1
|
Puisys A, Vindasiute-Narbute E, Razukevicius D, Akhondi S, Gallucci GO, Pedrinaci I. Influence of mucosal tissue height on implant crestal bone: A 10-year follow-up of a controlled clinical trial. J Dent 2024; 148:105224. [PMID: 38955258 DOI: 10.1016/j.jdent.2024.105224] [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: 06/11/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To evaluate the 10-year influence of soft tissue height (STH) on crestal bone level changes (CBC) in bone-level implants with non-matching internal conical connections. MATERIAL & METHODS From the initial 97 patients, 59 (19 men, 40 women, age 55.86 ± 9.5 years) returned for the recall visit. Based on baseline STH, they were categorized into T1 (thin STH ≤2 mm, n = 33), T2 (thin STH augmented with allogenic tissue matrix (ATM), n = 32), and C (thick STH >2 mm, n = 32). Implants were placed in the posterior mandible using a one-stage approach and received single screw-retained restorations. Clinical (PPD, BOP, PI) and radiographic examinations were conducted after 10 years, with CBC calculated mesial and distal to each implant. RESULTS After 10 years, implants in surgically thickened (T2) or naturally thick STH (C) showed bone gains of 0.57 ± 0.55 mm and 0.56 ± 0.40 mm, respectively (p < 0.0001) shifting from an initial CBC of -0.21 ± 0.33 mm to 0.36 ± 0.29 mm in the thick STH group and -0.2 ± 0.35 mm to 0.37 ± 0.29 mm in the surgically thickened STH group. Implants in naturally thin STH yielded a non-significant trend of bone loss (-0.12 ± 0.41 mm; p > 0.05). CONCLUSIONS Implants in thin STH (≤2 mm) exhibited greater CBC over the study period. Significant bone gains were observed in thick STH cases, indicating that naturally thick STH or STH augmentation with ATM may contribute to maintain CBC in long-term around implants. CLINICAL SIGNIFICANCE This is the first long-term follow-up study suggesting that adequate soft tissue height around implants helps maintain stable peri‑implant bone levels. While tissue thickness plays a key role, other factors also interact with peri‑implant tissue height to sustain crestal bone stability over time.
Collapse
Affiliation(s)
- Algirdas Puisys
- Private practice, VIC Clinic, Vivulskio 7, Vilnius LT 01362, Lithuania
| | | | - Danius Razukevicius
- Private practice, VIC Clinic, Vivulskio 7, Vilnius LT 01362, Lithuania; Faculty of Dentistry, Lithuania University of Health Science, Kaunas, Lithuania
| | - Samuel Akhondi
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain; Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA.
| |
Collapse
|
2
|
Quispe-López N, Guadilla Y, Gómez-Polo C, López-Valverde N, Flores-Fraile J, Montero J. The influence of implant depth, abutment height and mucosal phenotype on peri‑implant bone levels: A 2-year clinical trial. J Dent 2024; 148:105264. [PMID: 39053878 DOI: 10.1016/j.jdent.2024.105264] [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: 05/28/2024] [Revised: 07/21/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES To evaluate the bone changes around equicrestal and subcrestal implants, analyzing the effect of abutment height [short abutments (SA < 2 mm) and long abutments (LA > 2 mm)] and the three components of the peri‑implant soft-tissue phenotype. METHODS Twenty-six patients received 71 implants that were placed according to supracrestal tissue height (STH) in an equicrestal (n = 17), shallow subcrestal ≈1 mm (n = 33), or deep subcrestal ≈2 mm (n = 21) position. After 3 months of healing, rehabilitation was completed using metal-ceramic crowns on multi-unit abutments of 1.5 mm, 2.5 mm, or 3.5 mm in height, depending on the prosthetic space and STH. Longitudinal clinical parameters (STH, mucosal thickness, and keratinized mucosa width) and radiographic data [bone remodelling and marginal bone loss (MBL)] were collected at 3, 6, 12, and 24 months postsurgery. RESULTS The gain in STH was significantly greater around the implants placed in a subcrestal ≈2 mm position. After 2 years, the mean change in bone remodelling in the SA group was significantly greater than in the LA group. According to the multiple linear regression, bone remodelling depends primarily on abutment height (β = -0.43), followed by crestal position (β = 0.34), and keratinized mucosa width (β = -0.22), while MBL depends on abutment height (β = -0.37), and the patient's age (β = -0.36). CONCLUSIONS Implants placed in an equicrestal or subcrestal ≈1 mm position with LA undergo less bone remodelling, while the lowest level of MBL occurs in subcrestal ≈2 mm implants with LA. Differing soft-tissue thicknesses combined with the use of either SA or LA produced significant intergroup differences in bone remodelling and MBL. CLINICAL SIGNIFICANCE Abutment height is the most powerful predictor variable affecting bone remodelling and MBL. Depending on the dimensions of the peri‑implant soft-tissue phenotype, placing the implants subcrestally may also be a viable option to decrease bone remodelling and, consequently, reduce MBL. CLINICAL TRIAL REGISTRATION identification number: NCT05670340.
Collapse
Affiliation(s)
- Norberto Quispe-López
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| | - Yasmina Guadilla
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| | - Cristina Gómez-Polo
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| | - Nansi López-Valverde
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| | - Javier Flores-Fraile
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| | - Javier Montero
- Department of Surgery. Faculty of Medicine, Dental clinic. University of Salamanca. Campus Miguel de Unamuno. PC: 37007. Spain.
| |
Collapse
|
3
|
Puisys A, Vindasiute-Narbute E, Razukevicius D, Akhondi S, Gallucci GO, Pedrinaci I. Clinical efficacy of two vertical soft tissue augmentation techniques for peri-implant crestal bone level stability: A randomized clinical trial. Clin Implant Dent Relat Res 2024. [PMID: 39128852 DOI: 10.1111/cid.13365] [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: 05/24/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES This study aimed to compare the efficacy of two techniques-acellular dermal matrix (ADM) grafting and tenting technique (TT)-for soft tissue height (STH) augmentation simultaneous to implant placement to minimize peri-implant crestal bone level (CBL) changes. METHODS Forty patients with a healed single mandibular posterior edentulous site with a thin soft tissue phenotype were enrolled. Twenty patients received simultaneously to implant placement ADM grafting, while the others received submerged healing abutment (TT). Clinical peri-implant soft tissue height and radiographic CBL changes were measured at restoration delivery and 1-year follow-up. RESULTS Both techniques effectively increased soft tissue thickness, resulting in a final average STH of 3.4 ± 0.5 mm after augmentation. On average, soft tissue increased by 1.6 ± 0.5 mm in group ADM and by 1.8 ± 0.4 mm in group TT after augmentation. In Group ADM, mesial CBL decreased from 0.4 ± 0.3 mm to 0.1 ± 0.2 mm, and distal CBL decreased from 0.5 ± 0.3 mm to 0.2 ± 0.3 mm over 1 year. In Group TT, mesial CBL remained stable at 0.3 ± 0.2 mm, while distal CBL reduced slightly from 0.5 ± 0.5 mm to 0.3 ± 0.2 mm. Both groups showed minimal changes in CBL, indicating great stability (pmesial = 0.003, pdistal = 0.004). TT was particularly effective in preventing mesial bone loss (pmesial = 0.019). The mesial CBL changes significantly differed between groups (p = 0.019), and not significantly at distal sites (p = 0.944). Neither treatment exhibited significant bone remodeling below the implant shoulder. CONCLUSION This study suggests that both techniques were successful in STH augmentation, and they may effectively reduce peri-implant crestal bone level changes, with TT being slightly superior. TT was more prone to post-surgical complications. This RCT was not registered before participant recruitment and randomization.
Collapse
Affiliation(s)
| | | | - Dainius Razukevicius
- Private Practice, VIC Clinic, Vilnius, Lithuania
- Faculty of Dentistry, Lithuania University of Health Science, Kaunas, Lithuania
| | - Samuel Akhondi
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Ignacio Pedrinaci
- Department of Restorative Dentistry and Biomaterials Science, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
- Section of Graduate Periodontology, School of Dentistry, University Complutense, Madrid, Spain
| |
Collapse
|
4
|
Maza-Solano S, Baus-Domínguez M, Romero-Ruíz MM, Gutiérrez-Corrales A, Torres-Lagares D, Serrera-Figallo MÁ. Prospective observational cohort study of the change of the marginal bone crest in relation to the prosthetic abutment height and the peri-implant vertical mucosal thickness at implants positioned subcrestally. Clin Implant Dent Relat Res 2024; 26:750-762. [PMID: 38808756 DOI: 10.1111/cid.13347] [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: 12/28/2023] [Revised: 04/18/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
AIM To evaluate the influence on peri-implant crestal bone loss exerted by the vertical mucosal thickness and the abutment height over 12 months after placement of the restoration on subcrestal implants with change of platform, using a restoration abutment platform smaller than the implant platform. MATERIALS AND METHODS A total of 99 implants were rehabilitated in the maxillary and mandibular posterior regions. A total of 22 implants were rehabilitated in the maxilla and 77 implants in the mandible, using digitally designed customized abutments with Atlantis weborder software, from the commercial house Dentsply Sirona (Dentsply Sirona S.A., Barcelona, Spain), version 4.6.5, adapting the height to the vertical thickness of the mucosa. Clinical and radiographic monitoring begins during the surgical procedure of placement of the implant and ends 12 months afterwards. Crestal bone loss was evaluated through the Carestream® CS8100 3D radiographic equipment. RESULTS In all cases, the greatest loss of marginal bone occurred between the day of surgery (Tx) and placement of the rehabilitation (To). The average bone loss between both times was greater when the abutment height and vertical mucosal thickness did not exceed 3 mm. Subsequently, bone loss slowed and stabilized at 12 months. CONCLUSIONS The minimum abutment height and the vertical mucosal thickness are factors to take into account when minimizing peri-implant marginal bone loss, the abutment height having the greatest importance according to the clinical data obtained.
Collapse
Affiliation(s)
- Serafín Maza-Solano
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, Seville, Spain
| | - María Baus-Domínguez
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, Seville, Spain
| | | | - Aida Gutiérrez-Corrales
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, Seville, Spain
| | - Daniel Torres-Lagares
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, Seville, Spain
| | | |
Collapse
|
5
|
Martínez-Grau J, Robles D, Pérez RA, Marimon X, Fernández-Hernández S, Aroso C, Brizuela-Velasco A. Design Factors of Ti-Base Abutments Related to the Biomechanics Behavior of Dental Implant Prostheses: Finite Element Analysis and Validation via In Vitro Load Creeping Tests. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3746. [PMID: 39124410 PMCID: PMC11313398 DOI: 10.3390/ma17153746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
This study has been carried out to analyze the influence of the design of three geometric elements (wall thickness, platform width, and chamfer) of Ti-base abutments on the distribution of stresses and strains on the implant, the retention screw, the Ti base, and the bone. This study was carried out using FEA, analyzing eight different Ti-base models based on combinations of the geometric factors under study. The model was adapted to the standard Dynamic Loading Test For Endosseous Dental Implants. A force of 360 N with a direction of 30° was simulated and the maximum load values were calculated for each model, which are related to a result higher than the proportional elastic limit of the implant. The transferred stresses according to von Mises and microdeformations were measured for all the alloplastic elements and the simulated support bone, respectively. These results were validated with a static load test using a creep testing machine. The results show that the design factors involved with the most appropriate stress distribution are the chamfer, a thick wall, and a narrow platform. A greater thickness (0.4 mm) is also related to lower stress values according to von Mises at the level of the retaining screws. In general, the distributions of tension at the implants and microdeformation at the level of the cortical and trabecular bone are similar in all study models. The in vitro study on a Ti-base control model determined that the maximum load before the mechanical failure of the implant is 360 N, in accordance with the results obtained for all the Ti-base designs analyzed in the FEA. The results of this FEA study show that modifications to the Ti-base design influence the biomechanical behavior and, ultimately, the way in which tension is transferred to the entire prosthesis-implant-bone system.
Collapse
Affiliation(s)
- Jordi Martínez-Grau
- Bioengineering Institute of Technology (BIT), Universitat Internaciional de Catalunya (UIC), 08195 Sant Cugat del Vallés, Spain; (J.M.-G.); (R.A.P.); (X.M.)
| | - Daniel Robles
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (S.F.-H.); (A.B.-V.)
| | - Román A. Pérez
- Bioengineering Institute of Technology (BIT), Universitat Internaciional de Catalunya (UIC), 08195 Sant Cugat del Vallés, Spain; (J.M.-G.); (R.A.P.); (X.M.)
| | - Xavier Marimon
- Bioengineering Institute of Technology (BIT), Universitat Internaciional de Catalunya (UIC), 08195 Sant Cugat del Vallés, Spain; (J.M.-G.); (R.A.P.); (X.M.)
| | - Saray Fernández-Hernández
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (S.F.-H.); (A.B.-V.)
| | - Carlos Aroso
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Politécnico e Universitario (CESPU), 4585-116 Granda, Portugal;
| | - Aritza Brizuela-Velasco
- DENS-ia Research Group, Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (S.F.-H.); (A.B.-V.)
| |
Collapse
|
6
|
Calatrava J, Sanz-Sánchez I, Molina A, Bollain J, Martín C, Sanz M. Effect of one-time placement of the definitive abutment versus multiple healing abutment disconnections and reconnections during the prosthetic phase on radiographic and clinical outcomes: A 12-month randomized clinical trial. Clin Implant Dent Relat Res 2024. [PMID: 39011816 DOI: 10.1111/cid.13361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/10/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE The aim of this investigation was to evaluate the effect on clinical and radiological outcomes of the one-abutment, one-time protocol (test) versus placing the definitive abutment on the day of functional loading after having disconnected and connected three times the healing abutment during the prosthetic phase (control). MATERIALS AND METHODS Forty patients with 80 implants were randomly allocated to either the test or the control group. Changes in the radiographic marginal bone levels (MBLs), clinical outcomes, prosthetic-related outcomes, and patient-reported outcomes measures (PROMs) were assessed and compared 6 and 12 months after functional loading. RESULTS Thirty-seven patients with 74 implants were followed at 12 months. A statistically significant bone remodeling was observed in both groups following implant placement. MBLs were significantly greater in the control group at the 6- (-0.13 mm vs. -0.61 mm) and 12-month visits (-0.01 mm vs. -0.53 mm). Bone loss was significantly greater in the control group from surgery to 6 and 12 months and from loading to 6 and 12 months. The abutment height was significantly greater in the test group, however, there were no significant differences in the restorative angle. Similarly, there were no statistically significant differences between groups for the measured clinical variables (probing depth, plaque, and bleeding index) and PROMs. CONCLUSIONS Disconnecting and reconnecting the healing abutment was associated with significantly higher bone loss after 12 months, as compared to the placement of the definitive abutment at implant installation.
Collapse
Affiliation(s)
- Javier Calatrava
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Ana Molina
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Juan Bollain
- Section of Graduate Periodontology, University Complutense, Madrid, Spain
| | - Conchita Martín
- BIOCRAN (Craniofacial Biology: Orthodontics and Dentofacial Orthopedics) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
7
|
Poovarodom P, Rungsiyakull C, Suriyawanakul J, Li Q, Sasaki K, Yoda N, Rungsiyakull P. Multi-objective optimization of custom implant abutment design for enhanced bone remodeling in single-crown implants using 3D finite element analysis. Sci Rep 2024; 14:15867. [PMID: 38982141 DOI: 10.1038/s41598-024-66807-2] [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: 12/25/2023] [Accepted: 07/04/2024] [Indexed: 07/11/2024] Open
Abstract
The optimal configuration of a customized implant abutment is crucial for bone remodeling and is influenced by various design parameters. This study introduces an optimization process for designing two-piece zirconia dental implant abutments. The aim is to enhance bone remodeling, increase bone density in the peri-implant region, and reduce the risk of late implant failure. A 12-month bone remodeling algorithm subroutine in finite element analysis to optimize three parameters: implant placement depth, abutment taper degree, and gingival height of the titanium base abutment. The response surface analysis shows that implant placement depth and gingival height significantly impact bone density and uniformity. The taper degree has a smaller effect on bone remodeling. The optimization identified optimal values of 1.5 mm for depth, 35° for taper, and 0.5 mm for gingival height. The optimum model significantly increased cortical bone density from 1.2 to 1.937 g/cm3 in 2 months, while the original model reached 1.91 g/cm3 in 11 months. The standard deviation of density showed more uniform bone apposition, with the optimum model showing values 2 to 6 times lower than the original over 12 months. The cancellous bone showed a similar trend. In conclusion, the depth and taper have a significant effect on bone remodeling. This optimized model significantly improves bone density uniformity.
Collapse
Affiliation(s)
- Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
- Digital Laboratory Innovation, Department of Reconstructive and Rehabilitation Sciences, James B. Edwards College of Dental Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Jarupol Suriyawanakul
- Department of Mechanical Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen, 40000, Thailand
| | - Qing Li
- Faculty of Engineering, School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney, NSW, 2037, Australia
| | - Keiichi Sasaki
- Miyagi University, Taiwa, Miyagi, 981-3298, Japan
- Division of Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, 980-8576, Japan
| | - Nobuhiro Yoda
- Division of Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Miyagi, 980-8576, Japan
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand.
| |
Collapse
|
8
|
Mancini L, Strauss FJ, Lim HC, Tavelli L, Jung RE, Naenni N, Thoma DS. Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study. Clin Implant Dent Relat Res 2024; 26:554-563. [PMID: 38419210 DOI: 10.1111/cid.13314] [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: 10/28/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
AIM To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading. MATERIALS AND METHODS Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance. RESULTS A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05). CONCLUSION The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.
Collapse
Affiliation(s)
- Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Hyun-Chang Lim
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
9
|
Beltrán-Guijarro M, Pérez-Pevida E, Chávarri-Prado D, Estrada-Martínez A, Diéguez-Pereira M, Sánchez-Lasheras F, Brizuela-Velasco A. Biomechanical Effects of Ti-Base Abutment Height on the Dental Implant System: A Finite Element Analysis. J Funct Biomater 2024; 15:101. [PMID: 38667558 PMCID: PMC11051524 DOI: 10.3390/jfb15040101] [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: 02/21/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.
Collapse
Affiliation(s)
- Miguel Beltrán-Guijarro
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Department of Surgery, Faculty of Sports and Health Sciences, University of Zaragoza, 22006 Huesca, Spain
| | - Esteban Pérez-Pevida
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - David Chávarri-Prado
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Alejandro Estrada-Martínez
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Markel Diéguez-Pereira
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| | - Fernando Sánchez-Lasheras
- Department of Mathematics, University Institute of Space Sciences and Technologies of Asturias (ICTEA), University of Oviedo, 33006 Oviedo, Spain;
| | - Aritza Brizuela-Velasco
- Faculty of Health Sciences, Miguel de Cervantes European University, 47012 Valladolid, Spain; (D.C.-P.); (A.E.-M.); (M.D.-P.); (A.B.-V.)
| |
Collapse
|
10
|
Ibrahim AM, Elgamal M, Ragheb NA. One-time definitive attachment connection versus healing abutment placement for an implant-retained mandibular overdenture: Peri-implant metabolic activity. J Prosthet Dent 2024:S0022-3913(24)00192-6. [PMID: 38600003 DOI: 10.1016/j.prosdent.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 04/12/2024]
Abstract
STATEMENT OF PROBLEM Unscrewing the healing abutment can affect the soft tissue integration and apical migration of the biological width, which may compromise the integrity of peri-implant soft tissue. PURPOSE The purpose of this clinical study was to determine the level of glycosaminoglycan (GAG) detected in the peri-implant crevicular fluid (PICF) between the test group (1-time abutment) and control group (healing abutment) for implant-retained mandibular overdentures. MATERIAL AND METHODS Two dental implants were installed in the canine regions of the mandibular ridge of 18 healthy completely edentulous participants using 2-stage surgery and a delayed loading protocol. At the second stage surgery, the implant on the right side was exposed, and a healing abutment was screwed onto the implant (control group), while on the left side the definitive ball abutment was screwed onto the implant (test group). After 10 days, the healing abutment in the control group was unscrewed and replaced with the definitive ball abutment. For both groups, the ball attachment was directly picked up to incorporate the attachment house to the mandibular denture. PICF samples were collected from the participants at 7 days, 3 months, and 6 months after overdenture use. Statistical analysis was done with an independent samples t test (α=.05). RESULTS A significant difference was found in the volume of PICF and the level of GAG between the test and control groups at the 7-day evaluation period (P=.008, P=.002, respectively), while the volumes of PICF and the levels of GAG were not significantly different (P>.05) at the other evaluation periods. CONCLUSIONS The 1-time abutment protocol offers biochemical and economic advantages compared with the conventional method of using the healing abutment before placement of the definitive attachment for an implant-retained overdenture with single attachments.
Collapse
Affiliation(s)
- Abdallah Mohammed Ibrahim
- Associate Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Eldakahlia, Egypt.
| | - Mohamed Elgamal
- Associate Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Mansoura University, Eldakahlia, Egypt; and Associate Professor, Department of Removable Prosthodontics, Faculty of Dentistry, Horus University, Damietta, Egypt
| | - Nourhan Ahmed Ragheb
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Kafrelsheikh University, Kafrelsheikh, Egypt
| |
Collapse
|
11
|
Alpaslan NZ, Altindal D, Akbal D, Talmac AC, Keskin Tunc S, Ertugrul AS. Evaluation of the effect of Er,Cr:YSGG laser application on peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand and osteoprotegerin levels in the non-surgical treatment of peri-implantitis: A randomized clinical trial. J Periodontol 2024. [PMID: 38375939 DOI: 10.1002/jper.23-0540] [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: 09/15/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Abstract
BACKGROUND This study aimed to investigate the effect of erbium, chromium doped:yttrium,scandium,gallium,garnet (Er,Cr:YSGG) laser application combined with non-surgical mechanical debridement (MD) on clinical parameters and peri-implant crevicular fluid receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) levels in the treatment of peri-implantitis. METHODS A total of 49 patients who underwent non-surgical treatment of peri-implantitis were randomly divided into two groups. The control group (n = 26) received MD alone, while the laser group (n = 23) received MD+Er,Cr:YSGG. The clinical parameters (bleeding on probing [BoP], gingival index [GI], plaque index [PI], probing depth [PD]), marginal bone loss (MBL), and biochemical parameters (RANKL and OPG) were measured at baseline (T0) and 6 months after treatment (T1). RESULTS There was a statistically significant decrease in all the clinical parameters in both groups at T1 compared to T0 (p < 0.05). The BoP, PD, MBL, and RANKL reductions were significantly higher in the laser group than in the control group (p = 0.046, p = 0.014, p = 0.047, p = 0.045, respectively). The OPG levels significantly increased at T1 in the laser group (p = 0.01). The OPG/RANKL ratio increased significantly in both groups at T1, which favored the laser group (p = 0.034). CONCLUSIONS Although both treatment methods were influential in treating peri-implantitis, the laser group (MD+Er,Cr:YSGG) yielded more favorable results by reducing clinical inflammation and improving biochemical parameters. Based on these findings, Er,Cr:YSGG laser may be a beneficial adjunctive treatment in this patient group.
Collapse
Affiliation(s)
- Nazli Zeynep Alpaslan
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Dicle Altindal
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | | | - Ahmet Cemil Talmac
- Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey
| | - Serap Keskin Tunc
- Hamidiye Faculty of Dental Medicine, Department of Oral and Maxillofacial Surgery, University of Health Sciences, Istanbul, Turkey
| | - Abdullah Seckin Ertugrul
- Faculty of Dentistry, Department of Periodontology, Izmir Katip Celebi University, Izmir, Turkey
| |
Collapse
|
12
|
Bergmann A, Feng C, Chochlidakis K, Russo LL, Ercoli C. A comparison of alveolar ridge mucosa thickness in completely edentulous patients. J Prosthodont 2024; 33:132-140. [PMID: 37470112 DOI: 10.1111/jopr.13738] [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: 02/08/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE The purpose of this cross-sectional clinical study was to determine and compare alveolar ridge mucosa thickness at crestal, buccal, and lingual locations of the maxillary and mandibular arches in completely edentulous patients using a dedicated, ultrasonic gingival scanner. MATERIALS AND METHODS Thirty-eight completely edentulous subjects were included in the study. In each subject, soft tissue thickness was measured at 28 sites of the edentulous ridge by a single calibrated examiner. Intra-observer reliability was calculated with Intraclass Correlation Coefficients by measuring 10 subjects twice, after 1 week. Measurements (mm) were taken at the buccal, lingual, and crestal aspects of the ridge with a dedicated ultrasonic scanner. Repeated measures ANOVA and paired t-tests were used to compare the mean buccal, lingual, and crestal soft tissue thicknesses at each site. The Generalized Estimating Equations model was used to study the effects of age, sex, and race. Confidence level was set to 95%. RESULTS Mean tissue thickness ranged from 0.96 to 1.98 mm with a mean of 1.63 ± 0.25 mm. Intraclass Correlation Coefficients were > 0.97. No significant differences between buccal, crestal, and lingual sites were noted for the mandibular arch as well as at 4 sites on the maxillary arch (maxillary right second molar, maxillary right canine, maxillary left first premolar, maxillary left second molar). However, significant differences in soft tissue thickness were noted for all remaining maxillary sites. Race was found to be positively correlated with tissue thickness, with Black individuals showing a significantly greater thickness than White individuals at 4 sites (maxillary right first molar, maxillary left canine, mandibular right second premolar, mandibular right first molar). Age was found to be positively correlated with tissue thickness at 4 sites (maxillary left central incisor, maxillary left first molar, maxillary left second molar, mandibular left second premolar) and negatively correlated at 2 sites (mandibular right canine, mandibular right second molar). Female sex was positively (maxillary left second premolar, maxillary left second molar) and negatively (mandibular right canine) correlated, respectively, with tissue thickness at 3 sites. When data for anterior and posterior sites were respectively pooled, tissue thickness was significantly less at anterior sextant lingual and crestal sites, while no difference was seen for buccal sites. CONCLUSION Statistically significant differences for alveolar ridge mucosa thickness were found at several sites in the maxilla and between anterior and posterior sextants for lingual and crestal sites in the maxillary and mandibular arches. Tissue thickness differences were also noted for race with Black individuals showing greater tissue thickness at some sites. Age and sex did not show a clear effect on tissue thickness. Recorded differences in tissue thickness were however small and appear of uncertain clinical significance.
Collapse
Affiliation(s)
- Andrew Bergmann
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA
| | - Konstantinos Chochlidakis
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - Lucio Lo Russo
- Department of Prosthodontics, School of Dentistry, University of Foggia, Foggia, Italy
| | - Carlo Ercoli
- Departments of Prosthodontics and Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| |
Collapse
|
13
|
Han JW, Han JW, Pyo SW, Kim S. Impact of profile angle of CAD-CAM abutment on the marginal bone loss of implant-supported single-tooth posterior restorations. J Prosthet Dent 2023:S0022-3913(23)00780-1. [PMID: 38129258 DOI: 10.1016/j.prosdent.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
STATEMENT OF PROBLEM Although the emergence angle has been related to marginal bone loss, information regarding the relationship between the transmucosal configuration of a computer-aided design and computer-aided manufacturing (CAD-CAM) abutment at specific subgingival levels and the amount of marginal bone loss is lacking. PURPOSE The purpose of this retrospective clinical study was to evaluate the influence of CAD-CAM abutment profile angles, measured at different subgingival positions, on the marginal bone loss of posterior single-tooth implant-supported restorations. MATERIAL AND METHODS A total of 260 posterior single-tooth implant-supported restorations using CAD-CAM abutments were analyzed in 206 patients. All implants had internal conical seal connections with a platform-switched design. The following data were extracted using digital periapical radiography: emergence profile, profile angle at distance ranges of 0 to 1 mm, 1 to 2 mm, and 2 to 3 mm from the implant-abutment junction, and peri-implant marginal bone loss (MBL). The MBL was measured from the time of delivery of the restorations up to 7 years or more. A linear mixed model was applied to investigate whether there was a significant difference in MBL based on the emergence profile and time, followed by the Bonferroni correction post hoc test. A Pearson correlation analysis was used to analyze the correlation between the profile angle and MBL at each distance range. The cut-off points for each distance range were determined by using the c-index, and independent t tests were conducted based on these cut-off values to evaluate the statistical differences (α=.05 for all statistical analyses). RESULTS The convex emergence profile exhibited greater MBL than the concave and straight profiles at each follow-up visit (P<.001). A significant correlation was found between the profile angle and MBL in the 0 to 1 mm, 1 to 2 mm distance ranges. However, no significant correlation was found between the profile angle and MBL in the 2 to 3 mm distance range (P>.05). The cut-off points were 34 degrees at the mesial and 28 degrees at the distal in the 0 to 1 mm range, and 33 and 20 degrees at the mesial and distal in the 1 to 2 mm range. CONCLUSIONS The profile angle near the implant-abutment junction and the type of emergence profile of the CAD-CAM abutment were closely associated with MBL in implants with internal conical seal connection with a platform switch design.
Collapse
Affiliation(s)
- Jin-Won Han
- Former Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jin-Woo Han
- Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Se-Wook Pyo
- Clinical Assistant Professor, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sunjai Kim
- Professor and Chairman, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
| |
Collapse
|
14
|
Menchini Fabris GB, Toti P, Covani U, Crespi G, Luca S, Crespi R. Bone assessment around the delayed dental implant with and without preformed anatomical caps: A 1-year retrospective case-control study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101584. [PMID: 37532083 DOI: 10.1016/j.jormas.2023.101584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023]
Abstract
PURPOSES To investigate the amount of first-year peri‑implant bone loss and the development of the papillae when delayed dental implants loaded with anatomic cover screw and those underwent conventional healing protocol were compared. METHODS Edentulous healed sites had undergone delayed implants placement. In the anatomical cap group, patients were treated with a guided tissue healing, tooth-like cross-linkable acrylic resin caps had been immediately screwed on dental implants. The marginal loss of the alveolar bone height 1 year after surgery and Jemt's papillae index were obtained. Non-parametric statistics were performed with a level of significance of 1% RESULTS: Forty patients were included in the present retrospective analysis. After a follow-up of 1 year, none of the 40 included implants showed a failure. The Jemt's papilla index was 1.76±0.44 and 1.34±0.50 respectively for guided tissue healing and conventional healing group, without any significant difference. Within the first year of survey a bone loss of -1.27±0.26 mm for conventional healing treatment showed a statistically significant difference (p-value<0.0001) when it was compared to the negligible of the other group (-0.06±0.31 mm). CONCLUSIONS A guided healing procedure with preformed caps seemed to give better outcomes regarding marginal bone loss and papilla index than those of conventional abutments.
Collapse
Affiliation(s)
- Giovanni Battista Menchini Fabris
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy.
| | - Paolo Toti
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Ugo Covani
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Giovanni Crespi
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Signorini Luca
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Crespi
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| |
Collapse
|
15
|
Galindo-Moreno P, Catena A, Lopez-Chaichio L, Borges T, O’Valle F, Torrecillas-Martínez L, Padial-Molina M. The Influence of History of Severe Periodontitis on Estimated Long-Term Marginal Bone Loss around Implants Restored with Fixed Segmented Full-Arch Rehabilitation. J Clin Med 2023; 12:6665. [PMID: 37892803 PMCID: PMC10607884 DOI: 10.3390/jcm12206665] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study was to analyze the long-term marginal bone level (MBL) of implants supporting fixed full-arch restoration in patients who had previously lost their dentition due to severe periodontitis. This retrospective study included 35 patients in whom 342 implants with internal tapered conical connections were placed. MBL was analyzed radiographically over time and a long-term estimation of MBL was calculated. A mixed linear model with abutment height, graft, diameter and location (maxilla/mandible) as factors and gender, age, implant length and prosthetic variables as covariates was used to evaluate the influence on MBL. MBL in these patients showed an estimator of predictions at 4108 days after loading of -0.307 mm, SE = 0.042. Only 0.15% of implants were radiographically affected with MBL of 3 mm or more. The mixed linear model results showed a main effect of the type of opposing dentition, gender, implant diameter, and abutment height. Particularly, an abutment height of 1 mm had associated larger MBL than the remaining heights. Thus, it can be concluded that dental implants restored with fixed segmented full-arch rehabilitation in patients with a history of severe periodontal disease do not suffer important marginal bone loss if some specific factors are considered, mainly the use of long transmucosal abutments (≥2 mm).
Collapse
Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
| | - Andres Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, 18071 Granada, Spain
| | | | - Tiago Borges
- Centre of Interdisciplinary Research in Health, and Faculty of Dentistry, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
| | - Francisco O’Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Department of Pathology and IBIMER, School of Medicine, University of Granada, 18071 Granada, Spain
| | - Laura Torrecillas-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
- Private Practice, 18008 Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18071 Granada, Spain; (F.O.)
| |
Collapse
|
16
|
Bornes R, Montero J, Ferreira A, Rosa N, Correia A. Dentists' perceptions and usability testing of the implant disease risk assessment IDRA, a tool for preventing peri‑implant disease: A qualitative study. J Dent 2023; 136:104630. [PMID: 37488043 DOI: 10.1016/j.jdent.2023.104630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION we aimed to explore dentists' perceptions toward the implementation of a dental informatics risk assessment tool which estimates the risk for a patient to develop peri‑implantitis. MATERIALS AND METHODS the Implant Disease Risk Assessment Tool (IDRA) was presented to a convenience sample of seven dentists working in a university clinic, whom were asked to use IDRA with the information of three clinical cases whilst thinking aloud and then fill the System Usability Scale (SUS). A semi-structured interview technique was used with audio record to allow free expression of participants' perceptions related to the IDRA. The interviews information was categorized and analyzed by the authors. RESULTS to our knowledge, this is the first study conducted to develop a qualitative usability test of IDRA, evaluating the effectiveness, efficiency, and users' satisfaction. There were more variations in responses the greater the degree of complexity of the clinical case. Generally, the participants classified the tool as good, getting usability values of 77,2 (SD 19,8) and learnability 73,2 (SD 24,5). CONCLUSION four additional factors should be considered to improve IDRA tool: 1) considering the relation between contour angle and peri-implant tissue height; 2) automatic periodontal classification in the IDRA tool after completing the periodontogram in the clinical software; 3) presentation of a flowchart to assist therapeutic decisions alongside the final score defined by the IDRA tool; 4) integrating of precision tests such as Implantsafe® DR… (dentognostics gmbh, Jena) and Oralyzer®(dentognostics gmbh, Jena). CLINICAL SIGNIFICANCE etiology and pathogenesis of peri‑implant diseases is multifactorial. These tools must follow a natural integration to be easily applied in a clinical setting. It is important to study their usability from the clinicians' point of view, evaluating the effectiveness, efficiency, and users' satisfaction.
Collapse
Affiliation(s)
- Rita Bornes
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Centre for Interdisciplinary Research in Health (CIIS), Viseu, Portugal.
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | | | - Nuno Rosa
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Centre for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| | - André Correia
- Universidade Católica Portuguesa, Faculty of Dental Medicine (FMD), Centre for Interdisciplinary Research in Health (CIIS), Viseu, Portugal
| |
Collapse
|
17
|
Poovarodom P, Rungsiyakull C, Suriyawanakul J, Li Q, Sasaki K, Yoda N, Rungsiyakull P. Effect of gingival height of a titanium base on the biomechanical behavior of 2-piece custom implant abutments: A 3-dimensional nonlinear finite element study. J Prosthet Dent 2023; 130:380.e1-380.e9. [PMID: 37482534 DOI: 10.1016/j.prosdent.2023.06.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023]
Abstract
STATEMENT OF PROBLEM Titanium base (TiBase) abutments to restore an implant-supported single crown are available in different gingival heights, but information on the biomechanical effects of the gingival heights is lacking. PURPOSE The purpose of this nonlinear finite element analysis study was to evaluate the effects of TiBase gingival heights on the biomechanical behavior of custom zirconia (CustomZir) abutments and TiBase, including von Mises stress and maximum and minimum principal stress. MATERIAL AND METHODS TiBases with different gingival heights (0.5 mm, 1 mm, 1.5 mm, and 2 mm) with internal hexagon Morse taper connections were simulated in 3-dimensional models. The simulations (ANSYS Workbench 2020; ANSYS Inc) included the OsseoSpeed EV implant (Ø5.4 mm) (AstraTech; Dentsply Sirona), restoration, and surrounding bone in the mandibular first molar region. An occlusal force of 200 N was applied with a 2-mm horizontal offset toward the buccal side and a 30-degree inclination from the vertical axis. RESULTS High-stress concentration was observed in the uppermost internal connection area on the buccal side and the antirotational part of the titanium abutment on the lingual side in all models. CustomZir abutments with a shorter gingival height exhibited larger concentrated areas of volume average stress von Mises stress and higher magnitude of maximum and minimum principal stress compared with a taller gingival height. CONCLUSIONS A TiBase abutment with a taller gingival height reduced the fracture risk of a CustomZir abutment without increasing any mechanical risk.
Collapse
Affiliation(s)
- Pongsakorn Poovarodom
- PhD candidate, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chaiy Rungsiyakull
- Assistant Professor, Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
| | - Jarupol Suriyawanakul
- Assistant Professor, Department of Mechanical Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen, Thailand
| | - Qing Li
- Professor, School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering, The University of Sydney, Sydney, NSW, Australia
| | - Keiichi Sasaki
- President, Miyagi University, Taiwa, Miyagi, Japan; Executive Adviser, Tohoku University, Sendai, Miyagi, Japan
| | - Nobuhiro Yoda
- Senior Assistant Professor, Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Pimduen Rungsiyakull
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
| |
Collapse
|
18
|
Ghaly M, Tarrazzi D, Xia V, Tharrington S, Schoenbaum TR. Changes in Peri-implant Marginal Bone Level by Jaw Location: A Systematic Review and Meta-Analysis of 4970 Implants. J ORAL IMPLANTOL 2023; 49:444-455. [PMID: 37527152 DOI: 10.1563/aaid-joi-d-22-00252] [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: 12/15/2022] [Revised: 05/03/2023] [Accepted: 05/29/2023] [Indexed: 08/03/2023]
Abstract
The purpose of this study was to evaluate the current evidence on marginal bone-level changes (ΔMBL) around internal connection implants with fixed prostheses by jaw location over time. An electronic literature search for ΔMBL (change in marginal bone level) was conducted in 6 databases. The data from the included manuscripts were categorized by jaw sextant of the implants and duration of follow-up (<2 years, 2-5 years, and >5 years). Meta-analyses were performed on groups with at least 5 studies. A total of 1270 records were screened. Full-text review of 413 papers resulted in a total of 46 studies (representing 2259 patients with 4970 implants) included for quantitative synthesis and analysis. The ΔMBL was summarized at 2 time intervals with the following results: <2 years (anterior maxilla = 0.393 mm [95% confidence interval {CI}, 0.172, 0.613], posterior maxilla = 0.468 mm [95% CI, 0.288, 0.648], and posterior mandible 0.559 mm [95% CI, 0.397, 0.72]), 2 to 5 years (anterior maxilla = 0.683 mm [95% CI, 0.224, 1.142], posterior maxilla = 0.645 mm [95% CI, 0.42, 0.87], and posterior mandible 0.563 mm [95% CI, 0.278, 0.849]). There were insufficient studies in the anterior mandible and with follow-up data over 5 years for quantitative synthesis. Within the limitations of this study, location within the maxillary and mandibular jaws does not seem to influence ΔMBL around internal connection bone level implants with fixed restorations. Although there may be a tendency for greater initial remodeling in the posterior mandible followed by long-term stability, additional studies are needed to evaluate this further.
Collapse
Affiliation(s)
- Mira Ghaly
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta GA, USA
| | - Daler Tarrazzi
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta GA, USA
| | - Veronica Xia
- Dental College of Georgia, Augusta University, Augusta GA, USA
| | | | - Todd R Schoenbaum
- Department of Restorative Sciences, Dental College of Georgia, Augusta University, Augusta GA, USA
| |
Collapse
|
19
|
Troiano G, Fanelli F, Rapani A, Zotti M, Lombardi T, Zhurakivska K, Stacchi C. Can radiomic features extracted from intra-oral radiographs predict physiological bone remodelling around dental implants? A hypothesis-generating study. J Clin Periodontol 2023; 50:932-941. [PMID: 36843362 DOI: 10.1111/jcpe.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/02/2023] [Accepted: 02/19/2023] [Indexed: 02/28/2023]
Abstract
AIM The rate of physiological bone remodelling (PBR) occurring after implant placement has been associated with the later onset of progressive bone loss and peri-implantitis, leading to medium- and long-term implant therapy failure. It is still questionable, however, whether PBR is associated with specific bone characteristics. The aim of this study was to assess whether radiomic analysis could reveal not readily appreciable bone features useful for the prediction of PBR. MATERIALS AND METHODS Radiomic features were extracted from the radiographs taken at implant placement (T0) using LifeX software. Because of the multi-centre design of the source study, ComBat harmonization was applied to the cohort. Different machine-learning models were trained on selected radiomic features to develop and internally validate algorithms capable of predicting high PBR. In addition, results of the algorithm were included in a multivariate analysis with other clinical variables (tissue thickness and depth of implant position) to test their independent correlation with PBR. RESULTS Specific radiomic features extracted at T0 are associated with higher PBR around tissue-level implants after 3 months of unsubmerged healing (T1). In addition, taking advantage of machine-learning methods, a naive Bayes model was trained using radiomic features selected by fast correlation-based filter (FCBF), which showed the best performance in the prediction of PBR (AUC = 0.751, sensitivity = 66.0%, specificity = 68.4%, positive predictive value = 73.3%, negative predictive value = 60.5%). In addition, results of the whole model were included in a multivariate analysis with tissue thickness and depth of implant position, which were still found to be independently associated with PBR (p-value < .01). CONCLUSION The combination of radiomics and machine-learning methods seems to be a promising approach for the early prediction of PBR. Such an innovative approach could be also used for the study of not readily disclosed bone characteristics, thus helping to explain not fully understood clinical phenomena. Although promising, the performance of the radiomic model should be improved in terms of specificity and sensitivity by further studies in this field.
Collapse
Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Fanelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Matteo Zotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Teresa Lombardi
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
20
|
Cicciù M, Pratella U, Fiorillo L, Bernardello F, Perillo F, Rapani A, Stacchi C, Lombardi T. Influence of buccal and palatal bone thickness on post-surgical marginal bone changes around implants placed in posterior maxilla: a multi-centre prospective study. BMC Oral Health 2023; 23:309. [PMID: 37217911 DOI: 10.1186/s12903-023-02991-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Numerous clinical variables may influence early marginal bone loss (EMBL), including surgical, prosthetic and host-related factors. Among them, bone crest width plays a crucial role: an adequate peri-implant bone envelope has a protective effect against the influence of the aforementioned factors on marginal bone stability. The aim of the present study was to investigate the influence of buccal and palatal bone thickness at the time of implant placement on EMBL during the submerged healing period. METHODS Patients presenting a single edentulism in the upper premolar area and requiring implant-supported rehabilitation were enrolled following inclusion and exclusion criteria. Internal connection implants (Twinfit, Dentaurum, Ispringen, Germany) were inserted after piezoelectric implant site preparation. Mid-facial and mid-palatal thickness and height of the peri-implant bone were measured immediately after implant placement (T0) with a periodontal probe and recorded to the nearest 0.5 mm. After 3 months of submerged healing (T1), implants were uncovered and measurements were repeated with the same protocol. Kruskal-Wallis test for independent samples was used to compare bone changes from T0 to T1. Multivariate linear regression models were built to assess the influence of different variables on buccal and palatal EMBL. RESULTS Ninety patients (50 females, 40 males, mean age 42.9 ± 15.1 years), treated with the insertion of 90 implants in maxillary premolar area, were included in the final analysis. Mean buccal and palatal bone thickness at T0 were 2.42 ± 0.64 mm and 1.31 ± 0.38 mm, respectively. Mean buccal and palatal bone thickness at T1 were 1.92 ± 0.71 mm and 0.87 ± 0.49 mm, respectively. Changes in both buccal and palatal thickness from T0 to T1 resulted statistically significant (p = 0.000). Changes in vertical bone levels from T0 to T1 resulted not significant both on buccal (mean vertical resorption 0.04 ± 0.14 mm; p = 0.479) and palatal side (mean vertical resorption 0.03 ± 0.11 mm; p = 0.737). Multivariate linear regression analysis showed a significant negative correlation between vertical bone resorption and bone thickness at T0 on both buccal and palatal side. CONCLUSION The present findings suggest that a bone envelope > 2 mm on the buccal side and > 1 mm on the palatal side may effectively prevent peri-implant vertical bone resorption following surgical trauma. TRIAL REGISTRATION The present study was retrospectively recorded in a public register of clinical trials ( www. CLINICALTRIALS gov - NCT05632172) on 30/11/2022.
Collapse
Affiliation(s)
- Marco Cicciù
- School of Dentistry, Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, 95124, Italy
| | | | - Luca Fiorillo
- School of Dentistry, Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, 95124, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, 80121, Italy
- School of Dentistry, Aldent University, Tirana, 1001, Albania
| | | | | | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34125, Italy.
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, 34125, Italy
| | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, 88100, Italy
| |
Collapse
|
21
|
Gehrke SA, Scarano A, Cortellari GC, Fernandes GVO, Mesquita AMM, Bianchini MA. Marginal Bone Level and Biomechanical Behavior of Titanium-Indexed Abutment Base of Conical Connection Used for Single Ceramic Crowns on Morse-Taper Implant: A Clinical Retrospective Study. J Funct Biomater 2023; 14:jfb14030128. [PMID: 36976052 PMCID: PMC10057670 DOI: 10.3390/jfb14030128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
The goal of this retrospective clinical study was to evaluate the behavior of Morse-taper indexed abutments by analyzing the marginal bone level (MBL) after at least 12 months of function. Patients rehabilitated with single ceramic crowns between May 2015 and December 2020 received single Morse-taper connection implants (DuoCone implant) with two-piece straight abutment baseT used for at least 12 months, presenting periapical radiograph immediately after crown installation were enrolled. The position of the rehabilitated tooth and arch (maxilla or mandible), crown installation period, implant dimensions, abutment transmucosal height, installation site (immediate implant placement or healed area), associated with bone regeneration, immediate provisionalization, and complications after installation of the final crown were analyzed. The initial and final MBL was evaluated by comparing the initial and final X-rays. The level of significance was α = 0.05. Seventy-five patients (49 women and 26 men) enrolled had a mean period of evaluation of 22.7 ± 6.2 months. Thirty-one implant-abutment (IA) sets had between 12–18 months, 34 between 19–24 months, and 44 between 25–33 months. Only one patient failed due to an abutment fracture after 25 months of function. Fifty-eight implants were placed in the maxilla (53.2%) and 51 in the mandible (46.8%). Seventy-four implants were installed in healed sites (67.9%), and 35 were in fresh socket sites (32.1%). Thirty-two out of these 35 implants placed in fresh sockets had the gap filled with bone graft particles. Twenty-six implants received immediate provisionalization. The average MBL was −0.67 ± 0.65 mm in mesial and −0.70 ± 0.63 mm in distal (p = 0.5072). The most important finding was the statistically significant difference comparing the values obtained for MBL between the abutments with different transmucosal height portions, which were better for abutments with heights greater than 2.5 mm. Regarding the abutments’ diameter, 58 had 3.5 mm (53.2%) and 51 had 4.5 mm (46.8%). There was no statistical difference between them, with the following means and standard deviation, respectively, −0.57 ± 0.53 mm (mesial) and −0.66 ± 0.50 mm (distal), and −0.78 ± 0.75 mm (mesial) and −0.746 ± 0.76 mm (distal). Regarding the implant dimensions, 24 implants were 3.5 mm (22%), and 85 implants (78%) had 4.0 mm. In length, 51 implants had 9 mm (46.8%), 25 had 11 mm (22.9%), and 33 implants were 13 mm (30.3%). There was no statistical difference between the abutment diameters (p > 0.05). Within the limitations of this study, it was possible to conclude that better behavior and lesser marginal bone loss were observed when using abutment heights greater than 2.5 mm of transmucosal portion and when placed implants with 13 mm length. Furthermore, this type of abutment showed a little incidence of failures within the period analyzed in our study.
Collapse
Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n., 03202 Elche, Spain
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
- Department of Materials Engineering, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, Brazil
- Correspondence: (S.A.G.); (G.V.O.F.); Tel./Fax: +598-29015634 (S.A.G.)
| | - Antonio Scarano
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
- Correspondence: (S.A.G.); (G.V.O.F.); Tel./Fax: +598-29015634 (S.A.G.)
| | | | - Marco Aurélio Bianchini
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis 88040-900, Brazil
| |
Collapse
|
22
|
Stacchi C, Lamazza L, Rapani A, Troiano G, Messina M, Antonelli A, Giudice A, Lombardi T. Marginal bone changes around platform-switched conical connection implants placed 1 or 2 mm subcrestally: A multicenter crossover randomized controlled trial. Clin Implant Dent Relat Res 2023; 25:398-408. [PMID: 36725016 DOI: 10.1111/cid.13186] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION This study analyzes early marginal bone modifications occurring around platform-switched implants with conical connection placed 1 or 2 mm subcrestally. METHODS This crossover randomized controlled trial enrolled partially edentulous patients needing two implants in either the posterior maxilla or mandible. Each patient received two platform-switched implants with conical connection inserted 2 mm (Test) and 1 mm (Control) subcrestally. Definitive abutments were immediately connected and, after 4 months of unsubmerged healing, screwed metal-ceramic crowns were delivered. Radiographs were taken at implant placement (T0), prosthesis delivery (T1), and after 1 year of prosthetic loading (T2). RESULTS Fifty-one patients (25 males and 26 females; mean age 61.2 ± 12.1 years) totaling 102 implants were included in the final analysis. Mean peri-implant bone level (PBL) reduction from T0 to T2 was not significantly different around Test (0.49 ± 0.32 mm) and Control implants (0.46 ± 0.35 mm; p = 0.66). Multivariate linear regression models highlighted a significant positive correlation between history of periodontitis and PBL reduction. At T2, no Test group implant and 6 Control group implants exhibited PBL below the implant platform (11.8% of Control group implants). CONCLUSION No significant differences in peri-implant marginal bone changes were demonstrated after 1 year of prosthetic loading between platform-switched implants with conical connection inserted either 1 or 2 mm subcrestally. However, 2 mm subcrestal placement resulted in deeper implant positioning at T2, with no exposure of treated implant surface and potential preventive effect against subsequent peri-implant pathology.
Collapse
Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luca Lamazza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| |
Collapse
|
23
|
Muñoz M, Vilarrasa J, Ruíz-Magaz V, Albertini M, Nart J. Influence of the abutment height on marginal bone level changes around two-piece dental implants: Meta-analysis and trial sequential analysis of randomized clinical trials. Clin Oral Implants Res 2023; 34:81-94. [PMID: 36482067 DOI: 10.1111/clr.14025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/24/2022] [Accepted: 11/03/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The focused question was: "In systemically healthy individuals with at least one two-piece dental implant, what is the efficacy of long (≥2 mm; intervention) compared with short (<2 mm; comparison) shoulder height abutments in peri-implant marginal bone level (MBL) changes at <1 year and ≥1 year reported by randomized controlled clinical trials?" MATERIALS AND METHODS An electronic and hand search was conducted to identify RCTs published up to August 2022. The primary outcome variable was changed in MBL from implant surgery to subsequent follow-ups. Mean values and standard deviations for each study were extracted. Weighted mean differences and 95% confidence intervals were calculated. Meta-analysis for MBL changes was performed through a random-effect restricted maximum-likelihood model at early (<1 year) and late (≥1 year) stages of bone remodeling. Publication bias and sensitivity tests were also applied. Subgroup analysis was performed to further explore possible sources of heterogeneity in the estimated treatment effect. Trial sequential analysis was performed to assess the required information and false-positive results. RESULTS Six randomized clinical trials fulfilled the inclusion/exclusion criteria and were included in the qualitative and quantitative analysis with a follow-up range from 6 to 36 months after implant surgery. Meta-analysis revealed that long abutments significantly exhibited 0.27 mm (CI 95% -0.60, 0.06) and 0.33 mm (CI 05% -0.50, -0.16) lower MBL changes compared with short ones at <1 year and ≥1 year, respectively. Subgroup meta-analysis revealed that studies with implants placed in a more subcrestal position significantly exhibited less differences in MBL changes between long and short abutments. No meta-analysis was conducted for peri-implant clinical parameters, and soft-tissue changes provided that reported data were scarce. Trial sequential analysis revealed insufficient information size to provide a definitive answer on the effect of abutment height in MBL. CONCLUSIONS It might be cautiously concluded that two-piece implants with long abutments (≥2 mm) may display a protective role against marginal bone loss when compared with short ones (<2 mm) at <1 year and ≥1 year. A more subcrestal implant position seemed to minimize the effect of the abutment height in terms of MBL.
Collapse
Affiliation(s)
- Marta Muñoz
- Department of Periodontology, Universitat International de Catalunya, Barcelona, Spain
| | - Javi Vilarrasa
- Department of Periodontology, Universitat International de Catalunya, Barcelona, Spain
| | - Vanessa Ruíz-Magaz
- Department of Periodontology, Universitat International de Catalunya, Barcelona, Spain
| | - Matteo Albertini
- Department of Periodontology, Universitat International de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat International de Catalunya, Barcelona, Spain
| |
Collapse
|
24
|
Muacevic A, Adler JR, Eguia A. On Peri-Implant Bone Loss Theories: Trying To Piece Together the Jigsaw. Cureus 2023; 15:e33237. [PMID: 36733558 PMCID: PMC9890078 DOI: 10.7759/cureus.33237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
This review aims to explore the plausibility of new theories on the etiopathogenesis of marginal bone loss (MBL) and peri-implantitis (PI) and to discuss possible underlying pathogenic mechanisms. The former concept of osteointegration of dental implants can now be conceptualized as a foreign body response histologically characterized by a bony demarcation in combination with chronic inflammation. Different risk factors can provoke additional inflammation and, therefore, pro-inflammatory cytokine release in soft tissues and bone, leading to an overpass of the threshold of peri-implant bone defensive and regenerative capacity. Progressive bone loss observed in MBL and PI is ultimately due to a localized imbalance in the receptor activator of nuclear factor kappaB ligand (RANKL)/Receptor activator of nuclear factor κ B (RANK)/osteoprotegerin (OPG) pathway in favor of increased catabolic activity. The genetic background and the severity and duration of the risk factors could explain differences between individuals in the threshold needed to reach an imbalanced scenario. MBL and PI pathogenesis could be better explained by the "inflammation-immunological balance" theory rather than a solely "infectious disease" conception. The link between the effect of biofilm and other risk factors leading to an imbalanced foreign body response lies in osteoclast differentiation and activation pathways (over)stimulation.
Collapse
|
25
|
Monje A, González-Martín O, Ávila-Ortiz G. Impact of peri-implant soft tissue characteristics on health and esthetics. J ESTHET RESTOR DENT 2023; 35:183-196. [PMID: 36650691 DOI: 10.1111/jerd.13003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To review the impact of key peri-implant soft tissue characteristics on health and esthetics. MAIN CONSIDERATIONS The keratinized mucosa width (KMW), the mucosal thickness (MT), and the supracrestal tissue height (STH) are essential components of the peri-implant soft tissue phenotype. An inadequate KMW (<2 mm) has been associated with local discomfort upon oral hygiene performance and increased risk for the onset of peri-implant diseases. A minimum buccal MT (≥2 mm) is generally required to prevent esthetic issues related to the effect of transmucosal prosthetic elements on the color of the mucosa and can also contribute to long-term mucosal stability. STH is directly related to marginal bone remodeling patterns during the early healing process that follows the connection of transmucosal prosthetic components. Short STH, generally defined as <3 mm, has been consistently associated with marginal bone loss resulting from the physiologic establishment of the mucosal seal. Insufficient STH may also derive into the fabrication of unfavorable transmucosal prosthetic contours, which frequently results in unpleasing esthetic outcomes and predisposes to submarginal biofilm accumulation. Peri-implant soft tissue dehiscences (PISTDs) are a type of peri-implant deformity that are associated with esthetic issues and often occur in sites presenting KMW, MT, and/or STH deficiencies. PISTDs should be correctly diagnosed and treated accordingly, usually by means of multidisciplinary therapy. CONCLUSION Understanding the impact of different dimensional and morphologic features of the peri-implant mucosa on health and esthetic outcomes is fundamental to make appropriate clinical decisions in the context of tooth replacement therapy with implant-supported prostheses.
Collapse
Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - Oscar González-Martín
- Private Practice, Atelier Dental Madrid, Madrid, Spain.,Department of Periodontology, Complutense University of Madrid, Madrid, Spain
| | - Gustavo Ávila-Ortiz
- Private Practice, Atelier Dental Madrid, Madrid, Spain.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, USA.,Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| |
Collapse
|
26
|
Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36533411 DOI: 10.1111/cid.13155] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders. PURPOSE The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis. METHODS The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases. RESULTS Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases. CONCLUSION Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.
Collapse
Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
- Department of Periodontology, ZMK University of Bern Bern CH Switzerland
| | - Joseph Y. Kan
- Department of Implantology Loma Linda University Loma Linda California USA
| | - Wenche Borgnakke
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
| |
Collapse
|
27
|
Galindo-Moreno P, Ravidà A, Catena A, O'Valle F, Padial-Molina M, Wang HL. Limited marginal bone loss in implant-supported fixed full-arch rehabilitations after 5 years of follow-up. Clin Oral Implants Res 2022; 33:1224-1232. [PMID: 36184955 PMCID: PMC10092560 DOI: 10.1111/clr.14004] [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: 04/18/2022] [Revised: 08/05/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of the present study was to evaluate the 5-year results in terms of marginal bone level (MBL) around implants supporting fixed full-arch metal-ceramic restorations in a series of cases of patients who had lost their teeth in that dental arch because of severe periodontal disease. MATERIAL AND METHODS A retrospective cohort study was designed to evaluate the 5-year MBL results of OsseoSpeed™ Astra Tech TX implants with internal tapered conical connection. Age, gender, bone substratum, smoking habits, history of periodontitis, and prosthetic features were recorded. Mixed linear model was used to determine the influence of the different variables on MBL. RESULTS In this series, a total of 160 implants placed in 19 patients were evaluated. No implant failure was reported during the 5 years of follow-up. Only 14 (8.75%) implants had more than 2 mm of MBL. Abutment height, F(3,142) = 6.917, p < .001, and implant diameter, F(1,141) = 15.059, p < .001, were determined to be statistically associated with MBL. No other effect was significant. Pairwise comparisons showed that MBL was larger for abutment height = 1 (MBL = -0.987, SE = 0.186) compared with the remaining heights [-0.335 (0.171), -0.169 (0.192) and -0.247 (0.267), 2, 4 and 6 mm, respectively]. MBL was larger for narrow (-0.510, SE = 0.169) than for wide implants (-0.364, SE = 0.190). CONCLUSION The current study demonstrates that the vast majority of internal conical connection implants supporting fixed full-arch metal-ceramic restorations do not suffer from relevant MBL after 5 years in function. Particularly, those implants with transmucosal abutments longer than 2 mm show less than 0.5 mm from the implant shoulder to the marginal bone.
Collapse
Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Andrés Catena
- Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain
| | - Francisco O'Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
28
|
Pérez‐Sayans M, Castelo‐Baz P, Penarrocha‐Oltra D, Seijas‐Naya F, Conde‐Amboage M, Somoza‐Martín JM. Impact of abutment geometry on early implant marginal bone loss. A double-blind, randomized, 6-month clinical trial. Clin Oral Implants Res 2022; 33:1038-1048. [PMID: 35869615 PMCID: PMC9796139 DOI: 10.1111/clr.13985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/09/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The objective of this study was to analyze the impact of the abutment width on early marginal bone loss (MBL). MATERIAL AND METHODS A balanced, randomized, double-blind clinical trial with two parallel experimental arms was conducted without a control group. The arms were "cylindrical" abutment and "concave" abutment. Eighty hexagonal internal connection implants, each with a diameter of 4 × 10 mm, were placed in healed mature bone. The main variable was the peri-implant tissue stability, which was measured as MBL at 8 weeks and 6 months. RESULTS The final sample consisted of 77 implants that were placed in 25 patients. 38 (49.4%) were placed using the cylindrical abutment, and the other 39 (50.6%) were placed using the concave abutment. The early global MBL of -0.6 ± 0.7 mm in the cylindrical abutment group was significantly higher than it was in the concave abutment group, in which the early global MBL was -0.4 ± 0.6 mm (p = .030). The estimated effect size (ES) was negative for the cylindrical abutment (ES = -1.3730, CI -2.5919 to -0.1327; t-value = -2.4893; p = .0139), therefore implying a loss of mean bone level, and it was positive for the concave abutment (ES = 2.8231; CI: 1.4379 to 4.2083; t-value = 4.0957; p = .0002), therefore implying an increase in the average bone level. CONCLUSIONS The concave abutments presented significantly less early MBL at 6 months post-loading than classical cylindrical abutments did.
Collapse
Affiliation(s)
- Mario Pérez‐Sayans
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain,Health Research Institute of Santiago de Compostela (IDIS)Santiago de CompostelaSpain
| | - Pablo Castelo‐Baz
- Department of Restorative Dentistry and Endodontics, Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | | | - Flavio Seijas‐Naya
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | - Mercedes Conde‐Amboage
- CITMAgaSantiago de CompostelaSpain,Department of Statistics, Mathematical Analysis and Optimization, Models of Optimization, Decision, Statistics and Applications Reseach Group (MODESTYA)Universidade de Santiago de CompostelaSantiago de CompostelaSpain
| | - José M. Somoza‐Martín
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain,Health Research Institute of Santiago de Compostela (IDIS)Santiago de CompostelaSpain
| |
Collapse
|
29
|
Galindo‐Moreno P, Catena A, Pérez‐Sayáns M, Fernández‐Barbero JE, O'Valle F, Padial‐Molina M. Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study. Clin Implant Dent Relat Res 2022; 24:630-642. [PMID: 35831919 PMCID: PMC9796358 DOI: 10.1111/cid.13122] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of this study was to establish an objective criterion in terms of marginal bone level (MBL) to know the prognosis of an implant. MATERIALS AND METHODS A group of 176 patients in whom 590 implants were placed were included in this retrospective study. Patients older than 18 years, presenting either Kennedy class I or II edentulous section, or totally edentulous at least in one of the dental arches were included in this study. Those with any type of disturbance able to alter bone metabolism or with nontreated periodontal disease were excluded. Data on radiographic MBL at loading, 6 and 18 months later, age, gender, smoking habits, history of periodontitis, bone substratum, implant, and prosthetic features were recorded. Nonparametric receiver operating curves (ROC) were constructed for the MBL at 18 months in order to establish a distinction among high bone loser (HBL) and low bone loser (LBL) implants. Differences as a function of main variables were also determined, particularly abutment height and periodontal disease. RESULTS HBL implants lost at least 0.48 mm of MBL 6 months after loading; they reached at least 2 mm of MBL 18 months after loading. MBL rate followed a nonlinear trend, except in implants restored over long prosthetic abutments and in patients with history of severe periodontitis; in whom the rate of MBL over the time was nearly zero. CONCLUSION Implants that lose more than 0.5 mm of marginal bone 6 months after loading are at great risk of not being radiographically successful anymore. Therefore, 0.5 mm of MBL is proposed as a distinctive and objective criterion of success in Implant Dentistry within a 6-month follow-up period. A prosthetic abutment height ≥2 mm resulted the most protective factor in the peri-implant bone maintenance.
Collapse
Affiliation(s)
- Pablo Galindo‐Moreno
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
| | - Andrés Catena
- Department of Experimental Psychology, School of PsychologyUniversity of GranadaGranadaSpain
| | - Mario Pérez‐Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | | | - Francisco O'Valle
- Department of Pathology, School of Medicine & IBIMERUniversity of GranadaGranadaSpain,Instituto de Investigación Biosanitariaibs.GRANADAGranadaSpain
| | - Miguel Padial‐Molina
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
| |
Collapse
|
30
|
Spinato S, Bernardello F, Lombardi T, Soardi CM, Messina M, Zaffe D, Stacchi C. Influence of apico-coronal positioning of tissue-level implants on marginal bone stability during supracrestal tissue height establishment: A multi-center prospective study. Clin Implant Dent Relat Res 2022; 24:611-620. [PMID: 36000363 DOI: 10.1111/cid.13128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/24/2022] [Accepted: 08/06/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Supracrestal tissue height establishment is a crucial factor influencing peri-implant marginal bone modifications prior to prosthesis delivery. If mucosal thickness is insufficient, peri-implant marginal bone resorption occurs to allow appropriate supracrestal tissue height formation. This study evaluates if marginal bone resorption occurring around tissue-level implants before prosthetic loading could be compensated by adapting apico-coronal positioning to mucosal thickness. METHODS Patients requiring placement of one single implant in the posterior mandible were treated with tissue-level implants with a 3-mm high transmucosal machined component and moderately rough implant body. Based upon vertical mucosal thickness measured after buccal flap reflection, implants were placed with the treated part: (group 1) 2 mm below crestal level in presence of thin mucosa (<2.5 mm); (group 2) 1 mm below the crestal level in presence of medium mucosa (2.5-3.5 mm); (group 3) at equicrestal level in presence of thick mucosa (>3.5 mm). RESULTS Forty-nine implants, placed in 49 patients were included in final analysis (group 1: 18 implants; group 2: 16 implants; group 3: 15 implants). Mean marginal bone resorption after 5 months of healing was 0.66 ± 0.49 mm, 0.32 ± 0.41 mm, and 0.22 ± 0.52 mm in groups 1, 2, and 3, respectively. Inter-group analysis highlighted significant differences between the three groups after ANOVA test (p = 0.025). However, adaptation of apico-coronal implant positioning in relation to mucosal thickness, allowed to avoid early exposure of the treated surface in 100%, 93.7%, and 53.3% of the implants in groups 1, 2, and 3, respectively. CONCLUSION During supracrestal tissue height formation, tissue-level implants inserted adapting apico-coronal positioning in relation to mucosal thickness exhibited greater marginal bone resorption at sites with thin mucosa than at sites with medium or thick mucosa. However, anticipating supracrestal tissue height establishment by adapting apico-coronal implant positioning in relation to mucosal thickness may effectively prevent unwanted exposure of treated implant surface.
Collapse
Affiliation(s)
| | | | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | | | | | - Davide Zaffe
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
31
|
Luengo F, Solonko M, Sanz-Esporrín J, Sanz-Sánchez I, Herrera D, Sanz M. Clinical, Microbiological, and Biochemical Impact of the Surgical Treatment of Peri-Implantitis-A Prospective Case Series. J Clin Med 2022; 11:jcm11164699. [PMID: 36012939 PMCID: PMC9410201 DOI: 10.3390/jcm11164699] [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: 07/18/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of this study, a prospective case series, was to evaluate the clinical, microbiological, and biochemical impact of the surgical treatment of peri-implantitis. Methods: Thirty subjects with diagnosis of peri-implantitis were treated following a surgical protocol including access flaps, surface decontamination with ultrasonics and glycine powder air-polishing, and systemic antibiotics. Disease resolution was defined by the composite outcome including presence of probing depths (PD) ≤5 mm, absence of bleeding on probing (BoP)/suppuration, and no additional radiographic bone loss (>1 mm). Regression analysis was used to evaluate the patient-, implant-, and prosthetic-related factors possibly influencing treatment outcomes. Results: Patients were evaluated at 6 months post treatment, demonstrating statistically significant reductions in PD (2.14 ± 1.07 mm) and increase in mucosal recession (1.0 ± 0.77 mm). Plaque, BoP, and suppuration were also reduced by 40.56%, 62.22%, and 7.78%, respectively. Disease resolution was achieved in 56.67% of patients. No significant changes were detected in microbiological parameters except for a significant reduction in proportions of Parvimonas micra. Similarly, the levels of the biomarker interleukin-8 in crevicular fluid were significantly lower at 6 months. Conclusions: The proposed surgical treatment of peri-implantitis demonstrated statistically significant clinical improvements although the impact on microbiological and biochemical parameters was scarce.
Collapse
Affiliation(s)
- Fernando Luengo
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Myroslav Solonko
- Section of Periodontology, Faculty of Odontology, University Complutense, 28040 Madrid, Spain
| | - Javier Sanz-Esporrín
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
- Correspondence:
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, 28040 Madrid, Spain
| |
Collapse
|
32
|
Dib-Zaitum I, Guadilla-González Y, Flores-Fraile J, Dib-Zakkour J, Benito-Garzón L, Montero J. Effect Morphology and Surface Treatment of the Abutments of Dental Implants on the Dimension and Health of Peri-Implant Biological Space. MATERIALS 2022; 15:ma15134422. [PMID: 35806548 PMCID: PMC9267537 DOI: 10.3390/ma15134422] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 12/10/2022]
Abstract
Statement of the problem: The gingival configuration around implant abutments is of paramount importance for preserving the underlying marginal bone, and hence for the long-term success of dental implants. Objective: The objective was to study, clinically and histologically, the effects of the change in the morphology of abutments connected to the endosseous implant, and of their surface treatment. In particular, the objective was to ascertain the effect of changing the shape of the transepithelial pillar and the treatment of its surface on the dimensions, quality and health of the components of the peri-implant biological space, such as the dimensions of the epithelial and connective tissues of the biological space, the concentration of inflammatory cells and the density of collagen fibers. Methods: A clinical trial of 10 patients with a totally edentulous maxilla, who had four implants (IPX4010_GALIMPLANT®, Sarria, Spain) inserted in the area of the first and second molars on both sides with computer-guided implant surgery, was conducted with the final purpose of assessing the quality of the peri-implant soft tissue attachment around the transepithelial abutments which were employed (aesthetic machined (RM), aesthetic anodized (RA), slim machined (SM) and slim anodized (SA)). At 8 weeks and following the collection of the samples (removal of the implant-abutment assembly with its surrounding hard and soft tissue) and their processing for subsequent histological and histomorphometric analysis in order to study the dimensions, quality and health of the peri-implant soft tissue area, the variables previously mentioned were determined according to the aims of the study. By using appropriate diameter trephine in order to obtain a useful fringe of soft tissue around the transepithelial pillars, ANOVA and chi-square tests were performed. Results: The SPSS statistical analysis ANOVA results revealed that the machined slim abutments have a better performance considering the variables analyzed with epithelial and connective attachment heights of 1.52 mm and 2.3 mm, respectively, and that connective density (density of collagen fibers) was high at 85.7% of the sample size affected by the design for the slim abutments and 92.9% of the high-density sample size affected by the surface treatment for the machined surface. Conclusions: All variables studied, despite the small sample size, showed the superiority of the slim machined abutment among the four groups.
Collapse
Affiliation(s)
- Ibrahim Dib-Zaitum
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (I.D.-Z.); (Y.G.-G.); (J.D.-Z.); (J.M.)
| | - Yasmina Guadilla-González
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (I.D.-Z.); (Y.G.-G.); (J.D.-Z.); (J.M.)
| | - Javier Flores-Fraile
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (I.D.-Z.); (Y.G.-G.); (J.D.-Z.); (J.M.)
- Correspondence:
| | - Juan Dib-Zakkour
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (I.D.-Z.); (Y.G.-G.); (J.D.-Z.); (J.M.)
| | - Lorena Benito-Garzón
- Department of Human Anatomy and Histology, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Javier Montero
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain; (I.D.-Z.); (Y.G.-G.); (J.D.-Z.); (J.M.)
| |
Collapse
|
33
|
Coyac BR, Wolf BJ, Bahat DJ, Arioka M, Brunski JB, Helms JA. A WNT protein therapeutic accelerates consolidation of a bone graft substitute in a pre-clinical sinus augmentation model. J Clin Periodontol 2022; 49:782-798. [PMID: 35713219 DOI: 10.1111/jcpe.13674] [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: 10/20/2021] [Revised: 04/28/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
AIM Autologous bone grafts consolidate faster than bone graft substitutes (BGSs) but resorb over time, which compromises implant support. We hypothesized that differences in consolidation rates affected the mechanical properties of grafts and implant stability, and tested whether a pro-osteogenic protein, liposomal WNT3A (L-WNT3A), could accelerate graft consolidation. MATERIALS AND METHODS A transgenic mouse model of sinus augmentation with immunohistochemistry, enzymatic assays, and histology were used to quantitatively evaluate the osteogenic properties of autografts and BGSs. Composite and finite element modelling compared changes in the mechanical properties of grafts during healing until consolidation, and secondary implant stability following remodelling activities. BGSs were combined with L-WNT3A and tested for its osteogenic potential. RESULTS Compared with autografts, BGSs were bioinert and lacked osteoprogenitor cells. While in autografted sinuses, new bone arose evenly from all living autograft particles, new bone around BGSs solely initiated at the sinus floor, from the internal maxillary periosteum. WNT treatment of BGSs resulted in significantly higher expression levels of pro-osteogenic proteins (Osterix, Collagen I, alkaline phosphatase) and lower levels of bone-resorbing activity (tartrate-resistant acid phosphatase activity); together, these features culminated in faster new bone formation, comparable to that of an autograft. CONCLUSIONS WNT-treated BGSs supported faster consolidation, and because BGSs typically resist resorption, their use may be superior to autografts for sinus augmentation.
Collapse
Affiliation(s)
- Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA.,Department of Periodontology and Implant Dentistry, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Benjamin J Wolf
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Daniel J Bahat
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Masaki Arioka
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, School of Medicine, Stanford University, Palo Alto, California, USA
| |
Collapse
|
34
|
Strauss FJ, Siegenthaler M, Hämmerle CHF, Sailer I, Jung RE, Thoma DS. Restorative angle of zirconia restorations cemented on non-original titanium bases influences the initial marginal bone loss: 5-year results of a prospective cohort study. Clin Oral Implants Res 2022; 33:745-756. [PMID: 35570366 PMCID: PMC9543966 DOI: 10.1111/clr.13954] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Aim To assess radiographic, restorative, clinical and technical outcomes as well as patient satisfaction of directly veneered zirconia restorations cemented on non‐original titanium bases over 5 years. Material and Methods Twenty‐four patients with a single missing tooth in the aesthetic zone were recruited. All patients received a two‐piece implant with a screw‐retained veneered zirconia restoration cemented extraorally on a titanium base abutment. Marginal bone levels (MBL), marginal bone changes, technical complications, patient satisfaction and clinical parameters including probing depth, bleeding on probing and plaque index were assessed at crown delivery (baseline), at 1 year (FU‐1) and 5 years (FU‐5) of follow‐up. To investigate the relationship between restorative angle and MBL as well as marginal bone changes (bone loss/bone gain), correlation tests and linear regression models were carried out. Results Twenty‐two patients were available for re‐examination at 5 years. The mean MBL amounted to 0.54 ± 0.39 mm at baseline, and to 0.24 ± 0.35 at FU‐5 (=bone gain) (p < .001). At FU‐1, a positive correlation (r = .5) between the mesial restorative angle and mesial MBL was found (p = .012). Marginal bone changes between baseline and FU‐1 at mesial sites were also positively correlated with the mesial restorative angle (r = .5; p = .037). Linear and logistic regression models confirmed that mesial marginal bone loss was significantly associated with the mesial restorative angle at FU‐1 (p < .05). At 5 years, these significant associations at mesial sites disappeared (p > .05). At distal sites, no correlations or associations between the restorative angle and MBL or marginal bone changes were found regardless of the time point. During the 5‐year follow‐up, 5 technical complications occurred, mainly within the first year and mostly chippings. All patients were entirely satisfied with their implant‐supported restoration at 5 years. Conclusion Within the limitations of the present study, the restorative angle of implant‐supported crowns on non‐original titanium bases might influence the initial marginal bone loss but without affecting their favourable long‐term clinical performance. A restorative angle of <40° may limit the initial marginal bone loss at implant‐supported crowns with titanium bases.
Collapse
Affiliation(s)
- Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Marina Siegenthaler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| |
Collapse
|
35
|
Using Different Low-Profile Abutments for Assisting Mandibular Implant Overdenture: A Split-Mouth Study. Int J Dent 2022; 2022:8738220. [PMID: 35437443 PMCID: PMC9013306 DOI: 10.1155/2022/8738220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/08/2022] [Accepted: 03/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Using a pair of different low-profile abutments to assist mandibular implant overdenture (MIOD) in limited restorative space is questionable due to the different morphology. Objective To investigate the marginal bone level (MBL) change and peri-implant-tissue health (PITH) around a pair of OT Equator® and Locator® suprastructures assisting MIOD. Methods Seventeen edentulous patients received MIOD assisted by OT Equator® and Locator®. MBL change was investigated at the implant loading (T1), after six months (T2) and twelve months (T3) of implant loading. PITH was evaluated at T2 and T3. Results There was within abutment significant difference in MBL change after T2 and T3 of loading for Locator (0.05 ± 0.02 and 0.32 ± 0.08, respectively) (P=0.01); and for Equator (0.11 ± 0.08 and 0.21 ± 0.09, respectively) (P=0.01). Also, there was a significant difference between Locator and Equator on the modified plaque index (MPI) after T3 (P=0.01). The significant results were recorded for the MPI at T2 and T3 for Locator (0.92 ± 0.26 and 1.5 ± 0.51, respectively) (P=0.01) and for Equator (0.82 ± 0.26 and 1.42 ± 0.51, respectively) (P=0.003). For modified bleeding index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.19 and 1.14 ± 0.41, respectively) (P=0.03) and for Equator (0.46 ± 0.22 and 1.07 ± 0.41, respectively) (P=0.01). For gingival index, there was significant difference at T2 and T3 for Locator (0.57 ± 0.11 and 1.28 ± 0.35, respectively) (P=0.001) and for Equator (0.35 ± 0.21 and 1.1 ± 0.46, respectively) (P=0.001). Conclusions Using different pairs of the low-profile OT Equator® and Locator® abutments to assist MIOD is clinically acceptable based on the MBL change and PITH outcomes.
Collapse
|
36
|
AlHussainan NS, AlHossan WM, AlMusallam RS, Sambawa ZM, AlShammari AS, AlHusaan SF, AlKeraye RS. Influence of Crown Height of Dental Implant on Marginal Bone Loss: A Retrospective Study. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2022. [DOI: 10.51847/chooeqrmoz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
37
|
Veljanovski D, Atanasovska-Stojanovska A, Pivkova-Veljanovska A, Mijiritsky E, Bollen C. The Vertical Soft Tissue Thickness and Subcrestal Implant Placement as Factors for Peri-implant Crestal bone Stability. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim
The aim of this prospective study was to determine the influence of vertical soft tissue thickness on bone level changes in platform-switched implants placed eqicrestally or subcrestally and restored with screw-retained or cement-retained restorations.
Methods
Platform-switched bone-level implants were placed in a single stage manner in the posterior mandibular region. Implant sites were divided into thick (control) and thin (test) vertical soft tissue groups. The implants in the control group were placed equicrestally. The implant sites from the control group were randomly allocated to receive equicrestally or subcrestally placed implants. Bone remodeling/loss was radiographically measured at baseline, three months postoperatively and six months after delivery of final prosthetic restoration.
Results
The mean crestal bone loss values three months postoperatively and six months post prosthetic restoration were higher in sites with thin versus sites with thick gingiva. In implant sites with thin gingiva, subcrestally placed implants presented less bone loss than eqicrestally placed implants.
Conclusion
Platform switched implants are prone to more bone loss when they are placed in sites with thin soft tissue, regardless of the type of final restoration (screw-retained or cement-retained). Subcrestal placement of platform-switched implants can prevent crestal bone loss in sites with vertical soft tissue thickness < 3 mm.
Collapse
|
38
|
A Six-Year Prospective Comparative Study of Wide and Standard Diameter Implants in the Maxillary and Mandibular Posterior Area. MEDICINA-LITHUANIA 2021; 57:medicina57101009. [PMID: 34684046 PMCID: PMC8540610 DOI: 10.3390/medicina57101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The aim of our study was to test whether wide diameter (6 mm) implants perform differently from standard diameter (4 mm) implants in terms of marginal bone level and survival rate. Materials and Methods: Our sample comprised 72 patients who underwent surgery; a total of 80 implants were placed in the maxillary or mandibular molar region. Patients were divided into two groups according to the diameter of the implant, and were followed up for six years after the final setting of the prosthetics. In the test group, 40 implants with 6-mm diameter were inserted; in the control group, 40 standard diameter implants were inserted. Using panoramic radiographs, we investigated mesial and distal marginal bone levels around the implant fixtures. Results: After the first implant surgery, three implants, including one wide diameter and two standard diameter implants, failed due to lack of osseointegration. We did not note any fixture fracture during the six-year follow-up. After loading, we observed a six-year survival rate of 97.29% with no statistically significant difference from standard diameter implants, with a survival rate of 94.87%. Conclusions: This study shows that 6-mm diameter implants may be considered in the presence of adequate alveolar ridge width in the posterior maxillary and mandibular regions.
Collapse
|
39
|
Anitua E, Alkhraisat MH, Piñas L, Torre A, Eguia A. Implant-prosthetic treatment in patients with oral lichen planus: A systematic review. SPECIAL CARE IN DENTISTRY 2021; 42:60-72. [PMID: 34245172 DOI: 10.1111/scd.12629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/04/2021] [Accepted: 06/23/2021] [Indexed: 01/23/2023]
Abstract
AIMS This review is aiming on identifying the ideal implant-prosthetic treatment design in patients with OLP. METHODS AND RESULTS A systematic review was conducted using four electronic databases; Medline (PubMed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "which implant-prosthetic treatment design is most useful to ensure implant survival in OLP patients?". The study was pre-registered in PROSPERO (CRD 42020220102). Included articles quality was assessed using the "Newcastle-Ottawa scale" and the JBI critical appraisal tool for case series. No article was found specifically designed to analyze the prosthetic influence on implant survival in OLP patients. Despite, information about implant-prostheses in studies designed with other goals was compiled. Eight articles that involved 141 patients and 341 implants were finally selected. The weighted mean follow-up was 38 months and the weighted mean survival of the implants 98.9%. No statistical differences were observed between cemented or screw retained prostheses and the materials employed or the technology to manufacture the prostheses. CONCLUSION The influence of prosthetic design on implant survival in OLP patients is still poorly understood, but important clinical recommendations can be drawn. The strength of evidence was grade 3b (CEBM) or low (GRADE).
Collapse
Affiliation(s)
- Eduardo Anitua
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain.,Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Regnerative Medicine, BTI Biotechnology Institute, Vitoria, Spain
| | | | - Laura Piñas
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain
| | - Aintzane Torre
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain.,Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Stomatology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Asier Eguia
- Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Stomatology, University of the Basque Country UPV/EHU, Leioa, Spain
| |
Collapse
|
40
|
Gomez-Meda R, Esquivel J, Blatz MB. The esthetic biological contour concept for implant restoration emergence profile design. J ESTHET RESTOR DENT 2021; 33:173-184. [PMID: 33470498 DOI: 10.1111/jerd.12714] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/08/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Emergence profile design is important for stable peri-implant tissues and esthetically pleasing results with dental implant restorations, influenced by factors, such as, implant position and surrounding soft tissues. Different aspects of the emergence profile have been described, but detailed explanations of the different zones and corresponding designs are missing. This article describes the esthetic biological contour concept (EBC), differentiating important areas of the emergence profile and recommending particular designs for those zones. OVERVIEW The EBC concept considers specific parameters for proper design of the emergence profile of implant-supported restorations. Understanding the different zones of the emergence profile and their relation to factors like implant position, implant design, and soft tissue thickness is key. The suggested guidelines are geared toward providing more stable and esthetic results when restoring dental implants in the esthetic zone. CONCLUSIONS Each of the zones described in the EBC concept have a specific function in the design of the emergence profile. Understanding the importance and specific design features of the EBC zones facilitates esthetic and biologically sound treatment outcomes with interim and definitive implant restorations. CLINICAL SIGNIFICANCE Proper emergence profile design supports esthetic outcomes and provides favorable biological response to implant-supported restorations.
Collapse
Affiliation(s)
- Ramon Gomez-Meda
- Private practice restorative dentist, Meda Dental Institute, Ponferrada, Spain
| | - Jonathan Esquivel
- Assistant Professor, Department of Prosthodontics, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Markus B Blatz
- Professor of Restorative Dentistry, Chairman, Department of Preventive and Restorative Sciences, Assistant Dean for Digital Innovation and Professional Development, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
41
|
Wang ICI, Barootchi S, Tavelli L, Wang HL. The peri-implant phenotype and implant esthetic complications. Contemporary overview. J ESTHET RESTOR DENT 2021; 33:212-223. [PMID: 33459483 DOI: 10.1111/jerd.12709] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To provide a contemporary and comprehensive overview of the hard and soft tissue biological structures surrounding an osseointegrated dental implant (peri-implant referred to as the peri-implant phenotype), in the context of peri-implant esthetic complications. OVERVIEW The individual components of the peri-implant phenotype (keratinized mucosa width, mucosal thickness, supracrestal tissue height, and the peri-implant buccal bone) have been linked to different aspects of implant esthetics, as well as health-related aspects. At the time of implant therapy, respecting the biology of the peri-implant hard and soft tissues, and anticipating their remodeling patterns can alleviate future esthetic complications. CONCLUSIONS While the current literature may not allow for a point-by-point evidence based-recommendation for the required amount of each peri-implant structure, bearing in mind the proposed values for the components of the peri-implant phenotype, at the time of and prior to implant therapy can lead to more predictable treatment outcomes, and the avoidance of esthetic complications. CLINICAL SIGNIFICANCE Knowledge of hard and soft tissue components surrounding and osseointegrated dental implant, and their underlying biological remodeling process is crucial for carrying out a successful therapy and alleviating possible future esthetic challenges.
Collapse
Affiliation(s)
- I-Ching Izzie Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
42
|
Azizi A, Zamparini F, Spinelli A, Pirani C, Gandolfi MG, Prati C. Maryland-bridge application as a suitable technique to preserve marginal bone level of not-submerged supracrestal implants. ACTA ACUST UNITED AC 2021; 69:335-342. [PMID: 33393275 DOI: 10.23736/s0026-4970.20.04309-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND One to 6 months after implant placement is a critical time/period responsible for crestal bone loss that may affect implant osseointegration. The study aims to explore the effectiveness of provisional adhesive Maryland-bridge (AMB) applied to prevent marginal bone level (MBL) around implants placed in edentulous crestal bone in posterior area during osseointegration period. METHODS Healthy, non-smoker patients (N.=18) were included in the study. Titanium implants were placed nonsubmerged (i.e. tissue-level) with cover screws at gingival level in edentulous crestal bone with flapless technique. Nine patients randomly received an AMB, while 9 patients did not receive any AMB. Each AMB remained in place for 3 months and removed before impression. After 3 months abutments were applied, and provisional resin crowns cemented and definitive metal-ceramic crowns were cemented after 2-3 months. Periapical Rx were taken using paralleling technique before and after implant insertion, at 1, 3 months (pre-loading time) and after 6 months (post-loading time). MBL was evaluated in double-blind on scanned periapical radiographs and assessed at mesial and distal side of implants (M-MBL and D-MBL). Area of bone loss on mesial and distal side of implants (Area-M and Area-D) and Cervical Enamel Junction migration of mesial and distal adjacent teeth were also measured (CEJ-M and CEJ-D). Linear regression models were fitted to evaluate the existence of any significant difference. RESULTS Two drop-out was observed in AMB group. A total of 16 patients completed the study. After 6 months, all implants were safe and free from complications. AMB group showed the most stable MBL at 1-6 months, statistically different from non-AMB and resulted in a reduced crestal bone loss from baseline compared to Non AMB group. Area-M and Area-D were not statistically different between the groups. CEJ-M and CEJ-D were stable in both groups. CONCLUSIONS The use of Adhesive Maryland Bridge to protect non-submerged post-extractive implants is a safe procedure that prevents bone loss around implants and preserve the 3D architecture of crestal bone ridge.
Collapse
Affiliation(s)
- Arash Azizi
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Fausto Zamparini
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Andrea Spinelli
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Pirani
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria G Gandolfi
- Laboratory of Biomaterials and Oral Pathology, Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, Bologna, Italy
| | - Carlo Prati
- Endodontic Clinical Section, School of Dentistry, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy -
| |
Collapse
|
43
|
Galindo-Moreno P, Gutierrez-Garrido L, Lopez-Chaichio L, Guerra-Lorenzo C, Rodriguez-Alvarez R, Padial-Molina M. Crestal bone changes around early vs. conventionally loaded implants with a multi-phosphonate coated surface: A randomized pilot clinical trial. Clin Oral Implants Res 2020; 32:75-87. [PMID: 33210771 DOI: 10.1111/clr.13681] [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] [Received: 05/18/2020] [Revised: 10/04/2020] [Accepted: 11/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the marginal bone level around implants with a thin multi-phosphonate coated surface after either an early or conventional loading protocol. MATERIAL AND METHODS A randomized pilot clinical trial was conducted. Dental impressions were obtained after either 4 (test) or 8 weeks (control) and single crowns screwed-in 2 weeks later. Several variables were evaluated including radiographical marginal bone level (MBL), patient's level variables, and those related to the restoration and surrounding tissues. These data were obtained at several time points up to a 1-year follow-up. RESULTS Thirty-four patients were included in the study, 18 assigned to the test group. No differences at implant placement were detected for tissue thickness, keratinized mucosa, nor any other clinical or radiological variable. At the time of impressions, tissue was thinner in the test group (2.30 (0.46) versus 2.78 (0.66) mm, test versus control, respectively; p = .012) so shorter abutments were used in this group. Regardless, no significant changes in marginal bone level were detected neither within group along time nor between groups. The average MBL at the 1-year follow-up was -0.15 (0.32) versus -0.22 (0.37) (p = .443) (test versus control, respectively). None of the clinical or radiological variables evaluated had a determinant influence on the MBL at any visit nor group. CONCLUSION The use of implants with a multi-phosphonate coated surface for early loading offers successful radiographical outcomes 1 year after loading. MBL over time was not affected by taking the impressions 4 or 8 weeks after implant placement and loading them 2 weeks later.
Collapse
Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Lourdes Gutierrez-Garrido
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Lucia Lopez-Chaichio
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Claudia Guerra-Lorenzo
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Roque Rodriguez-Alvarez
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
44
|
Borges T, Montero J, Leitão B, Pereira M, Galindo-Moreno P. Periimplant bone changes in different abutment heights and insertion timing in posterior mandibular areas: Three-year results from a randomized prospective clinical trial. Clin Oral Implants Res 2020; 32:203-211. [PMID: 33230873 DOI: 10.1111/clr.13691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022]
Abstract
AIM To compare the influence of the abutment height and its insertion timing on the marginal bone change (MBC) variation of implants placed at posterior mandibular partial edentulous areas in a medium follow-up period. MATERIAL AND METHODS This randomized clinical trial (RCT) comprised a sample of patients with posterior mandibular edentulous areas, treated with at least two implants and distributed into three groups: implants connected to a 2 mm height abutment during the surgical stage (Group A); implants connected to a 1 mm height abutment during the surgical stage (Group B); and implants connected to a 2 mm height abutment after 2 months (Group C). Clinical and radiographic measurements were performed during a 36-month period (T4). The MBC was set as the main variable in study. Statistical significance was set at 0.05. RESULTS A total of 29 subjects and 59 implants were enrolled in this study. A mean MBC of 0.35 ± 0.46 mm, 0.60 ± 0.81 mm, and 0.71 ± 0.90 mm was computed for groups A, B and C, respectively, at T4. Significant differences were found between groups A and C in terms of MBC variation after 3 years of treatment (p = .048). Multiple linear regression analysis showed a significant influence of the first-year MBC and the abutment insertion timing has independent predictor variables for the MBC assessed at T4. CONCLUSION The installation of 2-mm prosthetic abutments, at the time of implant placement, in areas with limited keratinized mucosa presents as a favorable treatment option in terms of periimplant marginal bone maintenance.
Collapse
Affiliation(s)
- Tiago Borges
- Head of Oral Surgery, Faculty of Dental Medicine, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Portugal
| | - Javier Montero
- Department of Surgery. Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Bruno Leitão
- Faculty of Dental Medicine, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - Miguel Pereira
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
45
|
Factors Affecting Implant Failure and Marginal Bone Loss of Implants Placed by Post-Graduate Students: A 1-Year Prospective Cohort Study. MATERIALS 2020; 13:ma13204511. [PMID: 33053722 PMCID: PMC7601912 DOI: 10.3390/ma13204511] [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: 09/18/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 01/25/2023]
Abstract
Statement of the problem: Most of the clinical documentation of implant success and survival published in the literature have been issued by either experienced teams from university settings involving strict patient selection criteria or from seasoned private practitioners. By contrast, studies focusing on implants placed and rehabilitated by inexperienced post-graduate students are scarce. Purpose: To record failure rates and identify the contributing factors to implant failure and marginal bone loss (MBL) of implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up. Material and Methods: A prospective cohort study was conducted on study participants scheduled for implant therapy at the International University of Catalonia. An experienced mentor determined the treatment plan in accordance with the need of each participant who signed an informed consent. All surgeries and prosthetic rehabilitation were performed by the post-graduate students. Implant failure rate, contributors to implant failure, and MBL were investigated among 24 variables related to patient health, local site, and implant and prosthetic characteristics. The risk of implant failure was analyzed with a simple binary logistic regression model with generalized equation equations (GEE) models, obtaining unadjusted odds ratios (OR). The relationship between MBL and the other independent variables was studied by simple linear regression estimated with GEE models and the Wald chi2 test. Results: One hundred and thirty dental implants have been placed and rehabilitated by post-graduate students. Five implants failed before loading and none after restoration delivery; survival and success rates were 96.15% and 94.62%, respectively. None of the investigated variables significantly affected the implant survival rate. At the one-year follow-up, the mean (SD) MBL was 0.53 (0.39) mm. The following independent variables significantly affected the MBL: Diabetes, implant depth placement. The width of keratinized tissue (KT) and probing depth (PD) above 3 mm were found to be good indicators of MBL, with each additional mm of probing depth resulting in 0.11 mm more MBL. Conclusion: The survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up were high. No contributing factor was identified regarding implant failure. However, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and width of KT. Clinical Implications: Survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students were high at the one-year follow-up, similar to experienced practitioners. No contributing factors were identified regarding implant failure; however, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and KM.
Collapse
|
46
|
Verardi S, Orsini M, Lombardi T, Ausenda F, Testori T, Pulici A, Oreglia F, Valente NA, Stacchi C. Comparison between two different techniques for peri-implant soft tissue augmentation: Porcine dermal matrix graft versus tenting screw. J Periodontol 2020; 91:1011-1017. [PMID: 31858603 DOI: 10.1002/jper.19-0447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/22/2019] [Accepted: 11/17/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND The thickness of the soft tissues around dental implants is crucial for both the preservation of the marginal bone and esthetic profile. Many authors have showed the thickened soft tissues favor a better peri-implant bone stability; however, different thickening techniques can be used for this aim. METHODS Forty-seven patients were enrolled in this study, each one had one implant included in this analysis. According to the thickening procedure, patients were assigned into group A (porcine dermal matrix, n = 24) or B (healing abutment used as tenting screw to sustain the soft tissues, n = 23), soft tissue thickness was measured after flap elevation in a standardized way. Six months after implant placement, implants were uncovered and soft tissue thickness measured again. RESULTS At second stage, 6 months after implant placement, the mean vertical thickness was 3.01 ± 0.58 mm in group A and 2.25 ± 0.53 mm in group B. The difference between the two groups at 6 months was significant (P < 0.001). The mean vertical gain in group A was 1.33 ± 0.71 mm, whereas it was 0.43 ± 0.55 mm in group B. This difference was also statistically significant (P < 0.001). CONCLUSION The use of a healing abutment for "tenting effect" has limited efficacy to obtain a significant increase in soft tissue thickness. The use of a porcine dermal matrix at time of implant placement is effective to thicken peri-implant tissues.
Collapse
Affiliation(s)
- Simone Verardi
- Department of Periodontics, University of Washington, Seattle, WA
| | | | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | | | | | | | | | - Nicola Alberto Valente
- Unit of Oral Surgery and Implantology, Service of Maxillo-Facial Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
47
|
Gehrke P, Abazari C, Schlichter K, Fischer C, Duddeck D, Romanos GE, Weigl P. Qualitative and Semi-Quantitative Assessment of Processing-Related Surface Contamination of One- and Two-Piece CAD/CAM Abutments before and after Ultrasonic Cleaning. MATERIALS 2020; 13:ma13143225. [PMID: 32698443 PMCID: PMC7412481 DOI: 10.3390/ma13143225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/21/2022]
Abstract
Manufacturing processes of custom implant abutments may contaminate their surfaces with micro wear deposits and generic pollutants. Such particulate debris, if not removed, might be detrimental and provoke inflammatory reactions in peri-implant tissues. Although regulatory guidelines for adequate cleaning, disinfection, or sterilization exist, there does not appear to be a consistent application and data on the amount and extent of such contaminants is lacking. The aim of the present in vitro study was to evaluate the quality and quantity of processing-related surface contamination of computer-aided design/computer-aided manufacturing (CAD/CAM) abutments in the state of delivery and after ultrasonic cleaning. A total of 28 CAD/CAM monotype and hybrid abutments were cleaned and disinfected applying a three-stage ultrasonic protocol (Finevo protocol). Before and after cleaning, the chemical composition and the contamination of the abutments were assessed using scanning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX), and computer-aided planimetric measurement (CAPM). In the delivery condition, monotype abutments showed a significantly higher amount of debris compared to hybrid abutments (4.86 ± 6.10% vs. 0.03 ± 0.03%, p < 0.001). The polishing process applied in the laboratory after bonding the hybrid abutment components reduces the surface roughness and thus contributes substantially to their purity. The extent of contamination caused by computer-aided manufacturing of custom abutments can be substantially minimized using a three-stage ultrasonic protocol.
Collapse
Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
- Private Practice, Bismarckstrasse 27, 67059 Ludwigshafen, Germany
| | - Cyrus Abazari
- Private Practice, Karl-Berner-Straße 23, 79400 Kandern, Germany
| | - Kai Schlichter
- Private Practice, Konrad-Lerch-Ring 9, 76877 Offenbach, Germany
| | | | - Dirk Duddeck
- Medical Materials Research Institute, Max-Planck-Strasse 3, 12489 Berlin, Germany
| | - Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Paul Weigl
- Department of Prosthodontics and Head of Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
| |
Collapse
|
48
|
Li Manni L, Lecloux G, Rompen E, Aouini W, Shapira L, Lambert F. Clinical and radiographic assessment of circular versus triangular cross‐section neck Implants in the posterior maxilla: A 1‐year randomized controlled trial. Clin Oral Implants Res 2020; 31:814-824. [DOI: 10.1111/clr.13624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Lou Li Manni
- Department of Periodontology and Oral Surgery University Hospital of Liège Liège Belgium
| | - Geoffrey Lecloux
- Department of Periodontology and Oral Surgery University Hospital of Liège Liège Belgium
| | - Eric Rompen
- Department of Periodontology and Oral Surgery University Hospital of Liège Liège Belgium
| | - Walid Aouini
- Department of Periodontology and Oral Surgery University Hospital of Liège Liège Belgium
- Department of Periodontology Faculty of Dental Medicine Monastir Tunisia
| | - Lior Shapira
- Department of Periodontology Hebrew University‐Hadassah Faculty of Dental Medicine Jerusalem Israel
| | - France Lambert
- Department of Periodontology and Oral Surgery University Hospital of Liège Liège Belgium
- Dental Biomaterials Research Unit University of Liège Liège Belgium
| |
Collapse
|
49
|
Ravidà A, Galli M, Siqueira R, Saleh MHA, Galindo‐Moreno P, Wang H. Diagnosis of peri‐implant status after peri‐implantitis surgical treatment: Proposal of a new classification. J Periodontol 2020; 91:1553-1561. [DOI: 10.1002/jper.20-0124] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/24/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Andrea Ravidà
- Graduate Periodontics Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Matthew Galli
- Graduate Periodontics Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Rafael Siqueira
- Graduate Periodontics Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| | - Muhammad H. A. Saleh
- Graduate Periodontics Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
- Department of Periodontics University of Louisville School of Dentistry Louisville KY USA
| | - Pablo Galindo‐Moreno
- Oral Surgery and Implant Dentistry Department School of Dentistry. University of Granada Granada Spain
| | - Hom‐Lay Wang
- Graduate Periodontics Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA
| |
Collapse
|
50
|
Gonzalez-Gonzalez I, deLlanos-Lanchares H, Brizuela-Velasco A, Alvarez-Riesgo JA, Llorente-Pendas S, Herrero-Climent M, Alvarez-Arenal A. Complications of Fixed Full-Arch Implant-Supported Metal-Ceramic Prostheses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124250. [PMID: 32545913 PMCID: PMC7345239 DOI: 10.3390/ijerph17124250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/19/2022]
Abstract
We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were examined annually for biological and mechanical-technical complications during the five years of follow-up. Descriptive statistics and univariate logistic regression were calculated. The cumulative survival rate of the implants was 99.8%, and 98.8% prosthesis-based. Mucositis was the most frequent of the biological complications and peri-implantitis was recorded as 13.8% at restoration-level, 16.9% at patient level and 2.0% at implant level. An implant length greater than 10 mm was shown to be a protective factor against biological complications. The mechanical-technical complications were associated with implant diameter, abutment/implant connection and retention system. Loss of screw access filling was the most frequent prosthetic complication, followed by the fracture of the porcelain. Full-arch metal-ceramic prostheses show a high prevalence of implant and prosthesis survival, with few biological and mechanical-technical complications.
Collapse
Affiliation(s)
- Ignacio Gonzalez-Gonzalez
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Hector deLlanos-Lanchares
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Aritza Brizuela-Velasco
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
- Correspondence: ; Tel.: +34-661-842-026
| | - Jose-Antonio Alvarez-Riesgo
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | | | | | - Angel Alvarez-Arenal
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| |
Collapse
|