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Wang S, Chen X, Ling Z, Xie Y, Chen C, Shen X, He F. Clinical and radiographic outcomes of implant-supported fixed prostheses with cantilever extension in anterior mandible: A retrospective study. Clin Oral Implants Res 2024. [PMID: 38860608 DOI: 10.1111/clr.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The objective of this study is to analyze the clinical and radiographic outcomes of implant-supported fixed protheses with cantilever extensions (ISFPCs) in the partially edentulous anterior mandible. MATERIALS AND METHODS Patients who received anterior mandible implant restoration between January 2016 and December 2021 were included. Patients with two, three, or four continuous missing teeth receiving adjacent implant supported single-unit crowns (ISSCs), ISFPCs, implant-supported fixed protheses without cantilever extensions (ISFPNs) were divided into groups: ISSC+ISSC, ISFPC, ISSC+ISFPC, three-unit ISFPN, ISFPC+ISFPC, or four-unit ISFPN, respectively. We recorded and evaluated survival rates, mechanical and biological complications, peri-implant marginal bone loss (MBL), esthetic outcomes, and patient perceptions. Statistical analysis was performed using linear mixed models (LMM). RESULTS The study included 87 patients and 152 implants. No implant loss occurred during an average follow-up of 3.48 ± 1.85 years (range: 1-7 years). According to LMM models, prosthetic type had a statistically significant impact on MBL during follow-up periods, in favor of the ISFPC and ISFPC+ISFPC groups (0.16 ± 0.48 mm vs. 0.51 ± 0.49 mm, p = .034; 0.22 ± 0.49 mm vs. 0.60 ± 0.62 mm, p = .043, respectively). Mechanical and biological complications were relatively low and comparable. The four-unit ISFPC group had higher subjective esthetic scores compared with the ISSC+ISSC group (98.6 vs. 83.8, p < .05), and patients in the ISFPC+ISFPC group expressed greater satisfaction with cleanability than the ISFPN group (98.8 vs. 80.6). CONCLUSION ISFPCs offer a highly predictable treatment option in the anterior mandible, characterized by high survival rates, and comparable complication rates, peri-implant bone stability and esthetics to adjacent ISSCs or ISFPNs.
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Affiliation(s)
- Siyuan Wang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoyu Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhaoting Ling
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yiwen Xie
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Cong Chen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaoting Shen
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Clinical Research Center for Oral Disease of Zhejiang Province, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Cancer Center of Zhejiang University, Hangzhou, China
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Afrashtehfar KI, Stawarczyk B, Micovic Soldatovic D, Schmidlin PR. A proof of concept on implant-supported bilateral cantilever bridges: The T-Bridge approach. SWISS DENTAL JOURNAL 2024; 134:1-17. [PMID: 38757922 DOI: 10.61872/sdj-2024-03-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Indexed: 05/18/2024]
Abstract
The concept of bilateral cantilevers on a single central implant (T-design) for three-unit implant-supported fixed dental prostheses (ISFDPs) has not been explored nor tested. This technical hypothesis aimed to explore the feasibility of such an approach as a cost-effective alternative to conventional treatments. Careful considerations regarding implant diameter, length, ideal position, occlusal scheme, and bone remodeling are essential to ensure adequate support, stability, and prevention of complications. In this proof of concept, we present a preliminary case with this novel design to replace missing posterior teeth in a patient with narrow bone conditions. In addition, a series of planned investigations and preliminary results, including preclinical studies, are presented to illustrate our concept and its potential clinical implications. Clinically, after two-year follow-up, healthy and stable peri-implant tissues around the ISFDP exemplarily demonstrated excellent stability, functionality, and comfort, which is supported by acceptable fracture resistance data in vitro, suggesting indeed the practical potential and suitability. Thus, we claim that such a treatment modality has the at least theoretical potential to revolutionize implant dentistry by providing innovative and cost-effective treatment options for patients with partial ISFDPs in very specific cases. Of course, further research and evaluations are necessary to validate the clinical implications of this innovative hypothesis. Implementing the 3-on-1 T-bridge approach in partial ISFDPs could offer a promising alternative to traditional methods. If proven successful, this technique may lead to significant advancements in clinical practice, providing a less invasive cost-effective treatment option.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Evidence Based Practice Unit, College of Dentistry, Ajman University, Ajman City, UAE.
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Berne, Switzerland
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Private Practice Limited to Implant Dentistry, Richmond, Canada
- Private Practice Limited to Prosthodontics, Abu Dhabi, UAE
| | - Bogna Stawarczyk
- Department of Prosthodontics, Ludwig-Maximilians-University, Munich, Germany.
| | | | - Patrick R Schmidlin
- Division of Periodontal and Periimplantitis Sciences, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Bömicke W, Boisserée P, Rammelsberg P, Rues S. Initial damage and failure load of zirconia-ceramic and metal-ceramic posterior cantilever fixed partial dentures. Clin Oral Investig 2024; 28:94. [PMID: 38221600 PMCID: PMC10788321 DOI: 10.1007/s00784-024-05501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES The aim of this study was to compare failure load and initial damage in monolithic, partially veneered, and completely veneered (translucent) zirconia cantilevered fixed partial dentures (CFPDs), as well as completely veneered metal-ceramic CFPDs under different support and loading configurations. MATERIALS AND METHODS Eight test groups with anatomically congruent CFPDs (n = 8/group) were fabricated, differing in CFPD material/support structure/loading direction (load applied via steel ball (Ø 6 mm) 3 mm from the distal end of the pontic for axial loading with a 2-point contact on the inner cusp ridges of the buccal and oral cusps and 1.3 mm below the oral cusp tip for 30° oblique loading): (1) monolithic zirconia/CoCr abutment teeth/axial, (2) monolithic zirconia/CoCr abutment teeth/oblique, (3) partially veneered zirconia/CoCr abutment teeth/axial, (4) partially veneered zirconia/CoCr abutment teeth/oblique, (5) completely veneered zirconia/CoCr abutment teeth/axial, (6) completely veneered CoCr/CoCr abutment teeth/axial (control group), (7) partially veneered zirconia/implants/axial, and (8) partially veneered zirconia/natural teeth/axial. Restorations were artificially aged before failure testing. Statistical analysis was conducted using one-way ANOVA and Tukey post hoc tests. RESULTS Mean failure loads ranged from 392 N (group 8) to 1181 N (group 1). Axially loaded monolithic zirconia CFPDs (group 1) and controls (group 6) showed significantly higher failure loads. Oblique loading significantly reduced failure loads for monolithic zirconia CFPDs (group 2). Initial damage was observed in all groups except monolithic zirconia groups, and fractography revealed design flaws (sharp edges at the occlusal boundary of the veneering window) in partially veneered zirconia CFPDs. CONCLUSIONS Monolithic zirconia CFPDs might be a viable alternative to completely veneered CoCr CFPDs in terms of fracture load. However, oblique loading of monolithic zirconia CFPDs should be avoided in clinical scenarios. Design improvements are required for partially veneered zirconia CFPDs to enhance their load-bearing capacity. CLINICAL RELEVANCE Monolithic zirconia may represent a viable all-ceramic alternative to the established metal-ceramic option for CFPD fabrication. However, in daily clinical practice, careful occlusal adjustment and regular monitoring should ensure that oblique loading of the cantilever is avoided.
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Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Hayashi R, Takao S, Komasa S, Sekino T, Kusumoto T, Maekawa K. Effects of Argon Gas Plasma Treatment on Biocompatibility of Nanostructured Titanium. Int J Mol Sci 2023; 25:149. [PMID: 38203320 PMCID: PMC10779263 DOI: 10.3390/ijms25010149] [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: 11/28/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
In this study, we applied argon plasma treatment to titanium surfaces with nanostructures deposited by concentrated alkali treatment and investigated the effects on the surface of the material and the tissue surrounding an implant site. The results showed that the treatment with argon plasma removed carbon contaminants and increased the surface energy of the material while the nanoscale network structure deposited on the titanium surface remained in place. Reactive oxygen species reduced the oxidative stress of bone marrow cells on the treated titanium surface, creating a favorable environment for cell proliferation. Good results were observed in vitro evaluations using rat bone marrow cells. The group treated with argon plasma exhibited the highest apatite formation in experiments using simulated body fluids. The results of in vivo evaluation using rat femurs revealed that the treatment improved the amount of new bone formation around an implant. Thus, the results demonstrate that argon plasma treatment enhances the ability of nanostructured titanium surfaces to induce hard tissue differentiation and supports new bone formation around an implant site.
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Affiliation(s)
- Rina Hayashi
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata 573-1121, Osaka, Japan; (R.H.); (S.T.); (K.M.)
| | - Seiji Takao
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata 573-1121, Osaka, Japan; (R.H.); (S.T.); (K.M.)
| | - Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata 573-1121, Osaka, Japan; (R.H.); (S.T.); (K.M.)
| | - Tohru Sekino
- Department of Advanced Hard Materials, SANKEN (The Institute of Scientific and Industrial Research), Osaka University, 8-1 Mihogaoka, Ibaraki 567-0047, Osaka, Japan;
| | - Tetsuji Kusumoto
- Department of Oral Health Engineering, Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata 573-1121, Osaka, Japan;
| | - Kenji Maekawa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata 573-1121, Osaka, Japan; (R.H.); (S.T.); (K.M.)
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Abi Rached S, Chakar C, Samarani R, Menassa G, Sembronio S, Pucci R, Calabrese L, Cantore S, Malcangi A, Spirito F, DI Cosola M. Radiographic marginal bone level evaluation around two different tissue-level implant systems: a one-year prospective study. Minerva Dent Oral Sci 2023; 72:298-311. [PMID: 37326504 DOI: 10.23736/s2724-6329.23.04786-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Marginal bone loss, is a frequently reported variable in the evaluation of dental implants. The primary objective of this study was to evaluate radiographic marginal bone level changes around the two different tissue-level implant systems placed adjacently in the posterior maxilla or mandible. The influence of implant macro-geometry and vertical soft tissue thickness on marginal bone loss were also evaluated. METHODS Seven patients were included in the study and a total of 18 implants were analyzed. Each patient received two different implants placed adjacently in the maxilla or the mandible. The implants used in our study were either Straumann® SP cylindrical implants or JD Octa® tapered implants. During the surgery, vertical soft-tissue thickness was measured with a periodontal probe placed on the top of the bony crest and in the center of the future implant site. Healing abutments were then seated. Three months following implant placement, impressions were taken, and screw-retained metal ceramic prostheses were delivered. Standardized intraoral radiographs were taken immediately after implant placement and one year following implant loading in order to assess marginal bone level changes. RESULTS Results showed a mean marginal bone loss of 0.55±0.5 mm for Straumann® SP implants and 0.39±0.49 mm for JD Octa® implants after one year of loading and the difference was not statistically significant between the two systems. A statistically significant correlation was found between soft tissue thickness and marginal bone loss; in sites with thin mucosal tissues (≤2 mm), there was significantly greater bone loss compared to sites with thick, soft tissues (> 2 mm) in both implants. CONCLUSIONS Radiographic marginal bone loss was not statistically different between the two implant systems at the one-year examination period. Moreover, vertical soft tissue thickness influenced marginal bone loss regardless of the implant system used.
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Affiliation(s)
- Sandrine Abi Rached
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Carole Chakar
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Rawad Samarani
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Gabriel Menassa
- Department of Periodontology, Faculty of Dental Medicine, Cranio-Facial Research Laboratory, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Salvatore Sembronio
- Department of Maxillofacial Surgery, Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Resi Pucci
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Leonardo Calabrese
- Department of Oral Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Stefania Cantore
- Regional Dental Community Service "Sorriso & Benessere - Ricerca e Clinica", Bari, Italy -
| | | | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele DI Cosola
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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García-Sala Bonmatí F, Bustamante-Hernández N, Alonso Pérez-Barquero J, Maneiro-Lojo J, Fons-Badal C, Labaig-Caturla C, Fernández-Estevan L, Agustín-Panadero R. Implant-Supported Fixed Partial Dentures with Posterior Cantilevers: In Vitro Study of Mechanical Behavior. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6805. [PMID: 37895786 PMCID: PMC10608170 DOI: 10.3390/ma16206805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
Rehabilitation with dental implants is not always possible due to the lack of bone quality or quantity, in many cases due to bone atrophy or the morbidity of regenerative treatments. We find ourselves in situations of performing dental prostheses with cantilevers in order to rehabilitate our patients, thus simplifying the treatment. The aim of this study was to analyze the mechanical behavior of four types of fixed partial dentures with posterior cantilevers on two dental implants (convergent collar and transmucosal internal connection) through an in vitro study (compressive loading and cyclic loading). This study comprised four groups (n = 76): in Group 1, the prosthesis was screwed directly to the implant platform (DS; n = 19); in Group 2, the prosthesis was screwed to the telescopic interface on the implant head (INS; n = 19); in Group 3, the prosthesis was cemented to the telescopic abutment (INC; n = 19); and in Group 4, the prosthesis was cemented to the abutment (DC; n = 19). The sets were subjected to a cyclic loading test (80 N load for 240,000 cycles) and compressive loading test (100 KN load at a displacement rate of 0.5 mm/min), applying the load until failure occurred to any of the components at the abutment-prosthesis-implant interface. Subsequently, an optical microscopy analysis was performed to obtain more data on what had occurred in each group. Results: Group 1 (direct screw-retained prosthesis, DS) obtained the highest mean strength value of 663.5 ± 196.0 N. The other three groups were very homogeneous: 428.4 ± 63.1 N for Group 2 (INS), 486.7 ± 67.8 N for Group 3 (INC), and 458.9 ± 38.9 N for Group 4 (DC). The mean strength was significantly dependent on the type of connection (p < 0.001), and this difference was similar for all of the test conditions (cyclic and compressive loading) (p = 0.689). Implant-borne prostheses with convergent collars and transmucosal internal connections with posterior cantilevers screwed directly to the implant connection are a good solution in cases where implant placement cannot avoid extensions.
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Affiliation(s)
- Fernando García-Sala Bonmatí
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Naia Bustamante-Hernández
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Basque Country, 48940 Leioa, Spain;
| | - Jorge Alonso Pérez-Barquero
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Jesús Maneiro-Lojo
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Carla Fons-Badal
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Carla Labaig-Caturla
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Lucía Fernández-Estevan
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
| | - Rubén Agustín-Panadero
- Department of Dental Medicine, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain (J.M.-L.); (C.F.-B.); (R.A.-P.)
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Avila-Ortiz G, Vegh D, Mukaddam K, Galindo-Moreno P, Pjetursson B, Payer M. Treatment alternatives for the rehabilitation of the posterior edentulous maxilla. Periodontol 2000 2023; 93:183-204. [PMID: 37486029 DOI: 10.1111/prd.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023]
Abstract
Rehabilitation of the edentulous maxilla with implant-supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability and surgical access, among other factors. This review addresses several treatment options to replace missing teeth in posterior maxillary segments, namely the placement of standard implants in conjunction with maxillary sinus floor augmentation, short implants, tilted implants, and distal cantilever extensions. Pertinent technical information and a concise summary of relevant evidence on the reported outcomes of these different therapeutic approaches are presented, along with a set of clinical guidelines to facilitate decision-making processes and optimize the outcomes of therapy.
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Affiliation(s)
- Gustavo Avila-Ortiz
- Private Practice, Gonzalez + Solano Atelier Dental, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Dániel Vegh
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Khaled Mukaddam
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
- University Center of Dental Medicine, Department of Oral Surgery, University of Basel, Basel, Switzerland
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, University of Iceland, Reykjavik, Iceland
| | - Michael Payer
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Medicine & Oral Health, Medical University Graz, Graz, Austria
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Baaj R, Khalili M, Luke A, Weiner S. Strains in the implant collars supporting a cantilevered cross-arch bar prosthesis. An in vitro study. J Prosthodont 2023; 32:735-742. [PMID: 36648444 DOI: 10.1111/jopr.13649] [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: 09/27/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To examine the strains in the collar area of implants supporting a cantilevered cross-arch bar prosthesis during vertical load application. MATERIALS AND METHODS A milled cross-arch metal framework supported by four implants in a trapezoidal design was supported in polymethylmethacrylate. T-strain gage rosettes were attached to the crestal areas of the implants with two grids, one recording circumference strain of the crestal area of the implant and the second recording vertical strain, torquing strains of the implant. The framework was subject to vertical loading from an MTS 810 mechanical system. Loading sites were directly on anterior and posterior implants, and on a cantilever at 7.5, 15, 22.5, and 30 mm (0.5, 1.0, 1.5, and 2.0 of the anterior-posterior spread) distal from the posterior implant on the right side. The anterior-posterior (A-P) spread from anterior to posterior implants was 15 mm. Sites were loaded individually with 50 and 100 N. The data from the rosettes were transferred to a desktop computer and processed using StrainSmart 5000 software. RESULTS Means and standard deviations were calculated for the 10 trials at each of the loading sites. Two-way ANOVAs were done separately for each dependent variable, the vertical grid, and the circumferential grid. The independent variables were the load magnitude and the load site. Tukey's test was used to compare groups post hoc. When directly loading the implants, loading the anterior implant resulted initially in compression followed by increasing tensile strain with 100 N loads. Loading the implant adjacent to cantilever (the posterior implant) resulted in greater strain at the collar than that observed with anterior implant with minimal bending strains. When loading the cantilever, anterior implant showed increasing bending strain at greater cantilever length, whereas the circumferential strains were greater for the supporting implant adjacent to the cantilever, particularly at 100 N loads, p ≤ 0.001. CONCLUSIONS Limiting cantilever lengths to A-P spread ratios of 0.5 are preferred. Ratios greater than 1.0 should be avoided as flexing of the collar may occur. The dimensions of the implant, particularly wall thickness, adjacent to the cantilever should be carefully considered when planning the cantilevered implant-supported prosthesis.
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Affiliation(s)
- Rakan Baaj
- Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Maryam Khalili
- Department of Restorative Dentistry, Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA
| | - Allyn Luke
- Department of Restorative Dentistry, Rutgers University School of Dental Medicine, Newark, New Jersey, USA
| | - Saul Weiner
- Department of Restorative Dentistry, Rutgers University School of Dental Medicine, Newark, New Jersey, USA
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey, USA
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Oh SL, Choi SK. Management of a prosthetic complication on an implant restoration placed when the patient was 10 years old: A case report. J Prosthodont 2023; 32:5-9. [PMID: 36272533 DOI: 10.1111/jopr.13614] [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: 09/01/2022] [Accepted: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
The use of dental implants in pediatric patients may create unique complications. A 38-year-old patient presented with a mobile, cement-retained implant crown due to an abutment screw loosening. The maxillary right central incisor implant was placed when the patient was 10 years old. Pus discharge from the peri-implant sulcus was observed. The mucosal margin of the implant was at the level of the mucogingival junction of neighboring teeth. Radiographically, the platform of the implant appeared to be at the level of the apical third of the adjacent roots. After removing the existing implant-retained crown, the inflamed peri-implant tissue covering the implant platform was removed and the stability of the implant was confirmed. A new screw-retained implant crown was made using an angulated screw channel to correct the labiopalatal angulation of the implant and allow for retrievability. Pink porcelain was used to match the mucosal margin of the implant crown to that of the maxillary left central incisor. This case report highlights the risk of implant placement in pediatric patients and agrees with previous reports that implants should be delayed until growth is complete.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Seung Kee Choi
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland
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Seelig da Cunha K, De Lima Coltro MP, Drummond LG, Ozkomur A, Villarinho EA, Teixeira ER, Vigo Á, Shinkai RSA. Biomechanical variables affect peri-implant bone loss in implant-supported fixed complete dentures: a methodological and prospective study. J Prosthodont Res 2022; 67:173-179. [PMID: 35613872 DOI: 10.2186/jpr.jpr_d_21_00254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Implant-supported fixed complete dentures (IFCD) experience failures and complications related to biological and technical risk factors. This study investigated the effect of biomechanical variables of IFCD on 1-year peri-implant bone loss at the buccal, palatal/lingual, mesial, and distal implant sides. A new method was used to measure the geometric biomechanical variables of IFCD using cone beam computed tomography (CBCT). METHODS The study sample consisted of 246 external hexagon implants supporting 48 hybrid IFCD in 44 patients. CBCT images obtained immediately (T0) and 1 year (T1) after prosthesis installation were used to measure the support polygon area, clinical crown/implant (C/I) ratio (vertical lever), anteroposterior power and resistance arms, anterior and posterior cantilevers (horizontal levers), and peri-implant bone remodeling (T1-T0). Data were analyzed using multilevel multivariable models. RESULTS The average total bone loss in the mandible and maxilla were 0.88 mm, with a loss of 0.62 mm in the mandible and 1.08 mm in the maxilla. The C/I ratio had a significant effect on bone loss on the mesial, distal, and palatal/lingual sides (P <.05). The anterior cantilever had a protective effect on the lingual side of the anterior implant. No effect on bone loss was found for the support polygon area, posterior cantilever, resistance arm, or power arm (P >.05). CONCLUSIONS The results suggest that the C/I ratio and anterior cantilever in IFCD affect peri-implant bone loss according to the implant side and position in the arch.
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Affiliation(s)
- Kael Seelig da Cunha
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | - Maria Paula De Lima Coltro
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Ahmet Ozkomur
- Lutheran University of Brazil, Post-graduate Program in Dentistry, Canoas, Brazil
| | - Eduardo Aydos Villarinho
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil
| | | | - Álvaro Vigo
- Federal University of Rio Grande do Sul, Post-graduate Program in Epidemiology, Porto Alegre, Brazil
| | - Rosemary S A Shinkai
- Pontifical Catholic University of Rio Grande do Sul, Post-graduate Program in Dentistry, Porto Alegre, Brazil.,University of São Paulo, School of Dentistry, São Paulo, Brazil
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11
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Yu H, Qiu L. Analysis of fractured dental implant body from five different implant systems: a long-term retrospective study. Int J Oral Maxillofac Surg 2022; 51:1355-1361. [PMID: 35562314 DOI: 10.1016/j.ijom.2022.04.010] [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: 05/30/2021] [Revised: 04/16/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
The aim of this study was to perform an analysis of the incidence of implant body fracture and to identify possible risk factors. A long-term follow-up retrospective evaluation of 3477 patients who received 8588 implants from five implant systems was performed. Overall, 2810 patients who received 7502 implants, with an average follow-up of 6.9 years, were included in the analysis. The overall body fracture rate was 0.49% (37/7502), among which 32.4% (12/37) were implants with a reduced diameter. The estimated cumulative fracture rate was 1.24%. Fractures were observed in two patients with three Brånemark implants, 13 patients with 15 Nobel Replace implants, eight patients with eight Camlog implants, eight patients with 11 Ankylos implants, and none of the patients with Thommen implants. Most fractures occurred in the molar region (29/37) and in single implant-supported restorations (30/37). The results showed significant differences between splinted and unsplinted restorations (P = 0.005) and between regular and narrow diameter implants (P = 0.009). Within the limitations of this retrospective analysis, a narrow implant diameter is a potential risk factor for implant body fracture in the posterior region. Furthermore, unsplinted restorations appear to be associated with a higher rate of implant fracture.
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Affiliation(s)
- H Yu
- Fourth Division Department, Peking University School and Hospital of Stomatology, Chaoyang District, Beijing, China.
| | - L Qiu
- Fourth Division Department, Peking University School and Hospital of Stomatology, Chaoyang District, Beijing, China.
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12
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Vahnström M, Johansson PH, Svanborg P, Stenport VF. Comparison of porcelain veneer fracture in implant-supported fixed full-arch prostheses with a framework of either titanium, cobalt-chromium, or zirconia: An in vitro study. Clin Exp Dent Res 2022; 8:544-551. [PMID: 35313086 PMCID: PMC9033539 DOI: 10.1002/cre2.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The aim of this study was to compare porcelain veneer strength on screw‐retained implant‐supported fixed full‐arch prostheses with a framework of either milled titanium (Ti), cobalt–chromium (CoCr), and yttria‐stabilized zirconia (Y‐TZP) in an in vitro loading model. Materials and Methods Fifteen screw‐retained maxillary implant‐supported full‐arch prostheses (FDP), five each of Ti, CoCr, and Y‐TZP frameworks with porcelain veneers were included. All FDPs were subjected to thermocycling before loading until fracture of the veneer. The load was applied at the distal fossa of the occlusal area of the pontic replacing 24. Fracture loads were analyzed, and the fracture quality was assessed. Statistical analysis on the fracture load was performed using Kruskal–Wallis test. The statistical significance was set at p < .05. Results There was no statistical significance found between the groups regarding fracture load. The highest and lowest load was seen within the CoCr FDP, varying between 340 and 1484 N. Different types of fracture appearances were seen. The Y‐TZP FDPs had a higher number of fractures locally in the loaded area while CoCr and Ti more often showed cracks in the anterior region, at a distance from the loaded area. Conclusions Within the limitations of this study, the conclusion was that framework material may affect the fracture behavior of maxillary full‐arch bridges; however, there were no differences in veneer fracture strength when frameworks of Ti, CoCr, or Y‐TZP were compared.
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Affiliation(s)
- Märta Vahnström
- The Brånemark Clinic, Public Health Service, Region of Västra Götaland, Gothenburg, Sweden
| | - Petra H Johansson
- Department of Prostodontics/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Per Svanborg
- Department of Prostodontics/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Victoria F Stenport
- Department of Prostodontics/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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13
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Antiua E, Escuer V, Alkhraisat MH. Short Narrow Dental Implants versus Long Narrow Dental Implants in Fixed Prostheses: A Prospective Clinical Study. Dent J (Basel) 2022; 10:dj10030039. [PMID: 35323241 PMCID: PMC8947067 DOI: 10.3390/dj10030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022] Open
Abstract
There is a paucity of studies that assess short and narrow dental implants. This prospective study aimed to evaluate the performance of both short (≤8 mm) and narrow (≤3.5 mm width) dental implants supporting fixed prostheses in the atrophic maxilla or mandible. Towards that aim, patients with short implants were included in the study. The control group was those with long and narrow dental implants (length > 8 mm and diameter ≤ 3.5 mm). Clinical and demographic variables were extracted from clinical records. During the follow-up, implant survival and marginal bone loss were evaluated and statistically analysed. Forty-one implants were included (18 and 23 implants in the test and control groups, respectively). The median follow-up time was 26 months since insertion in both groups. The results revealed that there was no implant failure and no statistically significant differences in terms of marginal bone loss. Only one screw-loosening effect occurred in the short implants group. Short, narrow dental implants could be an alternative for the restoration of severely resorbed jaws.
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Affiliation(s)
- Eduardo Antiua
- Clínica Eduardo Anitua, 01007 Vitoria, Spain;
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
- BTI Biotechnology Institute, 01005 Vitoria, Spain
- Correspondence: (E.A.); (M.H.A.)
| | - Virginia Escuer
- Clínica Eduardo Anitua, 01007 Vitoria, Spain;
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Mohammad H. Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
- BTI Biotechnology Institute, 01005 Vitoria, Spain
- Correspondence: (E.A.); (M.H.A.)
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14
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Biomechanical analysis of inclined and cantilever design with different implant framework materials in mandibular complete-arch implant restorations. J Prosthet Dent 2022; 127:783.e1-783.e10. [DOI: 10.1016/j.prosdent.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 12/29/2022]
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15
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Altuwaijri SM, Alotaibi HN, Alnassar TM. The effect of the digital manufacturing technique of cantilevered implant-supported frameworks on abutment screw preload. J Adv Prosthodont 2022; 14:22-31. [PMID: 35284054 PMCID: PMC8891687 DOI: 10.4047/jap.2022.14.1.22] [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: 10/19/2021] [Revised: 12/29/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) µm while CAD-cast demonstrated the highest measurements of 29.2 (3.1) µm. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw’s preload stability under an aggressive loading situation.
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Affiliation(s)
- Shahad Mohammmed Altuwaijri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Prosthetic Dental Sciences, College of Dentistry, Almajmaah University, Almajmaah, Kingdom of Saudi Arabia
| | - Hanan Nejer Alotaibi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Talal Mughaileth Alnassar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
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16
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Gao X, Qin S, Cai H, Wan Q. Comparison of general and aesthetic effects between flapless and flap techniques in dental implantation: a meta-analysis of randomized controlled trials. Int J Implant Dent 2021; 7:100. [PMID: 34595691 PMCID: PMC8484394 DOI: 10.1186/s40729-021-00380-5] [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: 04/28/2021] [Accepted: 08/09/2021] [Indexed: 02/08/2023] Open
Abstract
Background Information about the aesthetic effects of flapless in implant surgeries is scant. Differences of the survival rate (SR) and crestal bone loss (CBL) between the two techniques were also controversial. Thus, this review was aimed to compare the general and aesthetic effects of flapless and flap approaches in implant surgeries. Materials and methods Following the principals of PRISMA, literature databases were searched for the eligible randomized controlled trials (RCTs) comparing the clinical performances of flap and flapless techniques. After that, relevant data of selected studies were pooled and analyzed to compare SR, bleeding on probing (BOP), probing depth (PD), visual analogue scale (VAS), papillae presentation index (PPI), keratinized mucosa (KM) width and CBL between the two techniques. Results Fourteen RCTs were included. No significant difference was found in SR (RR = − 0.01, 95% confidence interval (CI) (− 0.05, 0.04)), BOP (OR = 0.40, 95% CI (0.15, 1.02)), KM width (WMD = − 0.42, 95% CI (− 1.02, 0.17)) between two groups. Subgroup analysis revealed that the difference of CBL was insignificant in two groups (WMD = − 0.13, 95% CI (− 0.63, 0.38)). However, flap techniques would lead more peri-implant PD (WMD = − 0.37, 95% CI (− 0.51, − 0.23)). Subgroup analysis also indicated lower VAS scores in flapless group after 1 day (WMD = − 1.66, 95% CI (− 2.16, − 1.16)) but comparable pain experience after 3 days (WMD = − 0.59, 95% CI (− 1.33, 0.16)). Mean difference of PPI (WMD = 0.32, 95% CI (0.28, 0.35)) between the two groups was significant. Conclusions The flapless procedure showed a superiority in preserving gingival papillae, reducing postoperative pain and peri-implant PD compared to the flap procedure, while exhibiting comparable effects on SR, BOP, KW width changes and CBL. Flapless technique is more recommended at the ideal soft and hard tissue implanting sites.
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Affiliation(s)
- Xiaomeng Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China
| | - Siyu Qin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China
| | - He Cai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China.
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, People's Republic of China.
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17
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Gao WM, Geng W, Luo CC. Prosthetic complications of fixed dental prostheses supported by locking-taper implants: a retrospective study with a mean follow-up of 5 years. BMC Oral Health 2021; 21:476. [PMID: 34579694 PMCID: PMC8474706 DOI: 10.1186/s12903-021-01843-2] [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: 02/10/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restoration with locking-taper implants is a widely used methodology. However, conical connection systems such as locking-taper implant systems have rarely been examined. This study provides a retrospective investigation of locking-taper fixed restorations, mainly focusing on prosthetic complications. METHODS Patients undergo treatment with conical connected implants from 2008 to 2010 were examined. Preparation of the implant sites was performed according to the standard procedures for the Bicon system. Bone healing took over 6 months, and the prosthetic procedure was initiated thereafter. Integrated abutment crowns or gold porcelain crowns were used, and the prosthesis type was a single crown or a fixed dental prosthesis. Once the crown was in place, its occlusion was thoroughly checked and adjusted, and then the crown was glazed or finely polished. The Kaplan-Meier method was used to calculate the cumulative complication-free rates for 5 and 10 years. Additionally, a Cox regression model was used to identify the factors that independently influenced the results. Implant survival and marginal bone loss were also investigated. RESULTS A total of 392 patients who underwent 541 implants and 434 locking taper implant-based restorations from 2008 to 2010 were examined. The overall 5-year cumulative complication-free rate was 83.34%. The most common prosthetic complication was veneer chipping, with a frequency of 67.53%. According to the Cox regression model, the complication-free rate of integrated abutment crowns was significantly higher than that of gold porcelain crowns, that of molar regions was significantly higher than that of premolar regions, and that of females was significantly higher than that of males. Only three implant failures happened, and the mean marginal bone loss values at 1- year, 5-years and 10- years were 0.25 mm (95% CI ± 0.12), 0.40 mm (95% CI ± 0.03) and 0.51 mm (95% CI ± 0.05), respectively. CONCLUSION Veneer chipping was the most common complication with locking-taper implant-supported fixed restorations. The incidence of complications for IACs is significantly higher than that for GPCs. Age, location, and prosthesis type are not determinants of prosthetic complications. Besides, the long-term clinical effect of locking-taper implant can meet the clinical needs. The bone tissue level around the implant can maintain long-term stability.
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Affiliation(s)
- Wen Mo Gao
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tian Tan Xi Li, Dongcheng District, Beijing, 100050, People's Republic of China
| | - Wei Geng
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tian Tan Xi Li, Dongcheng District, Beijing, 100050, People's Republic of China.
| | - Chen Chen Luo
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tian Tan Xi Li, Dongcheng District, Beijing, 100050, People's Republic of China
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18
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Hamilton A, Jamjoom FZ, Alnasser M, Starr JR, Friedland B, Gallucci GO. Tilted versus axial implant distribution in the posterior edentulous maxilla: A CBCT analysis. Clin Oral Implants Res 2021; 32:1357-1365. [PMID: 34423882 DOI: 10.1111/clr.13836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/21/2021] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to determine whether distally angulating an implant is a successful strategy to avoid the maxillary sinus and the need for bone augmentation, while increasing the anterior-posterior (A-P) implant distribution in the edentulous maxilla. MATERIALS AND METHODS In 115 patients with edentulous maxillae, virtual implant planning was performed utilizing cone-beam computer tomographs. Axial (8 mm length) and tilted (12 mm length) dental implants with 30-degree and 45-degree angulation were virtually positioned to avoid entering the maxillary sinus, while maximizing A-P distribution. Measurements were made between the tilted and axial implants to assess the change in A-P distribution of implants at the implant and abutment levels. RESULTS Forty-seven sites (20.4%) were not able to have either treatment modality with insufficient bone for implant placement. Axial implants were placed more distally than 45-degree and 30-degree tilted implants in 24% and 42% of sites, respectively. The average change in A-P spread measured at the implant level, for 30- and 45-degree tilted implants was -0.25 mm (95% CI -0.76, 0.26) and 1.9 mm (95% CI 1.4, 2.3), respectively. When measured from the center of each multi-unit abutment the average increase in A-P distances for tilted implants appears larger in the 30-degree and 45-degree groups by 0.97 mm and 1.74 mm, respectively compared to measurements at the implant level. CONCLUSIONS Angulating 12 mm implants provides a limited increase in A-P distribution of implants in edentulous rehabilitation in most situations. In certain patients, the use of 8mm axial implants may provide a greater A-P spread.
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Affiliation(s)
- Adam Hamilton
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, WA, Australia
| | - Faris Z Jamjoom
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Muhsen Alnasser
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jacqueline R Starr
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Bernard Friedland
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Chair of the Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Komasa S, Kusumoto T, Hayashi R, Takao S, Li M, Yan S, Zeng Y, Yang Y, Hu H, Kobayashi Y, Agariguchi A, Nishida H, Hashimoto Y, Okazaki J. Effect of Argon-Based Atmospheric Pressure Plasma Treatment on Hard Tissue Formation on Titanium Surface. Int J Mol Sci 2021; 22:ijms22147617. [PMID: 34299241 PMCID: PMC8307890 DOI: 10.3390/ijms22147617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 01/07/2023] Open
Abstract
In this paper, we suggest that the atmospheric pressure plasma treatment of pure titanium metal may be useful for improving the ability of rat bone marrow cells (RBMCs) to induce hard tissue differentiation. Previous studies have reported that the use of argon gas induces a higher degree of hard tissue formation. Therefore, this study compares the effects of plasma treatment with argon gas on the initial adhesion ability and hard tissue differentiation-inducing ability of RBMCs. A commercially available titanium metal plate was used as the experimental material. A plate polished using water-resistant abrasive paper #1500 was used as the control, and a plate irradiated with argon mixed with atmospheric pressure plasma was used as the experimental plate. No structural change was observed on the surface of the titanium metal plate in the scanning electron microscopy results, and no change in the surface roughness was observed via scanning probe microscopy. X-ray photoelectron spectroscopy showed a decrease in the carbon peak and the formation of hydroxide in the experimental group. In the distilled water drop test, a significant decrease in the contact angle was observed for the experimental group, and the results indicated superhydrophilicity. Furthermore, the bovine serum albumin adsorption, initial adhesion of RBMCs, alkaline phosphatase activity, calcium deposition, and genetic marker expression of rat bone marrow cells were higher in the experimental group than those in the control group at all time points. Rat distal femur model are used as in vivo model. Additionally, microcomputed tomography analysis showed significantly higher results for the experimental group, indicating a large amount of the formed hard tissue. Histopathological evaluation also confirmed the presence of a prominent newly formed bone seen in the images of the experimental group. These results indicate that the atmospheric pressure plasma treatment with argon gas imparts superhydrophilicity, without changing the properties of the pure titanium plate surface. It was also clarified that it affects the initial adhesion of bone marrow cells and the induction of hard tissue differentiation.
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Affiliation(s)
- Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
- Correspondence: ; Tel.: +81-72-864-3084; Fax: +81-72-864-3184
| | - Tetsuji Kusumoto
- Department of Japan Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata-shi, Osaka 573-1121, Japan;
| | - Rina Hayashi
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Seiji Takao
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Min Li
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Sifan Yan
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Yuhao Zeng
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Yuanyuan Yang
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Hui Hu
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Yasuyuki Kobayashi
- Osaka Research Institute of Industrial Science and Technology, Morinomiya Center, 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan;
| | - Akinori Agariguchi
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
| | - Hisataka Nishida
- Department of Advanced Hard Materials, The Institute of Scientific and Industrial Research (ISIR), Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan;
| | - Yoshiya Hashimoto
- Department of Biomaterials, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan;
| | - Joji Okazaki
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (R.H.); (S.T.); (M.L.); (S.Y.); (Y.Z.); (Y.Y.); (H.H.); (A.A.); (J.O.)
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20
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Kawamura A, Akiba Y, Nagasawa M, Takashima M, Arai Y, Uoshima K. Bone heating and implant removal using a high-frequency electrosurgical device: An in vivo experimental study. Clin Oral Implants Res 2021; 32:989-997. [PMID: 34107095 DOI: 10.1111/clr.13793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/27/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Failed implant removal using a high-frequency electrosurgical device (HFED) has been reported to be less invasive than other surgical techniques. We sought to clarify the mechanism of removal torque reduction in an implant by heating with HFED. MATERIALS AND METHODS Sixty-eight Wistar rats received titanium implants on the maxillary bone 4 weeks after extraction of the first and second molars. The control group was sacrificed 6 weeks after implant installation. In the experimental group, the implant was heated by HFED for 10 s using three different power outputs, and samples were collected at 3, 7, and 14 days after heating. Removal torque measurement and histological analysis were performed in the control and experimental groups. Implant surfaces were observed using an electron-probe microanalyzer (EPMA). Data were analyzed using Mann-Whitney U test at a significance level of 5%. RESULTS The removal torque could not be measured in the control group due to fracture of the implant. After heating, the removal torque was measurable without fracture and decreased significantly at 14 days as compared with that at 3 days (p < .05). Heating with "min" power output resulted in a significantly smaller blank lacunae area and fewer osteoclasts at 14 days after heating (p < .05). EPMA revealed bone matrix adherence to outer surface of heated implant. CONCLUSIONS After heating, an enlarged area of blank lacunae around the implant and an increased number of osteoclasts into the bone marrow cavity were observed, which may have contributed to the reduction in removal torque.
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Affiliation(s)
- Atsushi Kawamura
- Oral Implant and Temporomandibular Joint Clinic, Medical and Dental Hospital, Niigata University, Niigata, Japan
| | - Yosuke Akiba
- Divisions of Bio-prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masako Nagasawa
- Divisions of Bio-prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Makiko Takashima
- Oral Implant and Temporomandibular Joint Clinic, Medical and Dental Hospital, Niigata University, Niigata, Japan
| | - Yoshiaki Arai
- Oral Implant and Temporomandibular Joint Clinic, Medical and Dental Hospital, Niigata University, Niigata, Japan
| | - Katsumi Uoshima
- Divisions of Bio-prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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21
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Alom G, Kwon HB, Lim YJ, Kim MJ. Three-dimensional finite element analysis of buccally cantilevered implant-supported prostheses in a severely resorbed mandible. J Adv Prosthodont 2021; 13:12-23. [PMID: 33747391 PMCID: PMC7943755 DOI: 10.4047/jap.2021.13.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. MATERIALS AND METHODS Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creatingan excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. RESULTS The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.
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Affiliation(s)
- Ghaith Alom
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Young-Jun Lim
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Myung-Joo Kim
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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22
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Yu W, Chen S, Li X, Ma X, Xu X. Evaluation of 1-Piece Versus 3-Piece Framework Designs for the Edentulous Mandible with Fixed Implant-Supported Prostheses: A Clinical, Occlusal and Biomechanical Study. J Prosthodont 2021; 30:290-297. [PMID: 33448507 DOI: 10.1111/jopr.13320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to evaluate the clinical, occlusal and biomechanical performance of 1-piece and 3-piece designs for implant-supported fixed dentures in the edentulous mandible. MATERIALS AND METHODS A total of 65 patients with edentulous mandibles who underwent fixed implant-supported restorations were recruited and subsequently assigned to 1 of 2 groups based on the framework design (1-piece or 3-piece). The participants underwent clinical and occlusal examination using a periodontal probe, T-Scan III system, and electromyography 12 months after prosthesis delivery. Two mandibular finite element models were created to evaluate stress values and their distribution during function. RESULTS Ninety-five point four percent (n = 62) of participants in the follow-up period underwent clinical and occlusal examination after prosthesis delivery. Clinical examination revealed a trend towards increased inflammation around the implants in the 1-piece prostheses. Occlusal parameters indicated that the 1-piece design was superior for the masticatory system than the 3-piece design. Biomechanical analysis revealed the highest stress values in the posterior region of the 3-piece design. CONCLUSIONS On the basis of ease of ensuring oral hygiene, when compared to the 3-piece design, the 1-piece framework design might be the superior therapy for restoring an edentulous mandible, based on occlusal and biomechanical outcomes.
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Affiliation(s)
- Wenqian Yu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Siyi Chen
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoqian Li
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoni Ma
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
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23
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Schmid E, Roccuzzo A, Morandini M, Ramseier CA, Sculean A, Salvi GE. Clinical and radiographic evaluation of implant-supported single-unit crowns with cantilever extension in posterior areas: A retrospective study with a follow-up of at least 10 years. Clin Implant Dent Relat Res 2021; 23:189-196. [PMID: 33448601 DOI: 10.1111/cid.12973] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Implant-supported restorations with cantilever extension may display high rates of biological and technical complications. PURPOSE To report the outcomes of single-unit crowns with cantilever extension (SCCs). MATERIALS AND METHODS Patients with SCCs were reevaluated after ≥10 years of loading. Radiographic marginal bone levels (mBLs) at baseline (ie, delivery of SCCs) and follow-up were calculated and compared between implant surfaces adjacent to and distant from the cantilever extension. Implant survival and success rates were calculated. RESULTS Twenty-one patients with 25 SCs supported by 25 implants were reevaluated after a mean of 13.6 ± 3.8 years (range: 10-19 years). No implants were lost. The mean overall mBLs changed from 0.99 mm ± 0.95 at baseline to 0.95 mm ± 0.99 at follow-up (p = 0.853). The mean pocket probing depths changed from 3.39 mm ± 0.62 at baseline to 3.34 mm ± 0.54 at follow-up (p = 0.635). Loss of retention occurred 3× in 2 patients (14.3%). At follow-up, peri-implant health was diagnosed in 10 (48%) and peri-implant mucositis in 11 (52%) patients, respectively. CONCLUSIONS Within the limitations of the present study, the use of implant-supported SCs with cantilever extension in posterior areas represents a reliable long-term treatment option with a 100% implant survival rate and minimal marginal bone level changes.
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Affiliation(s)
- Eric Schmid
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Michele Morandini
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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24
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Geckili O, Gencel B, Idemen AC, Dayan SC. Technique for Converting A Fractured Implant Locator Abutment to A Custom Implant Cast Post and Core. J Prosthodont 2021; 30:363-366. [PMID: 33438256 DOI: 10.1111/jopr.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2020] [Indexed: 11/26/2022] Open
Abstract
This technique article describes an efficient, cost effective and time saving procedure using the fractured abutment as a custom cast post and core when an overdenture abutment is fractured and attempts to retrieve the fractured segment fail.
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Affiliation(s)
- Onur Geckili
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Burc Gencel
- Program of Dental Technicians, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Aliye Ceren Idemen
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Suleyman Cagatay Dayan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.,Program of Dental Technicians, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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25
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Taha A, Al-Shahat MA, Ghazy M. Clinical and radiographic evaluations of implant-supported cantilever fixed partial dentures replacing maxillary anterior teeth: A randomized clinical trial. J Prosthet Dent 2020; 124:659-666. [DOI: 10.1016/j.prosdent.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 07/30/2019] [Accepted: 08/15/2019] [Indexed: 10/25/2022]
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26
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Taha A, Al-Shahat MA, Ghazy M. Clinical and radiographic evaluations of implant-supported cantilever fixed partial dentures replacing maxillary anterior teeth: A randomized clinical trial. J Prosthet Dent 2020; 124:659-666. [DOI: https:/doi.org/10.1016/j.prosdent.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2023]
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27
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Kim JH, Noh G, Hong SJ, Lee H. Biomechanical stress and microgap analysis of bone-level and tissue-level implant abutment structure according to the five different directions of occlusal loads. J Adv Prosthodont 2020; 12:316-321. [PMID: 33149853 PMCID: PMC7604240 DOI: 10.4047/jap.2020.12.5.316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The stress distribution and microgap formation on an implant abutment structure was evaluated to determine the relationship between the direction of the load and the stress value. MATERIALS AND METHODS Two types of three-dimensional models for the mandibular first molar were designed: bone-level implant and tissue-level implant. Each group consisted of an implant, surrounding bone, abutment, screw, and crown. Static finite element analysis was simulated through 200 N of occlusal load and preload at five different load directions: 0, 15, 30, 45, and 60°. The von Mises stress of the abutment and implant was evaluated. Microgap formation on the implant-abutment interface was also analyzed. RESULTS The stress values in the implant were as follows: 525, 322, 561, 778, and 1150 MPa in a bone level implant, and 254, 182, 259, 364, and 436 MPa in a tissue level implant at a load direction of 0, 15, 30, 45, and 60°, respectively. For microgap formation between the implant and abutment interface, three to seven-micron gaps were observed in the bone level implant under a load at 45 and 60°. In contrast, a three-micron gap was observed in the tissue level implant under a load at only 60°. CONCLUSION The mean stress of bone-level implant showed 2.2 times higher than that of tissue-level implant. When considering the loading point of occlusal surface and the direction of load, higher stress was noted when the vector was from the center of rotation in the implant prostheses.
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Affiliation(s)
- Jae-Hoon Kim
- Department of Dental Education, Dental Research Institute, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Gunwoo Noh
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Seoung-Jin Hong
- Department of Prosthodontics, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - Hyeonjong Lee
- Department of Prosthodontics, Dental Research Institute, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
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28
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Schmid E, Morandini M, Roccuzzo A, Ramseier CA, Sculean A, Salvi GE. Clinical and radiographic outcomes of implant‐supported fixed dental prostheses with cantilever extension. A retrospective cohort study with a follow‐up of at least 10 years. Clin Oral Implants Res 2020; 31:1243-1252. [DOI: 10.1111/clr.13672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/02/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Eric Schmid
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Michele Morandini
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
- Department of Oral and Maxillofacial Surgery Copenhagen University Hospital (Rigshospitalet) Copenhagen Denmark
| | - Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Anton Sculean
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Giovanni E. Salvi
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
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29
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Komasa S, Takao S, Yang Y, Zeng Y, Li M, Yan S, Zhang H, Komasa C, Kobayashi Y, Nishizaki H, Nishida H, Kusumoto T, Okazaki J. Effects of UV Treatment on Ceria-Stabilized Zirconia/Alumina Nanocomposite (NANOZR). MATERIALS 2020; 13:ma13122772. [PMID: 32570895 PMCID: PMC7345710 DOI: 10.3390/ma13122772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022]
Abstract
Nanostructured zirconia/alumina composite (NANOZR) has been explored as a suitable material for fabricating implants for patients with metal allergy. In this study, we examined the effect of UV treatment on the NANOZR surface. The experimental group was UV-treated NANOZR and the control group was untreated NANOZR. Observation of the surface of the UV-treated materials revealed no mechanical or structural change; however, the carbon content on the material surface was reduced, and the material surface displayed superhydrophilicity. Further, the effects of the UV-induced superhydrophilic properties of NANOZR plates on the adhesion behavior of various cells were investigated. Treatment of the NANOZR surface was found to facilitate protein adsorption onto it. An in vitro evaluation using rat bone marrow cells, human vascular endothelial cells, and rat periodontal ligament cells revealed high levels of adhesion in the experimental group. In addition, it was clarified that the NANOZR surface forms active oxygen and suppresses the generation of oxidative stress. Overall, the study results suggested that UV-treated NANOZR is useful as a new ceramic implant material.
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Affiliation(s)
- Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Seiji Takao
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yuanyuan Yang
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yuhao Zeng
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Min Li
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Sifan Yan
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Honghao Zhang
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Chisato Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yasuyuki Kobayashi
- Osaka Research Institute of Industrial Science and Technology, Morinomiya Center, 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan;
| | - Hiroshi Nishizaki
- Department of Japan, Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata-shi, Osaka 573-1121, Japan; (H.N.); (T.K.)
| | - Hisataka Nishida
- Department of Advanced Hard Materials, The Institute of Scientific and Industrial Research (ISIR), Osaka University, Osaka 567-0047, Japan;
| | - Tetsuji Kusumoto
- Department of Japan, Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata-shi, Osaka 573-1121, Japan; (H.N.); (T.K.)
| | - Joji Okazaki
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
- Correspondence: ; Tel.: +81-72-864-3084; Fax: +81-72-864-3184
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30
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Toniollo MB, Sá MDS, Silva FP, Reis GR, Macedo AP, Terada ASSD. Comparison of Conventional and Pontic Fixed Partial Dentures Over Implants Using the Finite Element Method: Three-Dimensional Analysis of Cortical and Medullary Bone Stress. J ORAL IMPLANTOL 2020; 46:175-181. [PMID: 32030425 DOI: 10.1563/aaid-joi-d-19-00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Rehabilitation with implant prostheses in posterior areas requires the maximum number of possible implants due to the greater masticatory load of the region. However, the necessary minimum requirements are not always present in full. This project analyzed the minimum principal stresses (TMiP, representative of the compressive stress) to the friable structures, specifically the vestibular face of the cortical bone and the vestibular and internal/lingual face of the medullary bone. The experimental groups were as follows: the regular splinted group (GR), with a conventional infrastructure on 3 regular-length Morse taper implants (4 × 11 mm); and the regular pontic group (GP), with a pontic infrastructure on 2 regular-length Morse taper implants (4 × 11 mm). The results showed that the TMiP of the cortical and medullary bones were greater for the GP in regions surrounding the implants (especially in the cervical and apical areas of the same region) but they did not reach bone damage levels, at least under the loads applied in this study. It was concluded that greater stress observed in the GP demonstrates greater fragility with this modality of rehabilitation; this should draw the professional's attention to possible biomechanical implications. Whenever possible, professionals should give preference to use of a greater number of implants in the rehabilitation system, with a focus on preserving the supporting tissue with the generation of less intense stresses.
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Affiliation(s)
| | - Mikaelly Dos Santos Sá
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Fernanda Pereira Silva
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Giselle Rodrigues Reis
- Dental School of Rio Verde, University of Rio Verde (FORV/UniRV), Rio Verde - GO, Brazil
| | - Ana Paula Macedo
- Dental School of Ribeirão Preto, University of São Paulo, Department of Dental Materials and Prosthodontics, Ribeirão Preto - SP, Brazil
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31
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Implant-supported 2-unit cantilevers compared with single crowns on adjacent implants: A comparative retrospective case series. J Prosthet Dent 2020; 123:717-723. [DOI: 10.1016/j.prosdent.2019.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 11/19/2022]
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32
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Tooth-to-Implant-Supported Fixed Partial Denture: A Comprehensive Overview of Systematic Reviews. IMPLANT DENT 2019; 28:490-499. [PMID: 31149914 DOI: 10.1097/id.0000000000000901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Tooth-to-implant-connected prostheses have been described as a possible treatment option for patients with long-span edentulous situations that were not conducive for placement of an adequate number of supporting implants. In this comprehensive overview of systematic reviews, the incidence of complications and the long-term survival rates of tooth-to-implant-supported fixed partial dentures (FPDs) were evaluated to determine whether it is a viable treatment. MATERIALS AND METHODS A systematic search of 5 electronic databases was conducted for systematic reviews and meta-analyses of tooth-to-implant-supported FPDs up to January 2017. The articles were AMSTAR rated for methodological quality, and low-quality articles were eliminated. RESULTS The initial search yielded 369 reviews in PubMed, 248 in Web of Science, 49 in EMBASE, 63 in Cochrane Library, and 27 in Google Scholar. After removal of duplicates and after full-text analysis, 5 were selected for the overview. CONCLUSIONS Within the limitations of this overview, it was concluded that (1) the 10-year survival rates for tooth-to-implant FPDs were lower than the 5-year survival rates, (2) the tooth-to-implant FPDs' survival was lower than the individual abutment tooth or implant supporting it, (3) the biological and technical complications were more at 10 years compared with 5 years, and (4) the intrusion of the abutment teeth was more in the nonrigid connection FPDs than the rigid connection FPDs. Therefore, tooth-to-implant FPDs are a viable option but should be considered secondary to other available options with higher long-term survival rates and lower complications.
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Sadowsky SJ. Occlusal overload with dental implants: a review. Int J Implant Dent 2019; 5:29. [PMID: 31332553 PMCID: PMC6646429 DOI: 10.1186/s40729-019-0180-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Controversy persists as to the role of occlusal overload in peri-implantitis. Animal studies have not revealed the biological threshold for fatigue failure in the peri-implant bone. On the other hand, clinical studies have demonstrated a link between parafunction and implant failure, although variables such as intensity and frequency of loads, as well as bone density, have led to different outcomes. The absence of specific engineering “building codes” for the clinician has relegated prosthetic design planning to intuitive guidelines for all patients. For example, higher crown to implant ratios (2–3:1), implant cantilever prostheses and non-splinted restorative designs have been avoided because of the concern for overload. However, evidence has not supported this general approach. A call for preclinical research to establish specific patient load thresholds is in order to establish a customized treatment plan.
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Affiliation(s)
- Steven J Sadowsky
- Preventive and Restorative Department, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
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Bhavsar I, Miller CS, Ebersole JL, Dawson DR, Thompson KL, Al‐Sabbagh M. Biological response to peri‐implantitis treatment. J Periodontal Res 2019; 54:720-728. [DOI: 10.1111/jre.12681] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 06/05/2019] [Accepted: 06/09/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Ishita Bhavsar
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Craig S. Miller
- Department of Oral Health Practice Division of Oral Diagnosis Oral Medicine and Oral Radiology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Jeffrey L. Ebersole
- Center for Oral Health Research College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Dolphus R. Dawson
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
| | - Katherine L. Thompson
- Department of Statistics College of Arts & Sciences University of Kentucky Lexington Kentucky USA
| | - Mohanad Al‐Sabbagh
- Department of Oral Health Practice Division of Periodontology College of Dentistry University of Kentucky Lexington Kentucky USA
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Pałka ŁR, Lazarov A. Immediately Loaded Bicortical Implants Inserted in Fresh Extraction and Healed Sites in Patients with and Without a History of Periodontal Disease. Ann Maxillofac Surg 2019; 9:371-378. [PMID: 31909018 PMCID: PMC6933992 DOI: 10.4103/ams.ams_147_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Bicortical screw implants may be used in both healed bone and fresh extraction sockets and loaded immediately. To date, there have not been too many studies reporting clinical results of such screws used in periodontally involved sites. This study aimed to assess many aspects of bicortical screw implants used to retain full-arch and segmental cemented prostheses in the rehabilitation of the mandible and maxilla in patients with or without a history of periodontal disease. MATERIALS AND METHODS This retrospective review involved 87 patients, of whom 77 had a history of periodontitis diagnosed before implant placement and 10 did not. They were treated following the same surgical procedure and received a total of 1019 implants which were immediately loaded with fixed prosthetic works. RESULTS A total of 1019 polished surface, one-piece, bicortical screw implants were used in 87 patients who underwent the same surgical treatment, i.e., tooth extraction and immediate implant placement were investigated, of which 526 were placed in the healed bone and 493 in fresh extraction sockets with the mean follow-up time of 22.2 ± 7.3 months. Results were analyzed using log-rank test, the Kaplan-Meier method, Chi-square test, and t-test. Cumulative survival at 12, 24, and 35 months after placement was 99.3%, 98.6%, and 97.0%, respectively. CONCLUSION Bicortical smooth surface implant concept with immediate loading protocol provided predictable outcomes and survival rate of 99% in patients with and without a history of periodontitis. More studies are needed to further support the clinical advantages of bicortical anchoraged smooth surface implants.
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Alayan J, Ivanovski S. Biological and technical outcomes of restored implants after maxillary sinus augmentation-Results at 1-year loading. Clin Oral Implants Res 2019; 30:849-860. [PMID: 31148293 DOI: 10.1111/clr.13489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report biological and technical outcomes of implant-supported restorations placed into previously maxillary sinus floor augmentation using the lateral wall approach (MSA) using anorganic bovine bone mineral (ABBM) + autogenous bone (AB) (control group) or collagen-stabilized ABBM (test group). MATERIALS AND METHODS Single implant was placed 6 months after MSA in 27 control and 26 test patients. Fixed restorations were delivered 12 weeks later and reviewed 12 months after function. Outcomes measured included implant survival, marginal bone levels (DIB), peri-implant parameters, and incidence of biological and technical complications. RESULTS Seven patients (three control, four test group) did not return for their 1-year review. No significant inter-group differences were noted for all parameters. At baseline (3 months after implant placement), a mean(SD) marginal bone loss of 0.66 mm (0.40) and 0.77 mm (0.48) from the implant shoulder was recorded in the control and test group, respectively. After 12 months of loading, a mean (SD) additional marginal bone loss of 0.32 mm (0.24) and 0.35 mm (0.23) was noted in the control and test group, respectively. Peri-implant mucositis (≥1 site BOP) was diagnosed in 62.9% of control and 69.23% of test patients. No peri-implantitis was diagnosed. Screw retention and single crowns predominated. Technical complications mostly comprised of ceramic veneer chipping and were noted in 7.4% of control and 11.54% of test patients. CONCLUSION Based on a short observation period, implant reconstruction of the partially edentulous posterior maxilla after MSA using ABBM + AB or collagen-stabilized ABBM led stable marginal bone levels, high prevalence of peri-implant mucositis, and low rates of technical complications.
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Affiliation(s)
- Jamil Alayan
- School of Dentistry and Oral Health, Centre for Medicine and Oral Health, Griffith University, Southport, Queensland, Australia
| | - Saso Ivanovski
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
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Tuna T, Kuhlmann L, Bishti S, Sirazitdinova E, Deserno T, Wolfart S. Removal of simulated biofilm at different implant crown designs with interproximal oral hygiene aids: An
in vitro
study. Clin Oral Implants Res 2019; 30:627-636. [DOI: 10.1111/clr.13448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/02/2019] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Taskin Tuna
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Lena Kuhlmann
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Shaza Bishti
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
| | - Ekaterina Sirazitdinova
- Department of Medical Informatics, Division of Image and Data Management RWTH University Aachen Germany
| | - Thomas Deserno
- Department of Medical Informatics, Division of Image and Data Management RWTH University Aachen Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials RWTH University Aachen Germany
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Abstract
Dental implants continue to grow in popularity because they are a predictable treatment to replace missing teeth. They have a high success rate; however, they are still associated with some clinical complications. This article discusses a diverse range of complications related to the restorative and mechanical aspects of dental implants and the management of such complications, as well as potential factors contributing to them.
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Affiliation(s)
- Ingeborg J De Kok
- Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA.
| | - Ibrahim S Duqum
- Division of Prosthodontics, Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA
| | - Lauren H Katz
- Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA
| | - Lyndon F Cooper
- Department of Oral Biology, University of Illinois at Chicago, College of Dentistry, Room 402E, 801 S Paulina Street, Chicago, IL 60612, USA
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Nagao M, Masaki C, Nakao M, Ito Y, Tsuka S, Mukaibo T, Kondo Y, Hosokawa R. Is Anterior Guidance a Key Factor on Planning Implant Treatment for Free-End Missing in the Posterior Mandible? J ORAL IMPLANTOL 2019; 45:100-105. [DOI: 10.1563/aaid-joi-d-17-00237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To perform safe implant treatment, the anatomical structure and bone quality at implant placement sites are evaluated based on a patient's computerized tomography (CT) data, but there is no definite method to determine placement sites and the appropriate number of implants. The objective of this study was to investigate the influence of the number and arrangement of implants on the stress distribution in 3-unit posterior fixed partial dentures for the posterior mandible by mechanical analysis using the finite element method. Three-dimensional finite element analysis models were constructed from the CT data of a patient with missing mandibular teeth (Nos. 35, 36, 37). Implant placement was simulated under various conditions. Superstructures were connected and fixed with a titanium frame. As the loading conditions, 400 N vertical and lateral loads (45° on the lingual side and 45° on the buccal side) were applied to the upper areas of Nos. 35, 36, and 37, and the stress distribution and frame displacement were evaluated. When a vertical force was applied, no difference of the von Mises stress was noted among the 5 experimental conditions. When lateral force was applied from the lingual and buccal sides at 45°, the stress was higher than that induced by vertical force under all conditions, and it was especially high under mesial and distal cantilever conditions. When displacement of the titanium frame was measured, the displacement caused by lateral force was greater than that due to vertical force. In addition, comparison between long and short distal cantilever bridges revealed that displacement of the titanium frame tended to be smaller when the short cantilever was used. These findings suggested that the stress on peri-implant tissues and displacement of the titanium frame vary depending on the configuration and number of implants, with greater stress and more marked displacement of the titanium frame being induced by lateral force when the number of implants is reduced and a cantilever bridge is selected.
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Affiliation(s)
- Mitsuharu Nagao
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
| | - Chihiro Masaki
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
| | | | | | - Shintaro Tsuka
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
| | - Taro Mukaibo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
| | - Yusuke Kondo
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
| | - Ryuji Hosokawa
- Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Graduate School, Fukuoka, Japan
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40
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Blanco J, Carral C, Argibay O, Liñares A. Implant placement in fresh extraction sockets. Periodontol 2000 2019; 79:151-167. [DOI: 10.1111/prd.12253] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Juan Blanco
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Cristina Carral
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Olalla Argibay
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Antonio Liñares
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
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Storelli S, Del Fabbro M, Scanferla M, Palandrani G, Romeo E. Implant supported cantilevered fixed dental rehabilitations in partially edentulous patients: Systematic review of the literature. Part I. Clin Oral Implants Res 2019; 29 Suppl 18:253-274. [PMID: 30306681 DOI: 10.1111/clr.13311] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate in which clinical situations a cantilever fixed implant supported restorations can be a treatment alternative and which complications are reported. MATERIALS AND METHODS Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant fixed restorations with at least 10 patients and with a mean follow-up of at least 5 year were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. Risk of bias assessment was evaluated. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. RESULTS A total of nine papers were selected for partially edentulous patients and reported high survival rate of the prosthesis. The estimated survival rate for 5-10 years was calculated to be 98.4% for the implants and 99.2% for the rehabilitations. Mechanical, technical and biological complications were reported with a cumulative 5-10 years complication rate of 28.66% and 26.57% for the patients and for the prosthesis, respectively. Two papers for single implant supporting 2-unit cantilever were not sufficient to draw conclusions. CONCLUSIONS There is evidence that cantilever can be successful treatment in partially edentulous patients. In two adjacent edentulous sites, data are not yet sufficient.
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Affiliation(s)
- Stefano Storelli
- Department of Biomedical, Surgical and Dental Sciences, Clinica Odontoiatrica ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, IRCCS Orthopedic Institute Galeazzi, University of Milan, Milan, Italy
| | - Massimo Scanferla
- Department of Biomedical, Surgical and Dental Sciences, Clinica Odontoiatrica ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giulia Palandrani
- Department of Biomedical, Surgical and Dental Sciences, Clinica Odontoiatrica ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Eugenio Romeo
- Department of Biomedical, Surgical and Dental Sciences, Clinica Odontoiatrica ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
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Ambard AJ, Clemens S, Phillips DS. Multidisciplinary Implant Rehabilitation of a Patient with Cleidocranial Dysostosis: A Journey from Age 13 to 21. J Prosthodont 2019; 28:361-364. [PMID: 30793425 DOI: 10.1111/jopr.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 11/26/2022] Open
Abstract
This clinical report describes the multidisciplinary oral rehabilitation of a teenage female patient with cleidocranial dysostosis, whose treatment was started in her teenage years. The unique challenges of delayed intervention are described in this report, highlighting the surgical, orthodontic, and prosthodontic care the patient received from age 13 to 21. Maintaining as many natural teeth as possible, orthodontically erupting impacted teeth using a mandibular provisional fixed implant prosthesis as anchor, crowning several natural teeth, and rehabilitating edentulous areas with fixed implant restorations provided the patient with esthetic and functional outcomes.
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Prosthetic Complications Affecting Single-Tooth Morse-Taper Connection Implants. J Craniofac Surg 2019; 29:2255-2262. [PMID: 29561486 DOI: 10.1097/scs.0000000000004495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the long-term cumulative implant survival rate (CISR%) and cumulative implant-crown success rate (CICSR%) of single-tooth Morse-taper connection implants, with particular attention to documenting the incidence of prosthetic complications. METHODS The customized records of all patients who had been treated with single-tooth Morse-taper connection implants in 2 dental centers during the period between January 2002 and December 2012 were revisited. These records included patient-related (gender, age at surgery, smoking, bruxism), implant-related (date of insertion, site/location, and length/diameter of the implant, previous/concomitant bone regeneration), and restoration-related (date of delivery of the provisional and final crown) information. In addition, these records contained information about any implant failure and biologic and/or prosthetic complication that occurred during the follow-up period as well as the radiographic documentation. The follow-up period comprised between 5 and 15 years. The main outcomes were CISR% and CICSR%, with the latter being defined as the condition in which no complication had affected the surviving implant-supported crown during the entire follow-up. Life-table analysis was used for the analysis of CISR% and CICSR%. Peri-implant marginal bone resorption (PIMBR) at 5, 10, and 15 years was a secondary outcome of this study. RESULTS In total, 578 patients who had received 612 implants were included in this study. The overall CISR% at 15 years was 94.8% (94.2% maxilla, 95.3% mandible). Among the surviving crowns, the overall CICSR% at 15 years was 94.5% (93.1% and 94.9% for anterior and posterior crowns, respectively), and the incidence of prosthetic complications was low (1.5%). The PIMBL amounted to 0.38 ± 0.29 mm, 0.49 ± 0.35 mm, and 0.94 ± 0.58 mm at the 5-, 10-, and 15-year follow-ups, respectively. CONCLUSION Morse-taper connection implants represent a reliable treatment procedure for the restoration of single-tooth gaps in the long term, with high CISR% (94.8%) at 15 years, a very low incidence of complications, and a high CICSR% (94.5%).
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Storelli S, Del Fabbro M, Scanferla M, Palandrani G, Romeo E. Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients: Systematic review of the literature. Part II. Clin Oral Implants Res 2018; 29 Suppl 18:275-294. [DOI: 10.1111/clr.13310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Stefano Storelli
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical; Surgical and Dental Sciences; IRCCS Orthopedic Institute Galeazzi; University of Milan; Milan Italy
| | - Massimo Scanferla
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Giulia Palandrani
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Eugenio Romeo
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
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Arinc H. Effects of Prosthetic Material and Framework Design on Stress Distribution in Dental Implants and Peripheral Bone: A Three-Dimensional Finite Element Analysis. Med Sci Monit 2018; 24:4279-4287. [PMID: 29930240 PMCID: PMC6045918 DOI: 10.12659/msm.908208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the effects of prosthetic material and framework design on the stress within dental implants and peripheral bone using finite element analysis (FEA). MATERIAL AND METHODS A mandibular implant-supported fixed dental prosthesis with different prosthetic materials [cobalt-chromium-supported ceramic (C), zirconia-supported ceramic (Z), and zirconia-reinforced polymethyl methacrylate (ZRPMMA)-supported resin (ZP)] and different connector widths (2, 3, and 4 mm) within the framework were used to evaluate stress via FEA under oblique loading conditions. Maximum principal (smax), minimum principal (smin), and von Mises (svM) stress values were obtained. RESULTS Minimum stress values were observed in the model with a 2-mm connector width for C and ZP. The models with 3-mm and 4-mm connector widths showed higher stress values than the model with a 2-mm connector width for C (48-50%) and ZP (50-52%). Similar stress values were observed in the 3- and 4-mm models. There was no significant difference in the amount of stress with Z regardless of connector width. The Z and ZP models showed similar stress values in the 3- and 4-mm models and higher stress values than in the C model. Z, ZP, and C showed the highest stress values for the model with a 2-mm connector width. CONCLUSIONS Changes in the material and width of connectors may influence stress on cortical bone, cancellous bone, and implants. C was associated with the lowest stress values. Higher maximum and minimum principal stress values were seen in cortical bone compared to cancellous bone.
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Affiliation(s)
- Hakan Arinc
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
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46
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Implant-Supported Fixed Partial Prostheses With Different Prosthetic Materials: A Three-Dimensional Finite Element Stress Analysis. IMPLANT DENT 2018. [PMID: 29517641 DOI: 10.1097/id.0000000000000750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effects of prosthetic material on the degree of stress to the cortical bone, trabecular bone, framework, and implants using finite element analysis (FEA). MATERIALS AND METHODS A mandibular implant-supported fixed prosthesis was designed. Different prosthetic materials [cobalt-chromium-supported ceramic, zirconia-supported ceramic, and zirconia-reinforced polymethyl methacrylate (ZRPMMA)-supported resin] were used. FEA was used to evaluate stress under different loading conditions. Maximum principal (σmax), minimum principal (σmin), and von Mises (σvM) stress values were obtained. RESULTS Similar σmax, σmin, and σvM values were observed in the cortical and trabecular bones and in implants under both loading conditions, with the exception of the ZRPMMA model, which showed the highest σmax, σmin, and σvM values in oblique loading. The ZRPMMA model had the lowest σvM value in the framework under both loading conditions. CONCLUSION ZRPMMA had the lowest stress values in the framework, with increased stress values in the implants and bone tissue. Framework and veneering materials may influence stress values under different loading conditions.
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Mechanical Characterisation and Biomechanical and Biological Behaviours of Ti-Zr Binary-Alloy Dental Implants. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2785863. [PMID: 29318142 PMCID: PMC5727844 DOI: 10.1155/2017/2785863] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/10/2017] [Accepted: 10/26/2017] [Indexed: 11/17/2022]
Abstract
The objective of the study is to characterise the mechanical properties of Ti-15Zr binary alloy dental implants and to describe their biomechanical behaviour as well as their osseointegration capacity compared with the conventional Ti-6Al-4V (TAV) alloy implants. The mechanical properties of Ti-15Zr binary alloy were characterised using Roxolid© implants (Straumann, Basel, Switzerland) via ultrasound. Their biomechanical behaviour was described via finite element analysis. Their osseointegration capacity was compared via an in vivo study performed on 12 adult rabbits. Young's modulus of the Roxolid© implant was around 103 GPa, and the Poisson coefficient was around 0.33. There were no significant differences in terms of Von Mises stress values at the implant and bone level between both alloys. Regarding deformation, the highest value was observed for Ti-15Zr implant, and the lowest value was observed for the cortical bone surrounding TAV implant, with no deformation differences at the bone level between both alloys. Histological analysis of the implants inserted in rabbits demonstrated higher BIC percentage for Ti-15Zr implants at 3 and 6 weeks. Ti-15Zr alloy showed elastic properties and biomechanical behaviours similar to TAV alloy, although Ti-15Zr implant had a greater BIC percentage after 3 and 6 weeks of osseointegration.
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Kourtis S, Damanaki M, Kaitatzidou S, Kaitatzidou A, Roussou V. Loosening of the fixing screw in single implant crowns: predisposing factors, prevention and treatment options. J ESTHET RESTOR DENT 2017; 29:233-246. [DOI: 10.1111/jerd.12303] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefanos Kourtis
- Department of Prosthodontics; National and Kapodestrian University of Athens; Greece
| | - Mariana Damanaki
- Department of Prosthodontics; National and Kapodestrian University of Athens; Greece
| | - Sofia Kaitatzidou
- Department of Prosthodontics; National and Kapodestrian University of Athens; Greece
| | | | - Vasiliki Roussou
- Department of Prosthodontics; National and Kapodestrian University of Athens; Greece
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Seemann R, Jirku A, Wagner F, Wutzl A. What do sales data tell us about implant survival? PLoS One 2017; 12:e0171128. [PMID: 28222128 PMCID: PMC5319692 DOI: 10.1371/journal.pone.0171128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/30/2016] [Indexed: 11/19/2022] Open
Abstract
Objective The aim of this study was to evaluate the influence of implant diameter, length and shape on a surrogate parameter of implant survival; i.e. the implant return rate in a big data analysis. Materials and methods A retrospective study was conducted and the factors influencing the success rates of 69,377 sold implants over a seven-year period were evaluated. The osseointegration program of a reseller provides reliable data of a single country. Implant loss rates were investigated using logistic regression models and regressed by implant type, diameter, and length. Results The return rate of 69,377 sold implants was 2.78% and comparable to implant loss rates in previous published prospective studies as its surrogate parameter. A total of 80% of implant returns had occurred within 157 days, and an additional 15% within 750.25 days. Diameters of 3.8 to 5.0mm showed the lowest return rates with its bottom in the 4.3mm implant whilst 6.0mm implants had significantly higher return rates. In comparison to the most sold implant length (13mm) shorter implants showed significantly higher early return rates. Conclusions The study provides evidence that in cases of standard indications and sufficient bone, the use of screw typed dental implants with 3.8 or 4.3 diameter and 11 or 13 mm length shows the lowest implant return rates. Other implants may be selected only in specific indications.
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Affiliation(s)
- Rudolf Seemann
- University Clinic of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | | | - Florian Wagner
- University Clinic of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria
| | - Arno Wutzl
- University Clinic of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria
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Sampaio Fernandes M, Vaz P, Braga AC, Sampaio Fernandes JC, Figueiral MH. The role of IL-1 gene polymorphisms (IL1A, IL1B, and IL1RN) as a risk factor in unsuccessful implants retaining overdentures. J Prosthodont Res 2017; 61:439-449. [PMID: 28223139 DOI: 10.1016/j.jpor.2017.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/19/2016] [Accepted: 01/17/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE Implant-supported overdentures are an alternative predictable rehabilitation method that has a high impact on improving the patient's quality of life. However, some biological complications may interfere with the maintenance and survival of these overdenture implants. The goal of this article was to assess the factors that affect peri-implant success, through a hypothetical prediction model for biological complications of implant overdentures. METHODS A retrospective observational, prevalence study was conducted in 58 edentulous Caucasian patients rehabilitated with implant overdentures. A total of 229 implants were included in the study. Anamnestic, clinical, and implant-related parameters were collected and recorded in a single database. "Patient" was chosen as the unit of analysis, and a complete screening protocol was established. The data analytical study included assessing the odds ratio, concerning the presence or absence of a particular risk factor, by using binary logistic regression modeling. Probability values (p values) inferior to 0.05 were considered as representing statistically significant evidence. RESULTS The performed prediction model included the following variables: mean probing depth, metal exposure, IL1B_allele2, maxillary edentulousness, and Fusobacterium nucleatum. The F. nucleatum showed significant association with the outcome. Introducing a negative coefficient appeared to prevent complications or even boost the biological defense when associated with other factors. CONCLUSIONS The prediction model developed in this study could serve as a basis for further improved models that would assist clinicians in the daily diagnosis and treatment planning practice of oral rehabilitation with implant overdentures.
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Affiliation(s)
| | - Paula Vaz
- Department of Orofacial Genetics, Faculty of Dental Medicine of the University of Porto, Portugal.
| | - Ana Cristina Braga
- Department of Production and Systems Engineering-Algoritmi Centre, University of Minho, Braga, Portugal.
| | | | - Maria Helena Figueiral
- Department of Removable Prosthesis, Faculty of Dental Medicine of the University of Porto, Portugal.
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