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Tabrizi R, Mehrabi P, Shafiei S, Azimi A, Moslemi H. Does crown-to-implant ratio affect marginal bone loss around a single short implant at the posterior of the mandible? Natl J Maxillofac Surg 2024; 15:273-277. [PMID: 39234123 PMCID: PMC11371288 DOI: 10.4103/njms.njms_27_23] [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: 02/12/2023] [Revised: 10/29/2023] [Accepted: 12/13/2023] [Indexed: 09/06/2024] Open
Abstract
Context Short implants are acceptable treatment options for atrophic ridges; however, they increase the crown-to-implant (C/I) ratio compared to regular length implants. The study aimed to assess the correlation between the C/I ratio and marginal bone loss (MBL) in single short implants at the posterior of the mandible. Aims The study aimed to assess the correlation between the C/I ratio and MBL in single short implants at the posterior of the mandible. Settings and Design Cross-sectional study. Materials and Methods This cross-sectional study assessed short implants with 6 mm lengths at the posterior of the mandible. The long-cone peri-apical digital radiographs were taken immediately after loading and 24 months later. Age, gender, implant diameter, gingival biotype, and implant brands were the study variables, and the C/I ratio was the predictive factor. The mean MBL at 2 years was considered the study outcome. Statistical Analysis Used The Pearson correlation test was applied to assess the correlation between MBL and C/I. Results Seventy implants (36 Straumann and 34 SGS implants) were studied. A significant difference was observed in the mean MBL between the two implant brands (P < 0.001). Besides, a correlation was found between MBL and the C/I ratio (P = 0.002). Conclusions It seems that the C/I ratio is associated with an MBL increase in single short implants at the posterior of the mandible.
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Affiliation(s)
- Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Mehrabi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shafiei
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Azimi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Moslemi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Gomes JMDL, Limírio JPJDO, Lemos CAA, Moraes SLDD, Minatel L, Pellizzer EP. Response to the "Letter to the Editor" regarding the article: Pellizzer EP, et al. The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and metaanalysis. J Prosthet Dent. 2021;126:497-502. J Prosthet Dent 2021; 127:524-525. [PMID: 34839907 DOI: 10.1016/j.prosdent.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Jéssica Marcela de Luna Gomes
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF-GV), Governador Valadares, Minas Gerais, Brazil
| | | | - Lurian Minatel
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Sadowsky SJ. Comments regarding: Pellizzer EP, Marcela de Luna Gomes J, Araújo Lemos CA, Minatel L, Justino de Oliveira Limírio JP, Dantas de Moraes SL. The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis. J Prosthet Dent 2021;126:497-502. J Prosthet Dent 2021; 127:524. [PMID: 34836649 DOI: 10.1016/j.prosdent.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif
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The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis. J Prosthet Dent 2021; 126:497-502. [DOI: 10.1016/j.prosdent.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/23/2023]
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Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
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Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
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Torres-Alemany A, Fernández-Estevan L, Agustín-Panadero R, Montiel-Company JM, Labaig-Rueda C, Mañes-Ferrer JF. Clinical Behavior of Short Dental Implants: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3271. [PMID: 33053872 PMCID: PMC7599668 DOI: 10.3390/jcm9103271] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 12/19/2022] Open
Abstract
Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to the loss of these. The aim of this systematic review and meta-analysis was to analyze the impact of the use of short implants on their survival and on peri-implant bone loss, evaluating the influence that length, diameter, and crown-to-implant ratio (C/I) have on these parameters. This systematic review was based on guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). An electronic search was conducted using terms related to the use of short implants in partially or totally edentulous patients. A total of five databases were consulted in the literature search: PubMed, Embase, Cochrane, Scopus, and Web of Science. After eliminating the duplicate articles and assessing which ones met the inclusion criteria, 15 articles were included for the qualitative analysis and 14 for the quantitative study. Through meta-analysis, the percentage of implant loss and peri-implant bone loss was estimated. Relating these parameters to length, diameter, and C/I ratio, no significant differences have been found for implant loss (values of p = 0.06, 0.10, and 0.9, respectively for length, diameter, and C/I ratio), nor for peri-implant bone loss (values of p = 0.71, 0.72, and 0.36, respectively for length, diameter, and C/I ratio). In conclusion, the use of short implants does not seem to have a significant influence on marginal bone loss or the survival rate of implants.
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Affiliation(s)
| | - Lucía Fernández-Estevan
- Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag 1, 46010 Valencia, Spain; (A.T.-A.); (R.A.-P.); (J.M.M.-C.); (C.L.-R.); (J.F.M.-F.)
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CT-based dentulous mandibular alveolar ridge measurements as predictors of crown-to-implant ratio for short and extra short dental implants. Sci Rep 2020; 10:16229. [PMID: 33004827 PMCID: PMC7530749 DOI: 10.1038/s41598-020-73180-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/25/2020] [Indexed: 12/17/2022] Open
Abstract
The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and horizontal dimensions of dentulous posterior mandibles in a sample of 18- to 25-year-olds were measured, and correlations of these dimensions with sex and site were investigated. Mandibular computed tomography scans from 100 subjects were considered. Vertical and horizontal bone and tooth measurements were taken at the sites of the second premolar (PM), and the mesial and distal roots of the first and second molars (M1m, M1d, M2m and M2d, respectively). A hypothetical crown-to-implant ratio (C/I R) was calculated assuming the insertion of short and extra short implants (5, 6 or 7 mm), at 1.5 mm from the inferior alveolar canal, maintaining the position of the existing occlusal plane. All vertical bone dimensions decreased from the PM to the M2d. Width measurements increased from the mesial (PM) to the distal sites (M1m, M1d, M2m and M2d). Males had significantly greater vertical and horizontal measurements than females at all sites. The mean C/I R was higher than 2 for all sizes of implant. The C/I R was lower for the second molar than for the second premolar, while it was similar for the first molar and the second premolar. Males had a higher C/I R than females. Computed tomography can be used to study the anatomical features of alveolar bone, and to predict some clinical aspects of prosthetic rehabilitation with implants, such as the crown-to-implant ratio in conditions of serious bone atrophy.
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Prospective, Clinical Pilot Study with Eleven 4-Mm Extra-Short Implants Splinted to Longer Implants for Posterior Maxilla Rehabilitation. J Clin Med 2020; 9:jcm9020357. [PMID: 32012979 PMCID: PMC7074081 DOI: 10.3390/jcm9020357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/17/2020] [Accepted: 01/26/2020] [Indexed: 01/01/2023] Open
Abstract
In many clinical situations, rehabilitation with implants in the posterior maxillary region is complicated by limited bone availability. In this context, the use of 4 mm long implants (known as extra-short implants) may be used thanks to the concept of osseointegration enhancement. It has been demonstrated that short implants offer an alternative to the regeneration procedures involved in placing longer implants in areas where bone height is compromised. This prospective pilot study tested a treatment protocol in which 11 extra-short (4 mm) implants were splinted to 11 mesially placed longer (8 mm) implants in the posterior maxillary regions of partially edentulous patients, without using supplementary bone regeneration procedures. Eleven patients were included in this single cohort study. The clinical performance of the extra-short implants was assessed during a two-year follow-up period, obtaining a 100% survival rate and mean bone loss of 0.3 mm. Implant stability measured by resonance frequency analysis (RFA) at the time of placement was 54.9 ± 4.9, increasing to 77.0 ± 2.6 at 24 months. The study demonstrated the gradual consolidation of osseointegration in bone of less-than-ideal quality in the posterior maxillary region. The results obtained show that a partially edentulous maxilla with reduced bone height may be rehabilitated by using an extra-short implant splinted to a mesial implant of 8mm length or longer. Despite the small sample size, this pilot study observed that extra-short implants achieved adequate bone stability and clinical performance after a 24-month follow-up.
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Malchiodi L, Giacomazzi E, Cucchi A, Ricciotti G, Caricasulo R, Bertossi D, Gherlone E. Relationship Between Crestal Bone Levels and Crown-to-Implant Ratio of Ultra-Short Implants With a Microrough Surface: A Prospective Study With 48 Months of Follow-Up. J ORAL IMPLANTOL 2018; 45:18-28. [PMID: 30040018 DOI: 10.1563/aaid-joi-d-17-00204] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this cohort study was to investigate the relationship between crestal bone levels and crown-to-implant ratio of ultra-short implants, after functional loading. Sixty patients with single or partial edentulism and alveolar bone atrophy were enrolled and treated between December 2009 and January 2016. Without using bone-grafting procedures, patients were rehabilitated with ultra-short implants characterized by a microrough surface and a 6-mm length. Clinical and anatomical crown-to-implant (C/I) ratios and crestal bone levels (CBL) were measured after a follow-up period ranging from 12 to 72 months; all peri-implant and prosthetic parameters were recorded. The data collected were statistically analyzed ( P = .05). A total of 47 patients with 66 ultra-short implants were completely followed up according to described protocol. The mean follow-up was 48.5 ± 19.1 months. The mean anatomical C/I ratio was 2.2, while the mean clinical C/I ratio was 2.6 ± 0.6 at baseline and 2.8 ± 0.6 at the last follow-up appointment. Mean CBL as calculated at the baseline was 0.7 ± 0.5 mm, while at the last appointment it measured 1.0 ± 0.5 mm. The overall implant-based success rate was 96.9%, and the mean peri-implant bone loss (PBL) was 0.3 ± 0.3 mm. No statistically significant relationship was found between anatomical or clinical C/I ratio and PBL. Ultra-short implants appear to offer a predictable solution for implant-prosthetic rehabilitation in patients with edentulism and bone atrophy. A high percentage of implants were successful, with minimal crestal bone loss. The high C/I ratio did not appear to influence either peri-implant bone loss or prosthetic complication rates.
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Affiliation(s)
- Luciano Malchiodi
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | | | - Alessandro Cucchi
- 3 Department of Biomedical and Neuromotorial Science, University of Bologna, Bologna, Italy
| | - Giulia Ricciotti
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Riccardo Caricasulo
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Dario Bertossi
- 1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Enrico Gherlone
- 4 Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
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Talo Yildirim T, Acun Kaya F, Yokus B, Colak M, Ozdemir Kaya E, Tekin G, Saribas E, Uysal E, Guncu GN. Associations of alveolar bone loss and interleukin-1β levels in one- and two-stage surgical procedures: a randomized prospective trial. Acta Odontol Scand 2017; 75:608-615. [PMID: 28826290 DOI: 10.1080/00016357.2017.1367959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Dental implants have been widely and successfully used in recent years as an alternative treatment for removable and fixed dental prostheses. The aim of this randomized prospective study was to determine the alveolar bone loss rate (ABLR) and IL-1β levels in one- and two-stage surgical procedures. MATERIALS AND METHODS This study included 40 patients with a single missing tooth in the posterior mandible; dental implants were inserted using a one-stage surgical procedure (Group I) or a two-stage surgical procedure (Group II). All clinical periodontal parameters were recorded; peri-implant crevicular fluid (PICF) samples were collected before loading (T0) and during the third (T1) and sixth (T2) months after loading. ABLR values were evaluated at T0 and T2 by using dental tomography. PICF was analysed after T2 samples were collected. The study was registered through clinicaltrials.gov; identifier NCT03045458. RESULTS This study found that, the probing pocket depth was found to be significantly higher in Group I than Group II at both T1 and T2 (p < .05). There was no significant difference in other clinical parameters between the groups (p > .05). There was a significant difference between Group I ABLR values at T0 and T2 (p < .05). The PICF IL-1β levels were not significantly different between groups (p > .05). CONCLUSIONS Within the limitations of the short observational period and small sample size of this study, two-stage implant placement shows comparable clinical outcomes to implants placed using a one-stage placement protocol.
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Affiliation(s)
- Tuba Talo Yildirim
- Department of Periodontology, Faculty of Dentistry, Firat University, Elazig, Turkey
| | - Filiz Acun Kaya
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - Beran Yokus
- Department of Biochemistry, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Mehmet Colak
- Department of Dento-Maxillofacial Radiology, Faculty of Dentistry, Dicle University, Dicle University, Diyarbakir, Turkey
| | | | - Giray Tekin
- Diyarbakir Mouth and Teeth Health Center, Diyarbakir, Turkey
| | - Ebru Saribas
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | - Ersin Uysal
- Department of Technics Programs, Diyarbakir Vocational High School, Dicle University, Diyarbakir, Turkey
| | - Guliz N. Guncu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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