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Ramezanzade S, Yates J, Tuminelli FJ, Keyhan SO, Yousefi P, Lopez-Lopez J. Zygomatic implants placed in atrophic maxilla: an overview of current systematic reviews and meta-analysis. Maxillofac Plast Reconstr Surg 2021; 43:1. [PMID: 33409713 PMCID: PMC7788139 DOI: 10.1186/s40902-020-00286-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Zygomatic implants are a treatment option for severely atrophic maxilla. MAIN TEXT This study aimed to summarize and evaluate systematic reviews assessing the clinical outcomes of zygomatic implants including survival/failure rate and complications. PubMed-MEDLINE, Google Scholar, LILACS, and the Cochrane Database were searched up to April 2020. Risk of bias assessment was conducted by the AMSTAR tool. Initial searches yielded 175 studies. These were assessed, and following title abstract and full-text evaluation, 7 studies (2 meta-analyses) were included in the final review. According to the AMSTAR tool, 1 was deemed high quality, 4 were classified as medium, and 2 as low quality. The mean AMSTAR score (±SD) was 5.28 of 9 (±2.36) ranging from 2/9 to 9/9. The reported survival rates ranged from 95.2 to 100% except for resected maxillas, which established higher failure rates up to 21.43%. Concerning the complications with the zygomatic implants, various surgical and prosthetic complications were reported with sinusitis being the most frequently observed complication. Zygomatic implants appears to offer a promising alternative to formal bone grafting techniques with lower costs, less complications, less morbidity, shorter treatment times, and comparably high survival rates. CONCLUSION Complications were rare and usually easy to manage. However, the treatment should be directed by appropriately trained clinicians with noticeable surgical experience.
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Affiliation(s)
| | - Julian Yates
- Department of Oral and Maxillofacial Surgery, University of Manchester, Manchester, UK
| | - Frank J. Tuminelli
- Department of Dental Medicine, Hofstra Northwell School of Medicine, New York, USA
| | - Seied Omid Keyhan
- Maxillofacial Surgery and Implantology Research Foundation., Tehran, Iran
- Craniomaxillofacial Research Center for Craniofacial Reconstruction, Tehran University of Medical Science, Shariati Hospital, Tehran, Iran
| | - Parisa Yousefi
- Department of Prosthodontics, Dental College, Isfahan University of Medical Science, Isfahan, Iran
| | - Jose Lopez-Lopez
- Department of Odontostomatology, School of Dentistry & Dental Hospital Barcelona University, University of Barcelona, Feixa Llarga, s/n – L’Hospitalet de Llobregat, 08907 Barcelona, Spain
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Edher F, Nguyen CT. Short dental implants: A scoping review of the literature for patients with head and neck cancer. J Prosthet Dent 2017; 119:736-742. [PMID: 28927926 DOI: 10.1016/j.prosdent.2017.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/06/2017] [Accepted: 06/08/2017] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Dental implants can be essential in the rehabilitation of various cancer defects, but their ideal placement can be complicated by the limited dimensions of the available host bone. Surgical interventions developed to increase the amount of bone are not all predictable or successful and can sometimes be contraindicated. Short dental implants have been suggested as an alternative option in sites where longer implants are not possible. Whether they provide a successful treatment option is unclear. PURPOSE The purpose of this study was to review the literature on short dental implants and assess whether they are a viable definitive treatment option for rehabilitating cancer patients with deficient bone. MATERIAL AND METHODS A scoping review of the literature was performed, including a search of established periodontal textbooks for articles on short dental implants combined with a search of PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. A search for all literature published before June 2016 was based on the following keywords: ['dental implants' OR 'dental implantation, endosseous' OR 'dental prosthesis, implant supported'] AND [short]. RESULTS The minimum acceptable implant length has been considered to be 6 mm. The survival rates of short implants varied between 74% and 96% at 5 years, depending on factors such as the quality of the patient's bone, primary stability of the implant, clinician's learning curve, and implant surface. Short implants can achieve results similar to those of longer implants in augmented bone and offer a treatment alternative that could reduce the need for invasive surgery and associated morbidity and be safer and more economical. CONCLUSIONS Short dental implants (6 mm to 8 mm) can be used successfully to support single or multiple fixed reconstructions or overdentures in atrophic maxillae and mandibles. The use of short dental implants lessens the need for advanced and complicated surgical bone augmentation procedures, which reduces complications, costs, treatment time, and morbidity. Short implants could be an alternative in the rehabilitation of patients with cancer.
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Affiliation(s)
- Faraj Edher
- Graduate student, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline T Nguyen
- Assistant Professor, Department of Oral Health Sciences, University of British Columbia; and Provincial Practice Leader in Prosthodontics, Department of Oral Oncology and Dentistry, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
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Dragan E, Guillaume OA, Haba D, Olszewski R. Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study. Med Sci Monit 2015; 21:2666-71. [PMID: 26363865 PMCID: PMC4572718 DOI: 10.12659/msm.894403] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. MATERIAL AND METHODS One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. RESULTS All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. CONCLUSIONS In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation.
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Affiliation(s)
- Eliza Dragan
- Departmenmt of Maxillofacial Radiology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Odri A Guillaume
- Orthopaedic Surgery and Traumatology, Regional Hospital of Orléans, Orléans, France
| | - Danisia Haba
- Departmenmt of Maxillofacial Radiology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Raphael Olszewski
- Department of Oral and Maxillofacial Surgery, Catholic University of Louvain, Brussels, Belgium
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Monteiro DR, Silva EVF, Pellizzer EP, Filho OM, Goiato MC. Posterior partially edentulous jaws, planning a rehabilitation with dental implants. World J Clin Cases 2015; 3:65-76. [PMID: 25610852 PMCID: PMC4295221 DOI: 10.12998/wjcc.v3.i1.65] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 07/22/2014] [Accepted: 12/10/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning.
METHODS: An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review.
RESULTS: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters.
CONCLUSION: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.
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von Salis-Soglio M, Stübinger S, Sidler M, Klein K, Ferguson SJ, Kämpf K, Zlinszky K, Buchini S, Curno R, Péchy P, Aronsson BO, von Rechenberg B. A novel multi-phosphonate surface treatment of titanium dental implants: a study in sheep. J Funct Biomater 2014; 5:135-57. [PMID: 25215424 PMCID: PMC4192609 DOI: 10.3390/jfb5030135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/20/2014] [Accepted: 09/02/2014] [Indexed: 01/18/2023] Open
Abstract
The aim of the present study was to evaluate a new multi-phosphonate surface treatment (SurfLink®) in an unloaded sheep model. Treated implants were compared to control implants in terms of bone to implant contact (BIC), bone formation, and biomechanical stability. The study used two types of implants (rough or machined surface finish) each with either the multi-phosphonate Wet or Dry treatment or no treatment (control) for a total of six groups. Animals were sacrificed after 2, 8, and 52 weeks. No adverse events were observed at any time point. At two weeks, removal torque showed significantly higher values for the multi-phosphonate treated rough surface (+32% and +29%, Dry and Wet, respectively) compared to rough control. At 52 weeks, a significantly higher removal torque was observed for the multi-phosphonate treated machined surfaces (+37% and 23%, Dry and Wet, respectively). The multi-phosphonate treated groups showed a positive tendency for higher BIC with time and increased new-old bone ratio at eight weeks. SEM images revealed greater amounts of organic materials on the multi-phosphonate treated compared to control implants, with the bone fracture (from the torque test) appearing within the bone rather than at the bone to implant interface as it occurred for control implants.
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Affiliation(s)
- Marcella von Salis-Soglio
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stefan Stübinger
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Michéle Sidler
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Karina Klein
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Stephen J Ferguson
- Institute for Biomechanics, ETH Zürich, Vladimir-Prelog-Weg 1-5/10, Zürich 8093, Switzerland.
| | - Käthi Kämpf
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Katalin Zlinszky
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
| | - Sabrina Buchini
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Richard Curno
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | - Péter Péchy
- Nano Bridging Molecules SA, Rte Cité Ouest 2, Gland 1196, Switzerland.
| | | | - Brigitte von Rechenberg
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zürich 8057, Switzerland.
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Nisand D, Renouard F. Short implant in limited bone volume. Periodontol 2000 2014; 66:72-96. [DOI: 10.1111/prd.12053] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 12/28/2022]
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Ali SA, Karthigeyan S, Deivanai M, Kumar A. Implant rehabilitation for atrophic maxilla: a review. J Indian Prosthodont Soc 2014; 14:196-207. [PMID: 25183902 DOI: 10.1007/s13191-014-0360-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 04/03/2014] [Indexed: 11/30/2022] Open
Abstract
A severely atrophied maxilla presents serious limitations for conventional implant placement. This presents challenge to the surgeon for implant placement in harmony with the planned prosthesis. Survey of various literatures using internet sources, manual searches, and common textbooks on dental implants shows, that a thorough knowledge of conventional augmentation procedures such as bone augmentation techniques, guided bone regeneration, alveolar distraction, maxillary sinus elevation techniques with or without grafting and contemporary techniques of implant placement provide effective long-term solutions in the management of the atrophic maxilla.
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Affiliation(s)
- Seyed Asharaf Ali
- Department Of Prosthodontics, Rajah Muthiah Dental College, Annamalai University, Chidambaram, Tamil Nadu India
| | - Suma Karthigeyan
- Department Of Prosthodontics, Rajah Muthiah Dental College, Annamalai University, Chidambaram, Tamil Nadu India
| | - Mangala Deivanai
- Department Of Prosthodontics, Rajah Muthiah Dental College, Annamalai University, Chidambaram, Tamil Nadu India
| | - Arun Kumar
- Department Of Prosthodontics, Rajah Muthiah Dental College, Annamalai University, Chidambaram, Tamil Nadu India
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Draenert FG, Sagheb K, Baumgardt K, Kämmerer PW. Retrospective analysis of survival rates and marginal bone loss on short implants in the mandible. Clin Oral Implants Res 2011; 23:1063-9. [PMID: 22092574 DOI: 10.1111/j.1600-0501.2011.02266.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Short implants have become an interesting alternative to bone augmentation in dental implantology. Design of shorter implants and longer surveillance times are a current research issue. The goal of this study was to show the survival rates of short implants below 9 mm in the partly edentulous mandibular premolar and molar regions with fixed prosthetics. Marginal vertical and 2D bone loss was evaluated additionally. Different implant designs are orientationally evaluated. MATERIAL AND METHODS A total of 247 dental implants with fixed prosthetics (crowns and bridges) in the premolar and molar region of the mandible were evaluated; 47 implants were 9 mm or shorter. Patient data were evaluated to acquire implant survival rates, implant diameter, gender and age. Panoramic X-rays were analysed for marginal bone loss. RESULTS Average surveillance time was 1327 days. Cumulative survival rate (CSR) of short implants was 98% (1 implants lost) compared to 94% in the longer implants group without significance. Thirty-five of the short implants were Astratech (0 losses) and 12 were Camlog Screw Line Promote Plus (1 loss). Early vertical and two-dimensional marginal bone loss was not significantly different in short and regular length implant group with an average of 0.6 mm and 0.7 mm(2) in short implants over the observation period. CONCLUSIONS Within the limitations of this study, we conclude that short implants with a length of 9 mm or less have equal survival rates compared with longer implants over the observation period of 1-3 years.
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Affiliation(s)
- Florian G Draenert
- Clinic for Oral & Maxillofacial Surgery, University of Mainz, Augustusplatz 2, 55131, Mainz, Germany. and florian
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Fortin T, Camby E, Alik M, Isidori M, Bouchet H. Panoramic images versus three-dimensional planning software for oral implant planning in atrophied posterior maxillary: a clinical radiological study. Clin Implant Dent Relat Res 2011; 15:198-204. [PMID: 21477064 DOI: 10.1111/j.1708-8208.2011.00342.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The objectives of this radiographic study were to determine to what degree the available residual bone area for implant placement was underestimated on panoramic radiographs (by comparison with multislice computed tomography CT/cone beam CT images combined with planning software) and to what degree the rate of severely resorbed posterior maxillae requiring sinus lift was overestimated on panoramic radiographs (by comparison with planning software in combination with strategic implant placement). MATERIALS AND METHODS During a 2-year period, every patient who presented for the placement of implants in the posterior maxilla was examined by three practitioners to discuss the treatment plan. When two to three practitioners indicated a sinus lift with creation of a lateral window, a CT scan was performed and examined using dedicated three-dimensional software by a clinician familiar with the Computer Assisted Design/ Computer Assisted Manufacturing (CAD/CAM) implant placement protocol. For each tooth to be replaced, the presence of anatomical features such as anterior or posterior wall, palatal curvature, and septa were examined in view of the placement of an 8-mm or longer implant. RESULTS One hundred one patients were studied in this case series for the treatment of 135 edentulous spans accounting for 301 missing teeth. After examination of the CT data on the three-dimensional software, 202 teeth (67.1%) could be replaced using a CAD/CAM procedure; 60.7% of the edentulous spans could be completely repaired by a crown or bridge supported by implants. In addition, 67.3% of edentulism with no teeth posterior to the span could be completely repaired using a fixed prosthesis supported by implants. CONCLUSION This radiological study demonstrates that the use of a panoramic exam for oral implant planning in severely resorbed maxillae overestimates the need for a sinus augmentation procedure when compared with the use of both three-dimensional planning software and strategic implant placement on small remaining bone volume.
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Affiliation(s)
- Thomas Fortin
- Departement of Oral Surgery, Dental University of Lyon, Lyon, France.
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Balleri P, Ferrari M, Veltri M. One-year outcome of implants strategically placed in the retrocanine bone triangle. Clin Implant Dent Relat Res 2011; 12:324-30. [PMID: 19438960 DOI: 10.1111/j.1708-8208.2009.00170.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Implant treatment in the partially edentulous maxilla is often challenging because of minimum bone volumes in distal direction. PURPOSE The aim of this study was to evaluate, after 1 year of loading, the outcome of three-unit fixed partial dentures supported by two implants in the retrocanine triangle. MATERIALS AND METHODS Twenty patients with atrophic posterior maxillae participated in the study. A total of 40 implants were placed in residual bone anterior to the sinus wall and posterior to the canine. Implant angulations and lengths were chosen to match as much as possible boundaries of the available bone. After a 6-month healing period, three-unit, screw-retained, fixed partial dentures were delivered. The patients were clinically and radiographically reexamined after 1 year of loading. RESULTS All the implants survived at the end of the follow-up. No differences in bone level changes resulted between axial and tilted implants. No biological or mechanical complications were recorded. CONCLUSIONS Within the limitations of this short-term study on relatively few patients, a positive outcome was seen for three-unit fixed partial dentures supported by two implants. Retrocanine placement of implants with carefully planned lengths and angulations might be an alternative to grafting procedures for restoration of atrophic posterior maxillae.
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Affiliation(s)
- Piero Balleri
- Department of Oral Surgery, University of Siena, Siena, Italy.
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Balleri P, Veltri M, Nuti N, Ferrari M. Implant Placement in Combination with Sinus Membrane Elevation without Biomaterials: A 1-Year Study on 15 Patients. Clin Implant Dent Relat Res 2010; 14:682-9. [DOI: 10.1111/j.1708-8208.2010.00318.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jung UW, Hong JY, Lee JS, Kim CS, Cho KS, Choi SH. A hybrid technique for sinus floor elevation in the severely resorbed posterior maxilla. J Periodontal Implant Sci 2010; 40:76-85. [PMID: 20498764 PMCID: PMC2872818 DOI: 10.5051/jpis.2010.40.2.76] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 03/25/2010] [Indexed: 12/02/2022] Open
Abstract
Purpose This study aimed to evaluate the effectiveness of the modified sinus floor elevation technique described hereafter as a "hybrid technique," in 11 patients with severely resorbed posterior maxillae. Methods Eleven patients who received 22 implants in the maxillary premolar and molar areas by the hybrid technique were enrolled in this study. A slot-shaped osteotomy for access was prepared on the lateral wall along the lower border of the sinus floor. The Schneiderian membrane was fully reflected through the lateral slot. Following drilling with the membrane protected by a periosteal elevator, the bone was grafted. All implants were placed simultaneously with sinus augmentation. The cumulative success rate was calculated and clinical parameters were recorded. Radiographic measurements were performed. Results All implants were well maintained at last follow up (cumulative success rate=100%). The mean residual bone height, augmented bone height, crown-to-implant ratio, and marginal bone loss were 4.1±1.64 mm, 8.76±1.77 mm, 1.21±0.33 mm, and 0.34±0.72 mm, respectively. Conclusions Simultaneous implant placement with sinus augmentation by hybrid technique showed successful clinical results over a 2-year observation period and may be a reliable modality for reconstruction of a severely resorbed posterior maxilla.
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Affiliation(s)
- Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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