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Passia N, Kern M. The Single Midline Implant in the Edentulous Mandible-Current Status of Clinical Trials. J Clin Med 2023; 12:jcm12113773. [PMID: 37297967 DOI: 10.3390/jcm12113773] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The single midline implant in the edentulous mandible is a treatment concept that has often been controversially discussed. Nearly 30 years ago, the first available clinical results revealed high implant survival rates and remarkable improvements in oral comfort, function, patient satisfaction and oral health-related quality of life for edentulous patients compared to the situation with no implant. However, the clinical trials were predominantly conducted with a small number of patients over a short to medium follow-up period. Today, numerous clinical investigations on the single midline implant in the edentulous mandible, which increasingly include longer-term observation periods, are available. It is the aim of this overview to present the current literature and to highlight the clinical problems. This article is a 2023 update of a review published by the authors in the German language in 2021 in the German journal Implantologie. In total, 19 prospective clinical trials with a follow-up period of 0.5-10 years were analyzed. Over this observation period, single implants with modern rough implant surfaces in the edentulous mandible reveal high implant survival rates of between 90.9 and 100% when a conventional delayed loading protocol was applied.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
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Silvestri F, Nguyen JF, Hüe O, Mense C. Lingual foramina of the anterior mandible in edentulous patients: CBCT analysis and surgical risk assessment. Ann Anat 2022; 244:151982. [PMID: 35882296 DOI: 10.1016/j.aanat.2022.151982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/28/2022] [Accepted: 06/28/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The mandible has various unnamed accessory foramina, and surgery is often performed in the symphyseal area. The aim of this study was to analyze the anatomical characteristics of mandibular lingual foramina with the objective of preventing clinical complications during implant surgery on an edentulous mandible. STUDY DESIGN A total of 100 cone beam computed tomography scans of completely edentulous patients were included in this study. For each canal, nine measurements were recorded in millimeters: seven length or height measurements and two diameter measurements. The placement of a standard implant was simulated and whether the implant passed through the canal was noted. The results were analyzed by t-test and chi-squared at a significance level of 0.05. Pearson correlation analysis was used to assess the relationship between variables. RESULTS We identified 309 foramina: 236 medial lingual foramina and 73 lateral lingual foramina. We found no significant relationship between the number of foramina and the age of the individuals, or between diameter and the age or gender of the individuals. The mandibular canal was injured in 32.7 % of implant placement simulations. CONCLUSION The risk of injury to neurovascular bundles is increased in edentulous patients due to vertical bone resorption.
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Affiliation(s)
- Frédéric Silvestri
- UMR 7268 ADES, CNRS, EFS, Aix-Marseille University, Faculté des sciences médicales et paramédicales, 27 Boulevard Jean Moulin, 13005, Marseille, France; Department of Prosthesis and Implantology, Ecole de médecine dentaire, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
| | - Jean-François Nguyen
- PSL Research University, Chimie ParisTech CNRS, Institut de Recherche de Chimie Paris, Paris, France; Odontologie Université de Paris, Paris, France, Chimie ParisTech CNRS, Institut de Recherche de Chimie Paris, Paris, France.
| | - Olivier Hüe
- Emeritus, Department of Prosthesis and Implantology, Ecole de Médecine dentaire, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
| | - Chloë Mense
- UMR 7268 ADES, CNRS, EFS, Aix-Marseille University, Faculté des sciences médicales et paramédicales, 27 Boulevard Jean Moulin, 13005, Marseille, France; Department of Prosthesis and Implantology, Ecole de médecine dentaire, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
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Chaar MS, Naguib AA, Abd Alsamad AM, Ahmed DF, Abdel Nabi N, Kern M. Vascular and neurosensory evaluation in relation to lingual canal anatomy after mandibular midline implant installation in edentulous patients. Clin Oral Investig 2022; 26:3311-3323. [PMID: 34985576 PMCID: PMC8898232 DOI: 10.1007/s00784-021-04312-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022]
Abstract
Objectives The aim of this study is to investigate vascular and neurosensory complications in edentulous patients following the installation of mandibular midline single implants in relation to lingual canals. Materials and methods After performing a cone beam computed tomography scan for the 50 recruited patients, the relationship between the potential implant site and the lingual canals was assessed, and all vascular and neurosensory complications were recorded. Results Six patients (12%) reported profuse bleeding during implant placement, and 13 (26%) reported transient neurosensory changes, which were resolved after 3 months. According to the virtual implant planning, 44 patients (88%) would have their implants touching the lingual canals, six of them reported vascular changes (14%), and 12 out of 44 patients reported neurosensory changes (27%). For the six patients who would have their implants not touching the lingual canals, one patient reported transient neurosensory changes. Conclusions The mandibular lingual canals are constant anatomic landmarks. Injury to the supra-spinosum lingual canals may occur during midline implant placement, depending on the implant length and the bone height. Clinical relevance Despite that injury to the supra-spinosum lingual canals during implant insertion does not result in permanent vascular or neurosensory complications, caution is required to avoid the perforation of the lingual cortices.
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Affiliation(s)
- Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany.
| | - Amr Ahmed Naguib
- Department of Removable Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Ahmed Mohamed Abd Alsamad
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Fahim Ahmed
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nouran Abdel Nabi
- Department of Removable Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
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Passia N, Oberbillig F, Goulioumis V, Naumova EA, Kern M, Arnold W. Three-Dimensional Reconstruction of the Genial Spinal Canal. Clin Anat 2019; 33:1102-1108. [PMID: 31688952 DOI: 10.1002/ca.23512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 10/17/2019] [Accepted: 10/26/2019] [Indexed: 01/01/2023]
Abstract
The aim of this anatomical study was to investigate the genial spinal canal histologically and to reconstruct it three-dimensionally to improve understanding of its anatomy and to reveal any differences between dentate and edentulous specimens. Two tissue blocks from the mandible between the left and right second incisors, one dentate and one edentulous, were fixed in 4.5% formaldehyde, decalcified and embedded in paraffin. Serial histological sections were prepared, stained with Azan and examined microscopically. Additionally, three-dimensional models of the blocks were reconstructed using microphotographs of the sections. The genial spinal canal in the dentate specimen contained a neurovascular bundle, which branched into a nerve innervating the incisor and a neurovascular bundle, whereas that in the edentulous specimen contained some nerves for vestibular gingival innervation and a vascular bundle. The results suggest differences in the genial spinal canal between dentate and edentulous mandibles. Further research is needed to confirm this finding. Clin. Anat., 33:1102-1108, 2020. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole Passia
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Franziska Oberbillig
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Vlasios Goulioumis
- Department of Operative and Preventive Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Ella A Naumova
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Wolfgang Arnold
- Department of Biological and Material Sciences in Dentistry, Faculty of Health, School of Dentistry, Witten/Herdecke University, Witten, Germany
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Costa ALF, Barbosa BV, Perez-Gomes JP, Calle AJM, Santamaria MP, Lopes SLPDC. Influence of voxel size on the accuracy of linear measurements of the condyle in images of cone beam computed tomography: A pilot study. J Clin Exp Dent 2018; 10:e876-e882. [PMID: 30386520 PMCID: PMC6203913 DOI: 10.4317/jced.54500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 08/06/2018] [Indexed: 11/23/2022] Open
Abstract
Background To analyze the influence of voxel size and exposure time on the accuracy of linear measurements of the condyle. Material and Methods Four macerated hemi-mandibles of pigs were scanned in nine different voxel size protocols. Three-dimensional models of the condyle were generated in order to establish a comparison between linear measurements obtained with each voxel protocol and those obtained with a caliper (gold standard). The comparison between the protocols was performed considering the average of the two measurements of the condyle in the latero-medial (LM) and antero-posterior (AP) axes and also through repeated measurement ANOVA with rank transformation. The level of significance was 5%. Results A significant difference was found between the protocols regarding the LM and AP variables (p-values = 0.0027 and 0.0263, respectively). In the LM axis, the protocol P6 (voxel size of 0.3 mm with scan time of 4.8 seconds) did not show statistical difference compared to the gold standard. The protocols P4 and P5 (voxel size of 0.25 mm with scan times of 14.7 and 26.9 seconds, respectively) were both statistically similar compared to caliper, although they have presented a longer scan time. In the AP axis, the protocol P8 (voxel size of 0.4 mm with time scan of 4.8 seconds) was statistically similar to the gold standard. Conclusions A smaller voxel size does not necessarily mean more accuracy regarding the linear measurements of the condyle. It is possible to obtain an acceptable level of accuracy with a larger voxel size and a shorter exposure time to radiation. Key words:CBCT, voxel size, linear measurement, diagnostic imaging.
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Affiliation(s)
- Andre-Luiz-Ferreira Costa
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | - Bruna-Viana Barbosa
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - João-Pedro Perez-Gomes
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | | | - Mauro-Pedrine Santamaria
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
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