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Azevedo L, Marques T, Karasan D, Fehmer V, Sailer I, Correia A, Gómez-Polo M. Effect of splinting scan bodies on the trueness of complete arch digital implant scans with 5 different intraoral scanners. J Prosthet Dent 2024; 132:204-210. [PMID: 37537105 DOI: 10.1016/j.prosdent.2023.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 08/05/2023]
Abstract
STATEMENT OF PROBLEM The absence of fixed reference points can affect the trueness of complete arch intraoral digital implant scans. The effect of splinting intraoral scan bodies (ISBs) or the inclusion of artificial landmarks (AL) on the trueness of complete arch digital implant scans is still unclear. PURPOSE The purpose of this study was to analyze the effect of splinting ISBs or the inclusion of AL on the trueness of complete arch digital implant scans with 5 intraoral scanners (IOSs). MATERIAL AND METHODS Six tissue-level dental implants (Straumann Tissue Level) were placed in an edentulous patient, and the correspondent definitive cast was digitized with a desktop scanner (IScan4D LS3i) to obtain the reference digital cast. Digital scans (n=10) were performed with 5 IOSs: TRIOS 4, Virtuo Vivo, Medit i700, iTero Element 5D, and Cerec Primescan. Three different scanning techniques were evaluated: conventional (cIOSs), splinted (sIOSs), and AL (AL-IOSs). The scan data obtained were imported into a metrology software program and superimposed to the reference digital cast by using a best-fit algorithm. The overall deviations of the positions of the ISBs were evaluated by using the root-mean-square (RMS) error (α=.05). RESULTS The mean ±standard deviation trueness values for the cIOSs, sIOSs, and AL-IOSs groups were 48 ±8 µm, 53 ±7 µm, and 49 ±11 µm, respectively, with no statistically significant differences (P=.06). Significant differences were found for the IOSs used with each technique (P<.001). Primescan (27 ±4 µm cIOSs; 28 ±3 µm sIOSs; 31 ±3 µm AL-IOSs) showed significantly higher trueness than iTero 5D (47 ±5 µm cIOSs; 47 ±4 µm sIOSs; 50 ±6 µm AL-IOSs) (P=.002) and TRIOS 4 (93 ±18 µm cIOSs; 76 ±18 µm sIOSs; 107 ±13 µm AL-IOSs) (P=.001) for all techniques. In addition, no significant differences were found between the techniques by using iTero 5D or Primescan (P=.348 and P=.059, respectively). CONCLUSIONS The cIOSs, sIOSs, and AL-IOSs techniques showed similar trueness. The IOS used influenced the trueness of complete arch digital implant scans.
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Affiliation(s)
- Luís Azevedo
- PhD candidate, Department of Conservative Dentistry and Orofacial Prostheses, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain; Researcher, Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa (UCP), Viseu, Portugal; and Research Assistant, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
| | - Tiago Marques
- Lecturer, Faculty of Dental Medicine, Universidade Católica Portuguesa (UCP), Viseu, Portugal; and Researcher, Center for Interdisciplinary Research in Health, The Catholic University of Portugal (UCP), Viseu, Portugal
| | - Duygu Karasan
- Assistant, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vincent Fehmer
- Master Dental Technician, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Head, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - André Correia
- Assistant Professor, Faculty of Dental Medicine, Universidade Católica Portuguesa (UCP), Viseu, Portugal; and Researcher, Center for Interdisciplinary Research in Health, The Catholic University of Portugal (UCP), Viseu, Portugal
| | - Miguel Gómez-Polo
- Associate Professor, Faculty of Dentistry, Department of Conservative Dentistry and Orofacial Prostheses, Complutense University of Madrid, Madrid, Spain
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Menini M, Canullo L, Iacono R, Triestino A, Caponio VCA, Savadori P, Pesce P, Pedetta A, Guerra F. Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study. Dent J (Basel) 2024; 12:198. [PMID: 39056985 PMCID: PMC11275297 DOI: 10.3390/dj12070198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student's t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed.
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Affiliation(s)
- Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Roberta Iacono
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
| | | | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 1, 7100 Foggia, Italy;
| | - Paolo Savadori
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Della Commenda, 10/12, 20122 Milan, Italy
- IRCCS Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Andrea Pedetta
- Private Practice, Via Colledoro 41, 00034 Colleferro, Italy;
| | - Fabrizio Guerra
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
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Ickroth A, Seyssens L, Christiaens V, Pitman J, Cosyn J. Immediate versus early implant placement for single tooth replacement in the aesthetic area: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:585-597. [PMID: 38558205 DOI: 10.1111/clr.14261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 02/23/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient-reported outcomes. MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction. RESULTS Out of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta-analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta-analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [-0.23; 0.86], p = .260; I2 = 83%, p < .001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [-0.23; 2.07], p = .120; I2 = 89%, p < .001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p = .480; I2 = 0%, p = .980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [-0.12, 0.17], p = .700; I2 = 0%, p = .470). Insufficient data were available for meta-analyses of other secondary outcomes. CONCLUSION In low-risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state-of-the-art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient-reported outcomes since these have been underreported.
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Affiliation(s)
- Axelle Ickroth
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jeremy Pitman
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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Morris GA, Steinberg MJ, Drago C. Full arch immediate occlusal loading using site specific implants: A clinical series of 10 patients (13 arches). J Prosthodont 2023; 32:204-213. [PMID: 36375088 DOI: 10.1111/jopr.13620] [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: 03/24/2022] [Accepted: 11/01/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Osseointegration of dental endosseous implants has proven to be effective, predictable, and clinically successful. Unloaded healing protocols were originally used in treating edentulous patients. Full arch immediate occlusal loading protocols have been shown to be as effective as unloaded healing protocols. This paper reports on the results, benefits, and limitations of one specific immediate loading protocol using site specific implants for fresh extraction and healed extraction sites. MATERIALS AND METHODS Ten consecutive patients [{13 arches} (age range: 64-81 years; average: 70.1) (4 males/6 females) were treated by the first 2 authors in private practice settings. Hopeless teeth were scheduled for extraction with immediate implant placement and immediate loading with insertion of full arch, screw-retained, acrylic resin interim prostheses within 24 hours. Implants were also placed into healed edentulous ridges. Insertion torque values for each implant were recorded. Interim prostheses were removed after at least 3 months of healing. Implants were reverse torque tested (35 Ncm) and evaluated for macroscopic mobility. Definitive full arch prostheses were made. Patients were followed for 21 to 48 months postimplant surgery. Panoramic radiographs were taken immediately postimplant placement and 1 year postoperative. RESULTS Thirteen arches were treated; 11 ultrawide diameter implants were placed into molar sockets, 26 inverted body-shift implants were placed into anterior sockets; 25 standard diameter, tapered implants were placed into edentulous sites; 2 zygomatic implants were placed in one patient. The total number of implants placed was 64 (4 preexisting implants were also used and not included in this study). The minimum implant insertion torque value was 20 Ncm. After 12 to 18 months of function (average 14 months), the implant and prosthetic survival rates were 100%. Eight patients were restored with definitive zirconia or acrylic resin hybrid fixed prostheses. Two patients were restored with bar titanium frameworks and removable overdenture prostheses. No prosthetic complications were reported for the definitive prostheses. CONCLUSIONS The results of this clinical series with site specific implants and immediate full arch occlusal loading in treating edentulous patients resulted in 100% clinical implant and prosthetic survival rates. According to this study, this protocol can be used with high levels of anticipated success.
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Affiliation(s)
- Gary A Morris
- Department of Graduate Education, Southern Illinois University School of Dentistry, Alton, Illinois
| | - Mark J Steinberg
- Oral and Maxillofacial Surgery Residency Program, Loyola University Medical Center, Chicago, Illinois
| | - Carl Drago
- Department of Graduate Prosthodontics, Marquette University School of Dentistry, Milwaukee, Wisconsin
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Ibrahim A, Chrcanovic BR. Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14247903. [PMID: 34947493 PMCID: PMC8708389 DOI: 10.3390/ma14247903] [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: 11/11/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022]
Abstract
The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was −0.053 mm (p = 0.089). There was an estimated decrease of 0.003 in OR (p = 0.284) and an increase of 0.006 mm (p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.
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Affiliation(s)
- Adam Ibrahim
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden;
| | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
- Correspondence:
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