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Kolerman R, Abu-Rabie H, Sculean A, Chaushu L, Szmukler-Moncler S, Tagger-Green N. Simultaneous implant placement and restoration with guided bone regeneration in the mandibular anterior region. Clin Oral Investig 2023; 27:7821-7832. [PMID: 37950025 DOI: 10.1007/s00784-023-05371-x] [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: 06/17/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Restoring the mandibular anterior teeth by implants can be difficult due to potential complications arising from using prosthetic implant connections that are larger than the incisors at the cementoenamel junction level. METHODS This retrospective study is aimed at determining the survival and esthetic outcomes of anterior mandible implants immediately placed and restored in patients diagnosed with stages 3-4 periodontitis. The study included 75 implants that were inserted along with guided bone regeneration in 42 patients. Over a follow-up period of 3 to 8 years (mean of 6.95 ± 1.78 years), the study evaluated esthetic, marginal bone loss (MBL), and biological and prosthetic complications. RESULTS No failures were recorded during the follow-up period; after eight years, the survival rate was 100%. Patient's age and gender did not have a statistically significant impact on MBL, but smokers had a greater MBL than non-smokers at the 8-year (2.98 mm vs. 1.23 mm, respectively, p = 0.016) time-point. At 3 years, only 13.3% of the implants had mesial papillae, 36.0% had distal papillae, and 16.0% had the cervical metallic part of the abutment exposed. Peri-implantitis was diagnosed in 20.7% of the patients at the 8-year follow-up time. CONCLUSIONS Based on the limitations of this study, immediate placement and restoration of the mandibular incisors can be a feasible procedure, but only a few implants achieved the complete restoration of the papillae.
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Affiliation(s)
- Roni Kolerman
- Department of Periodontology and Oral Implantology, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hanan Abu-Rabie
- The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anton Sculean
- Department of Periodontology, University of Berne, Bern, Switzerland
| | - Liat Chaushu
- Department of Periodontology and Oral Implantology, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Serge Szmukler-Moncler
- Research Department, MIS Implants Technologies, Israel, Bar-Lev Industrial Park, Misgav, Israel
| | - Nirit Tagger-Green
- Department of Periodontology and Oral Implantology, The Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Fujii Y, Hatori A, Minami S, Kanno Y, Hamada H, Miyazawa T, Chikazu D. Characteristics and Risk Factors for the Fracture of One-Piece Implants. J Maxillofac Oral Surg 2023; 22:1091-1098. [PMID: 38105858 PMCID: PMC10719176 DOI: 10.1007/s12663-023-02033-z] [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: 03/13/2023] [Accepted: 10/16/2023] [Indexed: 12/19/2023] Open
Abstract
Objective The one-piece dental implant was originally designed to overcome the structural weaknesses of the two-piece implant. However, a fractured one-piece implant requires removal because the abutment cannot be repaired or replaced to support new prosthetic restorations. The aim of this study was to clarify the features and risk factors for fracture of the one-piece implant. Methods This study was designed as a retrospective case series research. The subjects were patients who were treated for fractures of the one-piece implant at a clinic in Japan between 2012 and 2021. Fractures of the one-piece implant were diagnosed by cone-beam computed tomography, and the association between age and duration from implant placement to fracture was analyzed by one-way ANOVA followed by the Tukey test. Results Eighteen patients and 20 one-piece implants (under 39 years: 5 patients and 6 implants; 40-59 years: 7 patients and 7 implants; over 60 years: 6 patients and 7 implants) had fractures in their one-piece implants. Of the fractured implants, 11 had a diameter of 3 mm, and 9 had a diameter of 4 mm. The mean durations up to implant fracture were 662 days in the younger group, 1467 days in the middle group, and 1239 days in older group, and the duration was significantly shorter in the younger group. In addition, 83.3% of fracture implants in the younger group were in the molar region. All fractures of the one-piece implants occurred under the bone margin. Two patients had torus mandibularis, and 1 patient was had bruxism. Conclusions One-piece implants in younger patients that are located in the lower molar position are the most susceptible to implant fracture, and the fracture occurred under the bone margin in all cases.
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Affiliation(s)
- Yasuyuki Fujii
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
- Tokyo Ekimae Dental Clinic, 3-3-11 Kyobashi, Chuo-Ku, Tokyo, Japan
| | - Ayano Hatori
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Sakura Minami
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Yuki Kanno
- Tokyo Ekimae Dental Clinic, 3-3-11 Kyobashi, Chuo-Ku, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, 8-1 Kawada-Cho, Shinjuku-Ku, Tokyo, Japan
| | - Hayato Hamada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
| | | | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo, Japan
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Reis TAD, Borges GCS, Zancopé K, Neves FDD. Influence of diameter on mechanical behavior of morse taper narrow implants. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8666036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Dental implants could give back function, esthetics and quality of life to patients. The correct choice of the implant, especially in borderline cases, is essential for a satisfactory result. Aim: Thus, the objective of this study was to evaluate the mechanical behavior of Morse taper implants with two different prosthetic interfaces. Methods: Twenty self-locking Morse taper implants, 2.9 mm in diameter (FAC), and 20 Morse taper implants, 3.5 mm in diameter (CM) were divided into two groups (n=10), and submitted to strength to failure test, optical microscopic evaluation of fracture, metallographic analysis of the alloy, finite element analysis (FEA) and strain gauge test. A Student’s t test (α = 0.05) was made for a statistical analysis. Results: For the strength to failure test, a statistically difference was observed (p <0.001) between FAC (225.0 ± 19.8 N) and CM (397.3 ± 12.5 N). The optical microscopic evaluation demonstrated a fracture pattern that corroborated with FEA´s results. The metallographic analysis determined that the implants of the FAC group have titanium-aluminum-vanadium alloy in their composition. In the strain gauge test, there was no statistical difference (p = 0.833) between CM (1064.8 ± 575.04 μS) and FAC (1002.2 ± 657.6 μS) groups. Conclusion: Based on the results obtained in this study, ultra-narrow implants (FAC) should ideally be restricted to areas with low masticatory effort.
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Mohamed AMA, Askar MG, El Homossany MEMB. Stresses induced by one piece and two piece dental implants in All-on-4® implant supported prosthesis under simulated lateral occlusal loading: non linear finite element analysis study. BMC Oral Health 2022; 22:196. [PMID: 35599323 PMCID: PMC9125928 DOI: 10.1186/s12903-022-02228-9] [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: 02/27/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Correct choice of the implant design and the occlusal scheme is important for the success of implant supported restorations. So, the aim of the current study was to find out the difference in the stresses induced by the one piece dental implants designed to be used in the All-on-4® concept and the conventional two piece ones under simulated lateral occlusal schemes using nonlinear finite element analysis. Methods Two finite element models of the maxilla, implants, and prostheses were designed according to the All-on-4® concept. In the model TP, two piece dental implants were placed while in the model OP one piece dental implants were used. Two loading scenarios were applied to each model; the first one simulated a group function occlusal scheme while the second scenario simulated a canine guided one. Results The highest stress value was recorded in the model TP with the group function occlusion and the lowest stress value was in the model OP with the canine guidance occlusion. Conclusion The one-piece dental implants can be concluded to induce less stress compared to the two piece dental implants when used in the All-on-4® implant supported prosthesis in the different lateral occlusal schemes. Canine guided occlusion can be concluded to cause lower stress values in comparison to the group function occlusal scheme.
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Durrani F, Nahid R, Pandey S, Singh P, Pandey A. One-piece implants: Careful approach for complex rehabilitation. Natl J Maxillofac Surg 2021; 12:266-270. [PMID: 34483588 PMCID: PMC8386274 DOI: 10.4103/njms.njms_191_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 01/09/2021] [Indexed: 11/15/2022] Open
Abstract
It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved.
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Affiliation(s)
- Farhan Durrani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rakhshinda Nahid
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Preeti Singh
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aishwarya Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note. Dent J (Basel) 2019; 7:dj7030065. [PMID: 31261845 PMCID: PMC6784466 DOI: 10.3390/dj7030065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/12/2019] [Accepted: 06/18/2019] [Indexed: 12/02/2022] Open
Abstract
Dental rehabilitation with osseointegrated implants in reconstructed mandibles is a common procedure, but the technique still requires improvement, especially in its reliability and technical simplification. We herein report dental rehabilitation of a free fibula-reconstructed mandible with scar contracture. A vestibuloplasty technique with application of a polyglycolic acid (PGA) sheet is described. The implants were inserted into a viable fibula flap with severe scar contracture of the overlying epithelium resulting from vascular instability in skin paddle. Only the fibula periosteum was sutured after implant insertion; exposed surfaces were covered with a combination of PGA sheet and fibrin sealant. The area with PGA sheet coverage gradually healed with moderate contracture. The epithelium around the almost implants became immobilized. The implant-supported removable partial denture with custom titanium bar was acceptable. Dental rehabilitation is possible for reconstructed mandibles with severe scar contracture. Application of a PGA sheet may be useful for vestibuloplasty in patients with reconstructed mandibles.
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Reis TAD, Zancopé K, Karam FK, Neves FDD. Biomechanical behavior of extra-narrow implants after fatigue and pull-out tests. J Prosthet Dent 2019; 122:54.e1-54.e6. [PMID: 31202549 DOI: 10.1016/j.prosdent.2019.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
STATEMENT OF PROBLEM Narrow implants have limited indications, and implant fracture may occur when these indications are not followed. PURPOSE The purpose of this in vitro study was to investigate the mechanical behavior of a 2.9-mm-diameter implant using a fatigue limit test and to investigate the Morse effect of 2 different Morse taper systems, 2.9-mm-diameter (FAC group) and 3.75-mm-diameter (CM group) implants, using a pull-out test. The null hypothesis was that the tensile strengths of the components for both systems would be similar. MATERIAL AND METHODS The fatigue properties of 13 specimens under 6 loads were determined. The test was performed at 15 Hz and for 5×106 cycles. In the pull-out test, the specimens were divided into 2 groups (n=8), the FAC group (2.9-mm-diameter) and the CM group (3.75-mm-diameter). Statistical analysis for the pull-out test was performed with the Student t test (α=.05). RESULTS Thirteen specimens underwent the fatigue test. Only 5 did not fail when subjected to the frequency and number of cycles examined. Three of the specimens did not fail under a load of 130 N. The pull-out test showed a significant difference between the FAC and CM groups (P<.001). CONCLUSIONS According to the fatigue test, the extra-narrow implant (Facility; Neodent) was compatible with the low masticatory effort regions, as indicated by the manufacturer. The better performance of the FAC group in the pull-out test may be due to its design, which promotes the pure Morse effect in the implant-abutment interface, and the angulation of its internal conical portion.
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Affiliation(s)
- Taís Alves Dos Reis
- Doctoral student, Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia (UFU), Uberlândia, Brazil
| | - Karla Zancopé
- Professor, Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia (UFU), Uberlândia, Brazil
| | - Frederick Khalil Karam
- Professor, Department of Implantology and Oral Rehabilitation, School of Dentistry, University of Rio Verde (UniRV), Rio Verde, Brazil
| | - Flávio Domingues das Neves
- Professor, Department of Occlusion, Fixed Prosthodontics and Dental Materials, School of Dentistry, Federal University of Uberlândia (UFU), Uberlândia, Brazil.
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Marginal Bone Loss Around One-Piece Implants: A 10-Year Radiological and Clinical Follow-up Evaluation. IMPLANT DENT 2019; 28:237-243. [PMID: 31124820 DOI: 10.1097/id.0000000000000861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE This study was conducted to investigate one-piece narrow-diameter implants installed in maxillary lateral and mandibular incisor sites using immediate nonfunctional loading. MATERIALS AND METHODS In this 10-year clinical trial study, 42 narrow-diameter (3.0-mm) one-piece implants for 35 patients were inserted. Clinical and radiographic measurements were recorded in 10 years and analyzed statistically using t test. RESULTS A total of 26 patients (20 females and 6 males) with 30 implants were available for the 10-year follow-up. The 10-year implant survival rate was 100%. A statistically significant mean marginal bone loss was observed between 12 months and 10 years (0.18 ± 0.29 mm). The mean pocket depth increase was statistically significant (0.68 ± 0.83 mm). No bleeding on probing was observed around 90% of the implants. Full-mouth plaque index was registered at 20% of the implants. CONCLUSION The results obtained in this analysis suggest that modest marginal bone loss was observed around the implants. One-piece narrow-diameter implants (Maximus 3.0; BioHorizons) can predictably restore missing maxillary lateral incisors and mandibular incisors in cases of careful patient selection.
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Oh KC, Paik J, Kim JH. Esthetic Rehabilitation of Maxillary Anterior Teeth, Including an Immediate Provisionalization with an Implant-Supported Fixed Dental Prosthesis. J Clin Med 2019; 8:jcm8040428. [PMID: 30925756 PMCID: PMC6518017 DOI: 10.3390/jcm8040428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 01/22/2023] Open
Abstract
This report describes the case of a patient who required rehabilitation of their maxillary anterior teeth following a traumatic injury through a physical altercation. The decision was made to extract the maxillary central incisors and maxillary right lateral incisor, perform immediate implantation on the maxillary right lateral incisor and left central incisor areas, and place a three-unit immediate provisional restoration. Predesigned virtual teeth enabled efficient fabrication of the immediate provisional restoration following the implant placement. After a sufficient healing period with periodic check-ups, final impressions were made using a digital approach, with meticulous care taken to preserve the gingival architecture around the sites of rehabilitation. Thus, the custom abutments and definitive restoration were placed without eliciting an uncomfortable feeling in the patient. Both esthetic and functional outcomes were satisfactory. Reduced soft tissue volume around the implant restoration was observed, primarily within the two months post-extraction/implantation, based on superimposition of the serial scan data. Soft tissue volume changes in the present case suggest the need for controlled clinical studies of three-dimensional changes of gingival contours after extraction and/or implantation.
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Affiliation(s)
- Kyung Chul Oh
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
| | - Jeongwon Paik
- Department of Periodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
| | - Jee-Hwan Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul 03722, Korea.
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Schiegnitz E, Al‐Nawas B. Narrow‐diameter implants: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:21-40. [DOI: 10.1111/clr.13272] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
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