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Chen Z, Wang Y, Sun Z, Zhao J, Lin N, Zheng Y. Clinical evaluation of closed tray impression and intraoral scanning techniques in single posterior tissue-level implant-supported crowns: A self-controlled case study. J Prosthet Dent 2024:S0022-3913(24)00379-2. [PMID: 38955602 DOI: 10.1016/j.prosdent.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 07/04/2024]
Abstract
STATEMENT OF PROBLEM Different techniques have been used to record the locations of dental implants, yet research examining the clinical outcomes of posterior implant-supported prostheses generated by different techniques, particularly concerning their fit, is lacking. PURPOSE The purpose of this self-controlled study was to evaluate the clinical outcomes of closed tray impression making and intraoral scanning for single posterior implant-supported restorations. MATERIAL AND METHODS Eighty-two participants with a single missing posterior tooth were included. The restorations were delivered a minimum of 3 months after tissue-level implant placement. Each participant was provided with 2 screw-retained monolithic zirconia crowns, produced using 3-dimensional (3D) gel deposition from both closed tray impression making (control group) and intraoral scanning using an iTero scanner (experimental group). The recording operating time, the patient comfort assessed using a visual analog scale (VAS), and the fit of the crowns were recorded during clinical evaluation. The paired t test and Mann-Whitney U test were conducted to statistically analyze the differences between the 2 techniques (α=.05). RESULTS Seventy-six participants completed the study with a dropout rate of 7.3%. The mean ±standard deviation recording operating time of the control and experimental groups was 683 ±164 and 777 ±407 s, respectively (P<.05). The mean ±standard deviation VAS score of the control and experimental groups was 2.6 ±1.6 and 1.3 ±1.0, respectively (P<.05). The crowns in both groups showed excellent marginal fit (P>.05), but the occlusal contacts of crowns in the experimental group were significantly better (P<.05), while the interproximal contacts were significantly worse (P<.05) compared with those in the control group. In the control group, 1 crown was rated as Delta for occlusal contact and deemed clinically unacceptable. CONCLUSIONS In single posterior tissue-level implant-supported restorations, the clinical outcomes of most of the screw-retained monolithic zirconia crowns generated from closed tray impression making and intraoral scanning with the iTero system and fabricated by 3D gel deposition were acceptable. Compared with the closed tray impression technique, intraoral scanning resulted in better patient comfort and occlusal contacts but worse interproximal contacts. Efficiency was lower with intraoral scanning.
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Affiliation(s)
- Zhi Chen
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Ningbo Dental Hospital/Ningbo Oral Health Research Institute, Ningbo, PR China
| | - Yong Wang
- Attending, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Department of Stomatology, Shangcheng District Jiubao Community Health Center of Hangzhou City, Hangzhou, PR China
| | - Zhe Sun
- Resident, Department of General Dentistry, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jing Zhao
- Attending, Department of General Dentistry, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Nengjie Lin
- Resident, Department of General Dentistry, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Yuanna Zheng
- Professor, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Ningbo Dental Hospital/Ningbo Oral Health Research Institute, Ningbo, PR China.
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Puljic D, Petricevic N, Celebic A, Kovacic I, Milos M, Pavic D, Milat O. Mandibular Overdenture Supported by Two or Four Unsplinted or Two Splinted Ti-Zr Mini-Implants: In Vitro Study of Peri-Implant and Edentulous Area Strains. Biomimetics (Basel) 2024; 9:178. [PMID: 38534864 DOI: 10.3390/biomimetics9030178] [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: 12/22/2023] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
Clinical indications for the newly released Ti-Zr (Roxolid®) alloy mini-implants (MDIs) aimed for overdenture (OD) retention in subjects with narrow alveolar ridges are not fully defined. The aim of this study was to analyze peri-implant and posterior edentulous area microstrains utilizing models of the mandible mimicking a "real" mouth situation with two (splinted with a bar or as single units) or four unsplinted Ti-Zr MDIs. The models were virtually designed from a cone beam computed tomography (CBCT) scan of a convenient patient and printed. The artificial mucosa was two millimeters thick. After MDI insertion, the strain gauges were bonded on the oral and vestibular peri-implant sites, and on distal edentulous areas under a denture. After attaching the ODs to MDIs, the ODs were loaded using a metal plate positioned on the first artificial molars (posterior loadings) bilaterally and unilaterally with 50, 100, and 150 N forces, respectively. During anterior loadings, the plate was positioned on the denture's incisors and loaded with 50 and 100 N forces. Each loading was repeated 15 times. The means with standard deviations, and the significance of the differences (two- and three-factor MANOVA) were calculated. Variations in the MDI number, location, and splinting status elicited different microstrains. Higher loading forces elicited higher microstrains. Unilateral loadings elicited higher microstrains than bilateral and anterior loadings, especially on the loading side. Peri-implant microstrains were lower in the four-MDI single-unit model than in both two-MDI models (unsplinted and splinted). Posterior implants showed higher peri-implant microstrains than anterior in the four-MDI model. The splinting of the two-MDI did not have a significant effect on peri-implant microstrains but elicited lower microstrains in the posterior edentulous area. The strains did not exceed the bone reparatory mechanisms, although precaution and additional study should be addressed when two Ti-Zr MDIs support mandibular ODs.
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Affiliation(s)
- Dario Puljic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Nikola Petricevic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Asja Celebic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Ines Kovacic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Manuela Milos
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
| | - Dalibor Pavic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, 10000 Zagreb, Croatia
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Ahn JH, Lim YJ, Lee J, Baek YW, Kim MJ, Kwon HB. A One-Year Randomized Controlled Clinical Trial of Three Types of Narrow-Diameter Implants for Fixed Partial Implant-Supported Prosthesis in the Mandibular Incisor Area. Bioengineering (Basel) 2024; 11:272. [PMID: 38534546 DOI: 10.3390/bioengineering11030272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
Narrow-diameter implants (NDI) serve as a solution for treating limited bone volume in the anterior mandible. This study aimed to evaluate the one-year clinical outcomes of various NDIs in the mandibular incisor area after immediate loading in partially edentulous patients. This single-center, prospective, single-blinded, randomized controlled trial study included 21 patients, with 7 patients in each of the following groups: control (BLT NC SLActive®; Straumann), experimental group 1 (CMI IS-III Active® S-Narrow; Neobiotech), and experimental group 2 (CMI IS-III Active® Narrow; Neobiotech). Using full digital flow, two fixtures were placed in each patient and immediately provisionalized on the day of surgery. Evaluations encompassed periapical radiographs, implant stability quotient (ISQ), implant stability test (IST) readings, per-implant soft tissue health, patient satisfaction surveys, and esthetic score assessments. Definitive prostheses were delivered twelve weeks post-surgery (CRiS, number: KCT0007300). Following exclusions due to low stability values (n = 2), fixture failure (n = 5), and voluntary withdrawal (n = 1), the implant success rate for patients completing all clinical protocols stood at 100%. The resulting patient failure rates in the control, experimental group 1, and experimental group 2 were 50.0%, 42.9%, and 14.3%, respectively. There were no significant differences between the groups in terms of marginal bone loss, soft tissue health, patient satisfaction, and esthetic scores. Narrow implants showed superior clinical outcomes, followed by S-Narrow and Straumann implants. Calculated one-year survival rates at the implant level were 66.7% for the control group, 85.7% for experimental group 1, and 100% for experimental group 2. All three types of NDIs showed acceptable clinical and radiographic results during the year-long observation period.
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Affiliation(s)
- Ji-Ho Ahn
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Young-Jun Lim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Jungwon Lee
- Department of Periodontology, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul 03080, Republic of Korea
| | - Yeon-Wha Baek
- Department of Prosthodontics, Gwanak Center, Seoul National University Dental Hospital, Seoul 08826, Republic of Korea
| | - Myung-Joo Kim
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
| | - Ho-Beom Kwon
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea
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Müller F, Al-Nawas B, Storelli S, Quirynen M, Hicklin S, Castro-Laza J, Bassetti M, Srinivasan M. Small-diameter titanium grade IV and titanium-zirconium implants in edentulous mandibles: Ten-year results from a double-blind, randomised controlled split-mouth core-trial. Clin Oral Implants Res 2024; 35:77-88. [PMID: 37942666 DOI: 10.1111/clr.14199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
The goal of this extension study was to compare the 10-year outcome of 3.3 mm diameter titanium-zirconium (TiZr) or grade IV titanium (Ti) implants in mandibular implant-overdentures. MATERIALS AND METHODS This study is the 10-year follow-up from a randomised, controlled, double-blind, split-mouth multicentre clinical trial. Patients with edentulous mandibles had received two implants in the interforaminal region (bone-level, diameter 3.3 mm, microrough surface), one of TiZr (test) and one of Ti (control). Implant survival and success, plaque and sulcus bleeding indices, probing pocket depth, gingival margin, clinical attachment level and radiographic crestal bone levels were evaluated. RESULTS Fifty of 91 patients with implants were available for the 10-year examination and 36 patients were valid for the intent-to-treat (ITT) analysis. The implant success rate was calculated as 94.6% and 91.9% for the TiZr implants and the Ti implants respectively. Four implants were lost (TiZr = 1; Ti = 3) in the entire study period. Kaplan-Meier survival analyses estimated 10- year implant survival rate for TiZr to 98.9% and Ti 95.8%.The mean of total and functional crestal bone loss was 1.49 mm (±1.37 mm) and 0.82 mm (±1.09 mm) in the TiZr group and 1.56 mm (±1.34 mm) and 0.85 mm (±1.16 mm) in the Ti group. CONCLUSIONS This split-mouth design RCT on mandibular implant-overdentures evidenced, bearing in mind its follow-up time-related reduced cohort size, high 10-year implant success- and survival rates. These results confirm TiZr as well-suited implant material for realising small-diameter implants. Registered on www. CLINICALTRIALS gov: NCT01878331.
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Affiliation(s)
- Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | | | - Stefano Storelli
- Dental Clinic, San Paolo Hospital, University of Milan, Milan, Italy
| | - Marc Quirynen
- School of Dentistry, Catholic University Leuven, Leuven, Belgium
| | - Stefan Hicklin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Mario Bassetti
- Clinic for Oral and Maxillofacial Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Verma A, Agrawal KK, Chand P, Ramashanker, Tripathi S, Arya D. Clinical Outcomes of Titanium Zirconium and Titanium Dental Implants under Immediate Functional Loading in Posterior Mandibular Region. Indian J Dent Res 2023; 34:365-370. [PMID: 38739813 DOI: 10.4103/ijdr.ijdr_313_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/08/2023] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Studies comparing the clinical performance of titanium zirconium (Ti-Zr) and titanium (Ti) dental implants subjected to immediate loading in the posterior mandibular region where occlusal forces are higher are sparse in the current literature. Hence, the study aimed to evaluate and compare the clinical outcomes of Ti-Zr and Ti dental implants under immediate functional loading in the mandibular posterior region. METHODS Forty participants fulfilling the predetermined selection criteria were randomly grouped based on dental implant used; Titanium zirconium (Ti-Zr):20, and Titanium (Ti):20. Dental implants were placed through a standard full-thickness mucoperiosteal flap approach and loaded immediately fulfilling the principle of implant protective occlusion. Clinical parameters including crestal bone loss (CBL), modified plaque index (MPI), probing depth (PD) and modified sulcular bleeding index (MSBI) were measured at baseline and follow-up visits (4, 8, and 12 months). Obtained data were compared with standard tests such as the t-test, Chi-square test, and Mann-Whitney U test. RESULTS On intergroup comparison, CBL was more in the Ti-Zr group as compared to the Ti group at 4 months (0.72 ± 0.16 mm versus 0.70 ± 0.13 mm), but it was less at 8 months (1.08 ± 0.16 mm versus 1.13 ± 0.13 mm) and 12 months (1.19 ± 0.17 mm versus 1.24 ± 0.12 mm) but the difference was not statistically significant (P > 0.05). Mann-Whitney test also revealed no statistically significant difference in MPI, PD and MSBI at 4 months, 8 months and 12 months recall (P > 0.05). CONCLUSIONS CBL and periodontal parameters of Ti-Zr dental implants were found similar to Ti dental implants under immediate loading in the posterior mandibular region. However, further studies are needed to determine its long-term efficacy and cost-effectiveness.
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Affiliation(s)
- Aditi Verma
- Department of Prosthodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
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Possebon APDR, Schuster AJ, Chagas-Júnior OL, Pinto LDR, Faot F. Immediate versus conventional loading of mandibular implant-retained overdentures: a 3-year follow-up of a randomized controlled trial. Clin Oral Investig 2023; 27:5935-5946. [PMID: 37612525 DOI: 10.1007/s00784-023-05205-w] [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: 10/01/2022] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES There is a scarcity of randomized clinical trials (RCT) that report medium- and long-term results and a lack of consensus in the literature on the predictability of immediately loaded unsplinted narrow diameter implants supporting mandibular overdentures. This RCT compared the performance of conventional (CL) and immediate loading (IL) of mandibular overdentures retained by two narrow-diameter implants for 3 years. MATERIALS AND METHODS Patients from an RCT treated with CL or IL were invited to attend to 2- and 3-year follow-ups. Clinical, radiographic, functional, and oral health-related quality of life parameters were evaluated. Prosthetic maintenance events, biological complications, and success and survival rates were also recorded. The data were tested by multilevel mixed-effects linear regression analysis and chi-squared tests. RESULTS The 1-year survival rates of 90% in the CL group and 85% in the IL group were maintained as no implants were lost between 1 and 3 years. The marginal bone loss (MBL) in the IL group was significantly lower after year 3 (-0.04; p < 0.01). Significant changes were found only for the intra-group comparisons in the third year of function: (i) CL and IL presented similar progression of implant stability, MBL, and posterior bone area resorption; (ii) while CL started deteriorating of masticatory function, IL still exhibited functional evolution and (iii) oral comfort domain in the CL and pain domain in the IL were improved. CONCLUSION Although IL experienced the lowest MBL after 3 years, the outcomes showed that both loading protocols result in predictable medium-term rehabilitation when monitored annually. CLINICAL RELEVANCE It can be expected that in the third year of function, patients with immediate loading may present more complaints related to general performance even with acceptable masticatory function and self-reported improvements in oral comfort.
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Affiliation(s)
- Anna Paula da Rosa Possebon
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil
| | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Luciana de Rezende Pinto
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
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Kim JE, Yoon Y, Pae A, Kwon YD. Clinical outcome of narrow diameter dental implants: a 3-year retrospective study. Maxillofac Plast Reconstr Surg 2023; 45:26. [PMID: 37526800 PMCID: PMC10393933 DOI: 10.1186/s40902-023-00394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND This study aimed to analyze the clinical outcome and complications of narrow-diameter dental implants (NDIs) (diameter ≤3.5 mm). METHODS The 274 NDIs that met the selection criteria from 2013 to 2018 were included in the retrospective study, and the survival rates (SVR) were compared. Mechanical complications included screw loosening and fractures of the implant components, such as the implant fixture, abutment, and prosthesis. In addition, marginal bone loss (MBL) was measured immediately after surgery and 1 year after loading. RESULTS The 3-year cumulative SVR was 92.4%. Nineteen fixtures failed during the follow-up. The failure rate was significantly higher (OR=4.573, p<0.05) in smokers and was significantly higher in osteoporosis patients (OR=3.420, p<0.05). The vertical and horizontal values of MBL were 0.33±0.32 mm and 0.18±0.17 mm, respectively. Mechanical complications included screw loosening (5.5%) and porcelain fracture (2.2%), but no fractures of the fixture or components were observed. The choice of titanium and zirconium (TiZr) alloy implant was significantly more frequent in the posterior region. Bone graft was significantly more frequently done in the anterior region. CONCLUSIONS According to the high SVR and stability of NDIs, the findings of the study suggest that NDIs may be a replacement for regular diameter dental implants (RDIs) and the use of TiZr alloy could extend the indication of NDIs. In the esthetic area, contour augmentation may be a reason for increasing the frequency of bone grafts.
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Affiliation(s)
- Jae-Eun Kim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Youngjae Yoon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Ahran Pae
- Department of Prosthodontics, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Sales PHDH, Barros AWP, Oliveira-Neto OBD, de Lima FJC, Carvalho ADAT, Leão JC. Do zirconia dental implants present better clinical results than titanium dental implants? A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101324. [PMID: 36330865 DOI: 10.1016/j.jormas.2022.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants. METHODS Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants? RESULTS 3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I2 = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I2 = 0%). None of the studies evaluated had a low risk of bias. CONCLUSION Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil.
| | - Ana Waleska Pessoa Barros
- Post-Graduated Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego 1235 - Cidade Universitária, Recife, PE 50670-901, Brazil
| | | | | | | | - Jair Carneiro Leão
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
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Kochar SP, Reche A, Paul P. The Etiology and Management of Dental Implant Failure: A Review. Cureus 2022; 14:e30455. [DOI: 10.7759/cureus.30455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022] Open
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Effects of Different Titanium Surface Treatments on Adhesion, Proliferation and Differentiation of Bone Cells: An In Vitro Study. J Funct Biomater 2022; 13:jfb13030143. [PMID: 36135578 PMCID: PMC9503392 DOI: 10.3390/jfb13030143] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to evaluate the impacts of different sandblasting procedures in acid etching of Ti6Al4V surfaces on osteoblast cell behavior, regarding various physicochemical and topographical parameters. Furthermore, differences in osteoblast cell behavior between cpTi and Ti6Al4V SA surfaces were evaluated. Sandblasting and subsequent acid etching of cpTi and Ti6Al4V discs was performed with Al2O3 grains of different sizes and with varying blasting pressures. The micro- and nano-roughness of the experimental SA surfaces were analyzed via confocal, atomic force and scanning electron microscopy. Surface free energy and friction coefficients were determined. hFOB 1.19 cells were seeded to evaluate adhesion, proliferation and osteoblastic differentiation for up to 12 d via crystal violet assays, MTT assays, ALP activity assays and Alizarin Red staining assays. Differences in blasting procedures had significant impacts on surface macro- and micro-topography. The crystal violet assay revealed a significant inverse relationship between blasting grain size and hFOB cell growth after 7 days. This trend was also visible in the Alizarin Red assays staining after 12 d: there was significantly higher biomineralization visible in the group that was sandblasted with smaller grains (F180) when compared to standard-grain-size groups (F70). SA samples treated with reduced blasting pressure exhibited lower hFOB adhesion and growth capabilities at initial (2 h) and later time points for up to 7 days, when compared to the standard SA surface, even though micro-roughness and other relevant surface parameters were similar. Overall, etched-only surfaces consistently exhibited equivalent or higher adhesion, proliferation and differentiation capabilities when compared to all other sandblasted and etched surfaces. No differences were found between cpTi and Ti6Al4V SA surfaces. Subtle modifications in the blasting protocol for Ti6Al4V SA surfaces significantly affect the proliferative and differentiation behavior of human osteoblasts. Surface roughness parameters are not sufficient to predict osteoblast behavior on etched Ti6Al4V surfaces.
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Clinical Performance Comparing Titanium and Titanium–Zirconium or Zirconia Dental Implants: A Systematic Review of Randomized Controlled Trials. Dent J (Basel) 2022; 10:dj10050083. [PMID: 35621536 PMCID: PMC9140125 DOI: 10.3390/dj10050083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 01/27/2023] Open
Abstract
Objectives: This study aimed to compare clinical results between titanium (Ti), zirconia (Zr), or titanium–zirconium (TZ) dental implants and to analyze survival rate (SR), bleeding on probing (BoP), marginal bone loss (MBL), and/or probing depth (PD). Data source: Manual and electronic searches were conducted (PubMed and Web of Science) to identify randomized controlled trials that compared the outcomes of at least two implant types (control and test group) within the same study. The focused question was determined according to the PICOT strategy. Seven studies were included out of 202 research studies initially found. The follow-up periods ranged from 12 to 80 months, and the mean age was from 43.3 to 65.8 years old. The SR for Ti, TZ, and Zr implants ranged from 92.6% to 100%, 95.8% to 100%, and 87.5% to 91.25%, respectively; MBL for Ti, TZ, and Zr implants varied from −1.17 mm to −0.125 mm for Ti, −0.6 mm to −0.32 mm for TZ, and −0.25 mm to −1.38 mm for Zr. Studies showed a low incidence of mucositis and peri-implantitis; however, BoP for Zr was 16.43%, Ti ranged between 10% and 20%, and TZ from 10% to 13.8%. PD for Ti ranged from 1.6 mm to 3.05 mm, TZ was 3.12 mm (only one study), and Zr ranged from 2.21 mm to 2.6 mm. Conclusion: All three types of implants showed similar tissue behavior. However, the TZ group had better results when compared with Ti and Zr for SR, MBL, and BoP, except for PD. Furthermore, the worst SR was found in the Zr implants group.
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Haugen HJ, Chen H. Is There a Better Biomaterial for Dental Implants than Titanium?—A Review and Meta-Study Analysis. J Funct Biomater 2022; 13:jfb13020046. [PMID: 35645254 PMCID: PMC9149859 DOI: 10.3390/jfb13020046] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/28/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
This article focuses on preclinical studies and reviews the available evidence from the literature on dental implant and abutment materials in the last decade. Specifically, different peri-implantitis materials and how surface modifications may affect the peri-implant soft-tissue seal and subsequently delay or hinder peri-implantitis are examined. This review analyzed more than 30 studies that were Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), or prospective case series (CS) with at least six months of follow-up. Meta-analyses were performed to make a comparison between different implant materials (titanium vs. zirconia), including impact on bone changes, probing depth, plaque levels, and peri-implant mucosal inflammation, as well as how the properties of the implant material and surface modifications would affect the peri-implant soft-tissue seal and peri-implant health conditions. However, there was no clear evidence regarding whether titanium is better than other implant materials. Clinical evidence suggests no difference between different implant materials in peri-implant bone stability. The metal analysis offered a statistically significant advantage of zirconia implants over titanium regarding developing a favorable response to the alveolar bone.
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Affiliation(s)
- Håvard J. Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Correspondence:
| | - Hongyu Chen
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180, USA;
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13
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Fiorillo L, Cicciù M, Tozum TF, Saccucci M, Orlando C, Romano GL, D’Amico C, Cervino G. Endosseous Dental Implant Materials and Clinical Outcomes of Different Alloys: A Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:1979. [PMID: 35269211 PMCID: PMC8911578 DOI: 10.3390/ma15051979] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/17/2022]
Abstract
In recent years, implantology has made significant progress, as it has now become a safe and predictable practice. The development of new geometries, primary and secondary, of new surfaces and alloys, has made this possible. The purpose of this review is to analyze the different alloys present on the market, such as that in zirconia, and evaluate their clinical differences with those most commonly used, such as those in grade IV titanium. The review, conducted on major scientific databases such as Scopus, PubMed, Web of Science and MDPI yielded a startling number of 305 results. After the application of the filters and the evaluation of the results in the review, only 10 Randomized Clinical Trials (RCTs) were included. Multiple outcomes were considered, such as Marginal Bone Level (MBL), Bleeding on Probing (BoP), Survival Rate, Success Rate and parameters related to aesthetic and prosthetic factors. There are currently no statistically significant differences between the use of zirconia implants and titanium implants, neither for fixed prosthetic restorations nor for overdenture restorations. Only the cases reported complain about the rigidity and, therefore, the possibility of fracture of the zirconium. Certainly the continuous improvement in these materials will ensure that they could be used safely while maintaining their high aesthetic performance.
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Affiliation(s)
- Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (G.C.)
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy
- Department of Dentistry, University of Aldent, 1000 Tirana, Albania
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (G.C.)
| | - Tolga Fikret Tozum
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL 6007, USA;
| | - Matteo Saccucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Cristiano Orlando
- Behavioural Health Institute, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Giovanni Luca Romano
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Section of Pharmacology, University of Catania, 95124 Catania, Italy;
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (G.C.)
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina University, 98100 Messina, Italy; (L.F.); (C.D.); (G.C.)
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14
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Tan T, Zhao Q, Kuwae H, Ueno T, Chen P, Tsutsumi Y, Mizuno J, Hanawa T, Wakabayashi N. Surface properties and biocompatibility of sandblasted and acid-etched titanium-zirconium binary alloys with various compositions. Dent Mater J 2021; 41:266-272. [PMID: 34866118 DOI: 10.4012/dmj.2021-210] [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] [Indexed: 11/23/2022]
Abstract
Ti-Zr alloys have been investigated as an alternative to commercially pure Ti (c.p.Ti). According to our previous studies on the mechanical properties of Ti-Zr alloys, a Zr proportion in the range of 30-50 mol% has competitive advantages over Ti-10Zr and c.p.Ti. The aim of this study is to evaluate the biological response to Ti-Zr alloys with different compositions and their surface characteristics. Alloy surfaces are modified by sandblasting and sulfuric acid etching. As a result, similar surface structures are observed for c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas Ti-50Zr does not form a micro-rough structure by the same treatment process. No significant difference is found in the viability of cells on c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas lower cell attachment levels are detected on Ti-50Zr. In summary, Ti-30Zr reliably forms a micro-rough structure, which provides one evidence for its application in a new dental implant material.
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Affiliation(s)
- Tianbo Tan
- Removable Partial Prosthodontics, Department of Masticatory Function Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Qian Zhao
- Removable Partial Prosthodontics, Department of Masticatory Function Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Hiroyuki Kuwae
- Research Organization for Nano and Life Innovation, Waseda University
| | - Takeshi Ueno
- Removable Partial Prosthodontics, Department of Masticatory Function Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Peng Chen
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Yusuke Tsutsumi
- Research Center for Structural Materials, National Institute for Materials Science
| | - Jun Mizuno
- Research Organization for Nano and Life Innovation, Waseda University
| | - Takao Hanawa
- Department of Metallic Biomaterials, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University
| | - Noriyuki Wakabayashi
- Removable Partial Prosthodontics, Department of Masticatory Function Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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15
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Willis J, Li S, Crean SJ, Barrak FN. Is titanium alloy Ti-6Al-4 V cytotoxic to gingival fibroblasts-A systematic review. Clin Exp Dent Res 2021; 7:1037-1044. [PMID: 34018703 PMCID: PMC8638288 DOI: 10.1002/cre2.444] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/13/2021] [Accepted: 05/05/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Grade V titanium alloy (Ti-6Al-4 V) is a well-recognized metallic biomaterial for medical implants. There has been some controversy regarding the use of this alloy in medical devices in relation to the toxicity of vanadium. In Dentistry, Ti-6Al-4 V remains prevalent. This systematic review aims to evaluate the effects of Ti-6Al-4 V on cells relevant to oral environments such as gingival fibroblasts. MATERIALS AND METHODS A literature search was undertaken for relevant English language publications in the following databases: Dental and Oral Science, Medline and Web of Science. The electronic search was supplemented with a search of references. RESULTS After application of inclusion and exclusion criteria. A total of eight papers are included in this review. These papers were all in vitro studies and were categorized into whole implant, discs, or implant particles based on the type of test materials used in the studies. CONCLUSION Based on the analyses of the eight included studies in this review, if Ti-6Al-4 V as a material is unchallenged, i.e., as a whole implant in pH neutral environments, there appears to be little effect on fibroblasts. If Ti-6Al-4 V is challenged through corrosion or wear (particle release), the subsequent release of vanadium and aluminium particles has an increased cytotoxic effect in vitro in comparison to commercially pure titanium, hence concerns should be raised in the clinical setting.
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Affiliation(s)
- Jonathan Willis
- School of DentistryUniversity of Central LancashirePrestonUK
| | - Siwei Li
- Department of MaterialsRoyal School of Mines, Imperial College LondonLondonUK
| | - St John Crean
- School of DentistryUniversity of Central LancashirePrestonUK
| | - Fadi N. Barrak
- School of DentistryUniversity of Central LancashirePrestonUK
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16
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Sharma A, Waddell JN, Li KC, A Sharma L, Prior DJ, Duncan WJ. Is titanium-zirconium alloy a better alternative to pure titanium for oral implant? Composition, mechanical properties, and microstructure analysis. Saudi Dent J 2021; 33:546-553. [PMID: 34803299 PMCID: PMC8589587 DOI: 10.1016/j.sdentj.2020.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/18/2020] [Accepted: 08/23/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Titanium (Ti) is widely accepted as a biomaterial for orthopaedic and dental implants, primarily due to its capacity to integrate directly into the bone and its superior corrosion resistance. It has been suggested that titanium–zirconium alloy (TiZr), with 13–17% of zirconium, has better mechanical properties than pure Ti, but there are very few published studies assessing the suitability of TiZr for high-load- bearing implants. This study aimed to compare the mechanical properties and microstructures of TiZr and commercially pure titanium (Ti). Methodology Pure Ti and TiZr alloy discs were prepared and subjected to characterisation by nanoindentation, electron dispersive spectroscopy (EDS), X-ray diffraction (XRD), and electron backscatter diffraction (EBSD). Results The TiZr alloy was found to have significantly lower elastic modulus value (p < 0.0001) and greater hardness than Ti (p < 0.05). The EDS results confirmed the presence of Zr (13–17%) in the TiZr alloy, with XRD and EBSD images showing microstructure with the alpha phase similar to commercially available Ti. Conclusion The lower elastic modulus, higher hardness, presence of alpha phase, and the finer grain size of the TiZr alloy make it more suitable for high-load-bearing implants compared to commercially available Ti and is likely to encourage a positive biological response.
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Affiliation(s)
- Ajay Sharma
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - John N Waddell
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Kai C Li
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Lavanya A Sharma
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - David J Prior
- Department of Geology, University of Otago, Dunedin, New Zealand
| | - Warwick J Duncan
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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17
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Possebon APDR, Schuster AJ, Chagas-Júnior OL, Pinto LDR, Faot F. Prosthetic aftercare, mastication, and quality of life in mandibular overdenture wearers with narrow implants: A 3-year cohort study. J Dent 2021; 115:103880. [PMID: 34740638 DOI: 10.1016/j.jdent.2021.103880] [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: 06/08/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES This cohort study investigated clinical, functional, and quality of life outcomes, along with prosthetic maintenance events in mandibular overdenture (MO) wearers for 3 years. METHODS Thirty MO wearers with narrow diameter implants (NDIs) and locking taper stud abutments (Facility-Equator system) were annually monitored by registering the visible plaque index (VPI), peri‑implant inflammation (PI), calculus presence (CP), probing depth (PD), bleeding on probing (BOP), secondary implant stability (ISQ), marginal bone loss (MBL), masticatory performance and dental impact in daily life (DIDL) questionnaire domains. Multilevel mixed-effects linear regression was performed to analyse changes over time. Chi-square tests were performed to analyse the relationship between the appearance of prosthetic complications and maintenance occurrences. The survival rate of patients with NDIs was calculated using the Kaplan-Meier test. RESULTS Twenty-six individuals attended all follow-ups, the survival rate of 83.3% in the first year was maintained, and no one implant was lost over the 3-year period. There were significant differences for PD between 1 and 3 years (p ≤ 0.01) and between 2 and 3 years for PI (p ≤ 0.01), GI (p ≤ 0.01), ISQ (p = 0.02), and MBL (p ≤ 0.01). All masticatory performance outcomes showed significant differences (p ≤.01). Prosthetic maintenance events decreased significantly over time. Appearance, general performance, and eating and chewing domains presented high effect sizes. CONCLUSION Continued changes were observed in the clinical parameters of MO users over the 3-year period. In addition, most functional parameters, except for particle homogenization, improved significantly over time. The positive impact on quality of life is likely related to the significant reduction in prosthetic maintenance events. CLINICAL SIGNIFICANCE Periodic returns to assess peri‑implant tissues and MO maintenance should be performed to ensure the success of rehabilitation to assure improvements in masticatory function and oral health-related quality of life.
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Affiliation(s)
| | | | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, RS, Brazil
| | - Luciana de Rezende Pinto
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, RS, Brazil.
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18
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Bielemann AM, Schuster AJ, Possebon APDR, Schinestsck AR, Chagas-Junior OL, Faot F. Clinical performance of narrow-diameter implants with hydrophobic and hydrophilic surfaces with mandibular implant overdentures: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2021; 33:21-32. [PMID: 34551146 DOI: 10.1111/clr.13851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare peri-implant clinical and radiographic parameters between hydrophilic and hydrophobic narrow dental implants in patients with mandibular implant overdentures for 1 year. MATERIALS AND METHODS In a randomized, double-blind, split-mouth study with a 1-year follow-up, sixteen edentulous participants received two narrow-diameter implants in the anterior mandibular region with 2 types of surfaces: hydrophobic (Neoporos surface, NS) and hydrophilic (Acqua surface, AS). During the osseointegration period and after loading with mandibular implant overdentures, the outcomes monitored were (i) peri-implant health: early healing index (EHI), visible plaque index (VPI), calculus presence (CP), peri-implant inflammation (PI), probing depth (PD), and bleeding on probing (BOP); (ii) implant stability quotient (ISQ), (iii) crestal bone loss (CBL) and bone level change (BLC); and (iv) implant success and survival rates. RESULTS The PD in NS implants decreased by 31.78% between 15 and 30 days, while a similar reduction (-31.28%) occurred in the 3rd month in the AS group. The ISQ also decreased significantly during the 1st month in both groups: -10.95% after 7 days in the NS group and -7.46% after 15 days in the AS group. At 12 months, statistically significant differences were not observed; however, the AS surface presented 50.6% smaller CBL and 41.3% smaller BLC values. The success and survival rates were 62.5% for AS implants and 87.5% for NS implants. CONCLUSION Narrow-diameter implants with hydrophilic and hydrophobic surfaces loaded with mandibular implant overdentures showed no differences in peri-implant healing, stability, and peri-implant bone remodeling in the 1st year of follow-up.
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Affiliation(s)
- Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Otacílio Luiz Chagas-Junior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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19
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Wimmer L, Petrakakis P, El-Mahdy K, Herrmann S, Nolte D. Implant-prosthetic rehabilitation of patients with severe horizontal bone deficit on mini-implants with two-piece design-retrospective analysis after a mean follow-up of 5 years. Int J Implant Dent 2021; 7:71. [PMID: 34318379 PMCID: PMC8316513 DOI: 10.1186/s40729-021-00353-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a consequence of tooth loss due to trauma or extraction, a reduced alveolar crest volume limits the deployment of standard implants in certain patient cases. For this reason, minimal-invasive treatment with mini-dental implants (MDI) might be an option to allow implant treatment even in cases with severe horizontal bone loss without augmentation measures. The aim of this retrospective cohort study was to investigate clinical and radiological implant, as well as patient-related parameters after treatment with MDI. RESULTS Clinical and radiological records of 19 female (82.6%) and 4 male patients (17.4%) (N = 23), who received 52 mini-dental implants with a two-piece design in a single surgical center between November 2011 and October 2018, were retrospectively analyzed. Implants were submitted to conventional loading on different types of screwed superstructures. Crestal bone loss was measured on standardized periapical radiographs. Patient-related outcome parameters (PROMs) were recorded during follow-up period. Mean clinical and radiological follow-up was 69.6 months (5.8 years) and 51.6 months (4.3 years), respectively. Three implants were lost in two patients, leading to an implant survival rate of 94.2%. Mean radiological crestal bone loss was 1.6 mm. Both amount of peri-implant recession and crestal bone loss were significantly correlated (r = 0.65; p < 0.001). Likewise, a significant correlation was observed between deeper probing depths and increased peri-implant bone loss (r = 0.41; p = 0.012). Alveolar ridges with a reduced alveolar crest width were significantly correlated with higher peri-implant bone loss as well (r = - 0.33; p = 0.011). No prosthetic complications were reported during follow-up. Extent of midfacial recession and papilla height loss had a significant negative impact on most of the PROMs. CONCLUSIONS Treatment with MDI seems to be a successful alternative treatment option, especially for elderly patients with reduced crest width at implant sites. Due to the good clinical results and high survival and success rates, this treatment option was associated with high patient satisfaction. Despite the promising results, particular consideration should be given to appropriate treatment planning in these patients due to the strong correlation between peri-implant soft-tissue parameters, crestal bone loss, and reduced alveolar crest width.
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Affiliation(s)
- Lukas Wimmer
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany.,Private Dental Practice, St. Johann, Salzburg, Austria
| | | | - Karim El-Mahdy
- Department of Restorative Dentistry & Periodontology, Dental School, Ludwig Maximilian University, Munich, Germany
| | - Surian Herrmann
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany
| | - Dirk Nolte
- Clinic for Oral & Maxillofacial Surgery mkg-muc®, Munich, Germany. .,Ruhr University Bochum, Bochum, Germany.
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20
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Mortazavi H, Khodadoustan A, Kheiri A, Kheiri L. Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials. J Korean Assoc Oral Maxillofac Surg 2021; 47:153-174. [PMID: 34187956 PMCID: PMC8249186 DOI: 10.5125/jkaoms.2021.47.3.153] [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: 10/25/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissue-level designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Khodadoustan
- Member of Iranian Association of Periodontology, Private Practice, Tehran, Iran
| | - Aida Kheiri
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lida Kheiri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
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21
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Barker E, AlQobaly L, Shaikh Z, Franklin K, Moharamzadeh K. Implant Soft-Tissue Attachment Using 3D Oral Mucosal Models-A Pilot Study. Dent J (Basel) 2020; 8:E72. [PMID: 32645887 PMCID: PMC7558259 DOI: 10.3390/dj8030072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The aim of this study was to investigate soft-tissue attachment to different metal, ceramic, and polymer implant surfaces using an inflamed, three-dimensional (3D), tissue-engineered, human oral mucosal model, as well as multiple-endpoint qualitative and quantitative biological approaches. METHODS Normal human oral fibroblasts, OKF6/TERT-2 keratinocytes and THP-1 monocytes were cultured, and full-thickness, 3D oral mucosal models were engineered inside tissue culture inserts. Sand-blasted and acid-etched (SLA) and machined (M) titanium-zirconium alloy (TiZr; commercially known as Roxolid; Institut Straumann AG, Switzerland), ceramic (ZrO2), and polyether ether ketone (PEEK) rods (Ø 4 mm × 8 mm) were inserted into the center of tissue-engineered oral mucosa following a Ø 4mm punch biopsy. Inflammation was simulated with addition of the lipopolysaccharide (LPS) of Escherichia coli (E. coli) and tumor necrosis factor (TNF)-alpha to the culture medium. Implant soft-tissue attachment was assessed using histology, an implant pull-test with PrestoBlue assay, and scanning electron microscopy (SEM). RESULTS Inflamed, full-thickness, 3D human oral mucosal models with inserted implants were successfully engineered and histologically characterized. The implant pull-test with PrestoBlue assay showed higher viability of the tissue that remained attached to the TiZr-SLA surface compared to the other test groups. This difference was statistically significant (p < 0.05). SEM analysis showed evidence of epithelial cell attachment on different implant surfaces. CONCLUSIONS The inflamed, 3D, oral mucosal model has the potential to be used as a suitable in vitro test system for visualization and quantification of implant soft-tissue attachment. The results of our study indicate greater soft tissue attachment to TiZr-SLA compared to TiZr-M, ceramic, and PEEK surfaces.
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Affiliation(s)
| | | | | | | | - Keyvan Moharamzadeh
- School of Clinical Dentistry, University of Sheffield, Western Bank, Sheffield S10 2TN, UK; (E.B.); (L.A.); (Z.S.); (K.F.)
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22
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Schuster AJ, Marcello-Machado RM, Bielemann AM, Possebon APDR, Chagas Júnior OL, Faot F. Immediate vs conventional loading of Facility-Equator system in mandibular overdenture wearers: 1-year RCT with clinical, biological, and functional evaluation. Clin Implant Dent Relat Res 2020; 22:270-280. [PMID: 32363765 DOI: 10.1111/cid.12902] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/20/2020] [Accepted: 03/10/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The use of immediate loading (IML) is still poorly explored in elderly patients and implant-retained mandibular overdenture (IMO) wearers. For this reason, more comparisons to conventional loading (CL) are required. PURPOSE To evaluate the clinical, biological, functional, and oral health-related quality of life (OHRQOL) influence of CL and IML loading on elders wearing IMO retained by the Facility-Equator system up to 1 year after implant installation. MATERIAL AND METHODS Twenty edentulous patients received two narrow diameter implants in the mandible; the loading type (CL or IML) was randomized. The clinical parameters were monitored along with prosthetic events, marginal bone loss (MBL) and bone level change (BLC), implant stability quotients (ISQ), masticatory performance outcomes, and Interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in the peri-implant crevicular fluid during the first year of loading. The OHRQoL was assessed via the Oral Health Impact Profile-EDENT questionnaire. Data were analyzed by the Mann-Whitney, χ2 , Wilcoxon paired, and McNemar tests. RESULTS After 1 year, MBL, BLC and ISQ were statistically identical (P > .05) in the CL and IML groups. The probing depth at 12 months in the CL group (2.19 mm) was higher than in the IML group (1.29 mm; P ≤ .0001). TNF-α was 33.6% higher in the CL group at 6 months (P = .043), while IL-1β was significantly higher in the IML group up to 6 months. The survival rate was 90% in the CL group and 85% in the IML group; 33 prosthetic events occurred in CL group and 23 in IML group. CONCLUSIONS After 12 months, both loading protocols are viable and result in similar clinical, biological, functional, and OHRQOL outcomes. However, IML generates better adaptation of the peri-implant tissues, faster improvement in OHRQoL and fewer prosthetic intercurrences than CL.
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Affiliation(s)
- Alessandra J Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Raissa M Marcello-Machado
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Amália M Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Anna Paula da Rosa Possebon
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Otacílio L Chagas Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Alaqeely R, Babay N, AlQutub M. Dental implant primary stability in different regions of the Jawbone: CBCT-based 3D finite element analysis. Saudi Dent J 2020; 32:101-107. [PMID: 32071539 PMCID: PMC7016247 DOI: 10.1016/j.sdentj.2019.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/27/2019] [Accepted: 06/09/2019] [Indexed: 11/16/2022] Open
Abstract
Aim This study aimed to analyze the primary stability of dental implant in maxillary and mandibular anterior and posterior regions using a finite element analysis. Materials and methods CBCT images of maxillary and mandibular regions were collected from patients’ radiographic data and transformed to 3D models. A Straumann Dental implant was inserted in each bone model and then pulled-out, where amount von-Mises stress was obtained and analyzed for each. A comparison between the insertion and the pull-out was evaluated. Results Twenty-four images were randomly selected for analysis from 122 scans. In both the insertion and the pull-out of the dental implant, von-Mises stress was high in cortical as compared to the cancellous bone (p < 0.0001). Maxillary posterior region had a low von-Mises stress (p < 0.001). Bone plastic deformation was higher in cancellous than the cortical bone in all bone regions and was the lowest in maxillary posterior region (p < 0.001). Bone displacement decreased from Type I to type IV bone. Conclusion Evaluation of von-Mises stress showed different measurements in maxillary and mandibular regions. Bone deformation was low in the maxillary posterior region.
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Affiliation(s)
- Razan Alaqeely
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nadir Babay
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Montaser AlQutub
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
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Araki H, Nakano T, Ono S, Yatani H. Three-dimensional finite element analysis of extra short implants focusing on implant designs and materials. Int J Implant Dent 2020; 6:5. [PMID: 31993827 PMCID: PMC6987289 DOI: 10.1186/s40729-019-0202-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/11/2019] [Indexed: 12/24/2022] Open
Abstract
AIM When using short implants, fracture of the implant body and bone resorption are a concern because stress concentrates on and around a short implant. The purpose of this research is to investigate the differences in stress distribution between tissue level (TL) and bone level (BL) implant body designs, and between commercially pure titanium (cpTi) and the newer titanium-zirconium (TiZr) alloy in using short implants. MATERIALS AND METHODS Models of TL and BL implants were prepared for three-dimensional finite element analysis. The implants were produced in 10 mm, 8 mm, and 6 mm lengths, and the TL was also produced in a 4-mm length. A static load of 100 N inclined at 30° to the long axis was applied to the buccal side of the model. The largest maximum principal stress value in the cortical bone and the largest von Mises stress value in the implant body were evaluated. RESULTS Stress concentration was observed at the connection part of the implant, especially above the bone in TL and within the bone in BL. In the TL design, tensile stress occurred on the buccal side and compressive stress on the lingual side of the cortical bone. Conversely, in the BL design, tensile stress occurred on the lingual side of the cortical bone. CpTi and TiZr showed a similar stress distribution pattern. The maximum stress values were lower in the TL design than the BL design, and they were lower with TiZr than cpTi for both the cortical bone and implant body. The maximum value tended to increase as the length of the implant body decreased. In addition, the implant body design was more influential than its length, with the TL design showing a stress value similar to the longer BL design. CONCLUSION Using TiZr and a TL design may be more useful mechanically than cpTi and a BL design when the length of the implant body must be shorter because of insufficient vertical bone mass in the mandible.
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Affiliation(s)
- Haruka Araki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan.
| | - Shinji Ono
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan
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Esposito M, Ardebili Y, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Syst Rev 2019; 10:CD003815. [PMID: 31600407 PMCID: PMC6786862 DOI: 10.1002/14651858.cd003815.pub5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007. OBJECTIVES Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis. DATA COLLECTION AND ANALYSIS At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading. MAIN RESULTS We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces. AUTHORS' CONCLUSIONS Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
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Affiliation(s)
- Marco Esposito
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore Building, Oxford RoadManchesterUKM13 9PL
| | | | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore Building, Oxford RoadManchesterUKM13 9PL
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Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Nascimento GG, Del Bel Cury AA. Mapping of inflammatory biomarkers in the peri-implant crevicular fluid before and after the occlusal loading of narrow diameter implants. Clin Oral Investig 2019; 24:1311-1320. [PMID: 31312971 DOI: 10.1007/s00784-019-03010-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To monitor the cytokine release patterns in the peri-implant crevicular fluid (PICF) and to investigate which factors affect the success rate of narrow diameter implants (NDI) during the first year. MATERIAL AND METHODS Mandibular implant overdentures (IOD) retained by 2 NDI were installed in 16 clinically atrophic edentulous patients. The following parameters were monitored during the first year: (i) peri-implant health parameters (plaque index (PI), calculus presence (CP), gingival index (GI), probing depth (PD) and bleeding on probing (BoP); (ii) cytokine concentrations in the PICF (TNF-α, IL-1β, IL-6, IL-10); (iii) implant stability quotient (ISQ); (iv) marginal bone level (MBL) and bone level change (BLC); (v) implant success. The insertion torque, bone type, mandibular atrophy, time since edentulism, and smoking habits were also recorded. All data were analyzed using multivariable multilevel mixed-effects regression models. RESULTS The variability in the TNF-α release patterns temporarily reduced at weeks (w) 8-12, while the IL-1β concentrations remained low until they peaked at w48 [p < 0.05; + 177.55 pg/μl (+ 96.13 - + 258.97)]. Conversely, IL-10 release decreased significantly at w48 [p < 0.05; - 456.24 pg/μl (- 644.41 - - 268.07)]. The PD and ISQ decreased significantly (p < 0.05) over the follow-up period, while the MBL was stable after w48 with a BLC of 0.12 ± 0.71 mm. The overall success rate was 81.3%, and was influenced by TNF-α, IL-1β, IL-10, PI, GI, PD, smoking, and time since edentulism. CONCLUSION Pro- and anti-inflammatory cytokine release was balanced during the first 24 weeks. The GI, smoking, and time since edentulism are the most important factors determining the implant success. CLINICAL RELEVANCE The study contributes to the understanding of the osseointegration process in a clinically atrophic population rehabilitated with IOD, and highlights the importance of monitoring clinical peri-implant health-related parameters, smoking habit, and time since edentulism to predict implant success rates.
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Affiliation(s)
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves St., 457, Center, Pelotas, RS, Brazil.
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
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Makowiecki A, Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. An evaluation of superhydrophilic surfaces of dental implants - a systematic review and meta-analysis. BMC Oral Health 2019; 19:79. [PMID: 31077190 PMCID: PMC6509828 DOI: 10.1186/s12903-019-0767-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/15/2019] [Indexed: 01/07/2023] Open
Abstract
Background The characteristics of a dental implant surface have a decisive influence on the process of osseointegration. According to the current state of knowledge, surface modification can not only affect the morphology of cells, and in this way have a positive impact on osseointegration. Methods The objective of this study was to compare survival rates and marginal bone loss as well as assess the degree of stability of Straumann SLAactive® and Thomenn Incell® implants with a superhydrophilic surface. Authors present review of data published between 01.01.2008 and 12.31.2016 that was found in PubMed/MEDLINE internet database, An Internet search of databases produced a total of 1230 studies, 20 publications were finally selected for the present study based on the established selection and exclusion criteria. Results The statistical analysis was performed. A Cumulative Implant Survival Rate (CSR%) was 98.5%, Marginal bone loss (MBL) after 6 months was M = 0.60 mm and 0.6 5 mm after 12 months and secondary stability in a group Thommen implants M = 71.3 ISQ and M = 75.2 ISQ in group of Straumann. Conclusion Despite certain differences in the values of the studied parameters, both of the systems, i.e. Thommen Inicell and Straumann SLActive, demonstrated a high survival rate, a high level of implant stability and low marginal bone loss.
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Affiliation(s)
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland. .,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland.
| | - Artur Błaszczyszyn
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Tomasz Gedrange
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Orthodontics, Carl Gustav Carus Campus, Technische Universität Dresden, Germany, Fetscherstr. 74, 01307, Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
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Yin L, Chang Y, You Y, Liu C, Li J, Lai HC. Biological responses of human bone mesenchymal stem cells to Ti and TiZr implant materials. Clin Implant Dent Relat Res 2019; 21:550-564. [PMID: 31009155 DOI: 10.1111/cid.12756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/06/2019] [Accepted: 01/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Titanium-zirconium alloy (TiZr1317) is a new material used for biological implants. There are several studies on the effects of TiZr implants on the biological characteristics of human bone mesenchymal stem cells (hBMSCs). PURPOSE The purpose of this study was to investigate the biological responses of hBMSCs to implant holes affected by the physicochemical properties of oral implants (TiSLA , TiSLActive , TiZrSLA , and TiZrSLActive ). MATERIALS AND METHODS Grade 4 Ti and TiZr (13-17% Zr) substrates were modified by sand-blasted large-grit acid-etched (SLA) or hydrophilic sand-blasted large-grit acid-etched (SLActive), resulting in four types of surface with complex microstructures corresponding to the commercially-available implants SLA, RoxolidSLA, SLActive, and RoxolidSLActive (Institute Straumann AG, Basel, Switzerland). Physicochemical properties were detected and the biological responses of hBMSCs were observed. RESULTS Surface morphology characterization by scanning electron microscopy and atomic force microscopy revealed differences between the four groups. SLActive had higher surface energy/wettability than SLA, indicating that increased surface energy/wettability can promote the absorption of osteogenic proteins and enhance osseointegration. hBMSCs seeded on SLActive substrates exhibited better performance in terms of cell attachment, proliferation and osteoblastic differentiation than cells seeded on SLA. CONCLUSION Because of their more suitable physicochemical properties, TiSLActive and TiZrSLActive materials demonstrated more pronounced effects on the biological responses of hBMSCs compared with TiSLA and TiZrSLA .
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Affiliation(s)
- Lihua Yin
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yaoren Chang
- Department of Implantology, School/Hospital of Stomatology Lanzhou University, Lanzhou, Gansu, China
| | - Yuanhe You
- Department of Implantology, School/Hospital of Stomatology Lanzhou University, Lanzhou, Gansu, China
| | - Chun Liu
- Department of Implantology, School/Hospital of Stomatology Lanzhou University, Lanzhou, Gansu, China
| | - Jie Li
- Department of Implantology, School/Hospital of Stomatology Lanzhou University, Lanzhou, Gansu, China
| | - Hong-Chang Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
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Demirturk Kocasarac H, Ustaoglu G, Bayrak S, Katkar R, Geha H, Deahl ST, Mealey BL, Danaci M, Noujeim M. Evaluation of artifacts generated by titanium, zirconium, and titanium-zirconium alloy dental implants on MRI, CT, and CBCT images: A phantom study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:535-544. [PMID: 30879914 DOI: 10.1016/j.oooo.2019.01.074] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 01/16/2019] [Accepted: 01/20/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to assess artifacts generated by zirconium, titanium, and titanium-zirconium alloy implants on magnetic resonance imaging(MRI), computed tomography(CT), and cone beam computed tomography(CBCT) and to correlate the findings to the dose-area product and exposure factors on CT and CBCT. STUDY DESIGN Three phantoms were built by embedding zirconium, titanium, and titanium-zirconium implants in ultrasound gel. MRI, CT, and CBCT images were acquired by using multiple sequences and settings. For MRI, "artifact" was described as the length of signal void beyond the limits of the implant. For CT and CBCT, "artifact" was calculated by subtracting the gray level of the darkest pixel from the level of the lightest pixel. RESULTS On MRI, zirconium implants had minor distortion artifacts, whereas titanium and titanium-zirconium implants created extensive artifacts (P < .05). On CT and CBCT, artifacts were less prominent with titanium and titanium-zirconium implants compared with zirconium (P < .05). Titanium grade 5 implants with 0.3 and 0.4 mm3 voxels produced the least severe artifacts. CONCLUSIONS MRI images were less affected by artifacts from zirconium implants, whereas CT and CBCT images showed less severe artifacts from titanium and titanium-zirconium alloy implants. CT generated greater artifacts compared with CBCT. Larger CBCT voxel sizes reduced the dose-area product and the severity of artifacts.
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Affiliation(s)
- Husniye Demirturk Kocasarac
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA.
| | - Gulbahar Ustaoglu
- Chair, Department of Periodontology, Abant Izzet Baysal University, Bolu, Turkey
| | - Seval Bayrak
- Chair, Department of Oral and Maxillofacial Radiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Rujuta Katkar
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - Hassem Geha
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - S Thomas Deahl
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
| | - Brian L Mealey
- Graduate Program Director, Department of Periodontology, University of Texas Health San Antonio, TX, USA
| | - Murat Danaci
- Chair, Department of Radiology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Marcel Noujeim
- Department of Comprehensive Dentistry, University of Texas Health San Antonio, TX, USA and Department of General Dental Sciences, Marquette University, Milwaukee, WI, USA
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Hydrogen Interaction with Deep Surface Modified Zr-1Nb Alloy by High Intensity Ti Ion Implantation. METALS 2018. [DOI: 10.3390/met8121081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A deep surface modified TiZr layer was fabricated by high-intensity low-energy titanium ion implantation into zirconium alloy Zr-1Nb. Gas-phase hydrogenation was performed to evaluate protective properties of the modified layer against hydrogen permeation into Zr-1Nb alloy. The effects of ion implantation and hydrogen on microstructure, phase composition and elemental distribution of TiZr layer were analyzed by scanning electron microscopy, X-ray diffraction, and glow-discharge optical emission spectroscopy, respectively. It was revealed that TiZr layer (~10 μm thickness) is represented by α′ + α(TiZr) lamellar microstructure with gradient distribution of Ti through the layer depth. It was shown that the formation of TiZr layer provides significant reduction of hydrogen uptake by zirconium alloy at 400 and 500 °C. Hydrogenation of the modified layer leads to refinement of lamellar plates and formation of more homogenous microstructure. Hydrogen desorption from Ti-implanted Zr-1Nb alloy was analyzed by thermal desorption spectroscopy. Hydrogen interaction with the surface modified TiZr layer, as well as its resistance properties, are discussed.
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Schiegnitz E, Al‐Nawas B. Narrow‐diameter implants: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:21-40. [DOI: 10.1111/clr.13272] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
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Schimmel M, Srinivasan M, McKenna G, Müller F. Effect of advanced age and/or systemic medical conditions on dental implant survival: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:311-330. [DOI: 10.1111/clr.13288] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Martin Schimmel
- Division of GerodontologySchool of Dental MedicineUniversity of Bern Bern Switzerland
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
| | - Gerald McKenna
- Centre for Public HealthQueen's University Belfast Institute of Clinical Sciences Belfast UK
| | - Frauke Müller
- Division of Gerodontology and Removable ProsthodonticsUniversity Clinics of Dental MedicineUniversity of Geneva Geneva Switzerland
- Department of Internal Medicine, Rehabilitation and GeriatricsUniversity Hospitals of Geneva Thônex Switzerland
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Marcello-Machado RM, Faot F, Schuster AJ, Bielemann AM, Chagas Júnior OL, Del Bel Cury AA. One-year clinical outcomes of locking taper Equator attachments retaining mandibular overdentures to narrow diameter implants. Clin Implant Dent Relat Res 2018; 20:483-492. [PMID: 29577575 DOI: 10.1111/cid.12605] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 01/09/2018] [Accepted: 02/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Narrow diameter implants (NDI) are recommended to retain mandibular overdentures (MOs) in cases of limited bone thickness. It is necessary to evaluate the clinical behavior of NDI as MO retainers connected to a new screwless locking taper abutments, their predictability and maintenance problems. OBJECTIVES To evaluate the peri-implant tissue behavior around NDI and the performance of locking taper stud abutments as MO retainers. METHODOLOGY Thirty patients (average age of 67.5 years) received 2 NDI implants (2.9 × 10 mm) loaded after 12 weeks using Equator stud attachments. The plaque index (PI), calculus index (CI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), and implant stability quotient (ISQ) were monitored during osseointegration at 0, 4, 8, and 12 weeks and postloading at 24, 48, and 60 weeks. The marginal bone level (MBL) and bone level changes (BLC) were determined at baseline and 60 weeks. RESULTS The cumulative success rate was 83.3%. The PI oscillated in the first 24 weeks and decreased from 48 weeks onward, while the CI score showed significantly higher values at week 8 (22%). The GI also peaked at week 8 (18.6%) and decreased from week 12 onward. The PD decreased gradually over time, but no significant differences were found between weeks 8 and 12. The ISQ decreased significantly between 0 and 12 weeks. After MO loading, the ISQ values increased linearly and significantly between 12 and 24, 24 and 48, and 48 and 60 weeks and reached values similar to the primary stability after 60 weeks [56.1(42.0-65.3)]. No significant MBL was observed at 60 weeks, with an average BLC of -0.06 ± 0.64 mm. CONCLUSION NDI connected to locking taper Equator attachments showed a stable clinical behavior as an MO retainer for edentulous patients with clinical mandibular atrophy.
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Affiliation(s)
- Raissa Micaella Marcello-Machado
- Graduate Program in Clinical Dentistry, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Alessandra Julie Schuster
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Amália Machado Bielemann
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Otacílio Luiz Chagas Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Cinel S, Celik E, Sagirkaya E, Sahin O. Experimental evaluation of stress distribution with narrow diameter implants: A finite element analysis. J Prosthet Dent 2018. [DOI: 10.1016/j.prosdent.2017.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Badran Z, Struillou X, Strube N, Bourdin D, Dard M, Soueidan A, Hoornaert A. Clinical Performance of Narrow-Diameter Titanium-Zirconium Implants: A Systematic Review. IMPLANT DENT 2018; 26:316-323. [PMID: 28114266 DOI: 10.1097/id.0000000000000557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Implant-supported prosthetic rehabilitations are in constant augmentation in everyday dental practice. This is largely due to increasing demand from patients for fixed or implant-stabilized prosthesis, although they are frequently reticent to complex preimplant bone augmentation surgeries, whenever bone volume is lacking. Narrow-diameter implants (NDI; ≤3.5 mm) have been developed to offer relatively simple implant solutions in challenging bone-deficient sites. However, concerns regarding their mechanical properties have been raised. Special titanium-zirconium material (Ti-Zr), with superior mechanical resistance, compared with pure titanium alloys has been introduced into the market. The purpose of this systematic review was to determine the available data on clinical performance of Ti-Zr NDI. MATERIALS AND METHODS A literature search of all available clinical articles dealing with Ti-Zr NDI has been carried out. After including only prospective clinical trials, 14 papers were retrieved for thorough reviewing. CONCLUSION Short-term results from preliminary clinical reports are quite promising, although the number of published studies and the follow-up periods are still insufficient to determine the real benefit of this hybrid material compared with titanium, especially when using NDI.
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Affiliation(s)
- Zahi Badran
- *Clinical Instructor, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France; Associate Professor, Department of Periodontology, Faculty of Dental surgery, (Inserm U791/UIC 11) CHU de Nantes, France. †Clinical Instructor, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France. ‡Adjunct Assistant Professor, Department of Periodontology and Implant Dentistry, College of Dentistry, New York University, New York, NY, and Institut Straumann, Basel, Switzerland. §Professor and Head, Department of Periodontology, Faculty of Dental surgery, (Inserm U791/UIC 11) CHU de Nantes, Nantes, France. ¶Associate Professor and Head, Department of Oral Implantology, Faculty of Dental Surgery, University of Nantes, Nantes, France
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Marcello-Machado RM, Faot F, Schuster AJ, Nascimento GG, Del Bel Cury AA. Mini-implants and narrow diameter implants as mandibular overdenture retainers: A systematic review and meta-analysis of clinical and radiographic outcomes. J Oral Rehabil 2017; 45:161-183. [DOI: 10.1111/joor.12585] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 02/07/2023]
Affiliation(s)
- R. M. Marcello-Machado
- Department of Prosthodontics and Periodontology; Piracicaba Dental School, State University of Campinas Piracicaba; SP Brazil
| | - F. Faot
- Department of Restorative Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas RS Brazil
| | - A. J. Schuster
- Graduate Program in Dentistry; School of Dentistry; Federal University of Pelotas; Pelotas RS Brazil
| | - G. G. Nascimento
- Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - A. A. Del Bel Cury
- Department of Prosthodontics and Periodontology; Piracicaba Dental School; State University of Campinas; Piracicaba Brazil
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de Souza AB, Sukekava F, Tolentino L, César-Neto JB, Garcez-Filho J, Araújo MG. Narrow- and regular-diameter implants in the posterior region of the jaws to support single crowns: A 3-year split-mouth randomized clinical trial. Clin Oral Implants Res 2017; 29:100-107. [DOI: 10.1111/clr.13076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/20/2022]
Affiliation(s)
| | - Flávia Sukekava
- Division of Periodontics; School of Dentistry; University of São Paulo; São Paulo Brazil
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Iegami CM, Uehara PN, Sesma N, Pannuti CM, Tortamano Neto P, Mukai MK. Survival rate of titanium-zirconium narrow diameter dental implants versus commercially pure titanium narrow diameter dental implants: A systematic review. Clin Implant Dent Relat Res 2017; 19:1015-1022. [DOI: 10.1111/cid.12527] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/26/2017] [Accepted: 07/31/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Carolina Mayumi Iegami
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | | | - Newton Sesma
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | | | - Pedro Tortamano Neto
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
| | - Márcio Katsuyoshi Mukai
- Department of Prosthodontics; University of Sao Paulo, School of Dentistry, Sao Paulo; Brazil
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Bielemann AM, Marcello-Machado RM, Leite FRM, Martinho FC, Chagas-Júnior OL, Antoninha Del Bel Cury A, Faot F. Comparison between inflammation-related markers in peri-implant crevicular fluid and clinical parameters during osseointegration in edentulous jaws. Clin Oral Investig 2017; 22:531-543. [PMID: 28710652 DOI: 10.1007/s00784-017-2169-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 06/26/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The aim of this study is to improve the understanding of interleukin mechanisms during osseointegration to enhance the monitoring of implant failure and success. Clinical parameters, implant stability, and cytokine levels in peri-implant crevicular fluid (PICF) during early bone healing after implant placement were investigated. MATERIAL AND METHODS Sixty narrow implants were placed in mandible anterior region of 30 edentulous patients (67.23 ± 7.66 years). Bone type, insertion torque, and primary stability were registered during surgery. Clinical measurements of peri-implant health and the secondary implant stability quotient (ISQ) were recorded. Samples from the PICF were collected 1, 2, 4, 8, and 12 weeks after surgery and analyzed for IL-1β, IL-6, IL-10, and TNF-α levels using ELISAs. RESULTS The gingival index increased significantly during the first week (p = 0.05), while the plaque index increased significantly between 4 to 8 and 8 to 12 weeks (p < 0.05). The probing depth and the ISQ also reduced significantly (p < 0.05) over time. The TNF-α release increased significantly after the 2nd week for non-atrophic patients and 4th week for atrophic patients (p < 0.05). The IL-1β concentrations showed a short-lived peak after 1st week (p = 0.003), specially in atrophic patients and sites with bone type I (p = 0.034; p = 0.007). The IL-6 concentrations peaked during the 1st and 2nd weeks (p < 0.05; p = 0.005) in atrophic patients and in bone type II (p = 0.023; p = 0.003). The IL-10 concentrations increased gradually over time, showing the highest concentrations at the 12th week (p < 0.005). A total of 12 implants failed at different periods. CONCLUSION While the clinical measurements presented differences between the evaluation periods, these were not indicative of early dental implant failure or peri-implant diseases. Smoking, bone atrophy, and bone type can greatly influence the cytokines concentrations during the healing time.
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Affiliation(s)
| | | | | | - Frederico Canato Martinho
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry, State University of São Paulo, São José dos Campos, SP, Brazil
| | - Otacílio Luiz Chagas-Júnior
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, School of Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, RS, 96015-560, Brazil.
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Is there scientific evidence favoring the substitution of commercially pure titanium with titanium alloys for the manufacture of dental implants? MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 71:1201-1215. [DOI: 10.1016/j.msec.2016.10.025] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/07/2016] [Accepted: 10/16/2016] [Indexed: 11/22/2022]
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Abstract
STATEMENT OF PROBLEM Evidence is limited on the efficacy of narrow-diameter implants (NDIs) in the posterior jaw. PURPOSE The purpose of this systematic review was to assess the survival of NDIs and provide guidelines for their safe use. MATERIALS AND METHODS Electronic search of the English-language literature enriched by hand search to identify suitable publications was made. Only peer-reviewed clinical studies published from January 1990 through March 2014 were included. RESULTS Seventeen studies with a total of 1644 implants met the inclusion criteria, with an observation period from 1 up to 12 years. The mean survival rate of 98.6% was reported. Technical and other complications were observed. CONCLUSION Short-term clinical data suggest that NDIs may serve in the posterior jaw as an alternative to standard-diameter implants. However, certain clinical conditions must be observed to assure long-term success.
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Akimoto T, Ueno T, Tsutsumi Y, Doi H, Hanawa T, Wakabayashi N. Evaluation of corrosion resistance of implant-use Ti-Zr binary alloys with a range of compositions. J Biomed Mater Res B Appl Biomater 2016; 106:73-79. [PMID: 27860159 DOI: 10.1002/jbm.b.33811] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 10/05/2016] [Accepted: 10/27/2016] [Indexed: 11/12/2022]
Abstract
Although titanium-zirconium (Ti-Zr) alloy has been adopted for clinical applications, the ideal proportion of Zr in the alloy has not been identified. In this study, we investigated the biocompatibility of Ti-Zr alloy by evaluating its corrosion resistance to better understand whether there is an optimal range or value of Zr proportion in the alloy. We prepared pure Ti, Ti-30Zr, Ti-50Zr, Ti-70Zr, and pure Zr (mol% of Zr) samples and subjected them to anodic polarization and immersion tests in a lactic acid + sodium chloride (NaCl) solution and artificial saliva. We observed pitting corrosion in the Ti-70Zr and Zr after exposure to both solutions. After the immersion test, we found that pure Ti exhibited the greatest degree of dissolution in the lactic acid + NaCl solution, with the addition of Zr dramatically reducing Ti ion dissolution, with the reduction ultimately exceeding 90% in the case of the Ti-30Zr. Hence, although the localized corrosion resistance under severe conditions was compromised when the Zr content was more than 70%, metal ion release reduced owing to Zr addition and the corresponding formation of a stable passive layer. The results suggest that Ti-30Zr or a Zr proportion of less than 50% would offer an ideal level of corrosion resistance for clinical applications. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 73-79, 2018.
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Affiliation(s)
- Teisuke Akimoto
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takeshi Ueno
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yusuke Tsutsumi
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.,Graduate School of Engineering, The University of Tokyo, Bunyko, Tokyo, 113-8656, Japan
| | - Hisashi Doi
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
| | - Takao Hanawa
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan
| | - Noriyuki Wakabayashi
- Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Guo L, Feng Y, Guo HG, Liu BW, Zhang Y. Consequences of orthodontic treatment in malocclusion patients: clinical and microbial effects in adults and children. BMC Oral Health 2016; 16:112. [PMID: 27793138 PMCID: PMC5084385 DOI: 10.1186/s12903-016-0308-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malocclusion is a common disease of oral and maxillofacial region. The study was aimed to investigate levels changes of periodontal pathogens in malocclusion patients before, during and after orthodontic treatments, and to confirm the difference between adults and children. METHOD One hundred and eight malocclusion patients (46 adults and 62 children at the school-age) were randomly selected and received orthodontic treatment with fixed orthodontic appliances. Subgingival plaques were Porphyromonas gingivalis (P.gingivalis), Fusobacterium nucleatum (F. nucleatum), Prevotella intermedia (P. intermedia) and Tannerella forsythensis (T. forsythensis) collected from the observed regions before and after treatment. Clinical indexes, including plaque index (PLI), gingival index (GI), sulcus bleeding index (SBI), probing depth (PD) and attachment loss (AL) of observed teeth were examined. RESULTS The detection rates of P.gingivalis, F. nucleatum, P. intermedia and T. forsythensis increased from baseline to the third month without significant difference, and then returned to pretreatment levels 12 month after applying fixed orthodontic appliances. Adults' percentage contents of P.gingivalis, F. nucleatum, P. intermedia and T. forsythensis were significantly higher than those of children at baseline and the first month, but not obvious at the third month. PLI and SBI were increased from baseline to the first and to the third month both in adults and children groups. Besides, PD were increased from baseline to first month, followed by a downward trend in the third month; however, all patients were failed to detect with AL. CONCLUSIONS Periodontal and microbiological statuses of malocclusion patients may be influenced by fixed orthodontic appliances in both adults and children, more significant in children than in adults. Some microbiological indexes have synchronous trend with the clinical indexes. Long-term efficacy of fixed orthodontic appliances for malocclusion should be confirmed by future researches.
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Affiliation(s)
- Li Guo
- Department of Stomatology, Ninth Hospital of Xi'an, No. 151, 2nd Ring Road East, Xi'an, 710054, People's Republic of China.
| | - Ying Feng
- Department of Stomatology, Ninth Hospital of Xi'an, No. 151, 2nd Ring Road East, Xi'an, 710054, People's Republic of China
| | - Hong-Gang Guo
- Department of Orthopedic, Engineering University Hospital of PAPF, Xi'an, 710086, People's Republic of China
| | - Bo-Wen Liu
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Yang Zhang
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
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Charles PD, Anandapandian PA, Samuel S. Osteogenic potential of laser modified and conditioned titanium zirconium surfaces. J Indian Prosthodont Soc 2016; 16:253-8. [PMID: 27621544 PMCID: PMC5000562 DOI: 10.4103/0972-4052.186403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Statement of Problem: The osseointegration of dental implant is related to their composition and surface treatment. Titanium zirconium (TiZr) has been introduced as an alternative to the commercially pure titanium and its alloys as dental implant material, which is attributed to its superior mechanical and biological properties. Surface treatments of TiZr have been introduced to enhance their osseointegration ability; however, reliable, easy to use surface modification technique has not been established. Purpose: The purpose of this study was to evaluate and compare the effect of neodymium-doped yttrium aluminum garnet (Nd-YAG) laser surface treatment of TiZr implant alloy on their osteogenic potential. Materials and Methods: Twenty disc-shaped samples of 5 mm diameter and 2 mm height were milled from the TiZr alloy ingot. The polished discs were ultrasonically cleaned in distilled water. Ten samples each were randomly selected as Group A control samples and Group B consisted of Nd-YAG laser surface etched and conditioned test samples. These were evaluated for cellular response. Cellular adhesion and proliferation were quantified, and the results were statistically analyzed using nonparametric analysis. Cellular morphology was observed using electron and epiflurosence microscopy. Results: Nd-YAG laser surface modified and conditioned TiZr samples increased the osteogenic potential. Conclusion: Nd-YAG laser surface modification of TiZr, improves the cellular activity, surface roughness, and wettability, thereby increasing the osteogenic potential.
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Affiliation(s)
- P David Charles
- Department of Prosthodontics, SRM Dental College, Chennai, Tamil Nadu, India
| | | | - Shila Samuel
- Department of Biochemistry, VRR Institute of Biomedical Science, Chennai, Tamil Nadu, India
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Kumar VV, Ebenezer S, Kämmerer PW, Jacob PC, Kuriakose MA, Hedne N, Wagner W, Al-Nawas B. Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial. J Craniomaxillofac Surg 2016; 44:1849-1858. [PMID: 27697397 DOI: 10.1016/j.jcms.2016.08.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 07/20/2016] [Accepted: 08/29/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). RESULTS 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. CONCLUSION The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant-loading phase and tend to decrease over time under appropriate management.
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Affiliation(s)
- Vinay V Kumar
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India; Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
| | - Supriya Ebenezer
- Department of Periodontics, M. R. Ambedkar Dental College & Hospital, Bangalore, India.
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Rostock University, Rostock, Germany.
| | - P C Jacob
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Moni A Kuriakose
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Naveen Hedne
- Head and Neck Institute (Head: Dr. Moni A. Kuriakose), Mazumdar Shaw Cancer Center, Narayana Health, Bommasandra, Bangalore, India.
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.
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Marković A, Đinić A, Calvo Guirado JL, Tahmaseb A, Šćepanović M, Janjić B. Randomized clinical study of the peri-implant healing to hydrophilic and hydrophobic implant surfaces in patients receiving anticoagulants. Clin Oral Implants Res 2016; 28:1241-1247. [DOI: 10.1111/clr.12948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Aleksa Marković
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Ana Đinić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - José Luis Calvo Guirado
- Department of Research; International Dentistry Research Cathedra; UCAM Universidad Catolica San Antonio de Murcia; Murcia Spain
| | - Ali Tahmaseb
- Department of Oral Implantology and Prosthetic Dentistry; Academic Center for Dentistry Amsterdam (ACTA); Move Research Institute; Amsterdam The Netherlands
| | - Miodrag Šćepanović
- Department of Prosthodontics; School of Dental Medicine; University of Belgrade; Belgrade Serbia
| | - Bojan Janjić
- Department of Oral Surgery; School of Dental Medicine; University of Belgrade; Belgrade Serbia
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Galli S, Jimbo R, Naito Y, Berner S, Dard M, Wennerberg A. Chemically modified titanium-zirconium implants in comparison with commercially pure titanium controls stimulate the early molecular pathways of bone healing. Clin Oral Implants Res 2016; 28:1234-1240. [DOI: 10.1111/clr.12947] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Silvia Galli
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Ryo Jimbo
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Oral and Maxillofacial Surgery and Oral Medicine; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Yoshihito Naito
- Oral Implant Center; Tokushima University Hospital; Tokushima Japan
| | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- College of Dentistry; New York University; New York NY USA
| | - Ann Wennerberg
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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Impact of Dental Implant Surface Modifications on Osseointegration. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6285620. [PMID: 27478833 PMCID: PMC4958483 DOI: 10.1155/2016/6285620] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/22/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022]
Abstract
Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.
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Al-Johany SS, Al Amri MD, Alsaeed S, Alalola B. Dental Implant Length and Diameter: A Proposed Classification Scheme. J Prosthodont 2016; 26:252-260. [PMID: 27379723 DOI: 10.1111/jopr.12517] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To propose a length-and-diameter-based classification scheme for dental implants to standardize terminology in the dental literature and communication between interested parties. MATERIALS AND METHODS This study was mainly based on searching two major resources: published scientific research papers and 14 of the most popular dental implant manufacturers. Indexed databases were searched from January 2004 up to and including February 2016 using the keywords "dental implant length" and "dental implant diameter." Retrieved titles and abstracts were screened, and related full-text articles were reviewed. Full-text articles that clearly stated the terms and measurements of implants used were included and considered for proposing this classification scheme. RESULTS The initial search for implant diameter and length yielded 1007 and 936 articles, respectively. A total of 85 studies (41 about diameter, 44 about length) were selected and reviewed. The remaining studies (966 about diameter, 892 about length) that did not abide by the eligibility criteria were excluded. The terms "long," "short," "standard," "wide," and "narrow" were the most commonly used terms in the literature. A classification scheme for implants by diameter and length was proposed. CONCLUSIONS Indexed publications contain a variety of terms used by authors to describe diameter and length of dental implants without conformity and standardization. The classification scheme proposed in this article could serve as a reference for interested parties.
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Affiliation(s)
- Sulieman S Al-Johany
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad D Al Amri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Suliman Alsaeed
- Department of Orthodontics, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bassam Alalola
- Department of Orthodontics, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Altuna P, Lucas-Taulé E, Gargallo-Albiol J, Figueras-Álvarez O, Hernández-Alfaro F, Nart J. Clinical evidence on titanium–zirconium dental implants: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2016; 45:842-50. [DOI: 10.1016/j.ijom.2016.01.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 10/21/2015] [Accepted: 01/11/2016] [Indexed: 11/15/2022]
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