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Mourad KE, Rashed NHAH, Altonbary GY, Fattah Hegazy SA. Five years of radiographic evaluation for the peri-implant bone changes of all-on-four implant prostheses constructed from different framework materials using different digital construction techniques. BMC Oral Health 2024; 24:910. [PMID: 39112988 PMCID: PMC11308698 DOI: 10.1186/s12903-024-04642-7] [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: 03/12/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND There is insufficient evidence recommending a framework material and a CAD/CAM manufacturing technique for mandibular implant-supported prostheses. The study objective was to evaluate the clinical application of different materials and construction techniques used for mandibular All-on-4 prosthesis on circumferential peri-implant bony changes after 5 years. METHODS Thirty-six male patients with all-on-4 mandibular implant-supported prostheses were recalled and divided into three groups. Group PK (patients with frameworks milled from PEEK blocks), Group PSM (patients with frameworks milled from soft metal blocks), and Group SLM (patients with frameworks constructed with additive manufacturing; selective laser melting). The circumferential bone level on all implant faces was assessed with a CBCT. Two-way repeated measures ANOVA was used to compare vertical bone loss (VBL) and horizontal bone loss (HBL) between different groups, implant positions, and observation times followed by Tukey's multiple comparisons. RESULTS For all observation times, there was a significant difference in VBL between groups for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the lowest VBL while group PK showed the highest for anterior and posterior implants. For all groups, HBL significantly increased after 5 years for both anterior and posterior implants (P < .001). For anterior implants, group PSM showed the highest HBL. For posterior implants, group PK and SLM showed the highest. CONCLUSION Within the study's limitations, mandibular implant-supported fixed frameworks fabricated with either milling from PEEK or soft metal blocks, or additive manufacturing (laser melting technology) exhibited significant vertical and horizontal bone height changes after 5 years. CLINICAL TRIAL REGISTRY NUMBER (NCT06071689) (11/10/2023).
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Affiliation(s)
- Khloud Ezzat Mourad
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
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Azarias JS, Alves Bento VA, de Moraes Melo Neto CL, Adriazola Ique MM, do Santos DM, Goiato MC. What Is the Survival Rate of Implants Loaded Immediately with a Branemark Protocol Prosthesis? A Review. Eur J Dent 2024. [PMID: 39013449 DOI: 10.1055/s-0044-1787818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
The aim of this review was to determine the survival rate of implants loaded immediately with a Branemark protocol prosthesis. An electronic search was performed in the PubMed/MEDLINE database from 2006 to February 2024, using a combination of Medical Subject Headings descriptors: "completely edentulous" and "immediate loading." Human clinical articles in English that evaluated the survival rate of implants loaded immediately with a Branemark protocol prosthesis after placement in the bone were included. A total of 546 articles were identified, of which 15 were included in this study. The 15 articles included in the literature showed a high implant survival rate (more than 93%) after immediate loading.
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Affiliation(s)
- Josuel Siqueira Azarias
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | | | - Manuel Martin Adriazola Ique
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Daniela Micheline do Santos
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Emfietzoglou R, Dereka X. Survival Rates of Short Dental Implants (≤6 mm) Used as an Alternative to Longer (>6 mm) Implants for the Rehabilitation of Posterior Partial Edentulism: A Systematic Review of RCTs. Dent J (Basel) 2024; 12:185. [PMID: 38920886 PMCID: PMC11202938 DOI: 10.3390/dj12060185] [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: 03/25/2024] [Revised: 05/30/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
Short dental implants have been proposed as an alternative treatment option to bone regeneration procedures for the rehabilitation of resorbed alveolar ridges. The aim of this paper was to systematically review randomized controlled trials (RCTs) comparing short implants (≤6 mm) and longer implants (>6 mm) in atrophic alveolar ridges in terms of implant survival rates, peri-implant marginal bone loss (MBL), prevalence of peri-implantitis and technical complications. A thorough electronic search was performed until September 2023. RCTs with follow-up of at least 1-year post-loading comparing short implants with rough surfaces to longer implants in the posterior jaws of systemically and periodontally healthy, partially edentulous adults were considered. Studies with incomplete information on the number of patients, follow-up or definition of "short implants" were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used for Risk of bias assessment. Fixed-effects meta-analysis of the selected studies was applied to compare the outcome variables. Random-effect meta-analysis was performed, on the basis of within-study comparisons. In total, 16 articles were selected for meta-analysis and incorporated 408 short implants and 475 longer implants inserted in 317 and 388 patients, respectively. The survival rates of longer implants in pristine or augmented bone were significantly increased compared to short implants (95%CI: 2-5%, p < 0.001). Standard-length implants displayed increased, although non-statistically significant MBL (95%CI: -0.17-0.04, p > 0.05), and prevalence of peri-implantitis (95%CI: 0-5%, p > 0.05). No statistically significant differences were observed between short and long implants in terms of technical complications (implant-level 95%CI: -4-6%, p > 0.05). Short implants represent a promising alternative treatment option for the rehabilitation of posterior jaws to avoid additional bone augmentation procedures. Nonetheless, they should be selected cautiously due to a potentially limited survival rate compared to longer implants. A major limitation of this study is the variability in the included studies regarding sample size, patient profile, type of bone, loading protocol, definition of peri-implantitis, among others. This study received no external funding. The study protocol was registered in PROSPERO (CRD42023485514).
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Aboelfadl A, Keilig L, Ebeid K, Ahmed MAM, Nouh I, Refaie A, Bourauel C. Biomechanical behavior of implant retained prostheses in the posterior maxilla using different materials: a finite element study. BMC Oral Health 2024; 24:455. [PMID: 38622680 PMCID: PMC11020654 DOI: 10.1186/s12903-024-04142-8] [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: 01/13/2024] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND The aim of this study is to evaluate the biomechanical behavior of the mesial and distal off-axial extensions of implant-retained prostheses in the posterior maxilla with different prosthetic materials using finite element analysis (FEA). METHODS Three dimensional (3D) finite element models with three implant configurations and prosthetic designs (fixed-fixed, mesial cantilever, and distal cantilever) were designed and modelled depending upon cone beam computed tomography (CBCT) images of an intact maxilla of an anonymous patient. Implant prostheses with two materials; Monolithic zirconia (Zr) and polyetherketoneketone (PEKK) were also modeled .The 3D modeling software Mimics Innovation Suite (Mimics 14.0 / 3-matic 7.01; Materialise, Leuven, Belgium) was used. All the models were imported into the FE package Marc/Mentat (ver. 2015; MSC Software, Los Angeles, Calif). Then, individual models were subjected to separate axial loads of 300 N. Von mises stress values were computed for the prostheses, implants, and bone under axial loading. RESULTS The highest von Mises stresses in implant (111.6 MPa) and bone (100.0 MPa) were recorded in distal cantilever model with PEKK material, while the lowest values in implant (48.9 MPa) and bone (19.6 MPa) were displayed in fixed fixed model with zirconia material. The distal cantilever model with zirconia material yielded the most elevated levels of von Mises stresses within the prosthesis (105 MPa), while the least stresses in prosthesis (35.4 MPa) were recorded in fixed fixed models with PEKK material. CONCLUSIONS In the light of this study, the combination of fixed fixed implant prosthesis without cantilever using a rigid zirconia material exhibits better biomechanical behavior and stress distribution around bone and implants. As a prosthetic material, low elastic modulus PEKK transmitted more stress to implants and surrounding bone especially with distal cantilever.
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Affiliation(s)
- Ahmad Aboelfadl
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Dental Prosthetics, Propaedeutics and Material Science, Dental School, University Hospital Bonn, Bonn, Germany
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | | | - Ingy Nouh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ashraf Refaie
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
- Department of Fixed Prosthodontics, Fayoum University, Fayoum, Egypt
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Sharaf MA, Wang S, Mashrah MA, Xu Y, Haider O, He F. Outcomes that may affect implant and prosthesis survival and complications in maxillary fixed prosthesis supported by four or six implants: A systematic review and meta-analysis. Heliyon 2024; 10:e24365. [PMID: 38317918 PMCID: PMC10839890 DOI: 10.1016/j.heliyon.2024.e24365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 02/07/2024] Open
Abstract
Objective To investigate whether the clinical and radiographical outcomes are affected when four or six implants support the maxillary fixed complete denture (FCD). Materials and methods This study was registered on PROSPERO (CRD42021226432) and followed the PRISMA guidelines. The focused PICO question was, "For an edentulous maxillary patient rehabilitated with an implant-supported fixed prosthesis, do the clinical and radiographical outcomes differ when four or six implants support the prosthesis ". A thorough search of the relevant studies was designed and performed electronically. The survival rate of implant and prosthesis, marginal bone loss, and complications (mechanical and biological) were the primary outcomes, whereas implant distribution and using the surgical guide, follow-up, and framework material were evaluated as secondary outcomes. Results Out of 1099 articles initially retrieved, 53 clearly stated the outcomes of interest and were included in this study. There were no significant differences in implant and prosthesis survival, technical/mechanical complications, and biological complications between the 4-implant group (4-IG) and the 6-implant group (6-IG). However, marginal bone loss (MBL) was significantly higher in the 4-IG (p < 0.01). The surgical guide and follow-up period did not significantly affect implant/prosthesis survival. Additionally, using the CAD/CAM milled framework and anteroposterior implant distribution were associated with significantly higher implant survival in the 6-IG (p < 0.01). Conclusion The findings of this study indicated that having a greater number of implants, as seen in the 6-implant group, can lead to a decrease in technical and biological complications and reduce marginal bone loss. It is worth noting that factors such as using CAD/CAM frameworks and the anteroposterior distribution of implants were recognized as important in improving implant survival rates when more implants are present.
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Affiliation(s)
- Mufeed Ahmed Sharaf
- Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen
| | - Siyuan Wang
- Department of Prosthodontics, 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, Hangzhou, Zhejiang, China
| | - Mubarak Ahmed Mashrah
- Department of Implantology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, Guangdong 510182, China
| | - Yangbo Xu
- Department of Prosthodontics, 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, Hangzhou, Zhejiang, China
| | - Ohood Haider
- Department of Orthodontics, Medical Center of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Fuming He
- Department of Prosthodontics, 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, Hangzhou, Zhejiang, China
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Kluenter T, Stoilov M. Implant-Retained Prosthetic Rehabilitation of a Patient with Severe Oral Lichen Sclerosus. Case Rep Dent 2023; 2023:6681076. [PMID: 38162824 PMCID: PMC10757662 DOI: 10.1155/2023/6681076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/19/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024] Open
Abstract
Background Lichen sclerosus is a rare condition that occurs in the genital area or on the extraoral skin but can also manifest orally (oral lichen sclerosus (OLS)). The condition is associated with atrophy, scarring, and functional limitations of the tissues. In the present case, an extremely pronounced variant is described, and the oral rehabilitation of the patient is presented. Case Report. The edentulous patient showed a progressive course with severely restricted mouth opening and persistent pain. Conventional dental treatment was therefore impossible. To address this issue, two implants were placed in each jaw at the position of the lateral incisors. After osseointegration and exposure of the implants, provisional bridges made of polymethyl-methacrylate were fitted to test the new jaw relation. After a successful provisional phase, an FDP in the sense of an extreme short dental arch (ESDA) has been inserted. Conclusion The experimental treatment of the patient with only a total of four implants and the ESDA concept represented a satisfactory therapy for the patient. The patient regained her chewing ability, which significantly increased her oral health-related quality of life (OHRQoL). Still, it should be noted that this is a high-risk and experimental prosthetic treatment.
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Affiliation(s)
- Tim Kluenter
- Department of Oral, Maxillofacial and Plastic Surgery, Medical Faculty, University of Bonn, Bonn, Germany
| | - Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Medical Faculty, University of Bonn, Bonn, Germany
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Yang Q, Guan X, Wang B, Zhang D, Bai J, Zhang X, Zhou Y. Implant survival rate and marginal bone loss with the all-on-4 immediate-loading strategy: A clinical retrospective study with 1 to 4 years of follow-up. J Prosthet Dent 2023; 130:849-857. [PMID: 35168818 DOI: 10.1016/j.prosdent.2021.12.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Assessing peri-implant marginal bone loss (MBL) and its risk factors with cone beam computed tomography (CBCT) may clarify the risk factors for the all-on-4 (5 or 6) strategy and further improve its survival rate. PURPOSE The purpose of this retrospective clinical study was to evaluate the implant survival rate, MBL, and associated risk factors of all-on-4 (5 or 6) prostheses after 1 to 4 years of follow-up with CBCT. MATERIAL AND METHODS A total of 56 participants rehabilitated with 325 implants by using the all-on-4 (5 or 6) concept between October 2015 and December 2019 were included. Outcome measures were cumulative implant survival (life-table analysis) and MBL. Four CBCT scans, a scan immediately after surgery (T0), a scan 1 year after surgery (T1), a scan 2 years after surgery (T2), and a scan 3 to 4 years after treatment (T3), were obtained to evaluate the MBL. The Pearson correlation coefficient analysis and linear mixed models were performed to assess the potential risk factors for MBL (α=.05). RESULTS The implant survival rate was 99.38%, and the prosthesis survival rate was 100%. The reductions in the vertical buccal bone height (△VBBH) were 0.74 ±0.10 mm (T0-T1), 0.37 ±0.12 mm (T1-T2), and 0.15 ±0.14 mm (T2-T3). Except for T2-T3, the △VBBH showed a significant difference at T0-T1 and T1-T2 (P≤.05). The alterations in vertical mesial bone height (VMBH), vertical distal bone height (VDBH), and vertical lingual bone height (VLBH) were similar to the trend observed in VBBH. The △VBBH (T0-T3) was negatively correlated with the horizontal buccal bone thickness (HBBT) (T0) (r=-.394, P<.001). Linear mixed models revealed that factors such as smoking (P=.001), mandible implant site (P<.001), immediate implant (P=.026), tilted implant (P<.001), female sex (P=.003), systemic disease (P=.025), and bruxism (P=.022) negatively affected MBL. The cantilever length (CL) also had a negative effect on MBL around the implants at the distal extension (P<.001). CONCLUSIONS The high implant and prosthesis survival rates and low MBL confirmed the predictability of the all-on-4 (5 or 6) concept. Smoking, mandible implant site, systemic disease, bruxism, female sex, immediate implant, tilted implant, and CL were identified as potential risk factors for MBL.
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Affiliation(s)
- Qingxia Yang
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Xiaoxu Guan
- Deputy chief dentist, Department of Endodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Baixiang Wang
- Attending dentist, Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Denghui Zhang
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Jingyao Bai
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Xiaoting Zhang
- Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China
| | - Yi Zhou
- Deputy chief dentist, Department of Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang, PR China.
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Alsi SA, Deshpande S, Pande N. Clinical outcomes of implant-supported prosthetic rehabilitation of severely atrophic maxilla: A systematic review. J Indian Prosthodont Soc 2023; 23:335-346. [PMID: 37861610 DOI: 10.4103/jips.jips_360_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Aim The purpose of this systematic review is to evaluate the clinical outcomes for the various methods of rehabilitation of a severely atrophic maxilla with the help of implant-supported fixed prosthesis. Materials and Methods The relevant publications published between 2013 and 2022 and written only in English were identified using an electronic search. The primary research question for this study was developed based on the PICO framework, which stands for population, intervention, control, and outcomes which was "What are the clinical outcomes of implant-supported prosthetic rehabilitation in patients with severely atrophic maxilla?" The relevancy of the articles was confirmed by examining their titles, abstracts, and complete texts to determine whether they satisfied the requirements for inclusion. Utilizing specialized study design-related bias assessment forms, the risk of bias was evaluated. Results The database search resulted in 1568 results; however, 1529 of them were eliminated because of insufficient, duplicate, or missing data. Additionally, manual searching yielded 11 articles. After 50 full-text papers were assessed for eligibility, 17 articles were eliminated. Thus, 33 studies in total are included in the current systematic review. Risk of bias analysis and GRADE evidence analysis were performed. Data were found to be heterogeneous and thus meta-analysis could not be done and narrative synthesis is presented. Conclusion The patient's condition and the clinician's expertise play a role in taking the decision on choice of technique for the fixed implant-supported rehabilitation of the severely atrophic maxilla. A high success and survival rate is produced by the majority of fixed implant-assisted prostheses despite the biologic and prosthetic problems. A single approach cannot be recommended as the gold standard. The choice is dependent on the patient's biological factors as well as the clinician's expertise. The included studies were assessed using GRADE criteria. The quality of evidence is low-medium. Therefore, to better comprehend the clinical effectiveness of the treatment alternatives, more well-designed randomized controlled trials with longer follow-up period are required.
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Affiliation(s)
- Shachi Atul Alsi
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
| | - Saee Deshpande
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
| | - Neelam Pande
- Department of Prosthodontics, VSPM DCRC, Nagpur, Maharashtra, India
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Ding Y, Zhou H, Zhang W, Chen J, Zheng Y, Wang L, Yang F. Evaluation of a platform-switched Morse taper connection for all-on-four or six treatment in edentulous or terminal dentition treatment: A retrospective study with 1-8 years of follow-up. Clin Implant Dent Relat Res 2023; 25:815-828. [PMID: 37248812 DOI: 10.1111/cid.13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND The survival rate, marginal bone loss and soft tissue health of the Ankylos implants and the balanced base abutments in all-on-four or six implant restoration of edentulous or terminal dentition patients has not been reported in the clinical research. PURPOSE This retrospective study aimed to evaluate the Ankylos implants and the balanced base abutments in all-on-four or six implant restoration of edentulous or terminal dentition patients after 1-8 years of follow-up. MATERIALS AND METHODS A retrospective study was conducted based on the medical records of 33 patients who received all-on-four or six treatments from April 2014 to May 2020. Four radiographic examinations [immediate postoperative (T0), definitive restorations (T1), 1-3 years after prosthetic restorations (T2), and more than 3 years after prosthetic restorations (T3)] were obtained to evaluate vertical bone height (VBH). We also calculated the survival rate and examined the condition of soft tissue with this implant system in edentulous or terminal dentition patients. Three-level linear model analyses were used to explore potential risk factors for VBH changes on the mesial and distal sides. The generalized linear model was used to analyze the influencing factors of BOP and plaque. RESULTS A total of 218 implants were included in this study. The cumulative survival rate of the implants was 97.25% before the definitive prosthesis, 96.33% within 3 years of follow-up and 95.32% after more than 3 years of follow-up. The mean ± standard deviation (SD) bone losses of the VBH were 0.27 ± 0.05 mm (T1-T3) on the mesial side and 0.49 ± 0.06 mm (T1-T3) on the distal side. During 1-8 years of follow-up, the height and angle of the abutment (p < 0.001), the mandible implant site (p < 0.001), the length of the implant (p = 0.014 < 0.05) and age (p = 0.029 < 0.05) showed statistically significant effects on vertical mesial bone height (VMBH) and vertical distal bone height (VDBH). The risk of BOP among participants who brushed three times a day was lower than those who brushed less than three times. The plaque risk of short abutment height was higher than the long abutment. CONCLUSION The current study showed that the Ankylos implants with the balanced base abutments in all-on-four or six implants treatment is a viable and predictable option with a high survival rate and low marginal bone loss in edentulous or terminal dentition patients. VBH around the implants was strongly associated with the mandible implant site, abutment height and angle, the length of the implant and age. Moreover, teeth-brushing times and abutment height significantly affect soft tissue health.
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Affiliation(s)
- Yude Ding
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Huajun Zhou
- College of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wentao Zhang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuanna Zheng
- College of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
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Mourad KE, Altonbary GY, Emera RMK, Hegazy SAF. Polyetheretherketone CAD-CAM framework for all-on-4 mandibular full arch prosthesis: Three years' retrospective study of periimplant soft tissue changes and ridge base relationship. J Prosthodont 2022. [PMID: 36069047 DOI: 10.1111/jopr.13602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was conducted to evaluate the clinical peri-implant soft tissue changes during first year after occlusal loading and the ridge base relation after three years for mandibular CAD-CAM manufactured screw-retained implant-supported hybrid prosthesis of polyetheretherketone (PEEK) framework utilized with All-on-Four treatment concept. MATERIAL AND METHODS Sixteen completely edentulous patients were rehabilitated by 4 implants following the All-On-Four protocol. After 3 months, the definitive prosthesis was constructed to be a screw retained CAD-CAM milled framework from the modified PEEK (BioHPP), bonded to polymethylmethacrylate (PMMA) teeth and a pink shaded indirect light-polymerized nanofilled composite resin imitating the soft tissues. Peri-implant soft tissue changes regarding plaque, bleeding, gingival scores, and probing depth were evaluated at prosthesis insertion (T0), six months (T1) and 12 months (T2) after insertion. Also, monitoring of the ridge base relation was performed using cone beam computed tomography after one year (T0), two years (T1), and three years (T2) after mandibular fixed detachable All-on-Four framework insertion. Using Shapiro Wilk tests using SPSS® software version 22 (SPSS Inc.), all clinical data were non- parametric while the ridge base relation data was parametric. RESULTS There were statistically significant differences regarding plaque, gingival, and bleeding scores for all implants with advancement of time. However, there was a statistically insignificant difference regarding probing depth in the posterior implants (p = .581). Regarding ridge base relation, there was a significant difference between observation times only in the anterior ridge area in between the two anterior implants (p = .011). CONCLUSION Within limitations of the study, the full arch PEEK framework of fixed-detachable, hybrid prosthesis used with All-on-Four concept for rehabilitation of mandibular edentulous arches is an acceptable treatment approach. Based on the stable ridge base relation posteriorly found in this study, less stress is distributed to the underlining bone due to the shock absorbing ability of PEEK. Special considerations for frequent soft tissue follow up and regular maintenance of oral hygiene measures are recommended. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Khloud E Mourad
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Gilan Y Altonbary
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Radwa M K Emera
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Salah A F Hegazy
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Biomechanical analysis of inclined and cantilever design with different implant framework materials in mandibular complete-arch implant restorations. J Prosthet Dent 2022; 127:783.e1-783.e10. [DOI: 10.1016/j.prosdent.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 12/29/2022]
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Wu H, Shi Q, Huang Y, Chang P, Huo N, Jiang Y, Wang J. Failure Risk of Short Dental Implants Under Immediate Loading: A Meta-Analysis. J Prosthodont 2021; 30:569-580. [PMID: 33932052 DOI: 10.1111/jopr.13376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Currently, there is no clear clinical evidence that short implants are suitable for immediate loading. Therefore, this meta-analysis aims to evaluate whether immediate loading increases the failure risk of short dental implants. MATERIALS AND METHODS This meta-analysis was registered at PROSPERO (CRD 42020195890). PubMed, Embase, and Cochrane Library databases were searched to collect all clinical studies comparing the failure rates of short dental implants (<10 mm) and standard implants (≥10 mm) under the condition of immediate loading and studies comparing the failure rates of short dental implants under immediate loading versus early or delayed loading. All of the clinical studies with available relevant data were eligible for inclusion. The Cochrane Risk of Bias tool was adopted to evaluate the risk of bias for the randomized controlled trial (RCT), while Newcastle-Ottawa Quality Assessment Scale (NOS) was used for the observational studies (OS). The OR value of each included study and its 95% CI were pooled to estimate the failure risk of short dental implants under immediate loading. The heterogeneity among studies was evaluated through Cochran's Q test and I2 . RESULTS Seventeen studies, 5 RCTs and 12 OS studies, with a total of 2461 dental implants were analyzed. Four of the RCT studies were of low risk of bias and one was of unclear risk, while all of the OS studies were of moderate or high quality. Compared with standard implants, short implants did not have an increased failure risk under immediate loading (OR: 1.38, 95% CI: 0.67-2.84, p = 0.997, fixed model). In addition, the OR value of implant failure for short implants under immediate loading compared to that for short implants under early or delayed loading was 1.22 (95% CI: 0.33-4.55, p = 0.104, random model), which was also not significantly different. CONCLUSIONS There is not enough evidence to show that short dental implants under immediate loading may have higher implant failure risk compared to standard implants under immediate loading and short implants under early or delayed loading. Therefore, an immediate loading protocol may not increase the failure risk of short dental implants.
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Affiliation(s)
- Hao Wu
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Quan Shi
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yang Huang
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ping Chang
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Na Huo
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yi Jiang
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Juncheng Wang
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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Bozyel D, Taşar Faruk S. Biomechanical Behavior of All-on-4 and M-4 Configurations in an Atrophic Maxilla: A 3D Finite Element Method. Med Sci Monit 2021; 27:e929908. [PMID: 33774647 PMCID: PMC8015646 DOI: 10.12659/msm.929908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In edentulous patients, the concept of 4 implants with early loading has been widely used in clinical settings. In the case of bone atrophy in the anterior maxilla, using short implants or an angulated implant may be a good choice for treatment. The occlusal scheme remains a key aspect of All-on-4. The aim of this study was to use the 3-dimensional (3D) finite element method (FEM) to evaluate how different All-on-4 designs for canine-guided and group function occlusion affected the distribution of stress in the atrophic premaxilla. MATERIAL AND METHODS A 3D edentulous maxilla model was created and in 3D FEM, 3 different configurations - M4, All-on-4, and short implant - were modeled by changing the anterior implants and using 2 different occlusal schemes. For each model, the occlusal load was applied to simulate lateral movements. For cortical bone, the maximum and minimum principal stress values were generated, and for ductile materials, von Mises stress values were obtained. RESULTS No significant differences were detected among the models; generally, however, the highest stress values were observed in the M-4 model and the models with short implants. Slightly higher stress values were observed in the group function occlusion group than in the canine-guided occlusion group. CONCLUSIONS To promote better primary stabilization, M-4 or short implant configurations with canine-guided occlusion appear to be preferable for patients who have severe atrophy in the anterior maxilla.
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Affiliation(s)
- Delal Bozyel
- Department of Prosthodontics, Near East University, Nicosia, Cyprus
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14
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Oh JH, Kim YS, Lim JY, Choi BH. Stress Distribution on the Prosthetic Screws in the All-on-4 Concept: A Three-Dimensional Finite Element Analysis. J ORAL IMPLANTOL 2020; 46:3-12. [PMID: 31647687 DOI: 10.1563/aaid-joi-d-19-00090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The all-on-4 concept, which is used to rehabilitate edentulous patients, can present with mechanical complications such as screw loosening and fracture. The purpose of this study was to evaluate the stress patterns induced in the prosthetic screws by the different prosthetic screw and abutment designs in the all-on-4 concept using finite element analysis. Von Mises stress values on 6 groups of each screw type, including short and narrow screw, short abutment; short and wide screw, short abutment; long and wide screw, short abutment; short and narrow screw, long abutment; short and wide screw, long abutment; and long and wide screw, long abutment, were compared under a cantilever loading of 200 N that was applied on the farther posterior to the position of the connection between the distal implant and the metal framework. Posterior prosthetic screws showed higher stress values than anterior prosthetic screws. The stress values in posterior prosthetic screws decreased as the length and diameter increased. In conclusion, the long and wide screw design offers advantages in stress distribution when compared with the short and narrow design.
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Affiliation(s)
- Ji-Hyeon Oh
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Young-Seong Kim
- Department of Mechanical, Robotics and Energy Engineering, Dongguk University, Seoul, South Korea
| | - Joong Yeon Lim
- Department of Mechanical, Robotics and Energy Engineering, Dongguk University, Seoul, South Korea
| | - Byung-Ho Choi
- Department of Dentistry, Yonsei University Wonju College of Medicine, Wonju, South Korea
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15
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Abstract
Edentulous sites are often characterized by inadequate bone volume for dental implant therapy. Bone augmentation procedures for site development involve longer healing period and are often invasive, costly, and associated with postoperative morbidity. This article discusses alternatives to invasive bone grafting procedures that are often used to develop implant sites. Owing to the broad nature of this topic, it is presented in two articles. In part I, the use of short and narrow-diameter implants are discussed. Part II reviews the use of tilted as well as fewer implants to support a prosthesis.
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Abstract
Edentulism, defined as the complete loss of all dentition, is a worldwide phenomenon. Edentulism occurs because of biologic disease processes, such as dental caries, periodontal diseases, trauma, and oral cancer. Edentulism is accompanied by several comorbidities that can significantly influence an individual. Although the rate of edentulism is declining, the number of edentulous patients continues to rise because of the increase in population. The management of edentulous patient has been addressed since the early days of dentistry. This article describes complete dentures and their maintenance, and advanced technology in complete dentures, and in implant-retained and implant-supported prosthesis.
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Affiliation(s)
- Damian J Lee
- Advanced Prosthodontics Program, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, 305 West 12th Avenue, Room 2039L, Columbus, OH 43210, USA.
| | - Paola C Saponaro
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, 305 West 12th Avenue, Room 3005Q, Columbus, OH 43210, USA
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Bagegni A, Abou-Ayash S, Rücker G, Algarny A, Att W. The influence of prosthetic material on implant and prosthetic survival of implant-supported fixed complete dentures: a systematic review and meta-analysis. J Prosthodont Res 2019; 63:251-265. [PMID: 30871937 DOI: 10.1016/j.jpor.2019.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/20/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Evaluating the impact of the prosthetic material on implant- and prosthetic survival of implant-supported fixed complete dentures. STUDY SELECTION Electronic and hand searches were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify clinical studies including at least 10 patients restored with implant-supported dentures. The primary outcome was to evaluate the implant survival rate according to the applied restorative materials. The prosthetic survival rate was evaluated as secondary outcomes. RESULTS Forty-one of 2254 studies were finally selected. A statistically significant difference (p = 0.0337) was found between implant survival rates in the main restorative groups (metal-ceramic:97%(95%CI [0.96;0.98]), all-ceramic:99%(95%CI [0.98;1.00]), metal-resin:97%(95%CI [0.96;0.98])). Prosthetic survival rates were: (metal-ceramic:95%(95%CI [0.89;0.97]), all-ceramic:97%(95%CI [0.92;0.99]), metal-resin:97%(95%CI [0.95;0.98]), with no statistically significant difference (p = 0.3796) between the groups. Chipping incidence rates were as follows: metal-ceramic:8%(95%CI[0.03;0.20]), all-ceramic:15%(95%CI [0.06;0.32]), and metal-resin:22%(95%CI [0.13;0.33]). Five types of exact restorative materials were identified (porcelain-fused-to-non-precious alloy, porcelain-fused-to-zirconia, precious-metal-acrylic-resin, non-precious-metal-acrylic resin, and PMMA). Again, implant survival rates were statistically significantly influenced by the applied restorative materials (p = 0.0126), whereas, no significant differences were reported regarding prosthetic survival rate. CONCLUSIONS Prosthetic material selection seems to have no clinically relevant influence on implant- and prosthetic survival rate in implant-supported fixed complete dentures. Due to the high chipping rate, quantifying prosthetic survival alone does not seem to be a reliable tool for evaluating the outcome of the restorations and providing recommendations. These results, along with the obvious lack of evidence, suggest that clinicians must exercise caution whenever porcelain-fused-to-zirconia or metal-resin restorations are considered.
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Affiliation(s)
- Aimen Bagegni
- Department of Prosthodontics, School of Dentistry, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry And Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Gerta Rücker
- Institute for Medical Biometry and Statistics, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ahmad Algarny
- Department of Prosthodontics, School of Dentistry, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Wael Att
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, United States.
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Daudt Polido W, Aghaloo T, Emmett TW, Taylor TD, Morton D. Number of implants placed for complete‐arch fixed prostheses: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:154-183. [DOI: 10.1111/clr.13312] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/03/2018] [Accepted: 05/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Waldemar Daudt Polido
- Department of Oral and Maxillofacial SurgeryIndiana University School of Dentistry Indianapolis Indiana
| | - Tara Aghaloo
- Department of Oral and Maxillofacial SurgeryUCLA School of Dentistry Los Angeles California
| | - Thomas W. Emmett
- Ruth Lilly Medical LibraryIndiana University School of Medicine Indianapolis Indiana
| | - Thomas D. Taylor
- Department of Reconstructive SciencesUniversity of Connecticut School of Dental Medicine Farmington Connecticut
| | - Dean Morton
- Department of ProsthodonticsIndiana University School of Dentistry Indianapolis Indiana
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Minimally Invasive Approach Based on Pterygoid and Short Implants for Rehabilitation of an Extremely Atrophic Maxilla: Case Report. IMPLANT DENT 2018; 26:639-644. [PMID: 28486354 DOI: 10.1097/id.0000000000000603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Extremely atrophic maxillae can be considered the most important indication for three-dimensional maxillary reconstruction. Different bone-augmentation techniques have been suggested to accomplish this. This article illustrates a minimally invasive approach to rehabilitation of the extremely atrophic maxilla. MATERIAL AND METHODS A 63-year-old male patient was referred for restoration of his totally edentulous maxilla with a fixed full-arch implant-prosthetic rehabilitation. Four short implants in the premaxillary region and 2 longer implants in the pterygomaxillary regions were inserted with piezoelectric implant site preparation. DISCUSSION At the 1-year follow-up appointment, no clinical or radiographic changes in the soft-tissue contours or crestal bone levels were observed. CONCLUSION This surgical approach, based on the combination of short implants in the premaxillary regions and pterygoid implants in the pterygomaxillary regions, represents a way to shorten treatment timing, minimize the risk of surgical complications, and reduce patient discomfort and costs.
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The Influence of the Crown-Implant Ratio on the Crestal Bone Level and Implant Secondary Stability: 36-Month Clinical Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4246874. [PMID: 29862269 PMCID: PMC5976988 DOI: 10.1155/2018/4246874] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/04/2018] [Indexed: 11/17/2022]
Abstract
Introduction When the era of dental implantology began, the pioneers defined some gold standards used in dental prosthetics treatment for implant-supported restorations. Referring to traditional prosthetics, it was taken for granted that the length of an implant placed in the alveolar bone (the equivalent of the root) should exceed the length of the superstructure. Aim of the Study The aim of the study was to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and the loss of the surrounding marginal bone and whether short implants can be used instead of sinus augmentation procedures. Material and Methods The patients participating in the study (n = 30) had one single tooth implant, a short (OsseoSpeed™ L6 Ø4 mm, Implants) or a regular implant (OsseoSpeed L11 and L13 Ø4 mm, DENTSPLY Implants), placed in the maxilla. The evaluation was based on clinical and radiological examination. The crown-to-implant ratio was determined by dividing the length of the crown together with the abutment by the length of the implant placed crestally. Mean crown-to-implant ratios were calculated separately for each group and its correlation with the MBL (marginal bone loss) and stability was assessed. The authors compared the correlation between the C/I ratio values, MBL, and secondary implant stability. Results Positive results in terms of primary and secondary stability were achieved with both (short and conventional) implants. The MBL was low for short and conventional implants being 0.34 ± 0.24 mm and 0.22 ± 0.46 mm, respectively. No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the marginal bone loss. Conclusions Short implants can be successfully used to support single crowns. The study has revealed no significant differences in the clinical performance of prosthetic restorations supported by short implants. Clinical trial registration number is NCT03471000.
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Fiber-Reinforced Resin Fixed Prostheses on 4 Short Implants in Severely Atrophic Maxillas: 1-Year Results of a Prospective Cohort Study. J Oral Maxillofac Surg 2018. [PMID: 29534871 DOI: 10.1016/j.joms.2018.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to report on 1-year outcomes of fixed full-arch fiber-reinforced resin bridges on short implants in atrophic maxillary jaws. MATERIALS AND METHODS A prospective cohort study was designed and patients with severely atrophic maxillas, corresponding to Cawood and Howell Classes V and VI, were included. Mesial and distal peri-implant bone levels were assessed on panoramic radiographs that were taken at the time of implant insertion (baseline) and during follow-up visits. RESULTS Eighteen patients with 72 implants inserted in atrophic maxillary jaws were included in this study. All patients had a follow-up visit 1 year after loading. The cumulative 1-year patient-based implant survival rate was 88.8%, and the cumulative 1-year implant-based survival rate was 97.2%. The marginal bone level (MBL) was -0.5 ± 0.5 mm at the time of loading (n = 72) and -0.8 ± 0.6 mm (n = 72) after 1 year. The MBL depended substantially on the depth at the time of insertion. No prosthetic failure, such as chipping or fracture, occurred within the first year of loading. CONCLUSION Prosthetic rehabilitation of atrophic maxillas with prostheses supported by 4 4.0- × 5.0-mm or 3.0- × 8.0-mm implants seems to be a viable and cost-effective treatment option in the short-term.
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Anitua E, Flores C, Flores J, Alkhraisat MH. Clinical Effectiveness of 6.5-mm-Long Implants to Support Two-Implant Fixed Prostheses in Premolar-Molar Region: The Influence of Immediate Loading and the Length of Splinting Implant. J Prosthodont 2018; 28:e688-e693. [DOI: 10.1111/jopr.12761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2017] [Indexed: 12/24/2022] Open
Affiliation(s)
- Eduardo Anitua
- Private practice in oral implantology; Vitoria Spain
- UIRMI (UPV/EHU-Fundación Eduardo Anitua); University Institute for Regenerative Medicine and Oral Implantology; Vitoria Spain
- BTI Biotechnology Institute; Vitoria Spain
| | - Carlos Flores
- Private practice in oral implantology; Vitoria Spain
| | - Javier Flores
- Private practice in oral implantology; Vitoria Spain
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Abstract
BACKGROUND There is an increasing number of scientific evidence supporting the clinical use of short dental implants. However, few studies have evaluated the long-term outcomes of immediate loading protocols in short implants. This study aims to evaluate immediate loading of short dental implants in the posterior regions of the maxillae. MATERIALS AND METHODS Patients having short implants in maxillae posterior areas inserted before December, 2010 and immediately loaded were selected. The following data were gathered regarding patients' age and gender, implant dimensions, anatomical location, and prosthodontic treatment. The outcome variables were peri-implant bone remodeling and the survival rates of the short implants and the prosthesis. RESULTS A 10 short implants were placed in 8 patients. The mean follow-up time was 4.6 ± 1.21 years after loading and 1 implant failed. One prosthetic complication occurred. No prostheses failed resulting in a survival rate of 100%. CONCLUSIONS The immediate loading of short implants in maxillae posterior areas could save time, cost and could be regarded as a successful treatment.
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Affiliation(s)
- Eduardo Anitua
- Private practice of oral implantology, Eduardo Anitua Foundation, Vitoria, Spain
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Soto-Penaloza D, Zaragozí-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: Systematic review. J Clin Exp Dent 2017; 9:e474-e488. [PMID: 28298995 PMCID: PMC5347302 DOI: 10.4317/jced.53613] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/16/2016] [Indexed: 12/13/2022] Open
Abstract
Objectives To systematically review the literature on the “all-on-four” treatment concept regarding its indications, surgical procedures, prosthetic protocols and technical and biological complications after at least three years in function. Study Design The three major electronic databases were screened: MEDLINE (via PubMed), EMBASE, and the Cochrane Library of the Cochrane Collaboration (CENTRAL). In addition, electronic screening was made of the ‘grey literature’ using the System for Information on Grey Literature in Europe - Open Grey, covering the period from January 2005 up to and including April 2016. Results A total of 728 articles were obtained from the initial screening process. Of these articles, 24 fulfilled the inclusion criteria. Methodological quality assessment showed sample size calculation to be reported by only one study, and follow-up did not include a large number of participants - a fact that may introduce bias and lead to misleading interpretations of the study results. Conclusions The all-on-four treatment concept offers a predictable way to treat the atrophic jaw in patients that do not prefer regenerative procedures, which increase morbidity and the treatment fees. The results obtained indicate a survival rate for more than 24 months of 99.8%. However, current evidence is limited due the scarcity of information referred to methodological quality, a lack of adequate follow-up, and sample attrition. Biological complications (e.g., peri-implantitis) are reported in few patients after a mean follow-up of two years. Adequate definition of the success / survival criteria is thus necessary, due the high prevalence of peri-implant diseases. Key words:All-on-four, all-on-4, tilted implants, dental prostheses, immediate loading.
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Affiliation(s)
- David Soto-Penaloza
- Collaborating Lecturer, Master in Oral Surgery and Implant Dentistry, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Regino Zaragozí-Alonso
- Dentist, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - María Penarrocha-Diago
- Assistant Professor of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Miguel Penarrocha-Diago
- Professor and Chairman of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
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