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Kuebler A, Noelken R. The influence of connective tissue grafting on the reconstruction of a missing facial bone wall using immediate implant placement and simultaneous bone reconstruction: a retrospective long-term cohort study. Int J Implant Dent 2024; 10:25. [PMID: 38760582 PMCID: PMC11101404 DOI: 10.1186/s40729-024-00533-2] [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: 11/20/2023] [Accepted: 03/05/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE This retrospective cohort study evaluates the influence of connective tissue grafts (CTG) on bone regeneration at implant sites with total loss of the buccal bone wall treated with flapless immediate implant placement (IIP) and reconstruction with autogenous bone chips (AB) within a follow-up of up to 13 years. METHODS Sixty implants were inserted in 55 patients in sites with total loss of the buccal bone wall between 2008 and 2021. The implants were inserted and the buccal gaps were grafted by AB. A subgroup of 34 sites was grafted additionally with CTG using tunnel technique. Primary outcome was the vertical bone regeneration in height and thickness. Secondary outcome parameters were interproximal marginal bone level, recession, soft tissue esthetics (PES), width of keratinized mucosa (KMW) and probing depths (PPD). RESULTS Mean follow-up period was 60.8 months. In 55 sites a complete vertical bone regeneration was documented. The mean buccal bone level increased by 10.6 mm significantly. The thickness of the buccal bone wall ranged between 1.7 and 1.9 mm, and was significantly thicker in sites without CTG. Interproximal marginal bone level was at implant shoulder level. The mean recession improved significantly by 1.2 mm. In sites with CTG, recessions and PES improved significantly more. CONCLUSIONS Additional CTG in extraction sites with total buccal bone loss followed by IIP with simultaneous AB grafting led to improved PES and recession, but also to a thinner buccal bone wall compared to sites grafted just with AB.
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Affiliation(s)
- Andreas Kuebler
- Private Practice for Oral Surgery, Paradiesplatz 7-13, 88131, Lindau/Lake Constance, Germany.
| | - Robert Noelken
- Private Practice for Oral Surgery, Paradiesplatz 7-13, 88131, Lindau/Lake Constance, Germany
- Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
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Berberi A, Zoghbi AE, Aad G, Tehini G. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024; 25:213-220. [PMID: 38690692 DOI: 10.5005/jp-journals-10024-3659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
AIM The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. MATERIALS AND METHODS A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. RESULTS Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. CONCLUSION The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. CLINICAL SIGNIFICANCE Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.
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Affiliation(s)
- Antoine Berberi
- Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon, Phone: +961 37331173, e-mail: ;
| | - Amine El Zoghbi
- Department of Prosthodontics and Occlusion, Faculty of Dental Medicine Saint Joseph University, Beirut, Lebanon
| | - Georges Aad
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon
| | - Georges Tehini
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon, and College of Healthcare Technology, American University of Baghdad
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Godani A, Iyer J, Nadgere J, Mohite A, Gaikwad A. Impact of immediate interim restoration on peri-implant tissues around immediately placed single dental implants in the esthetic region: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00045-3. [PMID: 38355364 DOI: 10.1016/j.prosdent.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
STATEMENT OF PROBLEM Immediate implant placement with an immediate interim restoration is a well-established protocol. Nevertheless, a consensus regarding the impact of immediate interim restoration on peri-implant tissues around single dental implants is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to address the research question: "Does the placement of an immediate interim restoration influence the mid-facial mucosal (MFM) marginal and interdental papilla (IDP) levels around single dental implants placed in the anterior esthetic region by using an immediate implant placement protocol?" MATERIAL AND METHODS A comprehensive literature search was made in the Medline/PubMed, Scopus, Cochrane, and Science Direct electronic databases for articles published in English evaluating the impact of immediate interim restoration on peri-implant tissues around single dental implants in the anterior esthetic region. The primary outcomes assessed were changes in the MFM marginal and IDP levels. Additional outcomes were marginal bone (MB) loss, esthetic outcomes involving the pink and white esthetic scores (PES and WES), implant survival rates, and patient reported outcome measures (PROMs). The risk of bias assessment was performed by using the RoB 2 tool for randomized trials and the Newcastle-Ottawa scale for nonrandomized studies. Meta-analysis was performed by using random and fixed effects model (α=.05) in the RevMan software program. RESULTS Sixteen studies were included that analyzed 836 single dental implants involving 823 patients. The meta-analysis showed no significant differences in implants with and without interim restoration in terms of MFM marginal level (MD=0.01; 95% CI=-1.23 to 1.25; P=.98), mesial IDP level (MD=0.12; 95% CI=-0.23 to 0.47; P=.50), distal IDP level (MD=0.20; 95% CI=-0.40 to 0.79; P=.52), and MB loss (MD=0.01; 95% CI=-0.42 to 0.43; P=.97). The systematic analysis for survival rates determined no notable difference in implants with or without an interim restoration. However, the esthetic outcomes and PROMs substantially improved with immediate interim restorations. The RoB 2 tool showed a moderate to low risk of bias, and the Newcastle-Ottawa scale indicated high-quality studies. CONCLUSIONS After a 12-month follow-up, immediate interim restoration had no significant impact on peri-implant soft (MFM marginal and IDP levels) and hard tissues (MB loss) around immediately placed single dental implants. Nevertheless, additional well-designed and well-implemented clinical trials with long-term follow-up periods are needed to provide more precise evidence-based recommendations.
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Affiliation(s)
- Aashi Godani
- Postgraduate student, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani Iyer
- Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India.
| | - Jyoti Nadgere
- Professor and Head, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Anuradha Mohite
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Amit Gaikwad
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India; Doctoral Researcher, Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany; and Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hanover Medical School, Hanover, Germany
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Liu X, Lv H, Chen M, Chen S, Jia K, Quni S, Zhang L, Zhou Y. Case report and literature review: autonomous robotic system assisted palatal implantation at an anterior teeth site compromised by periapical cyst. Front Med (Lausanne) 2024; 11:1335043. [PMID: 38288274 PMCID: PMC10822917 DOI: 10.3389/fmed.2024.1335043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Abstract
Background Immediate implant placement (IIP), which preserves gingival height and papilla shape while simultaneously accelerating the implant treatment period, has become a popular method due to its commendable clinical outcomes. Nonetheless, deploying immediate implants demands specific preconditions concerning the remaining alveolar bone. This poses a challenge to the accuracy of implant surgery. Case presentation In this report, we present the case of a 60-year-old woman with a left upper anterior tooth crown dislodged for over a month. Cone beam computed tomography (CBCT) revealed the absence of a labial bone wall on tooth 22, a remaining 1 mm bone wall on the labial side of the root apex, and a 17.2 mm*8.9 mm*4.7 mm shadow in the periapical region of the root apices of teeth 21 and 22, with the narrowest width on the sagittal plane being approximately 5 mm. After the surgeon removed the cyst, they completed the subsequent implantation surgery using an autonomous robot in a challenging aesthetic area. This method circumvented the potential exposure of the screw thread on the labial implant surface, assured initial implant stability. Conclusion Five months after the operation, the dental crown was restored. The implant remained stable, with yielding notable clinical results. To the best of our knowledge, this clinical case is the first to report the feasibility and precision of immediate implantation in anterior teeth site with periapical cyst removal, performed by an autonomous robotic surgical system. Autonomous robots exhibit exceptional accuracy by accurately controlling axial and angular errors. It can improve the accuracy of implant surgery, which may become a key technology for changing implant surgery. However, further clinical trials are still needed to provide a basis for the rapid development of robotic surgery field.
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Affiliation(s)
- Xiuyu Liu
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Huixin Lv
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Meiqing Chen
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Siyu Chen
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Kewen Jia
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Sezhen Quni
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Lu Zhang
- Hospital of Stomatogy, Jilin University, Changchun, China
| | - Yanmin Zhou
- Hospital of Stomatogy, Jilin University, Changchun, China
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Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
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Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Limmeechokchai S, Kan JYK, Rungcharassaeng K, Chen JT, Goodacre B, Lozada J. Facial Contour Preservation of Anterior Immediate Single-Tooth Replacement With the Socket Shield Technique Versus Connective Tissue Graft: A Case Report. J ORAL IMPLANTOL 2023; 49:495-500. [PMID: 37776256 DOI: 10.1563/aaid-joi-d-23-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
The socket shield technique and subepithelial connective tissue graft following immediate implant placement with provisionalization had been advocated for peri-implant facial contour and gingival architecture preservation. This case report used three-dimensional volumetric analysis to longitudinally assess the peri-implant facial contour change before and after these procedures. The results demonstrated comparable and acceptable preservation of peri-implant facial contour between the two procedures after 2 years of function.
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Affiliation(s)
| | - Joseph Y K Kan
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | | | - Joey T Chen
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Brian Goodacre
- Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Jaime Lozada
- Loma Linda University School of Dentistry, Loma Linda, Calif
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Groenendijk E, Staas TA, Bronkhorst EM, Raghoebar GM, Meijer GJ. Factors Associated with Esthetic Outcomes of Flapless Immediate Placed and Loaded Implants in the Maxillary Incisor Region—Three-Year Results of a Prospective Case Series. J Clin Med 2023; 12:jcm12072625. [PMID: 37048707 PMCID: PMC10094793 DOI: 10.3390/jcm12072625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Flapless immediate implant placement and provisionalization (FIIPP) is often associated with an increased risk of buccal soft-tissue recession. This study aims to assess the 3-year esthetic outcome. In 100 consecutive patients, one maxillary incisor, with or without a pre-extraction buccal bone defect (≤5 mm), was replaced by an implant installed in a maximal palatal position (buccal gap ≥2 mm). The created gaps were filled with bovine bone substitute. Patient satisfaction (PS), pink esthetic scores (PES/modPES), and white esthetic score (WES) were calculated at different time points. A multilevel regression analysis (MRA) was performed to analyze which factors may be associated with the esthetics. After three years, PS scored 8.9 ± 0.84 on a scale of 10 (n = 83), and the soft-tissue esthetics were high (PES = 12.2; modPES = 8.5), as was the WES (8.2), showing no decrease from one year. Buccal bone defect size and smoking could not be associated with the soft-tissue outcome; however, implant location, gap size, and emergence profiles could. Performing FIIPP, the final crown (WES) scored highest when it was cemented, the soft tissue (PES/modPES) in central-incisor positions, and all (WES/PES/modPES) with concave emergence profiles.
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Sehgal V, Ruangsawasdi N, Kiattavorncharoen S, Bencharit S, Thanasrisuebwong P. Occlusive and Proliferative Properties of Different Collagen Membranes-An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1657. [PMID: 36837285 PMCID: PMC9964610 DOI: 10.3390/ma16041657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Different collagen barrier membranes come in various sources and crosslinking that may affect barrier function and tissue integration. This study investigated barrier function and tissue integration of the three different collagen membranes (Jason®: porcine pericardium, GENOSS: bovine tendon, and BioMend® Extend: cross-linked bovine tendon) with human gingival fibroblasts. The barrier function and tissue integration properties were determined under confocal microscopy. Morphological characteristics were observed using scanning electron microscopy. Our results showed that all collagen membranes allowed a small number of cells to migrate, and the difference in barrier function ability was not significant. The cross-linked characteristics did not improve barrier ability. The native collagen membrane surfaces allowed evenly scattered proliferation of HGF, while the cross-linked collagen membrane induced patchy proliferation. Statistically significant differences in cell proliferation were found between Jason and BioMend Extend membranes (p = 0.04). Scanning electron microscope showed a compact membrane surface at the top, while the bottom surfaces displayed interwoven collagen fibers, which were denser in the crosslinked collagen membranes. Within the limitations of this study, collagen membranes of different origins and physical properties can adequately prevent the invasion of unwanted cells. Native collagen membranes may provide a better surface for gingival cell attachment and proliferation.
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Affiliation(s)
- Vishal Sehgal
- Master of Science Program in Implant Dentistry, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Nisarat Ruangsawasdi
- Department of Pharmacology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Sirichai Kiattavorncharoen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Sompop Bencharit
- Office of Oral Health Innovation, Department of Oral Rehabilitation, The James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
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9
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Abdelwahab D, Ezz AlArab A, El Nahass H. Soft tissue esthetics around immediately provisionalized delayed implants with and without connective tissue graft: A randomized clinical trial pilot study. Clin Implant Dent Relat Res 2023; 25:11-22. [PMID: 36579756 DOI: 10.1111/cid.13168] [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: 06/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evaluate the peri-implant soft tissue esthetics following a single, immediately provisionalized, delayed implant with/-out subepithelial connective tissue graft (SCTG). MATERIAL AND METHODS The eligible patients were randomized into two groups. Immediate provisionalization was performed with (test group: SCTGG) or without SCTG (control group: NGG). The soft tissue esthetics was assessed by Pink Esthetic Score (PES) and Mucosal Scarring Index (MSI), at 6 and 12 months, following final implant restoration. RESULTS The SCTGG, compared to NGG, yielded a 0.2 increased PES at 12 months (95% confidence interval (CI): -1, 1.4) and a 0.2 decreased MSI score (95% CI -0.9, 0.5) with no statistically significant differences in PES and MSI between both groups (p > 0.05). CONCLUSION Soft tissue grafting around immediately provisionalized delayed implants could exhibit comparable results to immediate provisionalization alone in terms of peri-implant soft tissue esthetics using PES and MSI (ClinicalTrials.gov Identifier: NCT03770975).
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Affiliation(s)
- Dina Abdelwahab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Azza Ezz AlArab
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Hani El Nahass
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Hsieh MC, Huang CH, Hsu ML. Effect of cutting flute design features on primary stability of immediate implant placement and restoration: a dynamic experimental analysis. Med Biol Eng Comput 2023; 61:475-484. [PMID: 36515776 DOI: 10.1007/s11517-022-02722-w] [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: 01/10/2022] [Accepted: 11/20/2022] [Indexed: 12/15/2022]
Abstract
Self-tapping implants with self-cutting flutes may influence primary stability, especially for the immediate implant placement and restoration protocol in which implants are affixed to the bone in the apical portion. Screw geometry differs between brands, and the effect of apical design on its clinical outcomes remains unclear. This study is aimed at investigating the influence of cutting flute shape (spiral, straight, and without flute) on primary stability by using a dynamic experimental test. Six types of dental implants were designed using computer-aided design and computer-aided manufacturing technology, consisting of three types of cutting flute shapes along with two types of screw features. A dynamic mechanical test was performed using a cyclic loading scheme. The mechanical behaviors of resistance to lateral load (RLL), maximum force, and energy dissipation were compared between groups. In the dynamic test, implants without cutting flute also exhibited higher values in RLL, maximum force, and energy dissipation. The aggressive thread implant with straight flute displayed higher RLL and had a significantly higher values in RLL (p = 0.033) at the threshold point of bone-implant interface breakdown. The implants without cutting flutes exhibited higher primary stability. Straight flute design would improve RLL for aggressive thread implant.
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Affiliation(s)
- Min-Chieh Hsieh
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chang-Hung Huang
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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11
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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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12
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Trimpou G, Schwarz F, Begić A, Hess P, Lermen J, Keim N, Obreja K, Parvini P. Clinical performance of immediately placed and restored progressive-type implants in the esthetic zone: a prospective observational study. Int J Implant Dent 2022; 8:57. [PMID: 36414824 PMCID: PMC9681970 DOI: 10.1186/s40729-022-00462-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/12/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess implant success and survival of immediately placed and restored progressive-type implants in the esthetic zone. MATERIAL AND METHODS A total of n = 21 patients (21 implants) had received an immediate placement of a tapered, two-part implant with a progressive thread design (PL) for a single tooth replacement in the anterior maxilla. An immediate 'non full-functional loaded' restoration was provided upon adequate primary stability on a final patient-specific abutment (one abutment-one time concept). The final restoration was provided at 12 weeks (baseline). Implant survival and success (e.g. bleeding on probing-BOP, probing pocket depth-PD, mucosal recession-MR, pink esthetic score-PES) as well as patient- reported outcomes (PROM`S) were recorded at 6 and 12 months. RESULTS An adequate primary implant stability (i.e. insertion torque > 35 Ncm) was obtained at all but one sites. At 12 months, implant survival (n = 20 patients) amounted to 100%. Non-significant changes to baseline were noted for mean BOP (2.5 ± 28.2%), PD (- 0.26 ± 0.73 mm), and MR (0.0 ± 0.4 mm) values. PES values amounted to 12.9 ± 1.14 and 13.2 ± 0.84 at 6 and 12 months. Technical and mechanical complications were not observed. Patients expressed an overall high satisfaction. CONCLUSIONS The presented immediacy protocol was associated with high survival and success rates on the short-term.
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Affiliation(s)
- G. Trimpou
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - F. Schwarz
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - A. Begić
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - P. Hess
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - J. Lermen
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - N. Keim
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - K. Obreja
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - P. Parvini
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
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13
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Siegenthaler M, Strauss FJ, Gamper F, Hämmerle CHF, Jung RE, Thoma DS. Anterior implant restorations with a convex emergence profile increase the frequency of recession: 12-month results of a randomized controlled clinical trial. J Clin Periodontol 2022; 49:1145-1157. [PMID: 35817419 PMCID: PMC9804465 DOI: 10.1111/jcpe.13696] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 01/05/2023]
Abstract
AIM To test whether the emergence profile (CONVEX or CONCAVE) of implant-supported crowns influences the mucosal margin stability up to 12 months after insertion of the final restoration. MATERIALS AND METHODS Forty-seven patients with a single implant in the anterior region were randomly allocated to one of three groups: (1) CONVEX (n = 15), implant provisional and an implant-supported crown both with a convex profile; (2) CONCAVE (n = 16), implant provisional and an implant-supported crown both with a concave profile; (3) CONTROL (n = 16), no provisional (healing abutment only) and an implant-supported crown. All patients were recalled at baseline, 6, and 12 months. The stability of mucosal margin along with clinical, aesthetic, and profilometric outcomes as well as time and costs were evaluated. To predict the presence of recession, multivariable logistic regressions were performed and linear models using generalized estimation equations were conducted for the different outcomes. RESULTS Forty-four patients were available at 12 months post-loading. The frequency of mucosal recession amounted to 64.3% in group CONVEX, 14.3% in group CONCAVE, and 31.4% in group CONTROL. Regression models revealed that a CONVEX profile was significantly associated with the presence of recessions (odds ratio: 12.6, 95% confidence interval: 1.82-88.48, p = .01) compared with the CONCAVE profile. Pink aesthetic scores amounted to 5.9 in group CONVEX, 6.2 in group CONCAVE, and 5.4 in group CONTROL, with no significant differences between the groups (p = .735). Groups CONVEX and CONCAVE increased the appointments and costs compared with the CONTROL group. CONCLUSIONS The use of implant-supported provisionals with a CONCAVE emergence profile results in a greater stability of the mucosal margin compared with a CONVEX profile up to 12 months of loading. This is accompanied, however, by increased time and costs compared with the absence of a provisional and may not necessarily enhance the aesthetic outcomes. TRIAL REGISTRATION German Clinical Trials Register; DRKS00009420.
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Affiliation(s)
| | - Franz J. Strauss
- Clinic of Reconstructive DentistryUniversity of ZurichZürichSwitzerland
| | - Felix Gamper
- Clinic of Reconstructive DentistryUniversity of ZurichZürichSwitzerland
| | | | - Ronald E. Jung
- Clinic of Reconstructive DentistryUniversity of ZurichZürichSwitzerland
| | - Daniel S. Thoma
- Clinic of Reconstructive DentistryUniversity of ZurichZürichSwitzerland,Department of Periodontology, Research Institute for Periodontal Regeneration, College of DentistryYonsei UniversitySeoulSouth Korea
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14
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Kaddas C, Papamanoli E, Bobetsis YA. Etiology and Treatment of Peri-Implant Soft Tissue Dehiscences: A Narrative Review. Dent J (Basel) 2022; 10:dj10050086. [PMID: 35621539 PMCID: PMC9139705 DOI: 10.3390/dj10050086] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 02/07/2023] Open
Abstract
Implant soft tissue dehiscences compromise not only the aesthetics of the supported restorations but implant survival in the long run. The aim of this narrative review was to briefly present the causative factors of buccal peri-implant soft tissue dehiscences (PSTDs), how these are classified, and the current therapeutic approaches. Implant malposition and the thin peri-implant phenotype are the two major determinants for the occurrence of PSTDs, but other risk factors have also been identified. The most common surgical procedure for treating PSTDs is the split-thickness coronally advanced flap combined with either a connective tissue graft or acellular dermal matrix materials. However, depending on the class and subtype of the dehiscence, the combination of surgical techniques with modifications in the restoration may further ameliorate the final result. In general, within a five-year follow-up period, most techniques lead to a satisfactory aesthetic result, although full coverage of the implant/abutment surface is not always achievable, especially in more extended lesions.
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Affiliation(s)
- Charalampos Kaddas
- Private Practice, 115 27 Athens, Greece;
- Correspondence: (C.K.); (Y.A.B.); Tel.: +30-698-119-7563 (C.K.)
| | | | - Yiorgos A. Bobetsis
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- Correspondence: (C.K.); (Y.A.B.); Tel.: +30-698-119-7563 (C.K.)
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15
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Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res 2022; 33:634-655. [PMID: 35318752 DOI: 10.1111/clr.13924] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. MATERIALS AND METHODS Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. RESULTS Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001). CONCLUSIONS Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
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Affiliation(s)
- Algirdas Puisys
- Vilnius Research Group, Private Practice VIC Clinic, Vilnius, Lithuania
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16
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Santhanakrishnan M, Subramanian V, Ramesh N, Kamaleeshwari R. Radiographic and Esthetic Evaluation Following Immediate Implant Placement with or without Socket Shield and Delayed Implant Placement Following Socket Preservation in the Maxillary Esthetic Region - A Randomized Controlled Clinical Trial. Clin Cosmet Investig Dent 2021; 13:479-494. [PMID: 34824552 PMCID: PMC8610775 DOI: 10.2147/ccide.s332687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/04/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was assessment of the changes in soft and hard tissues in the esthetic zone of maxilla following immediate implant placement (IIP) with and without the socket shield technique (SST) and placement of implants 4 months following socket preservation (DIP) in terms of alterations in crestal bone thickness (CBT) and soft tissue changes evaluated by means of pink esthetic scores (PES) following placement of implants in the esthetic zone of maxilla. MATERIALS AND METHODS In the maxillary esthetic region, 75 dental implants were placed totally, with 25 implants each in the SST, IIP, and DIP groups. All participants were subjected to undergo CBCT for assessing the variations in thickness of crestal aspect of facial/buccal/labial alveolar bone (CBT). PES and PROMS (patient-related outcome measures) were assessed using VAS for pain threshold and esthetic satisfaction following implant placement and after 6th post-operative month. RESULTS The mean reduction in CBT showed a statistically significant difference between and within the groups, in comparison to IIP and DIP groups, which demonstrated an average reduction in CBT 0.4 ± 0.1 and 0.2 ± 0.1 at 6 months following implant placement, respectively. The SST group showed a significantly lesser reduction in CBT of 0.05 ± 0.02. However, the mean difference in PES within and among the groups showed no significant difference statistically at P < 0.05. On comparison of individual scores of PES between the groups, the results showed significant difference statistically at P < 0.001. CONCLUSION The SST group demonstrated minimal reduction in CBT and a superior PES at the end of 6 months compared with the IIP and DIP groups.
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Affiliation(s)
- Muthukumar Santhanakrishnan
- Faculty of Dental Sciences, Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Vedavalli Subramanian
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Nithyakalyani Ramesh
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - R Kamaleeshwari
- Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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17
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Cosyn J, Wessels R, Garcia Cabeza R, Ackerman J, Eeckhout C, Christiaens V. Soft tissue metric parameters, methods and aesthetic indices in implant dentistry: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:93-107. [PMID: 34642983 DOI: 10.1111/clr.13756] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/26/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The primary objective was to provide an overview of soft tissue metric parameters, methods, and aesthetic indices in implant dentistry. The secondary objective was to describe reliability and validity of aesthetic indices. MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase, and Cochrane databases up to October 2020 to identify studies on soft tissue metric parameters, methods, and aesthetic indices. Aesthetic indices were evaluated in terms of reliability and validity. Data extraction was performed by the same reviewers. RESULTS Five metric parameters (papilla height, linear changes in soft tissue level, color assessment, soft tissue thickness, and profilometric soft tissue changes) registered by means of several methods (intra-oral registrations, radiographic assessments, digital analyses, and ultrasonic assessments), and 15 aesthetic indices (Papilla Index (PI), ad hoc questions scored with Visual Analogue Scales, Pink Esthetic Score (PES), Implant Crown Aesthetic Index (ICAI), Implant Aesthetic Score (IAS), Rompen Index, Subjective Esthetic Score, White Esthetic Score, Copenhagen Index, Complex Esthetic Index, Californian Dental Association Index (CDAI), Peri-Implant, and Crown Index, Functional Implant Prosthodontic Score, Implant Restoration Esthetic Index (IREI), and Mucosal Scarring Index (MSI)) could be identified. With respect to metric parameters and methods, intra-oral registrations were least accurate whereas profilometric soft tissue changes on the basis of digital surface models were most accurate. Six aesthetic indices showed good inter-rater reliability (PI, PES, ICAI, CDAI, IREI, and MSI). Good validity could only be shown for two indices (PES and CEI). Given this and on the basis of ease of use and ease of interpretation, PES qualified best for clinical research on single implants. None of the indices fulfilled the quality criteria for clinical research on multiple implants. CONCLUSION Many soft tissue assessment methods with varying reliability and validity have been described and used, which hampers uniform reporting in implant dentistry. Clinical investigators are advised to measure linear and profilometric soft tissue changes using digital surface models, and to use a reliable and validated aesthetic index. Currently, PES qualifies best for aesthetic evaluation of single implants. An index is to be developed to assess the aesthetic outcome of rehabilitations on multiple implants.
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Affiliation(s)
- Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Retief Wessels
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Ricardo Garcia Cabeza
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Julie Ackerman
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Célien Eeckhout
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
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18
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Pjetursson BE, Sailer I, Latyshev A, Rabel K, Kohal RJ, Karasan D. A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns. Clin Oral Implants Res 2021; 32 Suppl 21:254-288. [PMID: 34642991 PMCID: PMC9293296 DOI: 10.1111/clr.13863] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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Affiliation(s)
- Bjarni Elvar Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrey Latyshev
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Maxillofacial, Oral and Plastic Surgery, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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19
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Raghoebar GM, Korfage A, Meijer HJA, Gareb B, Vissink A, Delli K. Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:138-156. [PMID: 34642988 DOI: 10.1111/clr.13759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid-buccal mucosa, at implants sites in the zone of the aesthetic priority. MATERIAL AND METHODS MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow-up of ≥1 year after implant placement. Outcome measures assessed included changes in level and thickness of mid-buccal mucosa, implant survival, peri-implant health and patients' satisfaction. RESULTS Eighteen out of 2,185 articles fulfilled the inclusion criteria. Meta-analysis revealed a significant difference in vertical mid-buccal soft tissue change (0.34 mm, 95% CI: 0.13-0.56, p = .002) and mid-buccal mucosa thickness (0.66 mm, 95% CI: 0.35-0.97, p < .001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid-buccal mucosa level following delayed implant placement (0.17 mm, 95% CI: 0.01-0.34, p = .042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22 mm, 95% CI: -0.04-0.47, p = .095). Observed changes remained stable in the medium term. CONCLUSION Soft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid-buccal mucosa following immediate implant placement and less recession in mid-buccal mucosa following delayed implant placement compared with no graft.
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Affiliation(s)
- Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anke Korfage
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Centre for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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20
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Immediate Implant Placement and Provisionalization in the Esthetic Zone: A 6.5-Year Follow-Up and Literature Review. Case Rep Dent 2021; 2021:4290193. [PMID: 34567810 PMCID: PMC8457954 DOI: 10.1155/2021/4290193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022] Open
Abstract
The success of dental implant therapy in the esthetic zone requires not only functional osseointegration but also a satisfactory esthetic outcome. To establish harmony, balance, and continuity of gingival architecture between an implant restoration and the adjacent natural dentition is challenging. Immediate implant placement and provisionalization following tooth extraction have been documented as a predictable treatment modality, with fewer surgical interventions needed, to replace a missing tooth in the esthetic zone. This case report illustrates immediate implant placement and provisionalization to replace a failing maxillary right central incisor while maintaining optimal gingival esthetics. The maxillary right central incisor was extracted without flap elevation to minimize soft and hard tissue trauma. Immediately afterwards, the implant was installed using a surgical stent and restored with a provisional crown that had no occlusal contacts. During healing, no significant adverse effects were observed clinically or radiographically. This proposed treatment modality provided the patient with immediate esthetics, function, and comfort without any complications during a follow-up period of 6.5 years.
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21
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Lilet R, Desiron M, Finelle G, Lecloux G, Seidel L, Lambert F. Immediate implant placement combining socket seal abutment and peri-implant socket filling: A prospective case series. Clin Oral Implants Res 2021; 33:33-44. [PMID: 34551159 DOI: 10.1111/clr.13852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/02/2021] [Accepted: 05/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this prospective case series was to assess the implant outcomes as well as hard and soft tissue dimensional changes of immediate implant placement in posterior sites using a custom-made sealing socket abutment (SSA) combined to peri-implant socket filling (PISF). MATERIAL AND METHODS Twenty patients were considered for single extraction and immediate implant in upper or lower posterior regions. The remaining peri-implant sockets were filled with Deproteinized Bovine Bone Mineral. Based on intra-oral scans (IOS), custom-made SSAs were placed the same day. Implant survival rate, peri-implant bone changes, peri-implant health and pink esthetic score (PES) were recorded up to 1 year post-implant placement. Moreover, CBCT and IOS were performed to monitor hard and soft tissue dimensional changes. RESULTS One implant failed to osseointegrate leading to an implant survival rate of 95% after 1 year. Peri-implant bone changes yielded 0.19 ± 0.31 mm and 84.2% of the implants displayed no or mild bleeding on probing. Horizontal bone remodeling was not significant from baseline to 1 year at any levels. Finally, soft tissue profile was stable in the most cervical area while minor changes occurred during the first 6 months below the gingival margin. The absence of mid-buccal recession (0.07 mm) and good PES were found after 1 year. CONCLUSION Despite its limitations, this study showed that immediate implants in the posterior region using the SSA + PISF protocol resulted in promising implant outcomes with limited hard and soft tissue dimensional changes while decreasing the overall treatment time.
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Affiliation(s)
- Romane Lilet
- Department of Periodontology and Oral Surgery, University Hospital Center (CHU) of Liège, Liege, Belgium
| | - Martin Desiron
- Department of Removable and Implant Prosthesis, Faculty of Medicine, University of Liege, Liege, Belgium
| | - Gary Finelle
- Private Practice, Paris, France.,Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Geoffrey Lecloux
- Department of Periodontology and Oral Surgery, University Hospital Center (CHU) of Liège, Liege, Belgium
| | - Laurence Seidel
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liege, Liege, Belgium
| | - France Lambert
- Department of Periodontology and Oral Surgery, University Hospital Center (CHU) of Liège, Liege, Belgium.,Dental Biomaterials Research Unit (d-BRU), University of Liège, Liege, Belgium
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22
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Groenendijk E, Bronkhorst EM, Meijer GJ. Does the pre-operative buccal soft tissue level at teeth or gingival phenotype dictate the aesthetic outcome after flapless immediate implant placement and provisionalization? Analysis of a prospective clinical case series. Int J Implant Dent 2021; 7:84. [PMID: 34448101 PMCID: PMC8390706 DOI: 10.1186/s40729-021-00366-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Immediate implant placement (IIP) often is related to mid-buccal recession in literature. To draw conclusions about the behavior of the soft tissues following IIP, pre-operative aesthetic measurements have to be taken into account. The aim of analysis of these prospective clinical case series data was to elucidate whether the pre-operative buccal soft tissue level (STL) or gingival phenotype influence the 1-year pink aesthetic outcome after performing flapless immediate implant placement and provisionalization (FIIPP) maxillary incisor cases. MATERIALS AND METHODS In 97 patients, a maxillary incisor was replaced performing FIIPP. STL and phenotype were analyzed on light-photographs made pre-operatively (T0), direct post-operatively (T1), after placement of the permanent crown (T2), and 1 year post-operatively (T3). To investigate if a pre-operative buccal soft tissue deficiency or excess influenced the total pink esthetic score (total-PES) per patient at T3, PES-3 was modified by adding a minus ("-") or plus ("+") in case of a STL-deficiency or excess, respectively. RESULTS Pre-operatively, 40% of the cases showed a mid-buccal recession (STL-deficiency), 19% STL-excess, while in 41% an equal level in comparison with the contra-lateral tooth was observed (STL-neutral). One year post-operatively, 79% (31/39) of the recession cases showed soft tissue gain, while STL-excess cases showed the highest rate of soft tissue reduction (94%; 17/18). This resulted in a decrease of soft tissue recessions and excesses (to 26% and 4%, respectively), and an increase of ideal STL (PES-3-score 2) to 70%. The 1-year aesthetic outcome was not statistically different (p = 0.577) between patients with a pre-operative soft tissue recession (mean T3 total-PES = 12.18) or STL excess (mean T3 total-PES = 11.94). Of the total population, 71 patients with a thin, and 26 with a thick phenotype were evaluated. No statistical difference (p = 0.08) was present in aesthetic outcome between the two phenotypes (thin mean T3 total-PES = 12.30, thick mean T3 total-PES = 11.65). CONCLUSION Regardless of phenotype, preoperative soft tissue recession, or excess, comparable high aesthetic outcomes were achieved 1 year post-operatively. TRIAL REGISTRATION Ethical approval was obtained and registered on 20 October 2015 ( NTR5583/NL4170 ).
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Affiliation(s)
- Edith Groenendijk
- Clinique Implantologie Den Haag, Stadhouderslaan 12, 2517 HW, Den Haag, The Netherlands.
| | | | - Gert Jacobus Meijer
- Department of Oral and Maxillofacial Surgery, Radboudumc, Nijmegen, The Netherlands
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Tokuc B, Kan B. The effect of triangular cross-section neck design on crestal bone stability in the anterior mandible: A randomized, controlled, split-mouth clinical trial. Clin Oral Implants Res 2021; 32:1241-1250. [PMID: 34352125 DOI: 10.1111/clr.13821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/05/2021] [Accepted: 07/22/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This randomized controlled trial aimed to compare crestal bone loss (CBL) and buccal bone thickness (BBT) around triangular cross-section neck (TN) to round neck (RN) implants retaining mandibular overdentures one year after loading, using cone beam computed tomography (CBCT). MATERIAL AND METHODS Twenty edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN and TN groups. Clinical buccal bone thickness (CBBT) around the implants was measured with a caliper at baseline. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the baseline and two months after insertion. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also recorded at postoperative months 2, 6, and 12. CBCT was used to evaluate proximal CBL and BBT at three levels (0, -2, and -4 mm) one year after loading. RESULTS No implant loss was observed during the follow-up period. No significant differences in CBBT, ISQ values, and scores for PPD, PI, and GI between the two groups were observed at any time (p > .05). BBT was also comparable one year after loading (p > .05). The mean ± SD proximal CBL one year after loading was 0.58 ± 0.36 mm for TN and 0.91 ± 0.59 mm for RN (p < .01). CONCLUSIONS This study found better crestal bone preservation in the implants with the novel neck design than conventional neck design in the anterior mandible after a follow-up of one year. However, it may not be clinically noticeable.
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Affiliation(s)
- Berkay Tokuc
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Bahadır Kan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Okan University, Istanbul, Turkey
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Garcia-Sanchez R, Mardas N, Buti J, Ortiz Ruiz AJ, Pardo Zamora G. Immediate implant placement in fresh alveolar sockets with a minimal split-thickness envelope flap: A randomised controlled clinical trial. Clin Oral Implants Res 2021; 32:1115-1126. [PMID: 34218469 DOI: 10.1111/clr.13806] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF). MATERIALS AND METHODS Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12-month post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria. RESULTS 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control versus 10.80 test), WES scores (6.97 control versus 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 ± 0.22) and test group (0.92 ± 0.31) and patients' reported outcomes. CONCLUSIONS Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients' satisfaction. However, aesthetic failures were common in both groups.
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Affiliation(s)
- Ruben Garcia-Sanchez
- Universidad de Murcia, Murcia, Spain.,Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nikos Mardas
- QMUL, The London School of Dentistry, London, UK
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Mareque S, Castelo-Baz P, López-Malla J, Blanco J, Nart J, Vallés C. Clinical and esthetic outcomes of immediate implant placement compared to alveolar ridge preservation: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4735-4748. [PMID: 34100157 DOI: 10.1007/s00784-021-03986-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/11/2021] [Indexed: 11/30/2022]
Abstract
AIM The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes. METHODS A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes. RESULTS A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05). CONCLUSION The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP. CLINICAL RELEVANCE Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.
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Affiliation(s)
- Santiago Mareque
- School of Medicine and Dentistry, Periodontology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Joaquín López-Malla
- Department of Periodontology, Faculty of Dentistry, University of Alfonso X El Sabio, Madrid, Spain
| | - Juan Blanco
- School of Medicine and Dentistry, Periodontology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | - Cristina Vallés
- Department of Periodontology, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain
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Comisso I, Arias-Herrera S, Gupta S. Zirconium dioxide implants as an alternative to titanium: A systematic review. J Clin Exp Dent 2021; 13:e511-e519. [PMID: 33981400 PMCID: PMC8106941 DOI: 10.4317/jced.58063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 12/26/2020] [Indexed: 01/11/2023] Open
Abstract
Background This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of zirconium dioxide implants concerning titanium implants.
Material and Methods The electronic databases were searched until January 2020. Outcome measures were pink aesthetic score (PAS), white aesthetic score (WAS), bleeding on probing (BOP) and probing depth (PD). The addressed PICO question was: In partially edentulous patients in the upper-anterior sector, do zirconium dioxide implants provide aesthetic benefits over conventional titanium implants?
Results In the 15 articles included after the screening were evaluated respectively, the pink aesthetic score, white aesthetics score, the peri-implant, and crown index, bleeding on probing, plaque index, probing pocket depth, radiographic bone loss, papilla height, and survival and success rate. The results show how the aesthetic and clinical benefits and the survival and success rate of zirconium dioxide implants are, in general, better than titanium implants.
Conclusions Despite the optimal aesthetics, clinical and survival results obtained in the review, more studies are needed to confirm these data. Key words:Ceramic dental implants, zirconia implants, esthetics, zirconium dioxide and zirconia.
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Affiliation(s)
- Ivana Comisso
- Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry
| | - Santiago Arias-Herrera
- Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry.,Clinical and Applied in Implant-Prosthetics (ICAI) Research Group, Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry
| | - Saurabh Gupta
- Zirconia Implant Research Group, Silver Spring, MD, 20910, USA.,Master Dental Science, Universitat Jaume I, Castellón, Spain
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Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:1655-1675. [PMID: 33515121 DOI: 10.1007/s00784-021-03794-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Preserving peri-implant tissues after immediate implant placement (IIP), especially in aesthetic zones, is a topic of interest. OBJECTIVES This systematic review investigated the effects of currently available surgical procedures for preserving peri-implant tissue or ensuring dimensional stability following immediate implant placement. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement's guidelines were followed, and articles were sought on the PubMed and Cochrane databases with no date restrictions. Only randomised clinical trials that evaluated changes in soft and hard tissues around immediately placed implants were included. Statistical analyses were performed, and the studies´ quality was assessed using the Cochrane Collaboration tool. The agreement between reviewers was assessed based on Cohen's kappa statistics. RESULTS Of the 14 studies that met the inclusion criteria, 11 were analysed in the meta-analysis (kappa = 0.814; almost perfect agreement). The use of connective tissue grafts resulted in a significantly greater improvement of the facial gingival level (MD = -0.51; 95% CI: -0.76 to -0.31; p = < .001), and the placement of bone grafts significantly reduced the horizontal resorption of the buccal bone (MD = -0.59; 95% CI: -0.78 to -0.39; p < .001). CONCLUSION Connective tissue grafts and bone grafts positively influence tissue preservation around immediately placed implants. Neither the flapless technique nor palatal implant positioning resulted in significant improvements to any of the investigated parameters. Additional longitudinal studies are required. CLINICAL RELEVANCE This meta-analysis is useful for discerning the effects of soft tissue augmentation, bone grafting, the flapless technique, and palatal implant positioning on preserving peri-implant tissues after immediate implant placement.
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Lambrechts T, Doornewaard R, De Bruyckere T, Matthijs L, Deschepper E, Cosyn J. A multicenter cohort study on the association of the one-abutment one-time concept with marginal bone loss around bone level implants. Clin Oral Implants Res 2020; 32:192-202. [PMID: 33226676 DOI: 10.1111/clr.13689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the association of the one-abutment one-time concept with marginal bone loss (MBL) around bone-level implants in relation to other factors. MATERIALS AND METHODS Records from patients treated by four experienced implant surgeons between January 2016 and July 2019 were scrutinized. Subjects treated with two bone-level implant types with varying machined collar (subgroups: 0.5 and 0.8 mm) were considered, receiving a healing abutment (HA cohort) or a permanent abutment at the time of surgery (OT cohort). The primary outcome was MBL registered at 3 months and the longest follow-up. A clustered two-part regression model for semicontinuous data was used. RESULTS Data pertaining to 160 patients (92 females, mean age 54) and 344 implants (125 in HA cohort, 219 in OT cohort) were available for evaluation. Mean MBL amounted to 0.52 mm (SD 0.68) after a mean follow-up of 20 (SD 9.2) months, with 33.8% of the implants showing complete bone preservation and 5.0% demonstrating >2mm MBL. OT was not related to the presence of MBL using MBL as dependent binary variable (0: no MBL; 1: MBL irrespective of its magnitude). However, OT significantly reduced the magnitude of MBL with 0.300mm when compared to HA (p = .023) in the cases where MBL was detected. Subgroup (p = .212), smoking (p = .789), history of periodontitis (p = .839), type of edentulism (p = .054), implant surgeon (p = .079), patient compliance (p = .617), and follow-up (p = .443) failed to show a significant association with MBL in the regression model. Ninety-eight % of the implants survived. CONCLUSION Within the limitations of a cohort study, the one-abutment one-time concept was associated with a decrease in MBL at implant sites with bone loss. Therefore, the placement of a permanent abutment at the time of surgery seems relevant to limit marginal bone-level alterations.
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Affiliation(s)
- Tijs Lambrechts
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Ron Doornewaard
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Thomas De Bruyckere
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | | | - Ellen Deschepper
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
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Chapanov KI, Iliev GV, Kazakov ST. Online-based software for guiding immediate implantation to replace a tooth with root resorption in the esthetic zone. Clin Case Rep 2020; 8:2382-2389. [PMID: 33363746 PMCID: PMC7752444 DOI: 10.1002/ccr3.3117] [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: 12/05/2019] [Revised: 06/02/2020] [Accepted: 06/15/2020] [Indexed: 11/05/2022] Open
Abstract
This case report describes an alternative approach for the planning of immediate implant placement and provisionalization, which uses a new online dental software that predicts the esthetic outcome.
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Affiliation(s)
- Krasimir Ivanov Chapanov
- Department of Oral and Maxillofacial SurgeryFaculty of Dental MedicineMedical UniversitySofiaBulgaria
| | - Georgi Veselinov Iliev
- Department of Prosthetic Dental MedicineFaculty of Dental MedicineMedical UniversitySofiaBulgaria
| | - Stoyan Torezov Kazakov
- Department of Oral and Maxillofacial SurgeryFaculty of Dental MedicineMedical UniversitySofiaBulgaria
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Seyssens L, De Lat L, Cosyn J. Immediate implant placement with or without connective tissue graft: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:284-301. [PMID: 33125754 DOI: 10.1111/jcpe.13397] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/25/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, EMBASE and Cochrane databases as well as a manual search to identify eligible clinical studies up to January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12 months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs. RESULTS Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p < .001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p = .002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p = .06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. CONCLUSION CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness).
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Liesa De Lat
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Hsieh MC, Huang CH, Lin CL, Hsu ML. Effect of implant design on the initial biomechanical stability of two self-tapping dental implants. Clin Biomech (Bristol, Avon) 2020; 74:124-130. [PMID: 32361012 DOI: 10.1016/j.clinbiomech.2020.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 02/02/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study evaluated the effect of two self-tapping implants on implant stability in immediate implantation. METHODS Two types of self-tapping implants, straight flute (STF) and spiral flute (SPF) designs, were studied. Two synthetic bone blocks with varying densities (0.32 g/cm3 and 0.16 g/cm3) were chosen to simulate the bone quality of the anterior maxilla. Insertion torque values were measured by a torque testing machine during implant insertion. Four biomechanical tests were performed: resonance frequency analysis was conducted using the Osstell device, and the strengths of screw push-in, lateral bending, and pull-out were evaluated using an MTS machine. The strength for each design feature was obtained by averaging the results of 10 trials. In total, 40 specimens were tested for each bone density. Statistical difference was determined by one-way analysis of variance followed by Bonferroni post hoc multiple tests between groups. FINDINGS The STF and SPF groups exhibited similar insertion torque values (p = 0.525 in low-density bone, and p = 0.99 in high-density bone). A significant difference (p < 0.001) was observed in the push-in test between the two groups when low-density bone was tested. The SPF group exhibited a significantly higher lateral bending force (p = 0.001) and a higher stiffness (p < 0.001) than the STF group in high-density bone. The SPF design attained higher (p < 0.001) ISQ numbers than the STF design, but all numbers were below 60. INTERPRETATION Implant stability can be influenced by the apical fixture design of self-tapping implants in immediate implantation.
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Affiliation(s)
- Min-Chieh Hsieh
- Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chang-Hung Huang
- Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Chun-Li Lin
- School of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
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Groenendijk E, Staas TA, Bronkhorst E, Raghoebar GM, Meijer GJ. Immediate implant placement and provisionalization: Aesthetic outcome 1 year after implant placement. A prospective clinical multicenter study. Clin Implant Dent Relat Res 2020; 22:193-200. [PMID: 31991527 DOI: 10.1111/cid.12883] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/16/2019] [Accepted: 12/30/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prospective aesthetic outcomes on a high number of patients after immediate implant placement and provisionalization (IIPP) are lacking. PURPOSE To analyze the aesthetic outcome after IIPP. MATERIALS AND METHODS One hundred consecutive patients with a failing maxillary incisor were provided with an immediately placed and provisionalized nonloaded implant using a flapless procedure and palatal implant positioning. The remaining gap buccally was filled with a bone substitute. Preoperatively (T0), 2 weeks postoperatively (T1), direct after placement of the permanent crown (T2), and 1 year after IIPP (T3), standardized light photographs were made. Change in aesthetic score was the primary outcome measure. Both the white aesthetic score (WES) and pink aesthetic score (PES) were used. RESULTS In the first year postsurgery, the mean total-WES and total-PES scores raised from 4.5 to 8.2, and from 9.9 to 12.1, respectively. The mean PES scores for mesial and distal papilla, soft tissue marginal level, contour, color, and texture, raised significantly (P < .05), while the alveolar process contour, on average, remained stable from T0 to T3. CONCLUSIONS Within the limitations of this 1-year research, it may be concluded that, following this minimal invasive IIPP procedure, a high aesthetic outcome was achieved.
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Affiliation(s)
| | | | - Ewald Bronkhorst
- Department of Preventive and Curative Dentistry, Radboudumc, Nijmegen, The Netherlands
| | - Gerry Max Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gert Jacobus Meijer
- Department of Oral and Maxillofacial Surgery, Radboudumc, Nijmegen, The Netherlands
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Wang I, Chan H, Kinney J, Wang H. Volumetric facial contour changes of immediately placed implants with and without immediate provisionalization. J Periodontol 2020; 91:906-916. [DOI: 10.1002/jper.19-0308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/21/2019] [Accepted: 12/01/2019] [Indexed: 11/11/2022]
Affiliation(s)
- I‐Ching Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Hsun‐Liang Chan
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Janet Kinney
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor MI
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Boon L, De Mars G, Favril C, Duyck J, Quirynen M, Vandamme K. Esthetic evaluation of single implant restorations, adjacent single implant restorations, and implant-supported fixed partial dentures: A 1-year prospective study. Clin Implant Dent Relat Res 2020; 22:128-137. [PMID: 31912661 DOI: 10.1111/cid.12882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/18/2019] [Accepted: 12/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Peri-implant soft tissues esthetics varies and depends on the restoration type such as implant-supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). PURPOSE The aim of this prospective study was to assess the esthetic outcome of the peri-implant soft tissues of (NobelBiocare™) implant-supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. MATERIALS AND METHODS Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post-insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1-year follow-up. RESULTS The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant-supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant-supported FPD. CONCLUSION When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.
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Affiliation(s)
- L Boon
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Prosthetic & Restorative Dentistry, Leuven, Belgium
| | - G De Mars
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Periodontology, Leuven, Belgium
| | - C Favril
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Periodontology, Leuven, Belgium
| | - J Duyck
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Prosthetic & Restorative Dentistry, Leuven, Belgium
| | - M Quirynen
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Periodontology, Leuven, Belgium
| | - K Vandamme
- KU Leuven-Department of Oral Health Sciences, UZ Leuven University Hospitals Leuven-Prosthetic & Restorative Dentistry, Leuven, Belgium
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Saito H, Aichelmann‐Reidy MB, Oates TW. Advances in implant therapy in North America: Improved outcomes and application in the compromised dentition. Periodontol 2000 2019; 82:225-237. [DOI: 10.1111/prd.12319] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hanae Saito
- Division of Periodontics Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
| | - Mary Beth Aichelmann‐Reidy
- Division of Periodontics Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
| | - Thomas W. Oates
- Department of Advanced Oral Sciences & Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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Sun C, Zhao J, Liu Z, Tan L, Huang Y, Zhao L, Tao H. Comparing conventional flap‐less immediate implantation and socket‐shield technique for esthetic and clinical outcomes: A randomized clinical study. Clin Oral Implants Res 2019; 31:181-191. [PMID: 31680339 DOI: 10.1111/clr.13554] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 10/15/2019] [Accepted: 10/19/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Cong Sun
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Jinxiu Zhao
- Department of Stomatology People's Hospital of Gaomi Gaomi China
| | - Zhi Liu
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Lei Tan
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - YaLi Huang
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Liang Zhao
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
| | - Hong Tao
- Department of Stomatology the First Affiliated Hospital of Xi'an Jiaotong University Xi'an China
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Perez A, Caiazzo A, Valente NA, Toti P, Alfonsi F, Barone A. Standard vs customized healing abutments with simultaneous bone grafting for tissue changes around immediate implants. 1-year outcomes from a randomized clinical trial. Clin Implant Dent Relat Res 2019; 22:42-53. [PMID: 31797548 DOI: 10.1111/cid.12871] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/29/2019] [Accepted: 10/31/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Immediate implants have shown risks of esthetic complications. The hypothesis was that a customized healing abutment could improve the peri-implant tissue healing. PURPOSE To evaluate and compare the soft and hard tissue healing around immediate implants that received bone grafting and a customized vs a standard healing abutment. MATERIALS AND METHODS Patients, who required tooth extraction and who received an immediate implant (with an alloplastic graft material) were randomly assigned to a customized or a standard healing abutment group. Clinical and radiographic examinations were taken at baseline, at 4 and 12 months. RESULTS Twenty-five patients out of 61 were excluded from the study because unsuitable for immediate implantation. In total, 36 patients were randomized in the two groups. There were 17 females and 19 males (age range 23-77). No prosthetic or implant failure was registered during the study period. The Papilla Index was significantly higher in the customized than in the standard group at 4 and 12 months (P = .0002). The bone loss at mesial sites was significantly higher in the control than in the test group (P = .0014). CONCLUSION The customized healing abutment group showed the most favorable outcomes (in terms of PI and MBL) in case of immediate implant that received a peri-implant bone grafting procedure.
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Affiliation(s)
- Alexandre Perez
- Head of Clinical Activities, Unit of Oral Surgery and Implantology, Department of Oral and Maxillofacial Surgery, University Hospital of Geneva, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alfonso Caiazzo
- Private Practice, Salerno, Italy.,President of the Italian Academy of Osseointegration, Salerno, Italy
| | - Nicola A Valente
- Head of clinical activities Unit of Oral Surgery and Implantology, Department of Oral and Maxillofacial Surgery, University Hospital of Geneva, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paolo Toti
- Research Fellow, University Marconi, Rome, Italy
| | | | - Antonio Barone
- Unit of Implantology, Department of Surgical, Medical and Molecular Pathology, University of Pisa, University-Hospital of Pisa, Pisa, Italy.,Chairman of Oral Surgery and Implantology, Department of Oral and Maxillofacial Surgery, University Hospital of Geneva, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Chan HL, George F, Wang IC, Suárez López Del Amo F, Kinney J, Wang HL. A randomized controlled trial to compare aesthetic outcomes of immediately placed implants with and without immediate provisionalization. J Clin Periodontol 2019; 46:1061-1069. [PMID: 31292983 DOI: 10.1111/jcpe.13171] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 06/13/2019] [Accepted: 07/06/2019] [Indexed: 12/01/2022]
Abstract
INTRODUCTION There are mixed results regarding the aesthetic advantage of immediate provisionalization of dental implants. Therefore, this study aimed to compare facial mucosal level of single immediately placed implants with and without immediate provisionalization. METHODS Single implants were immediately placed to replace a hopeless maxillary anterior or premolar tooth in 40 subjects. Each implant was randomly assigned to receive a non-occluding temporary crown or a healing abutment after implant placement. At 4 months, these implants were permanently restored and followed up for 12 months. Clinical and radiographic parameters were measured and compared. RESULTS The implant survival rate at 12 months in the test and control group was 90% and 100%, respectively. Mid-facial mucosal marginal level and papilla height changes were minimal within groups, and no significant differences were found between the two groups. The amount of marginal bone remodelling was modest, with no significant difference between the two groups. Radiographic bone changes were not statistically different between the groups, except for the vertical crestal bone resorption. CONCLUSION Immediate implant placement with or without provisionalization can achieve stable vertical soft tissue level for 12 months as compared to pre-extraction level. However, immediate provisionalization was not able to improve the aesthetic outcome further.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Furat George
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - I-Ching Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | | | - Janet Kinney
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Thoma DS, Jung UW, Gil A, Kim MJ, Paeng KW, Jung RE, Fickl S. The effects of hard and soft tissue grafting and individualization of healing abutments at immediate implants: an experimental study in dogs. J Periodontal Implant Sci 2019; 49:171-184. [PMID: 31285941 PMCID: PMC6599753 DOI: 10.5051/jpis.2019.49.3.171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/16/2019] [Accepted: 05/21/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa (0.88±0.48 mm and 0.37±1.1 mm, respectively). The IA and IAG groups exhibited an apical shift of the mucosa (−0.7±1.15 mm and −1.1±0.96 mm, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of 4.1±0.28 mm and 4.0±0.53 mm relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6 mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group (−0.73±0.46 mm) lost less volume on the buccal side than the control (−0.93±0.44 mm), SA (−0.97±0.73 mm), and IAG (−0.88±0.45 mm) groups. Conclusions The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Alfonso Gil
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
| | - Stefan Fickl
- Department of Periodontology, Julius-Maximilians-University of Würzburg, Würzburg, Germany
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Tian J, Wei D, Zhao Y, Di P, Jiang X, Lin Y. Labial soft tissue contour dynamics following immediate implants and immediate provisionalization of single maxillary incisors: A 1‐year prospective study. Clin Implant Dent Relat Res 2019; 21:492-502. [PMID: 31058433 DOI: 10.1111/cid.12786] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Jiehua Tian
- Department of Oral ImplantologyPeking University School and Hospital of Stomatology Beijing China
| | - Donghao Wei
- Department of Oral ImplantologyPeking University School and Hospital of Stomatology Beijing China
| | - Yijiao Zhao
- Center of Digital DentistryPeking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology Beijing China
| | - Ping Di
- Department of Oral ImplantologyPeking University School and Hospital of Stomatology Beijing China
| | - Xi Jiang
- Department of Oral ImplantologyPeking University School and Hospital of Stomatology Beijing China
| | - Ye Lin
- Department of Oral ImplantologyPeking University School and Hospital of Stomatology Beijing China
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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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Rabel K, Spies BC, Pieralli S, Vach K, Kohal RJ. The clinical performance of all-ceramic implant-supported single crowns: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 18:196-223. [PMID: 30306684 DOI: 10.1111/clr.13337] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). MATERIAL AND METHODS Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. RESULTS Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. CONCLUSIONS All-ceramic implant-supported SCs showed-with the exception of a RNC material-high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs.
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Affiliation(s)
- Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Sanz-Martín I, Encalada C, Sanz-Sánchez I, Aracil J, Sanz M. Soft tissue augmentation at immediate implants using a novel xenogeneic collagen matrix in conjunction with immediate provisional restorations: A prospective case series. Clin Implant Dent Relat Res 2018; 21:145-153. [DOI: 10.1111/cid.12696] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 09/20/2018] [Accepted: 10/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Carolina Encalada
- Section of Graduate Periodontology; University Complutense; Madrid Spain
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Javier Aracil
- Section of Graduate Periodontology; University Complutense; Madrid Spain
| | - Mariano Sanz
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
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Hu C, Lin W, Gong T, Zuo Y, Qu Y, Man Y. Early Healing of Immediate Implants Connected With Two Types of Healing Abutments. IMPLANT DENT 2018; 27:646-652. [DOI: 10.1097/id.0000000000000809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cheng AW, Berridge JP, McGary RT, Erley KJ, Johnson TM. The Extraction Socket Management Continuum: A Hierarchical Approach to Dental Implant Site Development. Clin Adv Periodontics 2018; 9:91-104. [DOI: 10.1002/cap.10049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/16/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Albert W. Cheng
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Joshua P. Berridge
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Ryan T. McGary
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Kenneth J. Erley
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
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A randomized controlled clinical trial assessing initial crestal bone remodeling of implants with a different surface roughness. Clin Implant Dent Relat Res 2018; 20:824-828. [DOI: 10.1111/cid.12652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/04/2018] [Accepted: 06/09/2018] [Indexed: 11/26/2022]
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47
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Chen J, Chiang C, Zhang Y. Esthetic evaluation of natural teeth in anterior maxilla using the pink and white esthetic scores. Clin Implant Dent Relat Res 2018; 20:770-777. [PMID: 30048032 DOI: 10.1111/cid.12631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 05/04/2018] [Accepted: 05/11/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Natural teeth in the anterior maxilla are critical in determination the esthetic outcome of single implant prosthesis. PURPOSE The present study aimed to explore aesthetics of natural teeth in the anterior maxilla using the Pink Esthetic Score/White Esthetic Score (PES/WES) index. Additionally, inherent weak spots of natural teeth and high-risk parameters of prostheses were also considered. MATERIAL AND METHODS This cross-sectional study was performed by photographic analysis. RESULTS A total of 102 subjects and 306 teeth (the right incisor, lateral incisor and canine) were included. The grand means of the PES and WES were 12.92 and 8.75, respectively. The score of soft tissue margin, soft tissue contour and outline/volume of the crown were significantly lower than other variables. The PES and WES showed a downward trend with age. Most of the PES/WES values of the females exceeded those of the males. CONCLUSION The average level of natural teeth in PES and WES assessment were around 13 and 9, respectively. The soft tissue margin, soft tissue contour and outline/volume of the crown were high-risk parameters for the esthetic outcomes of implant reconstructions. Underlying factors, such as age and gender, contributed to the esthetics of natural teeth change.
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Affiliation(s)
- Jiang Chen
- Department of Oral Implantology, Affiliated Stomatological Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Chaoyou Chiang
- The School of Stomatology, Fujian Medical University, Fuzhou, Fujian, China. Fujian Biological Materials Engineering and Technology Center of Stomatology, Fuzhou, Fujian, China
| | - Yuqing Zhang
- The School of Stomatology, Fujian Medical University, Fuzhou, Fujian, China. Stomatological Key lab of Fujian College and University, Fujian Medical University, Fuzhou, Fujian, China
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Pour NN, Ghaedi B, Sohrabi M. Soft-tissue esthetic outcome of single implants: Immediate placement in fresh extraction sockets versus conventional placement in healed sockets. J Indian Soc Periodontol 2018; 22:249-253. [PMID: 29962705 PMCID: PMC6009153 DOI: 10.4103/jisp.jisp_21_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Immediate implant placement has advantages such as requiring fewer surgical procedures and decreased treatment time; however, unpredictable soft- and hard-tissue outcome is a problem. This study aimed to compare the soft-tissue esthetic outcome of single implants placed in fresh extraction sockets versus those placed in healed sockets. Materials and Methods: This cross-sectional, retrospective study was performed on 42 patients who received single implants. Twenty-two patients with a mean age of 40.14 years received immediate implants while 18 patients with a mean age of 43.40 years were subjected to conventional (delayed) implant placement. The mean follow-up time was 14.42 ± 8.37 months and 18.25 ± 7.10 months in the immediate and conventional groups, respectively. Outcome assessments included clinical and radiographic examinations. The esthetic outcome was objectively rated using the pink esthetic score (PES). Results: All implants fulfilled the success criteria. The mean PES was 8.54 ± 1.26 and 8.10 ± 1.65 in the immediate and conventional groups, respectively. This difference was not statistically significant (P = 0.329). The two PES parameters, namely, the facial mucosa curvature and facial mucosa level had the highest percentage of complete score. Conclusions: Immediate and conventional single implant treatments yielded comparable esthetic outcomes.
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Affiliation(s)
- Nima Naddaf Pour
- Department of Periodontology, Dental School, Islamic Azad University, Tehran, Iran
| | - Baharak Ghaedi
- Periodontist, Private Practice, Tehran University of Medical Science, Tehran, Iran
| | - Mona Sohrabi
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
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Lin CY, Chen Z, Pan WL, Wang HL. Impact of timing on soft tissue augmentation during implant treatment: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29:508-521. [PMID: 29603808 DOI: 10.1111/clr.13148] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND To achieve a predictable esthetic and functional outcome, soft tissue augmentation has become popular in implant treatment. OBJECTIVES The aim of this systematic review and meta-analysis was to assess the influence of different timing for soft tissue augmentation during implant treatment on soft tissue conditions and its stability. MATERIAL AND METHODS Electronic and manual searches for articles written in English up to September 2017 were performed by two independent reviewers. Human clinical studies with the purpose of evaluating outcomes (at least 3-month follow-up) of autogenous soft tissue graft for augmentation during implant treatment, either simultaneous or after implant placement (staged), were included. Cumulative changes of keratinized tissue width (KTW), soft tissue thickness (STT), and mid-buccal mucosal recession (MR) data were analyzed with a random-effects model to compare the postoperative outcomes. RESULTS Twenty-nine human studies (eight randomized clinical trials, six cohort studies, and 15 case series) that met the inclusion criteria were included. For the overall data, the weighted mean STT gain (1 year after surgery) was 1.03 mm (95% CI: 0.78-1.29 mm), among which the simultaneous group was 1.12 mm (95% CI: 0.75-1.49 mm) and staged group (3-6 months after implant placement) was 0.95 mm (95% CI: 0.58-1.31 mm). There was no statistically significant difference in KTW and MR between 3 months and more than 3 months after surgery. CONCLUSIONS This review revealed that the stability of soft tissue, in terms of KTW and mid-buccal MR, can be obtained 3 months after surgery. There is no difference between simultaneous and staged soft tissue augmentation during implant treatment, and both procedures significantly enhance KTW and STT.
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Affiliation(s)
- Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
- Chang Gung University, Taoyuan City, Taiwan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Whei-Lin Pan
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
- Chang Gung University, Taoyuan City, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
- State Key Laboratory of Oral Diseases, Department of Prosthodontics, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Raes S, Eghbali A, Chappuis V, Raes F, De Bruyn H, Cosyn J. A long-term prospective cohort study on immediately restored single tooth implants inserted in extraction sockets and healed ridges: CBCT analyses, soft tissue alterations, aesthetic ratings, and patient-reported outcomes. Clin Implant Dent Relat Res 2018; 20:522-530. [DOI: 10.1111/cid.12613] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/14/2018] [Accepted: 03/21/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Stefanie Raes
- Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences; Ghent University; Ghent Belgium
| | - Aryan Eghbali
- Oral Health Research Group (ORHE), Faculty of Medicine and Pharmacy; Vrije Universiteit Brussel; Brussels Belgium
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine; University of Bern; Bern Switzerland
| | - Filiep Raes
- Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences; Ghent University; Ghent Belgium
| | - Hugo De Bruyn
- Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences; Ghent University; Ghent Belgium
- Department of Prosthodontics, Faculty of Odontology; Malmö University; Malmö Sweden
- Department Periodontology and Implantology; College of Dental Science, Radboud University Medical Center; Nijmegen The Netherlands
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences; Ghent University; Ghent Belgium
- Oral Health Research Group (ORHE), Faculty of Medicine and Pharmacy; Vrije Universiteit Brussel; Brussels Belgium
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