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Sarzynski I, Pfeffer J, Nowakowski A, Pesun I. An up to thirty-year retrospective study on the success and survival of single unit and splinted implant-supported crowns in a dental school setting. J Prosthet Dent 2024:S0022-3913(24)00414-1. [PMID: 38969577 DOI: 10.1016/j.prosdent.2024.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 07/07/2024]
Abstract
STATEMENT OF PROBLEM Studies investigating the survival of implant-supported crowns provided in a dental school setting are sparse. PURPOSE The purpose of this retrospective study was to evaluate the success and reasons for failure of single unit and splinted implant-supported crowns provided in a dental school. MATERIAL AND METHODS Using the axiUm dental management software program and paper charts, all single unit and splinted implant-supported crowns provided between September 1989 and January 2020 were included for evaluation. Success, survival, and failure were recorded as well as reasons for failure. A Kaplan-Meier survival estimate with an associated P value, a life table analysis, and a log-rank test comparing the survival of single unit and splinted implant-supported crowns were performed. RESULTS Over 30 years, 678 implant-supported crowns (586 single unit and 92 splinted) had been provided. Of these crowns, 17 (2.90%) single unit crowns and 5 (5.43%) splinted crowns failed, with most being prosthetic failures for both single units (64.7%) and splinted (80%), rather than biologic failures. A total of 371 single unit (63.3%) and 46 splinted (50.0%) implant crowns were a complete success, and 215 single unit (36.7%) and 46 splinted (50.0%) crowns survived but had some type of complication. The overall implant-supported crown survival rate was 96.8%. The survival distribution of the single unit and splinted implant-supported crowns was not statistically significantly different [χ2(2)=1.285, P=.257]. CONCLUSIONS Both single unit and splinted implant-supported crowns had high success rates and showed similar survival rates. The most common causes of complications were also similar, with debonding and screw loosening of crowns being the most common complication for both single unit and splinted crowns.
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Affiliation(s)
- Isabella Sarzynski
- DMD Program Graduate, Department of Restorative Dentistry, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Juliana Pfeffer
- Assistant Professor, Department of Restorative Dentistry, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Anthony Nowakowski
- Assistant Professor, Department of Restorative Dentistry, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Igor Pesun
- Associate Professor, Director of Graduate Prosthodontics, Department of Restorative Dentistry, Dr Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
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Pascoal ALDB, Paiva KRG, Marinho LCN, Bezerra ADS, Calderon PDS. Impact of splinting implant-supported crowns on the performance of adjacent posterior implants: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00373-1. [PMID: 38955598 DOI: 10.1016/j.prosdent.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024]
Abstract
STATEMENT OF PROBLEM While rehabilitation with implant-supported crowns in the posterior region is widely practiced, guidance on clinical considerations when choosing between splinted or nonsplinted implant-supported crowns is limited. PURPOSE The purpose of this systematic review with meta-analysis was to assess whether adjacent implants with internal connections in the posterior region should be treated with splinted or nonsplinted crowns. MATERIAL AND METHODS The systematic review was registered on the prospective register of systematic reviews (PROSPERO) under the code, CRD42021248525. Two authors searched 4 electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) independently for articles published up to December 2023. Additionally, a hand search was conducted in the nonpeer-reviewed literature and the reference lists of included articles. Only clinical studies comparing splinted and nonsplinted hexagonal or conical internal connection adjacent implants in the posterior region were considered. A single-arm meta-analysis was conducted using RevMan. Risk of bias and quality were assessed using the Cochrane Collaboration's Tool for Assessing Risk and the Newcastle-Ottawa scale. RESULTS Qualitative synthesis included 17 studies, and quantitative synthesis involved 13 studies. A total of 2085 implants (1244 splinted and 841 nonsplinted) were inserted in 1027 participants, with observation times ranging from 5 months to 16 years. Thirteen studies related the type of crown retention (cemented or screw-retained). Only 2 studies related annual bone loss results considering the type of crown retention, but whether they were splinted or nonsplinted crowns and significant differences were not specified. The meta-analysis revealed no statistical differences between splinted and nonsplinted implants for biological complications (P=.95, I2=0%). However, the nonsplinted implants exhibited significantly more mechanical complications than the splinted implants (P<.001, I2=1%, RR 0.37; 95% IC [0.26-0.54]). The studies included demonstrated a low risk of bias and were of good quality. CONCLUSIONS Splinting was not found to affect the incidence of biological complications in posterior adjacent implants. However, more mechanical complications occurred in nonsplinted crowns than splinted ones.
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Affiliation(s)
- Ana Luísa de Barros Pascoal
- Temporary Assistant Professor, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | | | | | - Aliane da Silva Bezerra
- Postgraduate student, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
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Ahumada-DeGirolamo D, Azocar A, Delpiano-Mesina C, Maldonado-Cortés P, Muñoz MA, Luque-Martínez I, Bravo-Gallardo F. Splinting or non-splinting of fixed prostheses on adjacent implants: A critical review. J Prosthodont Res 2024; 68:206-214. [PMID: 37648482 DOI: 10.2186/jpr.jpr_d_22_00220] [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: 09/01/2023]
Abstract
PURPOSE The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted. STUDY SELECTION A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart. RESULTS A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design. CONCLUSIONS The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
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Affiliation(s)
| | - Andrea Azocar
- Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Carlos Delpiano-Mesina
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Pedro Maldonado-Cortés
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Miguel Angel Muñoz
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Issis Luque-Martínez
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Francisco Bravo-Gallardo
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
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Kermanshah H, Keshtkar A, Hassani A, Bitaraf T. Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up. Evid Based Dent 2023; 24:192-193. [PMID: 37568011 DOI: 10.1038/s41432-023-00924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To compare the difference of marginal level changes (MBL), implant failure (IF), biological and prosthetic complications (BC and PC), and prosthetic failure (PF) of short implants (SH) and standard implants (ST). MATERIALS AND METHODS Electronic searches (PubMed, Web of Science, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and manual searches were performed to identify all randomized controlled trials (RCTs) evaluating SH to ST. Applying Stata, a meta-analysis was conducted on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBL and the risk difference (RD) of the secondary outcome. RESULTS Twenty-four articles were involved in the present study. There were statistically significant differences in MBLs, preferring short implants in the maxilla (WMD: -0.147 (CI: -0.224, -0.070), I2: 76.6%; SMD: -0.757 (CI: -1.226, -0.289), I2: 89.2%) and in the mandible (WMD: -0.377 (CI: -0.656, -0.098), I2: 85.8%; SMD: -0.811 (CI: -1.418, -0.204), I2: 78.8%). There were no significant differences in IF (RD: 0.011 (-0.002, 0.023), I2: 0.0%), PF (RD:0.003 (-0.007, 0.014), I2: 0.0%), and PC (RD:0.001 (-0.008, 0.010), I2: 0.0%). There were significantly higher biological complications (RD: -0.071 (-0.106, -0.036), I2: 0.82.9%) for ST compared to SH in both jaws up to a 10-year follow-up. CONCLUSION SH and ST had comparable overall outcomes, but short implants had less marginal bone loss and lower biological complications. However, more research is needed to confirm these findings.
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Affiliation(s)
- Hamid Kermanshah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hassani
- Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Tahereh Bitaraf
- Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, 19585/175, Tehran, Iran.
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Shah AH, Patel P, Trivedi A, Shah A, Desai N, Talati M. A comparison of marginal bone loss, survival rate, and prosthetic complications in implant-supported splinted and nonsplinted restorations: A systematic review and meta-analysis. J Indian Prosthodont Soc 2022; 22:111-121. [PMID: 36511022 PMCID: PMC9132503 DOI: 10.4103/jips.jips_365_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim To compare marginal bone loss (MBL), implant survival rate and prosthetic complications of implant-supported splinted and non-splinted restorations (NSR). Settings and Design This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The PROSPERO registry, which keeps track of prospective systematic reviews, also received this paper (CRD42021229477). Material and Methods An electronic search was done in PubMed, the Cochrane Central Trials Register, Scopus, Science Direct, and Google Scholar searches were carried out. The search was limited to articles published in English and covered the period from January 2010 to August 2020. Statistical Analysis Used To conduct the meta analysis, researchers employed methodologies such as continuous measurement and odds ratios. Results For both qualitative and quantitative analysis, 19 scientific studies were chosen. 3682 implants were placed in 2099 patients with a mean age of 59 years (splinted, 2529; non-splinted, 1153); the mean age was not provided in 5 trials. For splinted restorations, there were statistically significant differences in MBL, indicating the former has less MBL than for NSR. Splinted restorations had much greater survival rates than NSR, according to a qualitative study. Rest prosthesis complications with or without splinting were essentially the same. Conclusions Splinted implant restorations lost less bone than non-splinted implant restorations, according to this meta analysis. This was particularly true for posterior restorations. Lower implant failure was associated with splinted restorations. Restorations with and without splinting had the same level of prosthetic problems.
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Affiliation(s)
- Aesha Harsh Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India,Address for correspondence: Dr. Aesha Harsh Shah, Department of Prosthodontics, Goenka Research Institute of Dental Science, Pethapur - Mahudi Road, Gandhinagar District, Near G.G.S, Piplaj, Ahmedabad, Gujarat - 382 610, India. E-mail:
| | - Pankaj Patel
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Aumkar Trivedi
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Adit Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Nikki Desai
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Mitangi Talati
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
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Posterior jaws rehabilitation with < 7mm-short implants. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e45-e56. [PMID: 34563727 DOI: 10.1016/j.jormas.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The results with shorter and shorter implants have been revolutionizing the implantology scenario and are worthy of being well-analyzed and understood. This review aims to add further knowledge about the last 10-years observation period on < 7mm-short implants in the posterior atrophic jaws, better defining the indication of their use. METHODS From a Medline database research, systematic reviews, controlled and no- controlled trials (CT, n-CT) with ≥ 3years-follow-ups on <7 mm / ≥ 5mm-short implants (group A), and clinical studies with ≥ 1year-follow-up on 4mm-short implants (group B) were considered. The outcomes, in terms of implant survival rate (SR), marginal bone loss (MBL), and complications were analyzed according to the duration of follow-ups, implant site (maxilla and mandible), type of prosthesis (single crown or splinted units), vertically impaired or normal sites. RESULTS Thirty-four trials (28 for group A and six for group B) were selected. Group A: a mean follow up of 5,8 (3-10) years came out; pre-and post-loading SR range was 94.4- 100% and 89.6-100%, respectively; the range of MBL was 0.12-1.49; 50% of CT found less statistically significant surgical complications in comparison with standard implants (ST) in reconstructed sites, while major prosthetic problems were recorded with short -implants (SH) in 37.5% of CT; in no atrophied sites, a mean SR range of 86.7-100 % vs. 88-100 % and a total bone loss of 2 vs.1.6 for SH vs.ST emerged. Group B: the overall mean follow-up period was 2,3 years, and the pre-and post- SR ranges were 93-100 % and 87.5-100 %, respectively. The MBL range was 0.02- 0.63 mm. All RCT reported significantly fewer surgical complications with SH than with ST in reconstructed mandibles within one year. No prosthetic complications were reported for up to 5 years using no pontics or cantilevers fixed bridges. CONCLUSIONS Similar or even better results for SH than ST in terms of post-loading SR and MBL came out for < 7mm/ ≥ 5mm-short implants in atrophic bone regardless of the prosthetic solutions, with less surgical complications but a few more prosthetic problems; the good results up to 5 years for 4mm-short implants in mandibles are associated with splinted and no-risk prosthetic solutions.
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Karcı BL, Oncu E. Comparison of Osteoimmunological and Microbiological Parameters of Extra Short and Longer Implants Loaded in the Posterior Mandible: A Split Mouth Randomized Clinical Study. Acta Stomatol Croat 2021; 55:238-247. [PMID: 34658370 PMCID: PMC8514233 DOI: 10.15644/asc55/3/1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/15/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the levels of TNF-α, PGE2, RANKL, RANK, OPG, the markers of periimplant bone loss in peri-implant crevicular fluid obtained around standard and extra short implants. Moreover, the levels of putative oral pathogens were investigated in the submucosal biofilm samples. MATERIAL AND METHODS The implants were divided into two groups according to their lengths: standard (≥8 mm) and extra short (4 mm). A total of 60 implants were researched in 30 patients. The probing depth (PD), clinical attachment level (CAL), presence of bleeding on probing (BOP), 3-year survival rate (CSR), and bone loss (BL) were measured. RESULTS No statistically significant difference was found in the values of PD, CAL, BOP, CSR, and BL between the groups (P> 0.05). Total amounts of PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG were not statistically significantly different between the groups (P> 0.05). The abundance of F. nucleatum, T. forsythia, P. intermedia, P. gingivalis, S. oralis and T. denticola was compared between the groups and the results were not statistically significant (P> 0.05). CONCLUSION The results of this study suggested that PGE2, TNF-α, RANKL, RANK, OPG, and RANKL/OPG in PICF, as well as microbiological parameters in submucosal biofilms, were similar between standard (≥8 mm) and extra short (4 mm) implants. Therefore, the implant length does not seem to influence the bone loss, levels of osteoimmunological and microbiological markers in the peri-implant tissues and survival rates.
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Affiliation(s)
- Bi Lge Karcı
- Bi̇lge Karcı, Alanya Alaaddin Keykubat University, Faculty of Dentistry, Department of Periodontology, Alanya, Antalya, Turkey
| | - Elif Oncu
- Elif Oncu, Necmettin Erbakan University, Faculty of Dentistry, Department of Periodontology, Konya, Turkey
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Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
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Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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Effect of the Location of Dental Mini-Implants on Strain Distribution under Mandibular Kennedy Class I Implant-Retained Removable Partial Dentures. Int J Dent 2021; 2021:6688521. [PMID: 34054963 PMCID: PMC8112937 DOI: 10.1155/2021/6688521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the effect of minidental implant location on strain distributions transmitted to tooth abutments and dental minidental implants under mandibular distal extension removable partial denture. Materials and Methods A mandibular Kennedy Class I distal extension model missing teeth 35–37 and 45–47 was constructed. Six dental mini-implants were placed at positions A, B, and C, where position A was 6.5 mm distal to the abutment teeth with 5 mm between each position. Fourteen uniaxial strain gauges were bonded on the model at the region of dental mini-implant and abutment (first premolar). Four groups were designated according to the location of the mini-implants. A load of 150 N and 200 N was applied using an Instron testing machine. Loadings consisted of bilateral and unilateral loading. Comparisons of the mean microstrains among all strain gauges in all situations were analyzed. Results Variation in mini-implant locations induced local strains in different areas. Strains at the tooth abutment were significantly decreased in the group in which implants were placed mesially. Strains around the mini-implants showed different patterns when loaded with different loading conditions. The group in which implants were placed distally showed the lowest strains compared to other groups. Conclusion Mesially placed mini-implants showed the lowest strain around abutment teeth, while a distally-placed mini-implants presented the lowest strain around mini-implants themselves. Under favorable biting force, mini-implant is an option to assist mandibular distal extension removable partial denture. Mesially placed mini-implants are recommended when the abutment has periodontally compromised conditions and a distally placed mini-implant when periodontal conditions are stable.
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Impact of Implant Surface Material and Microscale Roughness on the Initial Attachment and Proliferation of Primary Human Gingival Fibroblasts. BIOLOGY 2021; 10:biology10050356. [PMID: 33922217 PMCID: PMC8145850 DOI: 10.3390/biology10050356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 12/17/2022]
Abstract
Due to the rising demand for zirconia (Zr) based implant systems, it is important to understand the impact of Zr and titanium (Ti) implants and particularly their topography on soft tissue healing. As human gingival fibroblasts (hGFs) are the predominant cells in peri-implant soft tissue, we focused on examining the effect of implant material and surface roughness on hGFs' initial attachment, growth and the expression of proteins involved in the focal adhesion. hGFs isolated from eight healthy donors were cultured on the following surfaces: smooth titanium machined surface (TiM), smooth zirconia machined surface (ZrM), moderately rough titanium surface (SLA), or moderately rough zirconia surface (ZLA) for up to 14 days. The initial attachment of hGFs was evaluated by scanning electron microscopy. Cell proliferation/viability was assessed by cell counting kit 8. Focal adhesion and cytoskeleton were visualized by a focal adhesion staining kit. The gene expression of focal adhesion kinase (FAK), α-smooth muscle actin (α-SMA), and integrin subunits ITG-β1, ITG-β4, ITG-α4, ITG-α5, ITG-α6, was evaluated by qPCR. Cell proliferation/viability was slightly decreased by moderately rough surfaces, whereas no effect of surface material was observed. Cell morphology was strikingly different between differently treated surfaces: on machined surfaces, cells had elongated morphology and were attached along the grooves, whereas on moderately rough surfaces, cells were randomly attached. Surface roughness had a more pronounced effect on the gene expression compared to the surface material. The expression of FAK, α-SMA, ITG-β4, ITG-α5, and ITG-α6 was enhanced by moderately rough surfaces compared to smooth surfaces. Within the limitations of this in vitro study, it can be concluded that the behavior of primary hGFs is primarily affected by surface structure, whereas no apparent advantage of Zr over Ti could be observed.
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The Influence of Surgical Experience and Bone Density on the Accuracy of Static Computer-Assisted Implant Surgery in Edentulous Jaws Using a Mucosa-Supported Surgical Template with a Half-Guided Implant Placement Protocol-A Randomized Clinical Study. MATERIALS 2020; 13:ma13245759. [PMID: 33348589 PMCID: PMC7765911 DOI: 10.3390/ma13245759] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
The aim of our randomized clinical study was to analyze the influence of surgical experience and bone density on the accuracy of static computer-assisted implant surgery (CAIS) in edentulous jaws using a mucosa-supported surgical template with a half-guided implant placement protocol. Altogether, 40 dental implants were placed in the edentulous jaws of 13 patients (novice surgeons: 18 implants, 6 patients (4 male), age 71 ± 10.1 years; experienced surgeons: 22 implants, 7 patients (4 male), age 69.2 ± 4.55 years). Angular deviation, coronal and apical global deviation and grey level measurements were calculated for all implants by a blinded investigator using coDiagnostiX software. 3DSlicer software was applied to calculate the bone volume fraction (BV/TV) for each site of implant placement. There were no statistically significant differences between the two study groups in either of the primary outcome variables. There was a statistically significant negative correlation between angular deviation and both grey level measurements (R-value: −0.331, p < 0.05) and BV/TV (R-value: −0.377, p < 0.05). The results of the study suggest that surgical experience did not influence the accuracy of implant placement. The higher the bone density at the sites of implant placement, the higher the accuracy of static CAIS.
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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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13
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Iezzi G, Perrotti V, Felice P, Barausse C, Piattelli A, Del Fabbro M. Are <7‐mm long implants in native bone as effective as longer implants in augmented bone for the rehabilitation of posterior atrophic jaws? A systematic review and meta‐analysis. Clin Implant Dent Relat Res 2020; 22:552-566. [DOI: 10.1111/cid.12946] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 08/30/2023]
Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Pietro Felice
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Carlo Barausse
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
- Biomaterials Engineering Catholic University of San Antonio de Murcia (UCAM) Murcia Spain
- Fondazione Villaserena per la Ricerca Città Sant'Angelo Pescara Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
- Dental Clinic IRCCS Orthopedic Institute Galeazzi Milan Italy
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14
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Stefanelli LV, Mandelaris GA, Franchina A, Di Nardo D, Galli M, Pagliarulo M, Testarelli L, Di Carlo S, Gambarini G. Accuracy Evaluation of 14 Maxillary Full Arch Implant Treatments Performed with Da Vinci Bridge: A Case Series. MATERIALS 2020; 13:ma13122806. [PMID: 32580340 PMCID: PMC7344455 DOI: 10.3390/ma13122806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/07/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022]
Abstract
The use of pterygoid implants can be an attractive alternative to sinus bone grafting in the treatment of posterior atrophic maxilla. This technique has not been widely used because of the difficulty of the surgical access, the presence of vital structures, and the prosthetic challenges. The use of dynamic computer aided implantology (DCAI) allows the clinician to utilize navigation dental implant surgery, which allows the surgeon to follow the osteotomy site and implant positioning in real time. A total of 14 patients (28 pterygoid implants and 56 intersinusal implants) were enrolled in the study for a full arch implant prosthetic rehabilitation (4 frontal implants and 2 pterygoids implants), using a dynamic navigation system. The reported accuracy of pterygoid implants inserted using DCAI was 0.72 mm at coronal point, 1.25 mm at apical 3D, 0.66 mm at apical depth, and 2.86° as angular deviation. The use of pterygoid implants in lieu of bone grafting represents a valid treatment opportunity to carry out a safe, accurate, and minimally invasive surgery, while reducing treatment time and avoiding cantilevers for a full implant prosthetic rehabilitation of the upper arch.
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Affiliation(s)
- Luigi V. Stefanelli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
| | - George A. Mandelaris
- Private Practice, Periodontics and Dental Implant Surgery; Periodontal Medicine & Surgical Specialists, LTD, Chicago, IL 60601, USA;
| | - Alessio Franchina
- Private Practice, Periodontics and Dental Implant Surgery, 36100 Vicenza, Italy;
| | - Dario Di Nardo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
- Correspondence: ; Tel.: +39-339-3935-527
| | - Massimo Galli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
| | - Michele Pagliarulo
- Faculty of Dental Medicine, University of Plovdiv, 4002 Plovdiv, Bulgary;
| | - Luca Testarelli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
| | - Stefano Di Carlo
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
| | - Gianluca Gambarini
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.V.S.); (M.G.); (L.T.); (S.D.C.); (G.G.)
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15
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Guida L, Annunziata M, Esposito U, Sirignano M, Torrisi P, Cecchinato D. 6‐mm‐short and 11‐mm‐long implants compared in the full‐arch rehabilitation of the edentulous mandible: A 3‐year multicenter randomized controlled trial. Clin Oral Implants Res 2019; 31:64-73. [DOI: 10.1111/clr.13547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/01/2019] [Accepted: 09/19/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Luigi Guida
- Multidisciplinary Department of Medical‐Surgical and Dental Specialties University of Campania “Luigi Vanvitelli” Naples Italy
- Department of Dentistry, Orthopedics and Rehabilitation University Hospital “Luigi Vanvitelli” Naples Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical‐Surgical and Dental Specialties University of Campania “Luigi Vanvitelli” Naples Italy
- Department of Dentistry, Orthopedics and Rehabilitation University Hospital “Luigi Vanvitelli” Naples Italy
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16
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Zuffetti F, Testarelli L, Bertani P, Vassilopoulos S, Testori T, Guarnieri R. A Retrospective Multicenter Study on Short Implants With a Laser-Microgrooved Collar (≤7.5 mm) in Posterior Edentulous Areas: Radiographic and Clinical Results up to 3 to 5 Years. J Oral Maxillofac Surg 2019; 78:217-227. [PMID: 31518549 DOI: 10.1016/j.joms.2019.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 11/15/2022]
Abstract
PURPOSE We aimed to retrospectively evaluate the radiographic and clinical results and the success rate of short implants with a laser-microgrooved collar (≤7.5 mm) placed in the posterior areas after up to 3 to 5 years of function and the possible influence of several variables-such as gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design-on implant marginal bone loss (MBL). MATERIALS AND METHODS A chart review was used for this multicenter study, which involved 5 private dental clinics. All patients had been treated with short dental implants with a laser-microgrooved collar from January 2012 to December 2015. RESULTS A total of 174 patients (99 male and 75 female patients; mean age, 51.6 ± 2.8 years) with 254 implants were evaluated. Seven short implants failed. The cumulative success rate was 97.2%, without a statistically significant difference between implants placed in the posterior maxilla and mandible. The mean MBL was 0.18 ± 0.7 mm at the mesial aspect and 0.19 ± 0.6 mm at the distal aspect. No statistical relationships were found between MBL and gender, periodontitis, smoking habit, location, implant stability at placement, and prosthetic fixation design. CONCLUSIONS At the end of the 3- to 5-year follow-up period, short implants with a laser-microgrooved collar (≤7.5 mm) in the posterior areas yielded a relatively high cumulative success rate. The laser-microgrooved collar implant maintained stable marginal bone levels. No investigated variable was statistically associated with MBL.
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Affiliation(s)
- Francesco Zuffetti
- Assistant Professor, Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Institute, and Private Practice, Milan, Italy
| | - Luca Testarelli
- Associate Professor, Department of Oral and Maxillofacial Sciences, La Sapienza University, and Private Practice, Rome, Italy
| | | | - Spyridon Vassilopoulos
- Assistant Professor, Department of Periodontology, National and Kapodistrian University of Athens, and Private Practice, Athens, Greece
| | - Tiziano Testori
- Head of Section of Implantology and Oral Rehabilitation, Department of Odontology, IRCCS Galeazzi, University of Milan, Milan, Italy; Adjunct Clinical Associate Professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI; and Private Practice, Como, Italy
| | - Renzo Guarnieri
- Adjunct Professor, Department of Oral and Maxillofacial Sciences, La Sapienza University, Rome, and Private Practice, Treviso, Italy.
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