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Vilela N, Gurgel BCV, Bruzos CD, Duarte WR, da Silva HDP, Pannuti CM, Duarte PM. Preloading peri-implant crestal bone loss: A retrospective study of incidence and related factors. J Periodontol 2024. [PMID: 38923568 DOI: 10.1002/jper.24-0028] [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: 01/15/2024] [Revised: 03/06/2024] [Accepted: 04/17/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The aim of this study was to evaluate the incidence of preloading crestal bone loss (PLCBL) and to identify the patient-related and implant-related factors associated with PLCBL. METHODS This retrospective cohort examined the dental records of patients who received at least one dental implant. PLCBL was defined as a reduction ⩾0.5 mm and severe PLCBL (primary variable) as a reduction ⩾1.5 mm in mesial and/or distal bone level, measured from the day of implant placement to uncovering or abutment installation/crown delivery. The incidence of PLCBL and patient and implant variables were recorded. Bivariate analysis and binary logistic regression identified factors associated with PLCBL ⩾0.5 mm and ⩾1.5 mm. RESULTS A total of 746 dental implants placed in 361 patients from January 2011 to July 2021 was included in the analyses. Of the implants assessed, 24.4% (n = 182) exhibited PLCBL ⩾ 0.5 mm and 10.5% (n = 78) presented severe PLCBL (i.e., ⩾1.5 mm). Males (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.11-3.07), patients with diabetes (OR = 3.33, 95% CI = 1.73-6.42), and those allergic to penicillin (OR = 3.13, 95% CI = 1.57-6.22) were more likely to experience severe PLCBL (p < 0.05). Implants placed in the anterior area (OR = 2.08, 95% CI = 1.16-3.73), with bone-level platform-abutment connection (OR = 4.73, 95% CI = 1.94-11.49) and inserted supracrestally (OR = 3.77, 95% CI = 1.84-7.72), presented a greater risk of developing severe PLCBL (p < 0.05). Implants placed in a previously grafted area presented a lower likelihood of developing severe PLCBL (OR = 0.489, 95% CI = 0.28-0.84). CONCLUSION The incidence of PLCBL ⩾ 0.5 mm and ⩾1.5 mm was 24.4% and 10.5%, respectively. Male sex, diabetes, allergy to penicillin, anterior location, bone-level platform-abutment connection, and supracrestal implant placement are potential risk factors for severe PLCBL. A previously grafted area is a potential protective factor.
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Affiliation(s)
- Nathalia Vilela
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Bruno C V Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Carlos De Bruzos
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Wagner R Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Hélio D P da Silva
- Department of Dentistry, Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil
| | - Claudio M Pannuti
- Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida, USA
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Quispe-López N, Marques T, Guadilla Y, Flores-Fraile J, Garrido-Martínez P, Montero J. Using the Modified Apical Access Technique to Treat Peri-Implant Mucosa Defects: Description of the Technique and Three-Dimensional Quantitative Measurement of Buccal Augmented Tissue. Dent J (Basel) 2024; 12:194. [PMID: 39056981 PMCID: PMC11276234 DOI: 10.3390/dj12070194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/10/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
The importance of augmenting the peri-implant soft- and hard-tissue architecture is now widely accepted. However, while most contemporary research supports this premise, clinicians are encountering peri-implant soft tissue defects with increasing frequency, which they are therefore required to reconstruct. These complications can result from the difficulty of establishing an appropriate diagnosis and treatment plan or from suboptimal clinical situations (implant malposition, insufficient vestibular alveolar bone thickness or inadequate mucosal thickness). In this context, it is the peri-implant soft-tissue phenotype that most influences esthetic and health-related results in the short and long term. This article describes two clinical cases in which a modification of the apical access technique is presented that may be useful in clinical scenarios requiring large gains in mucosal thickness. Use of the modified bilaminar apical access with de-epithelialized free gingival graft technique showed promising results, with a significant increase in mucosal thickness and satisfactory outcomes in esthetics and peri-implant health.
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Affiliation(s)
- Norberto Quispe-López
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (Y.G.); (J.F.-F.); (J.M.)
| | - Tiago Marques
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Yasmina Guadilla
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (Y.G.); (J.F.-F.); (J.M.)
| | - Javier Flores-Fraile
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (Y.G.); (J.F.-F.); (J.M.)
| | - Pablo Garrido-Martínez
- Department of Prosthesis, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain;
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, Dental Clinic, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (Y.G.); (J.F.-F.); (J.M.)
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An YZ, Song YW, Thoma DS, Strauss FJ, Lee JS. Enhancing guided bone regeneration with cross-linked collagen-conjugated xenogeneic bone blocks and membrane fixation: A preclinical in vivo study. Clin Oral Implants Res 2024. [PMID: 38838049 DOI: 10.1111/clr.14309] [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: 09/06/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To determine whether combining cross-linked (CL) collagen-integrated xenogeneic bone blocks stabilized with the fixation of resorbable collagen membranes (CM) can enhance guided bone regeneration (GBR) in the overaugmented calvarial defect model. MATERIALS AND METHODS Four circular defects with a diameter of 8 mm were prepared in the calvarium of 13 rabbits. Defects were randomly assigned to receive one of the following treatments: (i) non-cross-linked (NCL) porcine-derived collagen-embedded bone block covered by a CM without fixation (NCL + unfix group); (ii) NCL bone block covered by CM with fixation using bone-tack (NCL + fix group); (iii) cross-linked (CL) porcine-derived collagen-embedded bone block covered by CM without fixation (CL + unfix group); and (iv) CL bone block covered by CM with fixation using bone-tack fixation (CL + fix group). The efficacy of GBR was assessed through histological and molecular analyses after 2 and 8 weeks. RESULTS At 2 weeks, there were no significant differences in histologically measured areas of newly formed bone among the groups. At 8 weeks, however, the CL + fix group exhibited a larger area of new bone (5.08 ± 1.09 mm2, mean ± standard deviation) compared to the NCL + unfix (1.62 ± 0.42 mm2; p < .0083), NCL + fix (3.97 ± 1.39 mm2) and CL + unfix (2.55 ± 1.04 mm2) groups. Additionally, the expression levels of tumour necrosis factor-alpha, fibroblast growth factor-2, vascular endothelial growth factor, osteocalcin and calcitonin receptor were significantly higher in the CL + fix group compared to the other three groups (p < .0083). CONCLUSION Cross-linked bone blocks stabilized with collagen membrane fixation can significantly enhance GBR.
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Affiliation(s)
- Yin-Zhe An
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou, Guangdong, China
| | - Young Woo Song
- Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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Steyer E, Theisen K, Hulla H, Ubaidha Maheen C, Sokolowski A, Lorenzoni M. Eleven- to fifteen-year outcome for two-piece implants with an internal tube-in-tube connection: a cross-sectional analysis of 245 implants. Oral Maxillofac Surg 2024; 28:859-867. [PMID: 38315402 DOI: 10.1007/s10006-024-01215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this retrospective study was to evaluate the outcomes of a two-piece implant system with a tube-in-tube internal connection after up to 15 years of clinical use. MATERIAL AND METHODS A retrospective follow-up examination of patients treated with internal tube-in-tube implants between 2003 and 2006 was conducted. The implant survival rates, peri-implant conditions (marginal bone loss, bleeding on probing, plaque index, probing depth), and technical complications were determined. RESULTS In total, 312 dental implants were placed in 152 patients. Of the original 152 patients enrolled, 245 implants in 112 patients were available for a follow-up evaluation after 11 to 15 years (mean observation time, 12.9 ± 1.1 years). The overall implant survival rate was 93.9%. Outcomes for MBL (1.49 ± 1.23 mm), PI (24.3 ± 22.2%), BOP (18.3 ± 28.7%), and PD (2.74 ± 1.21 mm) were observed. Selected parameters (time after implant surgery, smoking habits, bone augmentation (GBR)) showed an influence on MBL and PD. CONCLUSIONS The internal tube-in-tube implant system showed favorable long-term results. The correlation of MBL and PD with the patient-specific factor smoking habit is in accordance with other studies. CLINICAL RELEVANCE Camlog Root-Line implants with a tube-in-tube implant-abutment connection and a 1.6-mm polished neck configuration have demonstrated favorable long-term outcomes in daily clinical practice. However, it is important to note that these implants are no longer available on the market.
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Affiliation(s)
- Elisabeth Steyer
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Kerstin Theisen
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria.
| | - Helfried Hulla
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
- Private Practice Straß, Graz, Austria
| | - Ceeneena Ubaidha Maheen
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Alwin Sokolowski
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
| | - Martin Lorenzoni
- Division of Operative Dentistry, Periodontology and Prosthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, Billrothgasse 4, 8010, Graz, Austria
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Cucchi A, Maiani F, Franceschi D, Sassano M, Fiorino A, Urban IA, Corinaldesi G. The influence of vertical ridge augmentation techniques on peri-implant bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2024; 26:15-65. [PMID: 38114425 DOI: 10.1111/cid.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to peri-implant bone loss (PBL), after at least 12 months of functional loading. MATERIAL AND METHODS The search was conducted to find all the studies about VRA and measurements of PBL with at least 12 months follow-up. Three pairwise meta-analysis (MA) was performed to completely evaluate the outcomes. RESULTS A total of 42 studies were included, of which 11 were randomized clinical trials (RCTs). RCTs were available only for guided bone regeneration (GBR), onlay, and inlay techniques. The weighted mean estimate (WME) of PBL value was found to be 1.38 mm (95% confidence interval [95% CI]: 1.10-1.66) after a mean follow-up of 41.0 ± 27.8 months. GBR, Inlay, Onlay, osteodistraction, and SBB represented in weight 32.9%, 30.6%, 25.0%, 7.6%, and 3.9%, respectively; and their WME (95% CI) were 1.06 (0.87-1.26) mm, 1.72 (1.00-2.43) mm, 1.31 (0.87-1.75) mm, 1.81 (0.87-1.75) mm, and 0.66 (0.55-0.77) mm, respectively. Among the secondary outcomes, the analysis was conducted for vertical bone gain, healing complication rate, surgical complication rate, implant survival, and success rate. CONCLUSIONS The primary findings of the meta-analysis, based on the changes between final and baseline values, showed that the peri-implant bone loss could be influenced by the type of intervention but there is a need to evaluate in RCTs the behavior of the peri-implant bone levels after long-term follow-up for all techniques.
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Affiliation(s)
| | | | - Debora Franceschi
- Department of Experimental and Clinic Medicine, University of Florence, Firenze, Italy
| | - Michele Sassano
- Department of Life Sciences and Public Health, Catholic University of The Sacred Heart, Rome, Italy
| | - Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Napoli, Italy
| | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics, University of Szeged, Szeged, Hungary
- Urban Regeneration Institute, Budapest, Hungary
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Shah B, Dukka H, Alhachache S, Hill M, Cheng G, Sekula M. Analysis of risk factors for early crestal bone loss in osseointegrated, submerged implants prior to restoration. J Periodontol 2023; 94:1405-1413. [PMID: 37436693 DOI: 10.1002/jper.23-0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/09/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Evidence on the etiology behind bone loss around submerged, prosthetically nonloaded implants is still limited. The long-term stability and success of implants with early crestal bone loss (ECBL), especially when placed as two-stage implants, is uncertain. Hence, the aim of this retrospective study is to analyze the potential patient-level, tooth- and implant-related factors for ECBL around osseointegrated, submerged implants, before restoration as compared with healthy implants with no bone loss. METHODS Retrospective data were collected from patient electronic health records between 2015 and 2022. Control sites included healthy implants with no bone loss and test sites included implants with ECBL, both of which were submerged. Patient, tooth and implant level data were collected. ECBL was assessed using periapical radiographs obtained during implant placement and second-stage surgeries. Generalized estimating equation logistic regression models were used to account for multiple implants within patients. RESULTS The total number of implants included in the study was 200 from 120 patients. Lack of supportive periodontal therapy (SPT) was shown to have nearly five-times higher risk of developing ECBL and was statistically significant (p < 0.05). Guided bone regeneration (GBR) procedures before implant placement had a protective effect with an odds ratio of 0.29 (p < 0.05). CONCLUSIONS Lack of SPT was significantly associated with ECBL, while sites that received GBR procedures prior to implant placement were less likely to exhibit ECBL. Our results underscore the importance of periodontal treatment and SPT for peri-implant health, even when the implants are submerged and unrestored.
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Affiliation(s)
- Bansari Shah
- Private Practice, Naperville, Naperville, Illinois, USA
| | - Himabindu Dukka
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Sara Alhachache
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Margaret Hill
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - GuoLiang Cheng
- Department of Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- Department of Bioinformatics & Biostatistics, University of Louisville School of Public Health, Louisville, Kentucky, USA
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Mizraji G, Davidzohn A, Gursoy M, Gursoy U, Shapira L, Wilensky A. Membrane barriers for guided bone regeneration: An overview of available biomaterials. Periodontol 2000 2023; 93:56-76. [PMID: 37855164 DOI: 10.1111/prd.12502] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 10/20/2023]
Abstract
Dental implants revolutionized the treatment options for restoring form, function, and esthetics when one or more teeth are missing. At sites of insufficient bone, guided bone regeneration (GBR) is performed either prior to or in conjunction with implant placement to achieve a three-dimensional prosthetic-driven implant position. To date, GBR is well documented, widely used, and constitutes a predictable and successful approach for lateral and vertical bone augmentation of atrophic ridges. Evidence suggests that the use of barrier membranes maintains the major biological principles of GBR. Since the material used to construct barrier membranes ultimately dictates its characteristics and its ability to maintain the biological principles of GBR, several materials have been used over time. This review, summarizes the evolution of barrier membranes, focusing on the characteristics, advantages, and disadvantages of available occlusive barrier membranes and presents results of updated meta-analyses focusing on the effects of these membranes on the overall outcome.
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Affiliation(s)
- Gabriel Mizraji
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mervi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
- Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Ulvi Gursoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Asaf Wilensky
- Department of Periodontology, Faculty of Dental Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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Arunjaroensuk S, Thunyakitpisal P, Nampuksa K, Monmaturapoj N, Mattheos N, Pimkhaokham A. Stability of guided bone regeneration with two ratios of biphasic calcium phosphate at implant sites in the esthetic zone: A randomized controlled clinical trial. Clin Oral Implants Res 2023; 34:850-862. [PMID: 37314107 DOI: 10.1111/clr.14113] [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: 11/05/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023]
Abstract
AIMS The aim of this randomized, double-blind, clinical trial was to compare the stability of the horizontal dimensions (facial bone thickness) of augmented bone using biphasic calcium phosphate (BCP) with hydroxyapatite/β-tricalcium phosphate ratio of either 60/40 or 70/30. MATERIALS AND METHODS Sixty dental implants placed with contour augmentation in the esthetic zone were randomized to 60/40 BCP (n = 30) or 70/30 BCP (n = 30). Cone-beam computed tomographic was used to assess facial bone thickness post-implantation and 6 months later at implant platform and 2, 4, and 6 mm apical to it. RESULTS The percentage of horizontal dimension reduction was 23.64%, 12.83%, 9.62%, and 8.21% in 70/30 BCP group, while 44.26%, 31.91%, 25.88%, and 21.49% in 60/40 BCP group at the level of the implant platform and 2, 4, and 6 mm apical, respectively. Statistically significant difference was found at 6 months at all levels of measurement (p-value < .05). CONCLUSIONS BCP bone grafts with HA/β-TCP ratio of 60/40 and 70/30 showed comparable outcomes for contour augmentation simultaneously with implant placement. Interestingly, the 70/30 ratio was significantly superior in maintaining facial thickness and showed more stable horizontal dimensions of the augmented site.
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Affiliation(s)
- Sirida Arunjaroensuk
- Dental Biomaterials Science Program, Graduate School, Chulalongkorn University, Bangkok, Thailand
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Katanchalee Nampuksa
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Naruporn Monmaturapoj
- Assistive Technology and Medical Devices Research Center (A-MED), National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Simoni Malushi E, Isufi R, Kadaifciu D. Guided Bone Regeneration Effects on Bone Quantity and Outcomes of Dental Implants in Patients With Insufficient Bone Support: A Single-Center Observational Study. Cureus 2023; 15:e38988. [PMID: 37378176 PMCID: PMC10292071 DOI: 10.7759/cureus.38988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/29/2023] Open
Abstract
Background Guided bone regeneration (GBR) is used to influence on stabilization of dental implants in patients with insufficient bone quantity and anatomical problems. But many studies using GBR resulted in divergent results according to the efficiency of new bone quantity formation and implant survival. This research aimed to study the effects of GBR on the increase of bone quantity and short-term stabilization of dental implants in patients with insufficient bone support. Methodology The study included 26 patients that underwent the procedure for 40 dental implants from September 2020 to September 2021. In each case, the vertical bone support was intraoperatively measured, through the MEDIDENT Italia paradontal millimetric probe (Medident Italia, Carpi, Italy). The vertical bone defect was considered when the mean vertical depth between the abutment junction and the marginal bone was greater than 1mm up to 8mm. In the group with the presence of the vertical bone defect, GBR technique was used during the procedure of dental implants realized with synthetic bone graft, resorbable membrane, and platelet-rich fibrin (PRF), and the group was considered the study (GBR) group. The group of patients with no vertical bone defects (less than 1mm) and no need for any GBR technique use was considered the control (no-GBR) group. The bone support was evaluated again intraoperatively after six months in both groups when the healing abutments were positioned. The vertical bone defect for each group in baseline and after six months is presented as mean±SD and compared using a t-test. A t-test for Equality of Means was used to calculate the mean depth difference (MDD) between baseline and six months values in each group (GBR and no-GBR) and also between both groups. P-value ≤ 0.05 is considered statistically significant. Results Overall 40 dental implants were placed, 20 of them were included in the GBR group and 20 in the no-GBR group. In the GBR group, a statistically significant greater mean vertical bone defect in baseline (day 1), compared to the no-GBR group was found (-4.46±2.76 vs -0.27±0.22; MDD = -4.19 [-5.44 to -2.94] p<0.001). At six months of follow-up in the GBR group, a new bone around the implant was formed, presenting a significantly lower bone defect compared to the baseline measure (-0.39±0.43 vs -4.46±2.76; MDD = -4.07 mm [-5.37 to -2.78] p<0.001). In six months, no statistically significant difference between GBR and no-GBR group in bone support was found (-0.39±0.43 vs -0.27±0.22; MDD = -0.19 [-0.40 to -0.03] p=0.10). In each group, only one implant failure was observed. Conclusions The use of GBR showed an important reduction of vertical depth defect between healing abutment and marginal bone predisposing similar short-term stability and survival of dental implants. The use of GBR techniques could be essential in the stabilization of dental implants in patients with insufficient bone support.
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Affiliation(s)
| | - Renato Isufi
- Oral and Maxillofacial Surgery, University Dental Clinic, Tirana, ALB
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10
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Quirynen M, Lahoud P, Teughels W, Cortellini S, Dhondt R, Jacobs R, Temmerman A. Individual "alveolar phenotype" limits dimensions of lateral bone augmentation. J Clin Periodontol 2023; 50:500-510. [PMID: 36574768 DOI: 10.1111/jcpe.13764] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
AIM Alveolar ridge resorption following tooth extraction often renders a lateral bone augmentation inevitable. Some patients, however, suffer from severe early (during graft healing, Eres ) and/or late (during follow-up, Lres ) graft resorption. We explored the hypothesis that the "individual phenotypic dimensions" may partially explain the degree of such resorptions. MATERIALS AND METHODS Patients who underwent a guided bone regeneration (GBR) procedure were screened for inclusion according to the following criteria: (1) a relatively symmetrical maxillary arch; (2) an intact contra-lateral alveolar bone dimension; (3) the availability of a pre-operative cone-beam CT (CBCT); (4) a CBCT taken immediately after GBR, and (5) at least one CBCT scan ≥6 months after surgery. CBCT scans from different timepoints were registered and imported into the Mimics software (Materialise, Leuven, Belgium). Bone dimensions of the contra-lateral site of the augmentation, representing the "individual phenotypical dimension (IPD) of the alveolar crest", were superimposed on the augmented site and registered accordingly. As such, Eres and Lres could be measured over time, in relation to the IPD (in two dimensions; per millimetre apically from the alveolar crest, in the centre of the GBR), as well as in three dimensions (the entire GBR, 2 mm away from the mesial, distal, and apical border for standardization). RESULTS A total of 17 patients (23 augmented sites) were included. After Eres , the outline of the augmentation was in general located ±1 mm outside the IPD, but ≥1.5 years after GBR, it further moved towards the IPD (85% within 0.5 mm distance). CONCLUSIONS Within the limitations of this study, the results indicate that the dimensions of a lateral bone augmentation are defined by the "individual phenotypic bone boundaries" of the patient.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery and Department of Imaging and Pathology, UZ Leuven, OMFS-IMPATH Research Group, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery and Department of Imaging and Pathology, UZ Leuven, OMFS-IMPATH Research Group, KU Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Andy Temmerman
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Effect of ozone therapy on the modulation of inflammation and on new bone formation in critical defects of rat calvaria filled with autogenous graft. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101292. [PMID: 36150689 DOI: 10.1016/j.jormas.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of ozone therapy on new bone formation and inflammation modulation in defects of rat calvaria filled with autogenous bone. MATERIAL AND METHODS Critical size defects were created in the calvaria of 24 male Wistar rats. The animals were randomly divided into four groups according to the treatment: G1: clot; G2: clot and covered with xenogenic membrane; G3: particulate autogenous bone graft; G4: autogenous bone graft and application of 3 mL O2/O3 gas mixture (10 µg/ml). The defects were filled immediately after surgery with a bilateral retroauricular application, in the region immediately above the incision. After 21 days, the animals were euthanized, and the samples were processed for morphometric evaluations designed to measure both the intensity of the inflammatory infiltrate, and the presence of new bone formation in the defect. RESULTS The results showed a lower inflammation score and higher mean of newly formed bone in the region of the defect for the group associated with ozone therapy (G4). The bone formed in the region of the defect could be observed as being more lamellar and mineralized in the case of associated ozone therapy. CONCLUSION Ozone therapy represents a promising adjuvant therapy to accelerate tissue regeneration.
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12
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Kusirisin T, Suwanprateeb J, Buranawat B. Polycaprolactone versus collagen membrane and 1‐year clinical outcomes: A randomized controlled trial. Clin Implant Dent Relat Res 2022; 25:330-342. [PMID: 36519395 DOI: 10.1111/cid.13166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Polycaprolactone (PCL) is a synthetic aliphatic polyester widely used in biomedical applications with biodegradability in the body and promotes cell proliferation and differentiation. A newly developed bilayered PCL membrane was developed for possibly being used as a membrane in guided bone regeneration (GBR). PURPOSE To compare the clinical efficacy between a newly developed bilayered PCL membrane with a Cytoplast™ RTM collagen membrane for GBR with simultaneous implant placement. MATERIALS AND METHODS Twenty-four patients were randomized to PCL or RTM group, and a total of 24 dental implants were placed. Primary outcomes were patient mean buccal bone thickness (BBT) immediately postimplantation and at 6 months using cone-beam CT and soft tissue surface dimensional changes (STC) at crown insertion, 6 months, and 1 year after loading using intraoral scanner. Secondary outcomes included success rate, clinical parameters, healing index, implant stability, pink esthetic score, and marginal bone levels. RESULTS The percentage of reduced BBT at 6 months was 32.38%, 25.94%, and 23.96% in the test group and 34.42%, 14.75%, and 6.34% in the control group at the corresponding levels. The mean difference of changed BBT associated with PCL membrane, when compared to collagen membrane, at 6 months was -0.02 ± 0.18 mm (95% confidence interval [CI]: -0.40 to 0.35), 0.29 ± 0.28 mm (95% CI: -0.29 to 0.87), and 0.62 ± 0.38 mm (95% CI: -0.17 to 1.42) at 0, 2, and 4 mm from implant shoulder. Minimal loss of STC was observed in both groups up to 1 year of loading. The mean difference loss of surface dimensional change associated with PCL membrane, when compared to collagen membrane, at 1 year of loading was 0.31 ± 0.19 mm (95% CI: -0.07 to 0.70), 0.22 ± 0.26 mm (95% CI: -0.33 to 0.76), and 0.17 ± 0.30 mm (95% CI: -0.45 to 0.78) at 0, 2, and 4 mm from implant shoulder. None of these differences were statistically significant (unpaired t-test, degrees of freedom [df] = 22; p > 0.05). CONCLUSION Within the limits of this trial, both barrier membranes resulted in comparable outcomes for GBR with implant placement after 1 year in function. Further research is necessary with a larger sample size.
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Affiliation(s)
- Thun Kusirisin
- Department of Implantology, Faculty of Dentistry Thammasat University Pathum Thani Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center National Science and Technology Development Agency Pathum Thani Thailand
| | - Borvornwut Buranawat
- Department of Implantology, Faculty of Dentistry Thammasat University Pathum Thani Thailand
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Shen X, Yang S, Xu Y, Xu J, Feng Y, He F. Analysis of implant loss risk factors after simultaneous guided bone regeneration: A retrospective study of 5404 dental implants. Clin Implant Dent Relat Res 2022; 24:276-286. [PMID: 35395143 DOI: 10.1111/cid.13087] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose was to analyze the risk factors for implant loss after simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS Patients who underwent implant placement with simultaneous GBR between January 2011 and December 2018 were screened for this study. The cumulative survival rate (CSR) was calculated using the life table method. Log-rank test and Kaplan-Meier survival estimates were used to identify potential risk factors for implant loss. The association between the investigated variables and implant loss was determined using hazard ratios (HRs) obtained from a multivariate Cox regression analysis. RESULTS A total of 3973 patients with 5404 implants were included in this study. The CSRs of the implants at 1, 5, and 10 years were 99.6%, 98.9%, and 98.7%, respectively. Male patient (HR = 2.94, 95% CI: 1.41-6.14), periodontitis (HR = 4.26, 95% CI: 2.05-9.86), tissue-level implants (HR = 3.02, 95% CI: 1.30-6.98), narrow implants (HR = 2.71, 95% CI: 1.12-6.57), and implant length ≤10 mm (HR = 2.91, 95% CI: 1.41-6.02) significantly increased the risk of implant loss (p < 0.05). The risk of implant loss was significantly higher in the maxillary posterior region (HR = 2.26, 95% CI: 1.04-4.90) than in the maxillary anterior region (p < 0.05). Compared to Straumann, Nobel (HR = 4.07, 95% CI: 1.75-9.44) and other implant systems (HR = 14.23, 95% CI: 4.32-46.85) showed a significantly higher risk of implant loss (p < 0.05). CONCLUSION Male patient, periodontitis, maxillary posterior region, Nobel implant system, other implant systems, tissue-level implants, narrow implants, and implant length ≤10 mm were considered risk factors for implant loss after simultaneous GBR.
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Affiliation(s)
- Xiaoting Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People's Republic of China
| | - Sijia Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People's Republic of China
| | - Yangbo Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People's Republic of China
| | - Jiangang Xu
- Department of Orthopaedics & Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yi Feng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People's Republic of China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People's Republic of China
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14
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Jung RE, Brügger LV, Bienz SP, Hüsler J, Hämmerle CHF, Zitzmann NU. Clinical and radiographical performance of implants placed with simultaneous guided bone regeneration using resorbable and nonresorbable membranes after 22-24 years, a prospective, controlled clinical trial. Clin Oral Implants Res 2021; 32:1455-1465. [PMID: 34543460 PMCID: PMC9293322 DOI: 10.1111/clr.13845] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 02/03/2023]
Abstract
Aim The aim was to evaluate the performance of implants placed with simultaneous guided bone regeneration (GBR) using resorbable or nonresorbable membranes compared to implants placed in pristine bone without bone regeneration after an observation period of 22–24 years. Material and Methods The patient cohort of this clinical trial was treated from 1994 to 1996. Dehiscence defects were treated with GBR by either using resorbable collagen membranes (BG) or nonresorbable ePTFE membranes (GT). Implants placed in pristine bone served as a control (CT). Clinical parameters, marginal bone levels, and technical outcomes were evaluated following restoration placement and at the present follow‐up. A 3D radiographic analysis was conducted in order to assess buccal and oral bone dimensions. Implant survival was assessed with Kaplan–Meier analysis and a frailty model (level of significance 5%). Results Out of the originally 72 patients (mean age 75.4 ± 15.70 years) with 265 implants, 39 patients with 147 implants were included in the study after a median period of 23.5 years. Implant survival was 89.3% in group BG (n = 100), 90.2% in group GT (n = 37), and 93.8% in group CT (n = 105), without significant differences (Frailty proportional hazard model p = .79). Smoking had a negative effect on survival (p = .0122). Mean vertical marginal bone levels were −2.3 ± 1.4 mm (BG, n = 59), −3.0 ± 1.5 mm (GT, n = 21), and −2.3 ± 1.6 mm (CT, n = 52). The vertical buccal bone levels were −3.0 ± 1.9 mm (BG, n = 57), −3.5 ± 2.2 mm (GT, n = 21), and −2.6 ± 1.8 mm (CT, n = 49), without significant differences. Conclusion Implant placement with GBR procedures provides treatment outcomes with favorable implant survival rates (89.3%–93.8%) after 23.5 years. Smoking, however, affected implant survival negatively.
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Affiliation(s)
- Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Lily V Brügger
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Bienz SP, Payer M, Hjerppe J, Hüsler J, Jakse N, Schmidlin PR, Hämmerle CHF, Jung RE, Thoma DS. Primary bone augmentation leads to equally stable marginal tissue conditions comparing the use of xenograft blocks infused with BMP-2 and autogenous bone blocks: A 3D analysis after 3 years. Clin Oral Implants Res 2021; 32:1433-1443. [PMID: 34543475 PMCID: PMC9293361 DOI: 10.1111/clr.13843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 05/26/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022]
Abstract
Objectives To test whether or not primary bone augmentation using xenograft blocks infused with BMP‐2 or autogenous bone blocks lead to similar results regarding the implant survival and 3D marginal soft tissue contours. Methods Twenty‐four patients with an insufficient ridge width for implant placement in need of primary augmentation were randomly assigned to either a block of deproteinized bovine bone mineral infused with rhBMP‐2 (BMP) or an intraorally harvested block of autogenous bone (ABB). At 4 months, 1–4 dental implants were placed in the regenerated area. After crown insertion and at 3 years, peri‐implant tissue parameters, two‐ and three‐dimensional radiographic parameters, and soft tissue contour changes were evaluated. Explorative mixed model analyses were performed. The level of significance was set at 5%. Results At the 3‐year follow‐up, 23 patients with 40 implants were evaluated. The implant survival rate was 100% in both groups. At baseline, the marginal hard tissue levels amounted to −0.4 ± 0.8 mm (mean ± standard deviation) in the BMP group and −0.7 ± 1.0 mm in the ABB group. At 3 years, these values were −0.2 ± 0.4 mm (BMP) and −0.6 ± 1.0 mm (ABB). At baseline, the thickness of the buccal hard tissue at the level of the implant shoulder measured 1.1 ± 1.1 mm (BMP) and 1.4 ± 1.0 mm (ABB). At 3 years, it measured 0.9 ± 0.9 mm (BMP) and 0.7 ± 0.6 mm (ABB). Conclusions The present study demonstrated excellent implant survival rates and stable marginal hard tissue levels in both augmentation groups, 3 years after crown insertion. In addition, the clinical stability of soft and hard tissues was demonstrated in both groups.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Jenni Hjerppe
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Norbert Jakse
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, College of Dentistry, Research Institute for Periodontal Regeneration, Yonsei University, Seoul, Korea
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16
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Naenni N, Stucki L, Hüsler J, Schneider D, Hämmerle CHF, Jung RE, Thoma DS. Implants sites with concomitant bone regeneration using a resorbable or non-resorbable membrane result in stable marginal bone levels and similar profilometric outcomes over 5 years. Clin Oral Implants Res 2021; 32:893-904. [PMID: 33977571 DOI: 10.1111/clr.13764] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/25/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess clinical and radiographic outcomes as well as the profilometric contour alterations of peri-implant hard and soft tissues around single implants treated with simultaneous guided bone regeneration (GBR) at 5 years. MATERIALS AND METHODS Twenty-seven patients presenting with a single tooth gap in the esthetic zone received a two-piece implant. GBR was randomly performed using a resorbable (RES) or a non-resorbable membrane (N-RES) combined with a bone substitute material. Follow-up examinations were performed at baseline (BL = crown insertion), 1 year (FU-1), 3 years (FU-3), and at 5 years (FU-5) including clinical and radiographic parameters as well as profilometric changes. Statistics were performed by means of parametric and nonparametric tests. RESULTS At 5 years, 20 out of 27 patients (9 RES, 11 N-RES) were re-examined. Median values for probing depth changed insignificantly between BL and FU-5 in both groups. The median marginal bone levels were located 0.23 mm (0.06; 0.46; RES) and 0.17 mm (0.13;0.28; N-RES) below the implant shoulder at FU-5 (changes over time p < .05). The calculated median profilometric change between BL and FU-5 was -0.28 mm (-0.53;-0.20; RES; p = .016) and -0.24 mm (-0.43;0.08; N-RES; p = .102; intergroup p = .380). The horizontal bone thickness decreased significantly between re-entry and FU-5 for group RES at all measured levels (p < .05) measuring 0.87 mm (0.0; 2.05) at the implant shoulder, whereas the decrease for group N-RES was insignificant (p = .031) with 0 mm (0; 0.84) at the implant shoulder at 5 years. CONCLUSIONS Implants sites with concomitant GBR using a resorbable or non-resorbable membrane revealed stable marginal bone levels and clinical outcomes. Profilometric changes were clinically negligible over 5 years. The observed change in hard tissue thickness was partially compensated by an increase in soft tissue thickness.
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Affiliation(s)
- Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Lukas Stucki
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - David Schneider
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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Chen H, Gu T, Lai H, Gu X. Evaluation of hard tissue 3-dimensional stability around single implants placed with guided bone regeneration in the anterior maxilla: A 3-year retrospective study. J Prosthet Dent 2021; 128:919-927. [PMID: 33795161 DOI: 10.1016/j.prosdent.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Guided bone regeneration (GBR) is widely used to reconstruct peri-implant bone defects in the esthetic zone. However, the dimensional stability of this bone-biomaterial composite is not fully understood. PURPOSE The primary aim was to evaluate the hard tissue 3-dimensional (3D) stability around single implants placed with simultaneous GBR by using deproteinized bovine bone mineral (DBBM) in the anterior maxilla and explore possible influencing factors. MATERIAL AND METHODS The records of patients who had received implants in the anterior maxilla from January 2015 to March 2016 were reviewed retrospectively. The change in volume and thickness of the facial hard tissue were analyzed. To explore possible influencing factors, the thickness and surface area of facial graft were measured, and the time point at which implants were placed and the healing protocol were recorded. Secondary outcome measures were peri-implant marginal bone loss, bleeding on probing (BOP), and pink esthetic score (PES). Statistical analysis was conducted by using the Student t test, Mann-Whitney U test, Kruskal-Wallis test, or generalized estimating equation analysis (α=.05). RESULTS Fifty-five participants were included in this study, and no implants had been lost after 3 years. BOP was present in 10 (18.2%) participants. The mean ±standard deviation PES of all implants for this study was 11.0 ±2.1. The mean ±standard deviation percentage of residual hard tissue volume was 36.9 ±23.5%, with a significant difference found between time points before 9 months (P<.05). Type 3 implant placement (OR=1.449, P=.031) was found to have a higher percentage of residual hard tissue volume. A greater reduction of the facial hard tissue thickness was observed in participants with thicker postoperative facial grafting (OR=1.463, P=.001). No statistically significant difference was found between the facial, palatal, mesial, and distal peri-implant sites in terms of marginal bone loss (P>.05). CONCLUSIONS Although single-tooth implant placement combined with GBR using DBBM in the anterior maxilla offered satisfactory esthetic and functional outcomes after a 3-year follow-up, significant hard tissue volume and thickness reduction in grafted sites was detected, especially during the initial 9-month postoperative period. This phenomenon may be correlated with the timing of implant placement and the thickness of the facial graft.
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Affiliation(s)
- Haida Chen
- Resident Physician, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
| | - Tianyi Gu
- Graduate student, School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - Haiyan Lai
- Resident Physician, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
| | - Xinhua Gu
- Professor, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China.
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Abstract
The presence of satisfactory bone volume is fundamental for the achievement of osseointegration. This systematic review aims to analyse the use of titanium meshes in guided bone regeneration in terms of bone gain, survival and success rates of implants, and percentages of exposure. An electronic search was conducted Articles were selected from databases in MEDLINE (PubMed), SCOPUS, Scielo, and Cochrane Library databases to identify studies in which bone regeneration was performed through particulate bone and the use of titanium meshes. Twenty-one studies were included in the review. In total, 382 patients, 416 titanium meshes, and 709 implants were evaluated. The average bone gain was 4.3 mm in horizontal width and 4.11 mm in vertical height. The mesh exposure was highly prevalent (28%). The survival rate of 145 simultaneous implants was 99.5%; the survival rate of 507 delayed implants was 99%. The success rate of 105 simultaneous implants was 97%; the success rate of 285 delayed implants was 95.1%. The clinical studies currently available in the literature have shown the predictability of this technique. It has a high risk of soft tissue dehiscence and membrane exposure although the optimal management of membrane exposition permits obtaining a sufficient bone regeneration volume and prevents compromising the final treatment outcome.
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19
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Xiao W, Chen Y, Chu C, Dard MM, Man Y. Influence of implant location on titanium-zirconium alloy narrow-diameter implants: A 1-year prospective study in smoking and nonsmoking populations. J Prosthet Dent 2021; 128:159-166. [PMID: 33551139 DOI: 10.1016/j.prosdent.2020.09.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM Titanium-zirconium (Ti-Zr) alloy (Roxolid) narrow-diameter implants (NDIs) have been widely used for implant-supported prostheses in anterior and posterior regions in the jaws. However, the relationship between implant location and clinical outcome remains unclear. PURPOSE The purpose of this clinical study was to evaluate and compare the clinical and radiographic outcomes of NDIs placed in different regions of the jaws in both smokers and nonsmokers. MATERIAL AND METHODS Eighty-four participants scheduled to receive NDIs for tooth rehabilitation were included, and the inserted NDIs were divided into 3 groups depending on their locations: implants used to restore anterior teeth, implants used to restore premolars, and implants used to restore molars. Crestal bone loss (CBL), implant survival and success rates, bleeding on probing (BOP), and pocket probing depth (PPD) were evaluated 6 and 12 months after implant loading (α=.017 for implant survival and success rates after Bonferroni correction, α=.05 for other parameters). RESULTS Statistical analysis of 6- and 12-month CBL of all participants presented no statistically significant difference among the 3 groups. For smokers, the molar group presented significantly more CBL than the premolar group (0.90 ±0.94 versus 0.16 ±0.27 mm, P=.027) at the 6-month examination. The implant survival rates were 95.65%, 100%, and 100% for anterior, premolar, and molar regions, respectively (P=.283). No statistically significant difference was observed regarding periodontal parameters (P>.05). CONCLUSIONS Implant location has no influence on the clinical and radiographic parameters of Ti-Zr NDIs placed in a nonsmoking population. However, the combination of posterior location and smoking may induce higher risk of crestal bone loss. Caution should be taken when restoring molars for smokers with NDIs.
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Affiliation(s)
- Wenlan Xiao
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases &Department of Oral Implantology, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Yaqian Chen
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chenyu Chu
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Michel M Dard
- Global Medical Director, Medical Affairs, Straumann Group, Basel, Switzerland; Associate Professor of Dental Medicine, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, NY
| | - Yi Man
- Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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20
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Wang M, Zhang X, Li Y, Mo A. The Influence of Different Guided Bone Regeneration Procedures on the Contour of Bone Graft after Wound Closure: A Retrospective Cohort Study. MATERIALS 2021; 14:ma14030583. [PMID: 33513735 PMCID: PMC7865681 DOI: 10.3390/ma14030583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 02/05/2023]
Abstract
The aim of this study was to evaluate the impact of different guided bone regeneration (GBR) procedures on bone graft contour after wound closure in lateral ridge augmentation. A total of 48 patients with 63 augmented sites were included in this study. Participants were divided into 4 groups (n = 12 in each group) based on different surgical procedures: group 1: particulate bone substitute + collagen membrane; group 2: particulate bone substitute + collagen membrane + healing cap, group 3: particulate bone substitute + injectable platelet-rich fibrin (i-PRF) + collagen membrane; group 4: particulate bone substitute + i-PRF + surgical template + collagen membrane. After wound closure, the thickness of labial graft was measured at 0–5 mm apical to the implant shoulder (T0–T5). At T0–T2, the thickness of labial graft in group 4 was significantly higher than the other three groups (p < 0.05). And group 4 showed significantly more labial graft thickness than group 1 and group 2 at T3–T5 (p < 0.05). Within the limitations of this study, the use of i-PRF in combination with the surgical template in GBR may contribute to achieving an appropriate bone graft contour after wound closure.
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Affiliation(s)
- Maoxia Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (M.W.); (X.Z.)
| | - Xiaoqing Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (M.W.); (X.Z.)
| | - Yazhen Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
| | - Anchun Mo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; (M.W.); (X.Z.)
- Correspondence:
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21
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Cairo F, Nieri M, Cavalcanti R, Landi L, Rupe A, Sforza NM, Pace R, Barbato L. Marginal soft tissue recession after lateral guided bone regeneration at implant site: A long‐term study with at least 5 years of loading. Clin Oral Implants Res 2020; 31:1116-1124. [DOI: 10.1111/clr.13658] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | - Michele Nieri
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | | | | | | | | | - Riccardo Pace
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
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22
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Trombelli L, Pramstraller M, Severi M, Simonelli A, Farina R. Peri-implant tissue conditions at implants treated with Sub-periosteal Peri-implant Augmented Layer technique: A retrospective case series. Clin Oral Implants Res 2020; 31:992-1001. [PMID: 32781494 DOI: 10.1111/clr.13646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 07/27/2020] [Accepted: 08/03/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess peri-implant tissue conditions on the short term in patients receiving the Sub-periosteal Peri-implant Augmented Layer (SPAL) technique and in patients with adequate thickness (≥2 mm) of the peri-implant buccal bone plate (PBBP) at placement. METHODS Patients where either a dehiscence defect or thin PBBP at implant placement was corrected by SPAL technique (SPALdehiscence and SPALthin groups, respectively) and patients presenting a residual PBBP thickness ≥2 mm at implant placement (control group) were retrospectively selected. The number of peri-implant sites positive to bleeding on probing (BoP) at 6 months following prosthetic loading was the primary outcome. Also, height of keratinized mucosa, marginal soft tissue level, Plaque Index, peri-implant probing depth, suppuration on probing, and interproximal radiographic bone level (RBL) were evaluated. RESULTS Thirty-four patients (11 in the SPALdehiscence group, 11 in the SPALthin group, and 12 in the control group) were included. In each SPAL group, 10 patients (90.9%) showed peri-implant tissue thickness ≥2 mm at the most coronal portion of the implant at uncovering. The prevalence (number) of BoP-positive sites was 2, 1, and 0 in the SPALdehiscence , SPALthin , and control groups, respectively. RBL amounted to 0.3 mm in the SPALdehiscence group, 0.2 mm in the SPALthin group, and 0 mm in the control group. CONCLUSION After 6 months of prosthetic loading, patients treated with SPAL technique show limited peri-implant mucosal inflammation in association with shallow PD and adequate KM. At implants receiving SPAL technique, however, interproximal RBL was found apical to its ideal position.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Italy.,Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Mattia Pramstraller
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Italy.,Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Mattia Severi
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Italy
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Italy.,Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
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23
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Pamato S, Honório HM, da Costa JA, Traebert JL, Bonfante EA, Pereira JR. The influence of titanium base abutments on peri-implant soft tissue inflammatory parameters and marginal bone loss: A randomized clinical trial. Clin Implant Dent Relat Res 2020; 22:542-548. [PMID: 32441407 DOI: 10.1111/cid.12900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/18/2020] [Accepted: 03/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Some techniques in implant dentistry have been suggested that may potentially alter peri-implant soft and hard tissue parameters. PURPOSE To evaluate the peri-implant soft tissue inflammatory parameters and crestal bone loss around titanium base abutments. MATERIALS AND METHODS Fifty two implants were placed in 21 patients and restored by single crowns. Subjects were randomly allocated into two groups: cement-retained abutment (n = 24) and titanium base (n = 28). Peri-implant probing depth, and mesial and distal marginal bone loss (MBL) were evaluated at implant loading (T1), 6 and 12 months (T2 and T3, respectively). Peri-implant bleeding-on-probing was evaluated at T2 and T3. Two-way repeated measures analysis of variance, Tukey test, Man Whitney, and Pearson correlation were performed for statistical analysis at P < .05. RESULTS The mean difference of peri-implant MBL from implant installation to 12 months in function was 1.15 ± 0.82 mm for the cement-retained group, and 1.23 ± 0.79 mm for the titanium base group. No statistically significant difference was found between the two groups for clinical and radiographic peri-implant evaluation. CONCLUSIONS Titanium base abutments present no negative effect on peri-implant soft tissue and MBL. When used to support single crowns, both approaches performed likewise regarding clinical and radiographic parameters.
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Affiliation(s)
- Saulo Pamato
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Heitor Marques Honório
- Department of Pediatrics Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru Campus, São Paulo, Brazil
| | - Jorge Alexandre da Costa
- Department of Prosthodontics, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Jefferson Luiz Traebert
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru Campus, São Paulo, Brazil
| | - Jefferson Ricardo Pereira
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
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24
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Sluka B, Naenni N, Jung RE, Attin T, Schmidlin PR, Sahrmann P. Changes of radiopacity around implants of different lengths: Five-year follow-up data of a randomized clinical trial. Clin Oral Implants Res 2020; 31:488-494. [PMID: 32003872 DOI: 10.1111/clr.13584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/25/2019] [Accepted: 01/07/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To follow-up the radiographic changes in peri-implant bone of short (6 mm, test group) and long (10 mm, control group) single-unit implants five years after loading. MATERIALS AND METHODS Forty-three implants of the test and 44 implants of the control group could be reassessed from 96 originally included implants. Standardized areas of interest (AOI) were defined in the peri-implant bone at pre-defined locations at mid-length on both sides of the implants, and at the apex. An arbitrary mean grey scale value (GSV) was calculated for the AOI after brightness calibration of the radiographs. Changes for GSV were calculated and tested for possible inter- and intra-group differences using the Mann-Whitney and Wilcoxon tests. RESULTS The calculated intra-group differences between baseline and 5 years in the test group accounted for 2.4 ± 19.6 (i.e. slight brightening) and -6.2 ± 20.2 for the control group (i.e. slight shading), which resulted in a statistically significant difference in GSV change (p < .05). Crown-to-implant ratio was the only parameter showing an effect on GSV change (p = .001). CONCLUSIONS Assessing conventional radiographs, longer implants showed a slightly stronger change of radiopacity of the peri-implant bone (slight loss of density) than short ones (slightly enhanced density) after five years of loading.
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Affiliation(s)
- Benjamin Sluka
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
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25
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Thoma DS, Bienz SP, Figuero E, Jung RE, Sanz-Martín I. Efficacy of lateral bone augmentation performed simultaneously with dental implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:257-276. [PMID: 30675733 DOI: 10.1111/jcpe.13050] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To analyse the evidence regarding the efficacy of lateral bone augmentation procedures in terms of defect resolution in cases of horizontal ridge deficiencies after implant placement. MATERIALS AND METHODS Included studies met the following inclusion criteria: randomized controlled trials (RCTs) or controlled clinical trials (CCTs), re-entry procedure to assess defect resolution, minimum of 10 patients (5 per group). Meta-analyses were performed whenever possible, including subgroup analysis based on membranes and grafting materials. RESULTS Twenty-eight publications (20 short-term, 8 follow-up studies) were included. The most often used type of intervention was a xenogeneic particulated grafting material (XE) and a resorbable collagen membrane (CM). The mean defect height at baseline amounted to 5.1 mm (range 2.4-7.8) and decreased to a mean of 0.9 mm (range 0.2-2.2) at re-entry, and the mean defect resolution was 81.3% (range 56.4%-97.1%). Defect height reduction was not significantly different using CM+XE as control treatment compared to the combined data of the respective test groups [n = 11; weighted mean difference (WMD) = -0.006 mm; 95% CI, -0.61, 0.60; p = 0.985]. The absence of any lateral bone augmentation was less favourable than the conjunction of a membrane and a bone grafting material (n = 1; MD = -1.96 mm; 95% CI, -3.48, -0.44; p = 0.011). The lack of a grafting material was less favourable than the conjunction of grafting material and membrane (n = 1; MD = -2.44 mm; 95% CI, -4.53, -0.35; p = 0.022), and the addition of a membrane compared to a grafting material alone was more favourable (n = 3; WMD = 0.97 mm; 95% CI, 0.31, 1.64; p = 0.004). CONCLUSIONS Lateral bone augmentation is a successful treatment modality. For optimal defect height reduction, a barrier membrane and a grafting material should be combined.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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26
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Horizontal Ridge Augmentation and Contextual Implant Placement with a Resorbable Membrane and Particulated Anorganic Bovine Bone-Derived Mineral. Case Rep Dent 2019; 2019:6710340. [PMID: 31637061 PMCID: PMC6766170 DOI: 10.1155/2019/6710340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022] Open
Abstract
Alveolar ridge deficiency is considered a major limitation for successful implant placement. Various approaches have been developed to horizontal augmentation of bone volume. This case report presents the medium-term results of one-stage guided bone augmentation using an anorganic bovine bone (70%) and autologous bone (30%), placed in layers, in association with resorbable collagen membrane for a subsequent implant placement. The patient presented with a localized horizontal ridge defect in the posterior zone of the jaw. The clinical and radiographic presentations, as well as relevant literature, are presented.
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27
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Papi P, Di Carlo S, Rosella D, De Angelis F, Capogreco M, Pompa G. Peri-implantitis and extracellular matrix antibodies: A case-control study. Eur J Dent 2019; 11:340-344. [PMID: 28932144 PMCID: PMC5594963 DOI: 10.4103/ejd.ejd_28_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The aim of this case-control study was to compare patients with a healthy peri-implant environment and patients affected by peri-implantitis, evaluating the occurrence of antibodies to extracellular matrix (ECM) molecules. The authors hypothesized the presence of ECM autoantibodies in serum of peri-implantitis patients. MATERIALS AND METHODS Patients were divided into two groups: one with dental implants with a diagnosis of peri-implantitis and one control group with implants classified as being "healthy." Enzyme-linked immunosorbent assay was performed on patients' sera to detect human antibodies to type I, III, IV, and V collagens, laminin, and fibronectin. Fisher exact test was performed to evaluate statistical association, with a significant P < 0.05. RESULTS Forty-two patients were enrolled in this study, 27 females (64.28%) and 15 males (35.72%) with a mean age of 53 ± 29.69 years (age range 32-74). The presence of antibodies to CIII was recorded in 6/21 (28.57%) patients of test group, compared to just 2/21 (9.52%) for the control group, showing a statistically significant difference (P < 0.05). Other antibodies tested were found to be not statistically significant or absent. CONCLUSIONS Within the limitations of this study, it can be concluded that further studies, with larger sample and different design, are necessary to address the research purpose, evaluating possible associations between anti-ECM antibodies and peri-implantitis.
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Affiliation(s)
- Piero Papi
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Rosella
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Francesca De Angelis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Mario Capogreco
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
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28
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Ramanauskaite A, Borges T, Almeida BL, Correia A. Dental Implant Outcomes in Grafted Sockets: a Systematic Review and Meta-Analysis. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e8. [PMID: 31620270 PMCID: PMC6788428 DOI: 10.5037/jomr.2019.10308] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/05/2019] [Indexed: 12/28/2022]
Abstract
Objectives To assess the treatment outcomes of the dental implants placed in the grafted sockets. Material and Methods A search protocol was developed to evaluate the treatment outcomes of dental implants placed in the grafted sockets in terms of implant survival rates (primary outcome), marginal-bone-level (MBL) changes, clinical parameters (i.e., bleeding on probing, probing depth), occurrence of peri-implant diseases, and aesthetic outcomes (secondary outcomes). Randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective studies with at least 12 months of follow-up and a minimum of 10 patients having at least one dental implant inserted into the grafted socket were conducted. MEDLINE (PubMed) was searched for relevant articles published until 1st April 2019. A meta-analysis was performed using the random-effects model on the selected qualifying articles. Results The present analysis included 7 RCTs. The survival rate of the implants inserted into the grafted sockets ranged from 95 to 100% after 1 to 4 years of follow-up. MBL loss was found to be significantly greater for the implants placed in the non-grafted healed sites than for those placed in the previously grafted sockets (weighted mean difference = -1.961 mm, P < 0.0001). In terms of MBL changes, no difference was detected between immediately inserted implants versus implants placed in previously grafted sockets. None of the included studies reported on the clinical parameters or occurrence of peri-implant diseases Conclusions Implants inserted into the previously grafted sockets showed high survival rates and lower marginal-bone-level loss than the implants inserted into the non-grafted sites.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Carolinum, Goethe University, FrankfurtGermany
| | - Tiago Borges
- Center for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, ViseuPortugal
| | - Bruno Leitão Almeida
- Center for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, ViseuPortugal
| | - Andre Correia
- Center for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, ViseuPortugal
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29
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Benic GI, Eisner BM, Jung RE, Basler T, Schneider D, Hämmerle CHF. Hard tissue changes after guided bone regeneration of peri‐implant defects comparing block versus particulate bone substitutes: 6‐month results of a randomized controlled clinical trial. Clin Oral Implants Res 2019; 30:1016-1026. [DOI: 10.1111/clr.13515] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/01/2019] [Accepted: 07/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Goran I. Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Barbara M. Eisner
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Tobias Basler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - David Schneider
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland
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30
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Cucchi A, Sartori M, Parrilli A, Aldini NN, Vignudelli E, Corinaldesi G. Histological and histomorphometric analysis of bone tissue after guided bone regeneration with non‐resorbable membranes vs resorbable membranes and titanium mesh. Clin Implant Dent Relat Res 2019; 21:693-701. [DOI: 10.1111/cid.12814] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/16/2019] [Accepted: 06/16/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Alessandro Cucchi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM)Alma Mater Studiorum—University of Bologna Bologna Italy
| | - Maria Sartori
- Laboratorio di studi preclinici e chirurgici, Dipartimento RITIRCCS Istituto Ortopedico Rizzoli Bologna Italy
| | - Annapaola Parrilli
- Laboratorio di studi preclinici e chirurgici, Dipartimento RITIRCCS Istituto Ortopedico Rizzoli Bologna Italy
| | - Nicolò N. Aldini
- Laboratorio di studi preclinici e chirurgici, Dipartimento RITIRCCS Istituto Ortopedico Rizzoli Bologna Italy
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM)Alma Mater Studiorum—University of Bologna Bologna Italy
| | - Giuseppe Corinaldesi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM)Alma Mater Studiorum—University of Bologna Bologna Italy
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31
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Thoma DS, Bienz SP, Payer M, Hüsler J, Schmidlin PR, Hämmerle CHF, Jakse N, Jung RE. Randomized clinical study using xenograft blocks loaded with bone morphogenetic protein‐2 or autogenous bone blocks for ridge augmentation – A three‐dimensional analysis. Clin Oral Implants Res 2019; 30:872-881. [DOI: 10.1111/clr.13492] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Stefan P. Bienz
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology, School of Dentistry Medical University Graz Graz Austria
| | - Jürg Hüsler
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology University of Zurich Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
| | - Norbert Jakse
- Department of Oral Surgery and Radiology, School of Dentistry Medical University Graz Graz Austria
| | - Ronald E. Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science University of Zurich Zurich Switzerland
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32
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Fenbo M, Xingyu X, Bin T. Strontium chondroitin sulfate/silk fibroin blend membrane containing microporous structure modulates macrophage responses for guided bone regeneration. Carbohydr Polym 2019; 213:266-275. [DOI: 10.1016/j.carbpol.2019.02.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 12/19/2022]
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33
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Acharya A, Leung MCT, Ng KT, Fan MHM, Fokas G, Mattheos N. Peri-implant marginal bone loss rate pre- and post-loading: An exploratory analysis of associated factors. Clin Oral Implants Res 2019; 30:410-419. [PMID: 30921476 DOI: 10.1111/clr.13424] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/21/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To perform an exploratory analysis of factors influencing annual rates of peri-implant marginal bone loss (RBL) calculated over different time frames, at implants unaffected by peri-implantitis. MATERIAL AND METHODS A total of 154 implants from 86 patients were reviewed at 1.6-6.8 years after placement. Marginal bone levels (MBL) were assessed on intraoral radiographs at three time-points: immediately post-placement, time of loading, and least 1-year post-loading. RBLs (mm/year) were computed using these three time frames and corresponding MBL changes as: RBL placement-loading, RBL loading-review, RBL placement-review. Exploratory ordination of three RBLs, corresponding time durations, and 17 background factors were used for visualization. Hierarchical linear mixed-effects models (MEM) with predictor selection were applied to RBL outcomes. The correlation of actual MBL with MBLs predicted by RBL placement-loading and RBL loading-review was tested. RESULTS Median RBL placement-loading was 0.9 mm/year (IQR = 2.02), loading-review was 0.06 mm/year (IQR = 0.16), and overall RBL placement-review was 0.21 mm/year (IQR = 0.33). Among-patient variance was highest for RBL placement-loading (SD = 0.66). Longer time predicted lower RBL in all time frames. Shorter time of loading significantly predicted lower RBL placement-review. Augmentation predicted lower RBL placement-loading, while anterior location and older age predicted lower RBLs placement-loading placement-review. Only MBL projected using RBL placement-loading significantly correlated with actual MBL. CONCLUSIONS Exploratory analysis indicated RBL varied with the time duration used for calculation in pre- and post-loading, and overall periods. In each period, RBL declined with increasing time. Earlier loading predicted lower overall RBL. Higher pre-loading RBL predicted worse actual bone level.
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Affiliation(s)
- Aneesha Acharya
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China.,Department of Periodontology, Dr. D.Y.Patil Dental College and Hospital, Pimpri, Pune
| | - Ming Chi Terrence Leung
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - King Tung Ng
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Michael H M Fan
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - George Fokas
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
| | - Nikos Mattheos
- Implant Dentistry, Prosthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Jian B, Wu W, Song Y, Tan N, Ma C. Microporous elastomeric membranes fabricated with polyglycerol sebacate improved guided bone regeneration in a rabbit model. Int J Nanomedicine 2019; 14:2683-2692. [PMID: 31043781 PMCID: PMC6472284 DOI: 10.2147/ijn.s192167] [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] [Indexed: 01/25/2023] Open
Abstract
Purpose We aimed to fabricate guided bone regeneration (GBR) membrane using polyglycerol sebacate (PGS) and investigate the impact of scaffold pore size on osteogenesis. Materials and methods PGS microporous membrane was fabricated by salt-leaching technique with various pore sizes. Twenty-eight male New Zealand rabbits were randomly divided into four groups: 25 µm PGS membrane, 53 µm PGS membrane, collagen membrane, and blank control group. Subsequently, standardized and critical-sized tibia defects were made in rabbits and the defective regions were covered with the specifically prepared membranes. After 4 and 12 weeks of in vivo incubation, bone samples were harvested from tibia. Micro-computed tomography scanning was performed on all bone samples. A three-dimensional visible representation of the constructs was obtained and used to compare the ratios of the ossifying volume to total construct volume (bone volume to tissue volume [BV/TV]) of each sample in different groups; then, bone samples were stained with H&E and Masson's trichrome stain for general histology. Results At 4 weeks, the BV/TV in the 25 µm PGS group was found higher than that in the 53 µm PGS and collagen groups. At 12 weeks, the bone defect site guided by the 25 µm PGS membrane was almost completely covered by the new bone. However, the site guided by the 53 µm PGS membrane or collagen membrane was covered only most of the defects and the left part of the defect was unoccupied. Histological observation further verified these findings. Conclusion We thus concluded that the 25 µm PGS membrane played an advantageous role during 4-12 weeks as compared with those earlier degraded counterparts.
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Affiliation(s)
- Bo Jian
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China, .,Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China,
| | - Wei Wu
- Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China,
| | - Yingliang Song
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China,
| | - Naiwen Tan
- Department of Stomatology, Hospital 463 of PLA, Shenyang, Liaoning, People's Republic of China
| | - Chao Ma
- State Key Laboratory of Military Stomatology, Department of Implant Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China,
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Lee J, Park D, Koo KT, Seol YJ, Lee YM. Validity of a regenerative procedure for a minor bone defect with immediate implant placement: a systematic review and meta-analysis. Acta Odontol Scand 2019; 77:99-106. [PMID: 30600736 DOI: 10.1080/00016357.2018.1508743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This systematic review evaluates implant survival and the change in the width of the horizontal ridge following immediate implant placement with or without a regenerative procedure. MATERIALS AND METHODS An electronic search of MEDLINE, EMBASE, and the LILACS database of the Cochrane Central Register of controlled trials was performed, along with a manual search, up to April 2018. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) with >10 subjects were eligible for this systematic review. A meta-analysis of the risk difference in implant failure between the regenerative and non-regenerative procedure groups was performed using a fixed-effect model. In addition, a meta-analysis of the change in alveolar bone width was conducted using a fixed-effect model. RESULTS Seven studies (six RCTs and one CCT) were included. A meta-analysis of three studies found no statistically significant risk difference in implant failure between the regenerative procedure and non-regenerative procedure groups. A meta-analysis of four studies showed that horizontal shrinkage of the alveolar ridge in the site of immediate implant placement was statistically significantly lower with the regenerative procedure than without it (<1 year follow up studies: weighted mean difference (WMD) 0.75 mm, 95% confidence interval 0.41-1.09, p < .00001; ≥1 year follow up study: WMD 1.22, 95% confidence interval 0.52-1.91, p = .00006; total: WMD 0.84 mm, 95% confidence interval 0.53-1.14, p < .00001). CONCLUSION Within the study limitations, immediate implant placement with a regenerative procedure showed similar implant survival and less shrinkage of the ridge width than immediate implant placement without a regenerative procedure. Due to the high risk of bias and small sample sizes of the included studies, further clinical studies are warranted to draw definitive conclusions.
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Affiliation(s)
- Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Dueun Park
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Sanz-Sánchez I, Carrillo de Albornoz A, Figuero E, Schwarz F, Jung R, Sanz M, Thoma D. Effects of lateral bone augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29 Suppl 15:18-31. [PMID: 29498126 DOI: 10.1111/clr.13126] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This systematic review evaluated the evidence on the effect of the interventions aimed for lateral ridge augmentation (both simultaneously with implant placement or as a staged procedure) on peri-implant health or disease. METHODS A protocol was developed to answer the following PICO question: "In patients with horizontal alveolar ridge deficiencies (population), what is the effect of lateral bone augmentation procedures (intervention and comparison) on peri-implant health (outcome)?" Included studies were randomised controlled trials or controlled clinical trials with a follow-up of at least 12 months after implant loading. Meta-analyses were performed whenever possible, including subgroup analysis based on follow-up. RESULTS Twelve final publications from eight investigations were included. The results from the meta-analysis indicated that irrespective of the type of intervention, the inflammatory changes, based on bleeding on probing (%) were minimal, both at short- (n = 1; weighted mean difference [WMD] = -1.00; 95% CI [-14.04; 12.04]; p = .881) and long-term (n = 5; WMD = -5.63; 95% CI [-18.42; 7.16]; p = .881). When comparing different treatment modalities, no significant differences were observed (n = 6; WMD = -3.36; 95% CI [-12.49; 5.77]; p < .471). Similarly, changes in probing pocket depth and marginal bone levels were not significantly different among groups. The incidence of peri-implantitis was evaluated in three investigations and varied from 16% to 26% after a follow-up period of 6-8 years. CONCLUSIONS The results from this systematic review and meta-analysis have shown that lateral ridge augmentation procedures can maintain peri-implant health over time with low mucosal inflammatory changes and a relatively small incidence of peri-implant bone loss.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | | | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Frank Schwarz
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.,Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Ronald Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Daniel Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Maiorana C, Poli PP, Beretta M. Guided Bone Regeneration and Implant Placement in Association With a Coronally Positioned Palatal Sliding Flap: A 17-Year Follow-Up Case Report. J ORAL IMPLANTOL 2018; 44:371-376. [DOI: 10.1563/aaid-joi-d-18-00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Maggiore Policlinico Hospital, University of Milan, Milan, Italy
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Maggiore Policlinico Hospital, University of Milan, Milan, Italy
| | - Mario Beretta
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Maggiore Policlinico Hospital, University of Milan, Milan, Italy
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Cortellini S, Castro AB, Temmerman A, Van Dessel J, Pinto N, Jacobs R, Quirynen M. Leucocyte- and platelet-rich fibrin block for bone augmentation procedure: A proof-of-concept study. J Clin Periodontol 2018; 45:624-634. [DOI: 10.1111/jcpe.12877] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Simone Cortellini
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Ana B. Castro
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals; KU Leuven; Leuven Belgium
| | - Jeroen Van Dessel
- Department of Imaging and Pathology; Faculty of Medicine; OMFS-IMPATH Research Group; KU Leuven; Leuven Belgium
| | - Nelson Pinto
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven; Leuven Belgium
- Faculty of Dentistry; Postgraduate Implant Program; University of the Andes; Santiago Chile
| | - Reinhilde Jacobs
- Department of Imaging and Pathology; Faculty of Medicine; OMFS-IMPATH Research Group; KU Leuven; Leuven Belgium
- Oral and Maxillofacial Surgery; University Hospitals Leuven; Leuven Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences; Section of Periodontology; KU Leuven; Leuven Belgium
- Dentistry; University Hospitals; KU Leuven; Leuven Belgium
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Naenni N, Sahrmann P, Schmidlin P, Attin T, Wiedemeier D, Sapata V, Hämmerle C, Jung R. Five-Year Survival of Short Single-Tooth Implants (6 mm): A Randomized Controlled Clinical Trial. J Dent Res 2018. [DOI: 10.1177/0022034518758036] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to evaluate whether 6-mm dental implants in the posterior segments of either jaw perform equally well in terms of clinical and radiographic outcomes when compared with 10-mm implants after 5 y of loading. Patients with single-tooth gaps in the posterior area who were scheduled for implant therapy were randomly assigned to a group receiving either a 6- or 10-mm implant. After a healing period of 10 wk, implants were loaded with a screw-retained single crown and followed up at yearly intervals. Of 96 patients, 86 could be recalled after 5 y. The implant survival rates amounted to 91% (95% confidence interval: 0.836 to 0.998) for the 6-mm group and 100% for the 10-mm group ( P = 0.036). Median crown-to-implant (C/I) ratios were 1.75 (interquartile range [IQR], 1.50 to 1.90) for the 6-mm group and 1.04 (IQR, 0.95 to 1.15) for the 10-mm group, whereas the median marginal bone levels measured −0.29 mm (IQR, −0.92 to 0.23) for the 6-mm group and −0.15 mm (IQR: −0.93 – 0.41) for the 10-mm group after 5 y. The C/I ratio turned out to be statistically significant ( P < 0.001), whereas marginal bone levels showed no significant difference between the groups. The 6-mm implants exhibited significantly lower survival rates than the 10-mm implants over 5 y, whereas there was no difference between upper and lower jaws in terms of survival ( P = 0.58). Lost implants did not show any sign of marginal bone loss or peri-implant infection previous to loss of osseointegration. High C/I ratio and implant length had no significant effect on marginal bone level changes or technical and biological complications (German Clinical Trials Registry: DRKS00006290).
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Affiliation(s)
- N. Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - P. Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P.R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T. Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - D.B. Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - V. Sapata
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - C.H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - R.E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Eskan MA, Girouard ME, Morton D, Greenwell H. The effect of membrane exposure on lateral ridge augmentation: a case-controlled study. Int J Implant Dent 2017. [PMID: 28643223 PMCID: PMC5481288 DOI: 10.1186/s40729-017-0089-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed. This case-controlled study aimed to investigate potential effect of membrane exposure lateral ridge augmentation and subsequent implant placement. METHODS A total of 14 patients that did receive lateral ridge augmentation procedure using allogeneic cancellous graft particulate in combination with an alloplastic bioresorbable matrix barrier were retrospectively selected for this study. Bone width was measured at the crest with a digital caliper before bone augmentation and at the reopening for implant placement 4 months later for all patients. Cases where primary flap closure was achieved and the barrier did not expose throughout the time until implant placement were assigned to the control group (n = 7). Cases where primary closure could not be achieved or a barrier exposure happened within the first week following the initial surgery were assigned to the test group. RESULTS The measured alveolar ridge width before surgery as well as after GBR procedure were not statistically significant different between the two groups (p > 0.05). Both groups showed a significant (p < 0.05) increase in their mean alveolar ridge width 4 months after later augmentation procedure, from 3.4 ± 1.2 to 6.0 ± 1.1 mm in the control group and from 3.6 ± 1.0 to 5.0 ± 1.4 mm in the test group. However, the mean alveolar ridge gain was significantly greater in the control group than in the test group (p < 0.05). Consequently, the reduction of the augmented alveolar ridge was significantly higher in the test group averaging to 4.7 mm than for the control group showing a loss of 3.1 mm after 4 months, respectively. However, in all 14 cases, successful implant placement was achieved after 4 months. CONCLUSIONS Within the limit of this study, it can be concluded that early exposure of a bioresorbable matrix barrier during lateral ridge augmentation may compromise the results of the GBR procedure but may still result in a favorable alveolar ridge width gain that allows for the placement of dental implants.
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Affiliation(s)
- Mehmet A Eskan
- , Sisli, Istanbul, Turkey. .,Clinic Eska, Terrace Fulya, Tesvikiye Mah., Hakki Yeten Cad, Sisli, Istanbul, Turkey.
| | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN, 46202, USA
| | - Henry Greenwell
- Department of Oral Health and Rehabilitation, Division of Periodontics, University of Louisville School of Dentistry, Louisville, KY, 40292, USA
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Preparation of allogeneic bone for alveolar ridge augmentation. Cell Tissue Bank 2017; 18:313-321. [DOI: 10.1007/s10561-017-9631-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/13/2017] [Indexed: 10/19/2022]
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