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Liu L, Yu WH, Li XT, Zhao H, Yang JJ. Clinical application study of immediate implantation without bone grafting in maxillary molars: a clinical study with one-year follow up. Br J Oral Maxillofac Surg 2021; 60:332-336. [PMID: 34742603 DOI: 10.1016/j.bjoms.2021.07.023] [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: 04/14/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Our aim was to evaluate the clinical effect and feasibility of immediate implant placement combined with flap surgery with no bone grafting and non-submerged healing in the maxillary molar area. Thirty-five patients with failed single teeth in the molar area were selected. After minimally invasive extraction of the tooth, the flaps were elevated, and an implant inserted immediately; thereafter a healing abutment was connected. The mucoperiosteal flaps were sutured around the abutment without tension, and a permanent repair was performed six months later. During the study period, the implant survival rate, cone-beam computed tomography (CBCT) data, torque value, and the results of a subjective satisfaction survey conducted with a visual analogue scale (VAS), were evaluated to assess the procedure's therapeutic effect and feasibility. All 35 teeth were successfully implanted immediately after flap surgery. The mean (SD) torque value was 42.79 (5.70) N∙cm at the time of placement. During the six-month follow up and after one year of restoration, all 35 teeth showed no loosening, shedding of implants and restoration, or inflammation around the site. The mean (SD) value of the bony space around the implant immediately after the operation was 2.47 (0.56) mm. The bony spaces were filled with new bone after six months postoperatively. The mean (SD) VAS for satisfaction was 8.71 (1.05). Immediate implant placement combined with flap surgery without bone grafting and non-submerged healing is feasible for the maxillary molar area and produces a satisfactory clinical effect.
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Affiliation(s)
- Lu Liu
- The Affiliated Hospital of Qingdao University, Department of Oral and Maxillofacial Surgery, NO. 16 Jiangsu Road, Qingdao, Shandong 266003, China; School of Stomatology of Qingdao University, Qingdao 266003, China
| | - Wen-Hui Yu
- The Affiliated Hospital of Qingdao University, Department of Oral and Maxillofacial Surgery, NO. 16 Jiangsu Road, Qingdao, Shandong 266003, China; School of Stomatology of Qingdao University, Qingdao 266003, China
| | - Xi-Tao Li
- The Affiliated Hospital of Qingdao University, Department of Oral and Maxillofacial Surgery, NO. 16 Jiangsu Road, Qingdao, Shandong 266003, China; School of Stomatology of Qingdao University, Qingdao 266003, China
| | - Hui Zhao
- The Affiliated Hospital of Qingdao University, Department of Oral and Maxillofacial Surgery, NO. 16 Jiangsu Road, Qingdao, Shandong 266003, China; School of Stomatology of Qingdao University, Qingdao 266003, China
| | - Jian-Jun Yang
- The Affiliated Hospital of Qingdao University, Department of Oral and Maxillofacial Surgery, NO. 16 Jiangsu Road, Qingdao, Shandong 266003, China.
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El Chaar E, White C, Salama T, Andrawis A. Quantifying the Emergence Profile Contour for Immediate Provisionalization: A Proposed Mathematical Model. J ORAL IMPLANTOL 2021; 47:191-198. [PMID: 33201184 DOI: 10.1563/aaid-joi-d-20-00338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Identifying the ideal position of the final restoration prior to implant surgery is essential for optimal esthetics. The study of the emergence contour design of implant restorations has been limited. The aim of this report is to compile the factors that affect the final esthetic outcome and integrate those factors into an easy-to-use model. This geometric model includes a linear distance created by the placement of an implant platform in relation to the free gingival margin and a circle representing the emergence profile to create an emergence curve. If this model is evaluated and available, a practitioner can make appropriate decisions based on 3-dimensional immediate implant concepts.
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Affiliation(s)
| | | | | | - Andrew Andrawis
- Ashman Department of Periodontology and Implant Dentistry, New York University, New York, NY; and private practice, New York, New Jersey
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Huang G, Pan ST, Qiu JX. The Clinical Application of Porous Tantalum and Its New Development for Bone Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2021; 14:2647. [PMID: 34070153 PMCID: PMC8158527 DOI: 10.3390/ma14102647] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 12/13/2022]
Abstract
Porous tantalum (Ta) is a promising biomaterial and has been applied in orthopedics and dentistry for nearly two decades. The high porosity and interconnected pore structure of porous Ta promise fine bone ingrowth and new bone formation within the inner space, which further guarantee rapid osteointegration and bone-implant stability in the long term. Porous Ta has high wettability and surface energy that can facilitate adherence, proliferation and mineralization of osteoblasts. Meanwhile, the low elastic modulus and high friction coefficient of porous Ta allow it to effectively avoid the stress shield effect, minimize marginal bone loss and ensure primary stability. Accordingly, the satisfactory clinical application of porous Ta-based implants or prostheses is mainly derived from its excellent biological and mechanical properties. With the advent of additive manufacturing, personalized porous Ta-based implants or prostheses have shown their clinical value in the treatment of individual patients who need specially designed implants or prosthesis. In addition, many modification methods have been introduced to enhance the bioactivity and antibacterial property of porous Ta with promising in vitro and in vivo research results. In any case, choosing suitable patients is of great importance to guarantee surgical success after porous Ta insertion.
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Affiliation(s)
| | | | - Jia-Xuan Qiu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China; (G.H.); (S.-T.P.)
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Li J, Jansen JA, Walboomers XF, van den Beucken JJ. Mechanical aspects of dental implants and osseointegration: A narrative review. J Mech Behav Biomed Mater 2019; 103:103574. [PMID: 32090904 DOI: 10.1016/j.jmbbm.2019.103574] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 09/23/2019] [Accepted: 11/29/2019] [Indexed: 12/28/2022]
Abstract
With the need of rapid healing and long-term stability of dental implants, the existing Ti-based implant materials do not meet completely the current expectation of patients. Low elastic modulus Ti-alloys have shown superior biocompatibility and can achieve comparable or even faster bone formation in vivo at the interface of bone and the implant. Porous structured Ti alloys have shown to allow rapid bone ingrowth through their open structure and to achieve anchorage with bone tissue by increasing the bone-implant interface area. In addition to the mechanical properties of implant materials, the design of the implant body can be used to optimize load transfer and affect the ultimate results of osseointegration. The aim of this narrative review is to define the mechanical properties of dental implants, summarize the relationship between implant stability and osseointegration, discuss the effect of metallic implant mechanical properties (e.g. stiffness and porosity) on the bone response based on existing in vitro and in vivo information, and analyze load transfer through mechanical properties of the implant body. This narrative review concluded that although several studies have presented the advantages of low elastic modulus or high porosity alloys and their effect on osseointegration, further in vivo studies, especially long-term observational studies are needed to justify these novel materials as a replacement for current Ti-based implant materials.
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Affiliation(s)
- Jinmeng Li
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
| | - John A Jansen
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
| | - X Frank Walboomers
- Department of Biomaterials, Radboudumc, P.O. Box 9101, 6500, Nijmegen, HB, the Netherlands
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Han Q, Wang C, Chen H, Zhao X, Wang J. Porous Tantalum and Titanium in Orthopedics: A Review. ACS Biomater Sci Eng 2019; 5:5798-5824. [PMID: 33405672 DOI: 10.1021/acsbiomaterials.9b00493] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Porous metal is metal with special porous structures, which can offer high biocompatibility and low Young's modulus to satisfy the need for orthopedic applications. Titanium and tantalum are the most widely used porous metals in orthopedics due to their excellent biomechanical properties and biocompatibility. Porous titanium and tantalum have been studied and applied for a long history until now. Here in this review, various manufacturing methods of titanium and tantalum porous metals are introduced. Application of these porous metals in different parts of the body are summarized, and strengths and weaknesses of these porous metal implants in clinical practice are discussed frankly for future improvement from the viewpoint of orthopedic surgeons. Then according to the requirements from clinics, progress in research for clinical use is illustrated in four aspects. Various creative designs of microporous and functionally gradient structure, surface modification, and functional compound systems of porous metal are exhibited as reference for future research. Finally, the directions of orthopedic porous metal development were proposed from the clinical view based on the rapid progress of additive manufacturing. Controllable design of both macroscopic anatomical bionic shape and microscopic functional bionic gradient porous metal, which could meet the rigorous mechanical demand of bone reconstruction, should be developed as the focus. The modification of a porous metal surface and construction of a functional porous metal compound system, empowering stronger cell proliferation and antimicrobial and antineoplastic property to the porous metal implant, also should be taken into consideration.
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Affiliation(s)
- Qing Han
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Chenyu Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Hao Chen
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Xue Zhao
- Department of Endocrine and Metabolism, The First Hospital of Jilin University, Changchun, 130000 Jilin Province, China
| | - Jincheng Wang
- Department of Orthopedics, Second Hospital of Jilin University, Changchun, 130000 Jilin Province, China
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de Oliveira-Neto OB, Lemos CAA, Barbosa FT, de Sousa-Rodrigues CF, Camello de Lima FJ. Immediate dental implants placed into infected sites present a higher risk of failure than immediate dental implants placed into non-infected sites: Systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2019; 24:e518-e528. [PMID: 31232386 PMCID: PMC6667019 DOI: 10.4317/medoral.22954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background Alveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites. Material and Methods Seven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool. Results Of the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa=0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p= 0.04; 935 implants; i2= 0%). Peri-implant outcomes showed no statistical difference. Conclusions Immediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Peri-implant outcomes were not statistically affected in this intervention. Key words:Dental implants, infection, tooth socket, systematic review, immediate placement.
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Affiliation(s)
- O-B de Oliveira-Neto
- Department of Morphology, Anatomy Area, Piracicaba Dental School, University of Campinas, Av. Limeira, 901-Areião, Piracicaba, São Paulo, Brazil, Zip-Code: 13414-903,
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Natto ZS. Flapless Extraction and Immediate Implant Placed Into a Mandibular Molar Site: A Clinical Case Report and 5-Year Follow-Up. J ORAL IMPLANTOL 2019; 45:159-164. [DOI: 10.1563/aaid-joi-d-17-00154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Zuhair S. Natto
- Department of Dental Public Health, School of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Periodontology, School of Dental Medicine, Tufts University, Boston, Mass; Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University Boston, Mass
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Edelmann AR, Patel D, Allen RK, Gibson CJ, Best AM, Bencharit S. Retrospective analysis of porous tantalum trabecular metal-enhanced titanium dental implants. J Prosthet Dent 2018; 121:404-410. [PMID: 30396711 DOI: 10.1016/j.prosdent.2018.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The design of porous tantalum trabecular metal-enhanced titanium (TM) dental implants promises improved osseointegration, especially when grafting materials such as demineralized bone matrix are used; however, studies are lacking. PURPOSE The purpose of this retrospective study was to compare TM implants with conventional titanium alloy (Ti) implants with and without demineralized bone matrix in terms of peri-implant bone remodeling in the first year after implant loading. MATERIAL AND METHODS A chart review was used for all patients receiving Tapered Screw-Vent Ti and TM implants. Implants were placed and restored by a single provider between 2011 and 2015. Peri-implant bone remodeling was compared by using a paired t test (α=.05). RESULTS A total of 82 patients received 205 implants, 44 TM and 161 Ti implants (control). No implants failed in the TM group (survival rate of 100%), and 3 implants in total, 1 immediate, failed in the Ti groups (survival rate of 98.1%). TM implants exhibited a 0.28-mm bone gain on average, whereas the control group demonstrated 0.20 mm of marginal bone loss after the first year of implant loading. Multivariate logistic regression analysis demonstrated that the odds of having bone loss was 64% less (odds ratio: 0.36; 95% confidence interval: 0.14-0.94) in the TM group than in the Ti group after controlling for bone grafting, implant location, immediate placement, bone type, and pretreatment bone level. CONCLUSIONS TM implants exhibited less peri-implant bone loss than the control Ti implants.
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Affiliation(s)
- Alexander R Edelmann
- Resident, Department of Orthodontics, School of Dentistry, University of Texas Health Science Center, Houston, Texas
| | - Devang Patel
- Former doctoral student, Department of Prosthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Riley K Allen
- Research Assistant, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Chad J Gibson
- Undergraduate Research Assistant, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Al M Best
- Professor and Director of Faculty Research Development, Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Sompop Bencharit
- Associate Professor and Director of Digital Dentistry Technologies, Department of General Practice and Department of Oral and Maxillofacial Surgery, School of Dentistry; and Department of Biomedical Engineering, School of Engineering, Virginia Commonwealth University, Richmond, Va.
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