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Malchiodi L, Fiorino A, Merlino L, Cucchi A, Zotti F, Nocini PF. Analysis of ultra-short implants with different angulations: a retrospective case-control study with 2 to 9 years of follow-up. Clin Oral Investig 2024; 28:79. [PMID: 38183469 DOI: 10.1007/s00784-023-05460-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: 10/08/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Does the angulation of ultrashort implants influence the stability of the peri-implant bone? The present study aimed to evaluate the effectiveness of non-axial ultrashort implants after 2 to 9 years of follow-up in resorbed alveolar ridges. MATERIALS AND METHODS All partially edentulous patients with ultrashort implants (< 6 mm) used in the posterior region of an atrophic mandible or maxilla, to support partial dentures in conjunction with standard implants, were included in this study. Peri-implant bone loss, success and survival rates, crestal bone levels, crown-to-implant ratio and implant angulation were measured for each implant. Implants were divided into two groups: straight implants with angulation < 17° (control group) and tilted implants with angulation > 17° (test group). Statistical analysis was used to find any significant differences between the two study groups and to investigate significant linear correlations among all the variables (p = 0.05). RESULTS A total of 42 ultrashort implants with a mean of 4 years of follow-up were included: 20 ultrashort axially loaded implants and 22 tilted implants. Mean crestal bone levels from baseline loading to maximum follow-up did not reveal statistical differences in regard to PBL; mean success and survival rates were 100% in all groups. CONCLUSIONS PBL, success and survival rates of axial ultrashort implants and tilted ultrashort implants are comparable to those of conventional implants. CLINICAL RELEVANCE This retrospective study revealed that ultrashort implants, even when placed with an angulation > 17°, can safely be used to support partial fixed prostheses. Further prospective clinical studies with larger samples and prospective design are needed to confirm these findings.
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Affiliation(s)
- Luciano Malchiodi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Antonino Fiorino
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Via S. Pansini 5, 80131, Naples, Italy.
| | | | | | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
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Konstantinović VS, Abd-Ul-Salam H, Jelovac D, Ivanjac F, Miličić B. Pterygoid and tuberosity implants in the atrophic posterior maxilla: A retrospective cohort study. J Prosthet Dent 2023; 130:219.e1-219.e10. [PMID: 37481400 DOI: 10.1016/j.prosdent.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/24/2023]
Abstract
STATEMENT OF PROBLEM Rehabilitation of the partially or completely edentulous posterior maxilla using dental implants is a clinical challenge because of the presence of the maxillary sinus, as well as the low quality and quantity of bone in that region. In addition to bone augmentation procedures, posterior maxillary rehabilitation using implants includes their anchoring in bones such as the zygoma, pterygoid, and maxillary tuberosity, as well as in short implants. However, the performance of pterygoid and tuberosity implants in the atrophic posterior maxilla is unclear. PURPOSE The purpose of this retrospective cohort study was to evaluate the survival of tuberosity and pterygoid implants in patients with posterior maxillary atrophy. MATERIAL AND METHODS A nonprobability convenient sample of patients who had received fixed prostheses on implants placed in the maxillary tuberosity or pterygoid regions was analyzed retrospectively. Demographic variables included sex (male, female) and age. Implant-related variables included surface characteristics, site of placement, implant design, length, diameter, and anteroposterior insertion angle. Prosthetic-related variables included the type of reconstruction for rehabilitation and loading protocols. Implant survival, complications, crestal bone loss, and follow-up intervals were also documented. Collected data were analyzed at both patient and implant levels. The demographics and implant characteristics of patients receiving pterygoid or tuberosity implants were analyzed with a statistical software program (α=.05). Survival analysis was estimated by using the nonparametric Kaplan-Meier curve. RESULTS A total of 119 patients had 183 pterygoid or tuberosity implants inserted. Most implants in the pterygoid region (71.5%) were Ø4.1 mm (87.4%) and 15 mm in length (60.1%). The most common prostheses were complete maxillary reconstructions (49.2%) with late loading (74.3%). The average implant anteroposterior insertion angle was 60.8 degrees. The cumulative survival rate was 97.3% (n=178) during the mean follow-up period of 57 months (range 1 to 168 months). Among all implants placed, 2.7% failed (n=5) within 2 months of their placement. The statistically significant differences noted between tuberosity and pterygoid implants were related to design, surface characteristics, and loading. The average crestal bone loss was 1.5 mm. CONCLUSIONS The survival of the implants placed in the maxillary tuberosity and pterygoid regions was high in patients with posterior maxillary atrophy.
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Affiliation(s)
- Vitomir S Konstantinović
- Professor, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Hani Abd-Ul-Salam
- Adjunct Professor, Department of Population Oral Health, Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada; and Professor, Department of Diagnostic and Oral Surgical Dental Sciences, Faculty of Dentistry, Gulf Medical University, College of Dentistry, Ajman, Ajman, United Arab Emirates.
| | - Drago Jelovac
- Associate Professor, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Filip Ivanjac
- Research Associate, Clinic of Maxillofacial Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Biljana Miličić
- Professor, Department of Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
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Szabó ÁL, Nagy ÁL, Lászlófy C, Gajdács M, Bencsik P, Kárpáti K, Baráth Z. Distally Tilted Implants According to the All-on-Four ® Treatment Concept for the Rehabilitation of Complete Edentulism: A 3.5-Year Retrospective Radiographic Study of Clinical Outcomes and Marginal Bone Level Changes. Dent J (Basel) 2022; 10:dj10050082. [PMID: 35621535 PMCID: PMC9140184 DOI: 10.3390/dj10050082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Bone grafting procedures during the use of dental implants may be avoided by the use of tilted implants in the maxilla and the mandible; advantages of angled implants are associated with the extension of the distal cantilever, leading to better implant survival rates. However, the bending effect on the single tilting implants may increase the marginal bone stress. The purpose of the present study was to retrospectively assess the clinical success and proximal bone loss rate following the implantation of distally tilted implants according to the All-on-Four™ prosthetic concept—based on radiographic findings—in a single-center experience, in addition to the assessment of the outcomes in the context of various clinico-epidemiological correlates. During the study period, n = 36 patients (24 males and 12 females) with complete records of periapical radiographs, received a full-arch fixed bridge supported by two axial and two distal tilted implants; overall n = 144 and n = 144 implants (Nobel B) were place in the maxilla and mandibles of patients, respectively. Mean age of patients at the time of fixture installation was 58.75 ± 13.71 years; n =11 patients presented with relevant underlying conditions/habits. To assess peri-implant bone-level changes, matched and calibrated orthopantomogram (OPT) images were taken at follow-ups after 1.5 years, 2.5 years, and 3.5 years post-restoration, and marginal bone levels were assessed on the mesio- (MA) and disto-approximal (DA) aspects. All implants were successful, resulting in a 100% overall survival rate. The radiographic mean bone loss levels at baseline (mean ± SEM) were 0.181 ± 0.011 mm and 0.178 ± 0.017 mm in the maxilla and mandible, respectively, while by the 3.5-year mark, bone loss was 0.770 ± 0.029 mm and 0.713 ± 0.026 mm in the maxilla and mandible (p > 0.05), respectively; bone-level changes were significant over time (p = 0.035 and p = 0.033). Peri-implant bone loss was more aggressive around titled distal implants versus mesial actual position implants. The effect of smoking and other underlying conditions showed significantly higher (p < 0.05) bone resorption levels when assessed on an individual implant-level, while during patient-level analysis, only a tendency was shown for higher bone loss rates for both MA and DA implants (p > 0.05). Within its limitations, our study has concluded that the use of All-on-Four™ prosthetic concept for total arch rehabilitation yields higher bone loss in association with tilted implants and, in some cases, on the MA surfaces at vertically positioned implants after >40 months in function.
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Affiliation(s)
- Árpád László Szabó
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
- Oral Centrum Dental Ltd., Angyalka u. 1/A, 2030 Érd, Hungary
| | - Ádám László Nagy
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
| | - Csaba Lászlófy
- Sanoral Healthcare Ltd., Ó utca 6, 1066 Budapest, Hungary;
| | - Márió Gajdács
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 63., 6720 Szeged, Hungary;
| | - Péter Bencsik
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 12, 6721 Szeged, Hungary;
| | - Krisztina Kárpáti
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary;
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
- Correspondence: or ; Tel.: +36-62-545-297
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Preliminary Study to Evaluate Marginal Bone Loss in Cases of 2- and 3-Implant-Supported Fixed Partial Prostheses of the Posterior Mandible. J Craniofac Surg 2019; 30:1068-1072. [PMID: 30394968 DOI: 10.1097/scs.0000000000004855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate, by radiographic examinations, the marginal bone resorption around implants in cases of 2 and 3 implant-supported fixed partial prostheses (FPPs) at the posterior mandible. METHODS A retrospective study of 41 patients (23 males, 18 females) of an average age of 67 years (range, 53-85), with 2 and 3 implants-supported FPPs in the posterior mandible that were treated during 2006 to 2015. The mean follow-up time was 6.32 years (range, 2-10). Twenty-four patients had FPPs on 2 implants (a total of 48 implants). Seventeen patients had FPPs on 3 implants (a total of 51 implants). Clinical and radiographic follow-up examinations were performed. All radiographs were analyzed for changes in marginal bone height surrounding the implants. RESULTS The mean marginal bone loss around the most mesial implant was slightly higher in the 2-implant group (0.833 mm) compared with the 3-implant group (0.431 mm). The correlation between the mean marginal bone loss around the most mesial implant and the number of implants was of borderline value (P = 0.055). CONCLUSIONS Considering the limitations of this preliminary study, the authors found that the mesial implant in the 2-implant group is more susceptible to marginal bone loss.
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Araujo RZ, Santiago Júnior JF, Cardoso CL, Benites Condezo AF, Moreira Júnior R, Curi MM. Clinical outcomes of pterygoid implants: Systematic review and meta-analysis. J Craniomaxillofac Surg 2019; 47:651-660. [PMID: 30799134 DOI: 10.1016/j.jcms.2019.01.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/21/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022] Open
Abstract
The aim of this systematic literature review was to analyze clinical outcomes of pterygoid implant for the treatment of patients with atrophic posterior maxillae and to provide clinical recommendations for this dental implant technique. An extensive search of electronic databases (PubMed/Medline, Science Direct, Lilacs, Embase, and Cochrane Library) was conducted, for articles published between January 1995 and January 2018, to identify literature presenting clinical outcomes of pterygoid implants in the treatment of patients with atrophic posterior maxillae. The systematic review was performed in accordance with PRISMA/PICO statement guidelines, and the risk of bias was assessed (Australian National Health and Medical Research Council scale). The relative risk of implant failure was analyzed within a 95% confidence interval (95% CI). After screening 331 abstracts from the electronic databases, 36 full-text articles were accessed for eligibility, and a total of 6 studies were included in this systematic review (after applying the inclusion and exclusion criteria). All studies were retrospective in nature and were classified with a poor level of evidence. A total of 634 patients received 1.893 pterygoid implants, with a mean implant survival rate of 94.87%. The mean prevalence of implant failure was 0.056 with a 95% CI of 0.04-0.077. This study demonstrates that pterygoid implants can be successfully used in patients with atrophic posterior maxilla. However, the results should be interpreted with caution, given the presence of uncontrolled confounding factors in the included studies.
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Affiliation(s)
- Rafael Zetehaku Araujo
- Department of Oral Implantology and Dental Prosthesis, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | | | - Camila Lopes Cardoso
- Department of Oral Implantology, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | | | - Rosenvaldo Moreira Júnior
- Department of Oral and Maxillofacial Surgery, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
| | - Marcos Martins Curi
- Department of Oral and Maxillofacial Surgery, Hospital Santa Catarina, São Paulo, Brazil
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Gowd MS, Shankar T, Ranjan R, Singh A. Prosthetic Consideration in Implant-supported Prosthesis: A Review of Literature. J Int Soc Prev Community Dent 2017; 7:S1-S7. [PMID: 28713760 PMCID: PMC5502545 DOI: 10.4103/jispcd.jispcd_149_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
Modern dentistry has changed tremendously with implant therapy. For the successful implant therapy, making a proper treatment plan considering both surgical and prosthetic part in mind is the key of success. Often practitioners tend to create a treatment plan overlooking the basic principles of prosthetic part. This present review has discussed various prosthetic consideration of implant-supported prosthesis. A step-by-step detailed prosthetic option with their indications has been discussed to help all dental implant practitioners in making of an optimal treatment plan for each case.
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Affiliation(s)
- Manga Snigdha Gowd
- Department of Orthodontics and Dentofacial Orthopedics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Thatapudi Shankar
- Department of Prosthodontics, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Rajeev Ranjan
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Arpita Singh
- Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
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Casar-Espinosa JC, Castillo-Oyagüe R, Serrera-Figallo MÁ, Garrido-Serrano R, Lynch CD, Menéndez-Collar M, Torres-Lagares D, Gutiérrez-Pérez JL. Combination of straight and tilted implants for supporting screw-retained dental prostheses in atrophic posterior maxillae: A 2-year prospective study. J Dent 2017; 63:85-93. [PMID: 28587977 DOI: 10.1016/j.jdent.2017.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/13/2017] [Accepted: 05/30/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To evaluate the two-year survival rate (SR) and marginal bone loss (MBL) of fixed dental prostheses (FDPs) supported by straight (S) and tilted (T) implants under the influence of diverse study variables. METHODS A prospective investigation comprising 21 patients provided with a total of 27 maxillary screw-retained restorations fixed to 70 dental implants was developed. Two groups of implants were considered depending on their inclination with respect to the occlusal plane: Group 1 (S, n=37): straight/axial implants and Group 2 (T, n=33): tilted/angled fixations. Each FDP was supported by a combination of S and T implants. SR and MBL were assessed at the time of loading and two years after surgery. Patient-, surgical- and/or rehabilitation-related information was gathered. Data were statistically analysed at the α=0.05 significance level. RESULTS After 24 months, a 100% SR was achieved and the MBL of S and T implants were statistically similar. T implants located in the molar region showed lower MBL than did those replacing premolars (p=0.031). CONCLUSIONS Upright and angled fixations inserted at posterior maxillary areas resulted in comparable survival rates and peri-implant MBL after two years. The marginal bone resorption around tilted implants depended on their location. CLINICAL SIGNIFICANCE Screw-retained restorations fixed to straight and tilted implants seem to be a safe treatment option in posterior atrophic maxillae.
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Affiliation(s)
- Juan-Carlos Casar-Espinosa
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - Raquel Castillo-Oyagüe
- Department of Buccofacial Prostheses, Faculty of Dentistry, Complutense University of Madrid (U.C.M.), Pza. Ramón y Cajal, s/n, 28040, Madrid, Spain.
| | | | - Roberto Garrido-Serrano
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | | | - Manuel Menéndez-Collar
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - Daniel Torres-Lagares
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
| | - José-Luis Gutiérrez-Pérez
- Department of Stomatology, Faculty of Dentistry, University of Seville (US), C/Avicena, s/n, 41009, Seville, Spain
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Zhou W, Kuderer S, Liu Z, Ulm C, Rausch-Fan X, Tangl S. Peri-implant bone remodeling at the interface of three different implant types: a histomorphometric study in mini-pigs. Clin Oral Implants Res 2017; 28:1443-1449. [DOI: 10.1111/clr.13009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Wenjuan Zhou
- Department of Implant Dentistry; Yantai Stomatological Hospital; Binzhou Medical University; Yantai China
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research; Department of Oral Surgery; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
- Competence Center for Periodontal Research; Division of Conservative Dentistry and Periodontology; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Sonja Kuderer
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research; Department of Oral Surgery; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
- Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Zhonghao Liu
- Department of Implant Dentistry; Yantai Stomatological Hospital; Binzhou Medical University; Yantai China
| | - Christian Ulm
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research; Department of Oral Surgery; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
- Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Xiaohui Rausch-Fan
- Competence Center for Periodontal Research; Division of Conservative Dentistry and Periodontology; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
| | - Stefan Tangl
- Karl Donath Laboratory for Hard Tissue and Biomaterial Research; Department of Oral Surgery; University Clinic of Dentistry; Medical University of Vienna; Vienna Austria
- Austrian Cluster for Tissue Regeneration; Vienna Austria
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Sarmast ND, Wang HH, Ma R, Carrion JA, Iacono VJ. Retrieval of Displaced Implant Attributable to an Ill-Fitting Denture From the Maxillary Sinus Six Months After Transcrestal Sinus Floor Augmentation and Implant Placement. Clin Adv Periodontics 2016; 6:175-181. [PMID: 31535482 DOI: 10.1902/cap.2016.150086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/21/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Asymptomatic displacement of dental implants into the maxillary sinus after a transcrestal sinus augmentation is a rare complication that can occur when there is poor bone quality and minimal residual bone height. Patient compliance with postoperative appointments and failure to comply with denture-wearing instructions are critical contributing factors. To the best of the authors' knowledge, no cases of implant dislodgement attributable to a removable prosthesis have been reported in the literature, although some studies have suggested that improper occlusal forces can cause a long-standing implant to develop peri-implantitis and subsequent displacement of an implant into the sinus cavity. CASE PRESENTATION A 71-year-old female presented 6 months after undergoing transcrestal sinus lift and implant surgery that involved a modified Summers technique using mineralized solvent-dehydrated cancellous bone allograft and placement of six maxillary implants. A displaced dental implant was retrieved from the right maxillary sinus, which had an intact Schneiderian membrane. The patient was asymptomatic and infection free. The displaced implant was accessed and retrieved via a lateral window sinus technique. No clinical signs of sinus infection were evident, and there were no additional complications during the 2-year follow-up period. CONCLUSION This case report demonstrates a technique for the retrieval of implants that have been dislodged and migrated into the maxillary sinus cavity caused by an ill-fitting denture and improper masticatory forces.
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Affiliation(s)
- Nima D Sarmast
- Department of Periodontics and Dental Hygiene, University of Texas School of Dentistry at Houston, Houston, TX
| | - Howard H Wang
- Department of Periodontology, Stony Brook University School of Dental Medicine, Stony Brook, NY
| | - Rui Ma
- Private practice, Fairfield, CT
| | - Julio A Carrion
- Department of Periodontology, Stony Brook University School of Dental Medicine, Stony Brook, NY
| | - Vincent J Iacono
- Department of Periodontology, Stony Brook University School of Dental Medicine, Stony Brook, NY
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Comparative Finite Element Analysis of Short Implants and Lateralization of the Inferior Alveolar Nerve With Different Prosthesis Heights. J Craniofac Surg 2015; 26:2342-6. [PMID: 26491923 DOI: 10.1097/scs.0000000000002083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The lateralization of the inferior alveolar nerve (LIAN) and short implants are efficient options for rehabilitation of the posterior atrophic mandible. However, the loss of bone leads to prosthesis with greater height and lever effect that in turn can have different impact on treatments. Through the finite element method, the present study tests the hypothesis that conventional implants placed under LIAN and short implants have similar risk of bone loss regarding variable height of the crown and that crown-to-implant ratio is not a reliable resource to evaluate risk in these treatments. Computed tomography scans of mandibles were processed and implants and prosthetic components were reverse engineered for reconstruction of three-dimensional models to simulate 3 elements fixed partial dentures supported by 2 osseointegrated implants. The models of implants were based on MK III implants (Nobel Biocare, Zurich, Switzerland) with 4 mm in diameter by 7 mm in length representing short implants, and 15 mm in length representing implants used in LIAN. The implant/crown ratio for short implants was 1:1.5, 1:2, and 1:2.5 and LIAN models were modeled with exactly the same prosthesis, resulting in implant/crown ratios of 1:0.67, 1:0.89, and 1:1.12. The results partially rejected the hypothesis that LIAN and short implants have similar risk of bone loss, showing that although LIAN results were better in the models evaluated, the variations in height had proportionally similar impact on both treatments and accepted the hypothesis that crown-to-implant ratio was not a reliable resource to evaluate risk.
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