integrated, demonstrating ankylotic stability and healthy peri-implant soft tissues as documented by standard clinical parameters. Esthetic outcomes were assessed by the pink esthetic score (PES) and white esthetic score (WES) and confirmed pleasing results overall. WES values were slightly superior to PES values. Periapical radiographs showed minimal crestal bone loss around used bone-level implants with a mean bone loss of 0.18 mm at 3 years. Only two implants revealed bone loss between 0.5 and 1.0 mm. One of these implants had minor mucosal recession <1.0 mm. CONCLUSIONS This prospective study evaluates the concept of early implant placement and demonstrated successful tissue integration for all 20 implants and stable bone-crest levels around implant-abutment interfaces according to the platform-switching concept. The midterm 3-year follow-up revealed pleasing esthetic outcomes and stable facial soft tissues. The risk of mucosal recession was low, with only one patient showing minor recession of the facial mucosa. These encouraging results need to be confirmed with a 5-year follow-up examination.
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Affiliation(s)
- Daniel Buser
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Cosyn J, Eghbali A, De Bruyn H, Dierens M, De Rouck T. Single implant treatment in healing versus healed sites of the anterior maxilla: an aesthetic evaluation. Clin Implant Dent Relat Res 2010; 14:517-26. [PMID: 20662859 DOI: 10.1111/j.1708-8208.2010.00300.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim was to compare and document in detail the aesthetic outcome of single implant treatment in healing sites (early implant placement) with fully healed sites (conventional implant placement) of the anterior maxilla. MATERIALS AND METHODS A cross-sectional study in patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 was conducted. Surgical treatment involved standard flap elevation without releasing incisions and restorative procedures included cemented crowns in all patients. Only straightforward single implant treatments using Nobelreplace tapered TiUnite® implants (Nobel Biocare, Göteborg, Sweden) in healing sites (6-8 weeks following tooth extraction) and fully healed sites (≥6 months following tooth extraction) were considered with both neighboring teeth present and without the need for hard and/or soft tissue grafting. The aesthetic outcome was objectively rated using the pink esthetic score (PES) and white esthetic scrore (WES) by a blinded clinician who had not been involved in the treatment. Patients rated aesthetics by means of visual analogue scales. RESULTS Twenty-one out of 22 early and 25/27 conventional implant treatments were available for aesthetic evaluation after on average two and a half years of function (range 17-41 months). There were no significant differences for any of the criteria between the treatment concepts. Overall, papillae were most easy to satisfy, whereas alveolar process and tooth color most difficult. A thin-scalloped biotype was associated with low distal papillae (p=.041) and alveolar process deficiency (p=.039). Twenty-six percent of the cases were aesthetic failures (PES<8 and/or WES<6) and 13% showed an (almost) perfect outcome (PES≥12 and WES≥9). The remainder (61%) demonstrated acceptable aesthetics. There was no significant correlation between objective and subjective ratings. CONCLUSIONS Early and conventional single implant treatment yielded comparable aesthetic outcome. Albeit all treatments had been performed by experienced clinicians and only straightforward cases had been selected, 1 out of 4 cases were aesthetic failures and only a strict minority showed perfection. Research is required on the aesthetic outcome of alternative surgical procedures especially in high-risk patients with a thin-scalloped biotype.
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Affiliation(s)
- Jan Cosyn
- Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
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Eghbali A, De Bruyn H, De Rouck T, Cleymaet R, Wyn I, Cosyn J. Single Implant Treatment in Healing versus Healed Sites of the Anterior Maxilla: A Clinical and Radiographic Evaluation. Clin Implant Dent Relat Res 2010; 14:336-46. [DOI: 10.1111/j.1708-8208.2010.00283.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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