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Disha V, Čelebić A, Peršić S, Papić M, Rener-Sitar K. Orofacial esthetics, chewing function, and oral health-related quality of life in Kennedy class I patients with mini-implant-retained removable partial dentures: A 3-year clinical prospective study. Clin Oral Investig 2024; 28:353. [PMID: 38825621 DOI: 10.1007/s00784-024-05741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/24/2024] [Indexed: 06/04/2024]
Abstract
This prospective clinical study aimed to assess self-reported orofacial esthetics, chewing function, and oral health-related quality of life (OHRQoL) over three years in the Kennedy Class I patients without posterior dentition who received free-end saddle removable partial dentures (RPDs) retained by two mini dental implants (MDIs) inserted in the canine/first premolar region. The study's robust findings reaffirm the viability of MDI-retained RPDs as a treatment modality in contemporary prosthodontics, instilling confidence in the dental community. MATERIALS AND METHODS 92 participants with posterior edentulism in the maxilla or mandible received 184 MDIs and 92 RPDs. After one year, three participants were excluded, and another seven were excluded after three years. The final sample was 82 participants. Self-perceived orofacial esthetics was assessed by the Orofacial Esthetic Scale (OES), chewing function by the Chewing Function Questionnaire (CFQ), and the OHRQoL by the OHIP-14. Statistical analysis utilized multivariate regression analysis, standardized effect size calculation, Wilcoxon Signed Rank test, and Friedman's test. RESULTS OHRQoL and chewing function significantly improved (p < 0.001) one month after MDI loading by the new RPDs and continued to improve over the observation period (p < 0.05). The OES also significantly improved (p < 0.001) and remained almost unchanged over the next three years (p = 0.440). CONCLUSION Despite the limitations of this study, the MDI-retained RPD appears to be a viable treatment modality in contemporary prosthodontics from the patients' perspective.
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Affiliation(s)
- Visar Disha
- Department of Dentistry, Medical Faculty, Clinics of Prosthodontics, Pristina, Republic of Kosovo.
| | - Asja Čelebić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Sanja Peršić
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Milan Papić
- Department of Quantitative Methods in Business and Economy, Libertas International University, Zagreb, Croatia
| | - Ksenija Rener-Sitar
- Department for Prosthodontics, Dental Division, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department for Prosthetic Dentistry, University Dental Clinics, University Medical Center of Ljubljana, Ljubljana, Slovenia
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Yang Q, Fan Z, Tang P, Jiang Y, Han M, Li L. Characteristics of mandibular anterior alveolar bone in patients with different degrees of periodontitis: a retrospective study based on CBCT. Clin Oral Investig 2023; 27:6709-6721. [PMID: 37777638 DOI: 10.1007/s00784-023-05280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/24/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To investigate the alveolar bone characteristics of mandibular anterior teeth in patients with periodontitis. MATERIALS AND METHODS 100 patients with periodontitis were selected and grouped according to the degrees of alveolar bone resorption, age, gender, and tooth type. The labial thickness of the alveolar bone, the degree of alveolar bone resorption, angulation between the long axis of teeth and alveolar process, alveolar bone height and density of the mandibular anterior teeth were measured. RESULTS There were significant differences in alveolar bone morphology between these three groups. Compared with the mild and moderate groups, the severe group showed that the alveolar bone in the half of the root crown was thickened, the alveolar bone height was decreased, the cancellous alveolar bone density was increased, and the cortical alveolar bone density was decreased. The resorption of alveolar bone was characterized by greater resorption of proximal bone than that of labial bone with increased bone loss. There were also differences in alveolar bone characteristics among patients of different ages, genders, and tooth types. CONCLUSIONS The morphology of the mandibular anterior alveolar bone changed accordingly with the degree of periodontitis. Labial alveolar bone thickness and cortical alveolar bone density were negatively correlated with the degree of periodontitis, while alveolar bone height and cancellous alveolar bone density were positively correlated with the degree of periodontitis. CLINICAL RELEVANCE These results allow clinicians to better understand the alveolar bone morphology of the mandibular anterior teeth in patients with periodontitis, facilitating better treatment design and avoiding complications.
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Affiliation(s)
- Qi Yang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Zixin Fan
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Pengzhou Tang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Yue Jiang
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China
| | - Minxuan Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
- Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
| | - Lu Li
- Department of Periodontics, Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, 210029, China.
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Araújo MG, Dias DR, Matarazzo F. Anatomical characteristics of the alveolar process and basal bone that have an effect on socket healing. Periodontol 2000 2023; 93:277-288. [PMID: 37533162 DOI: 10.1111/prd.12506] [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: 01/31/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 08/04/2023]
Abstract
Following tooth extraction, a sequence of events takes place in order to close the wound and restore tissue homeostasis, a process called socket healing. The outcome of socket healing includes a marked reduction of the ridge dimensions. The amount of tissue loss that occurs during healing is influenced by several local and systemic factors. Thus, the aim of the present review was to describe the effect of anatomical characteristics of the alveolar process and basal bone on the socket healing outcome. The studies included showed that the quantity (number) and quality (composition) of socket walls exhibited a significant influence on the ridge diminution. A damaged socket (3 walls or less), as well as a thin buccal bone wall, which quickly resorbs negatively affected the healing outcome. Periodontally compromised sockets appeared to promote more extensive dimensional changes. Angulation between tooth and basal bone in addition to basal bone dimensions may also have altered the wound environment and influenced socket healing. The findings from the present review suggest that some anatomical characteristics of the alveolar process and basal bone have an effect on socket healing.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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de Elío Oliveros J, Gago García A, López Sacristán H, Truchuelo Díez P, Barrilero Martín C, Del Canto Díaz M, Del Canto Pingarrón M. Insertion Torque and Resonance Frequency Analysis in Tapered and Parallel Dental Implants. J ORAL IMPLANTOL 2023; 49:347-354. [PMID: 37527177 DOI: 10.1563/aaid-joi-d-21-00305] [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: 11/14/2021] [Revised: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 08/03/2023]
Abstract
Primary implant stability (PIS) is known to vary with recipient bone mass and density, dental implant design and surgical technique. The objective of this preliminary study was to compare rotational and lateral PIS of same-coronal-diameter conical and parallel implants, using insertion torque recorded with a dental implant motor set and implant stability quotient obtained from resonance frequency analysis (performed with both Osstell and Penguin systems) as measures of rotational and lateral stability, respectively. Additionally, the relationship between PIS and alveolar ridge width (ARW) was explored in both implant types. Sixty dental implants (30 tapered and 30 parallel) were randomly placed with a split-mouth design in 17 patients. Bone density and ARW were estimated from cone beam computed tomography images taken with radiological-surgical templates. Density and width values were similar in the 2 groups (P > .05). Implant coronal diameters were 3.75 mm in all cases, while consistent with the manufacturer's recommendations, final drill bit diameters used were 3.25 and 3.4 mm for parallel and tapered implants, respectively. Insertion torque was higher (P < .05) with parallel implants, but between-group differences in implant stability quotient were not significant (P > .05). In tapered implants, insertion torque was inversely correlated with ARW (P < .001). Notably, significant differences were observed between resonance frequency analysis values from Osstell and Penguin systems (P < .001). In conclusion, future studies should explore how PIS may be influenced by final drill bit size regardless of implant design and potential limits on the effectiveness of tapered implants to achieve good stability in thick low-density bone.
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Rai S, Misra D, Misra A, Tomar H, Dhawan A, Gupta R. Reliability of Grayscale Value for Bone Density Determination in Oral Rehabilitation using Dental Implants. Int J Appl Basic Med Res 2023; 13:143-148. [PMID: 38023594 PMCID: PMC10666835 DOI: 10.4103/ijabmr.ijabmr_3_23] [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: 01/02/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Quality and quantity of jaw bones have been previously classified in literature using different methods. Imaging modalities such as computed tomography (CT), successfully determine bone density of jaws. This study aims to establish the role of cone-beam CT (CBCT) in determining the density of cortical and cancellous bones at different jaw sites. Materials and Methods Eighty-three possible implant sites in healthy patients were evaluated using NewTomGiano CBCT machine. Cross-sections were obtained and cortical and cancellous bone densities on different aspects of the virtual implant in terms of Hounsfield unit (HU) were determined using New Net Technologies software version 6.1 and were classified according to software from D1 to D4. Data were entered into SPSS software (version 19.0) and were statistically analyzed. Results The mean HU showed the highest value for cortical and cancellous in the anterior mandible (mean HU 1874.01 and 1131.73, respectively) followed by the posterior mandible (mean HU 1789.20 and 872.95, respectively) and least in posterior maxilla (mean HU 1068.26 and 830.04, respectively). Maximum D1 bone type was found in cortical bone and D2 bone type was noted in cancellous bone area. Males showed very highly significant cortical bone thickness (P < 0.001) whereas females showed more cancellous bone thickness but the results were nonsignificant. Conclusion A high degree of concordance between different regions of jaw bones with a strong correlation between the four bone types was obtained. Bone density plays a pivotal role in determining the prognosis of the implant. CBCT has proven to be beneficial in bone density analysis.
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Affiliation(s)
- Shalu Rai
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Deepankar Misra
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Akansha Misra
- Department of Oral Pathology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Himanshi Tomar
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Ayush Dhawan
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Rohit Gupta
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
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Bone resorption after maxillary reconstruction with the vascularized free iliac flap. Int J Oral Maxillofac Surg 2023; 52:430-435. [PMID: 36008218 DOI: 10.1016/j.ijom.2022.08.010] [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: 12/03/2021] [Revised: 07/24/2022] [Accepted: 08/09/2022] [Indexed: 11/20/2022]
Abstract
The aim of this study was to evaluate the resorption of the iliac bone after maxillary reconstruction with a vascularized free iliac flap. Twenty-seven patients with maxillary defects who underwent maxillary reconstruction with the vascularized free iliac flap between January 2017 and January 2021 were included. Computed tomography (CT) images taken at 1 week, approximately 6 months, and 1 year after the surgery were used for evaluation. The total iliac bone thickness and height, cortical bone thickness, and cancellous bone density were measured in the CT images. Compared with 1 week after the surgery, the total thickness and height of the iliac bone were reduced significantly 1 year after the surgery, and the cortical bone thickness and cancellous bone density were reduced significantly at 6 months and 1 year after the surgery. Compared with 6 months after the surgery, cancellous bone density was reduced significantly 1 year after the surgery. In conclusion, during the first year after maxillary reconstruction with a vascularized free iliac flap, there was significant resorption of iliac bone, including the total iliac bone thickness and height, the cortical bone thickness, and the cancellous bone density.
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Olmedo-Gaya MV, Romero-Olid MN, Ocaña-Peinado FM, Vallecillo-Rivas M, Vallecillo C, Reyes-Botella C. Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04962-y. [PMID: 36977760 DOI: 10.1007/s00784-023-04962-y] [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: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. MATERIAL AND METHODS This randomized controlled clinical trial enrolled 108 patients (n=108 implants) distributed in three study groups: group 1 (n=36) underpreparation technique, group 2 (n=36) expander technique, and group 3 (n=36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. RESULTS ISQ values were associated with the patient's bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences (p<0.0001). Lower stability results were obtained when conventional drilling (69.31) was used compared to the use of underpreparation (74.29) or expanders (73.99) with a level of significance of p=0.008 and p=0.005, respectively. CONCLUSIONS The surgical technique influences the PS when there is low-quality bone. In low-quality bones, conventional drilling obtains lower ISQ values. CLINICAL RELEVANCE Replace the conventional drilling technique for an alternative, underpreparation or expanders, in low-quality bone in order to achieve greater primary stability.
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Affiliation(s)
| | | | | | | | - Cristina Vallecillo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.
- Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071, Granada, Spain.
| | - Candela Reyes-Botella
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
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Alhayati JZ, Al-Anee AM. Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ < 6.0 mm. A prospective clinical study. Oral Maxillofac Surg 2022:10.1007/s10006-022-01071-0. [PMID: 35567659 DOI: 10.1007/s10006-022-01071-0] [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: 01/25/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the efficacy of Versah drills in breaching the maxillary sinus floor while keeping the membrane intact, as well as measure the implant stability (primary stability at the time of implant placement by the osseous densification of the residual bone height (RBH) of ≥ 2.0 _ < 6.0 mm, and secondary stability after 6 months of osseous healing period). METHODS This prospective clinical study, which included twenty crestal sinus floor elevations, was conducted on 17 patients (10 males and 7 females, ages 29 to 70 years). The sinus membrane integrity was clinically checked at the time of osseodensification sinus lifting and confirmed by CBCT after sinus augmentation and implant insertion. Time of operation has been recorded from the first drill to implant installation. Primary implant stability was measured using an Osstell beacon at the time of implant placement, and secondary stability was measured after 6 months of osseous healing. RESULTS The mean of secondary stability in the current study is significantly higher than the mean of primary stability (P ≤ 0.011), which was 74.22 ± 8.11 and 69.85 ± 9.74, respectively, in RBH 3.81 mm as a mean. There was no clinical evidence of membrane perforation or complication reports, and the average operation time was 11.2 ± 1.85 min. CONCLUSION The current study found that at highly atrophic posterior maxilla with a residual bone height of ≥ 2.0 _ < 6.0 mm, osseodensification using Versah drills was effective in crestal sinus elevation with no membrane perforation, which was confirmed by cone-beam CT scan postoperatively, and showed higher primary and secondary implant stability.
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Affiliation(s)
- Jenna Z Alhayati
- Department of Oral & Maxillofacial Surgery/Dental Implant Unit, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Auday M Al-Anee
- Department of Oral & Maxillofacial Surgery/Dental Implant Unit, College of Dentistry, University of Baghdad, Baghdad, Iraq. .,Oral & Maxillofacial Surgery, Medical City, Al-Shaheed Gazi Alhariri Teaching Hospital for Specialized Surgeries, Baghdad, Iraq.
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Effect of bone quality and quantity on the primary stability of dental implants in a simulated bicortical placement. Clin Oral Investig 2020; 25:1265-1272. [PMID: 32651646 PMCID: PMC7878229 DOI: 10.1007/s00784-020-03432-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/24/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Conventional dental implants inserted in the molar region of the maxilla will reach into the sinus maxillaris when alveolar ridge height is limited. When surgery is performed without prior augmentation of the sinus floor, primary stability of the implant is important for successful osseointegration. This study aimed at identifying the impact of bone quality and quantity at the implantation site on primary implant stability of a simulated bicortical placement. MATERIALS AND METHODS In our in vitro measurements, bone mineral density, total bone thickness and overall cortical bone thickness were assessed by micro-computed tomography (μCT) of pig scapulae, which resembled well the bicortical situation found in human patients. Dental implants were inserted, and micromotion between bone and implant was measured while loading the implant with an axial torque. RESULTS The main findings were that primary implant stability did not depend on total bone thickness but tended to increase with either increasing bone mineral density or overall cortical bone thickness. CLINICAL RELEVANCE Limited bone height in the maxilla is a major problem when planning dental implants. To overcome this problem, several approaches, e.g. external or internal sinus floor elevation, have been established. When planning the insertion of a dental implant an important aspect is the primary stability which can be expected. With other factors, the dimensions of the cortical bone might be relevant in this context. It would, therefore, be helpful to define the minimum thickness of cortical bone required to achieve sufficient primary stability, thus avoiding additional surgical intervention.
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Schnutenhaus S, Brunken L, Edelmann C, Dreyhaupt J, Rudolph H, Luthardt RG. Alveolar ridge preservation and primary stability as influencing factors on the transfer accuracy of static guided implant placement: a prospective clinical trial. BMC Oral Health 2020; 20:178. [PMID: 32600405 PMCID: PMC7322921 DOI: 10.1186/s12903-020-01155-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this prospective clinical study was to investigate differences between virtually planned and clinically achieved implant positions in completely template-guided implant placements as a function of the tooth area, the use of alveolar ridge preservation, the implant length and diameter, and the primary implant stability. Methods The accuracy of 48 implants was analyzed. The implants were placed in a completely template-guided manner. The data of the planned implant positions were superimposed on the actual clinical implant positions, followed by measurements of the 3D deviations in terms of the coronal (dc) and apical distance (da), height (h), angulation (ang), and statistical analysis. Results The mean dc was 0.7 mm (SD: 0.3), the mean da was 1.4 mm (SD: 0.6), the mean h was 0.3 mm (SD: 0.3), and the mean ang was 4.1° (SD: 2.1). The tooth area and the use of alveolar ridge preservation had no significant effect on the results in terms of the implant positions. The implant length had a significant influence on da (p = 0.02). The implant diameter had a significant influence on ang (p = 0.04), and the primary stability had a significant influence on h (p = 0.02). Conclusion Template-guided implant placement offers a high degree of accuracy independent of the tooth area, the use of measures for alveolar ridge preservation or the implant configuration. A clinical benefit is therefore present, especially from a prosthetic point of view. Trial registration German Clinical Trial Register and the International Clinical Trials Registry Platform of the WHO: DRKS00005978; date of registration: 11/09/2015.
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Affiliation(s)
- Sigmar Schnutenhaus
- Zentrum für Zahnmedizin Dr. Schnutenhaus MVZ GmbH [Center for Dentistry Dr. Schnutenhaus Community Health Center (CHC) GmbH], Breiter Wasmen 10, 78247, Hilzingen, Germany. .,Department for Dentistry, Clinic for Prosthodontics, Universität Ulm, Department für Zahnheilkunde, Klinik für Zahnärztliche Prothetik [Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - Liesa Brunken
- Department for Dentistry, Clinic for Prosthodontics, Universität Ulm, Department für Zahnheilkunde, Klinik für Zahnärztliche Prothetik [Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Cornelia Edelmann
- Zentrum für Zahnmedizin Dr. Schnutenhaus MVZ GmbH [Center for Dentistry Dr. Schnutenhaus Community Health Center (CHC) GmbH], Breiter Wasmen 10, 78247, Hilzingen, Germany
| | - Jens Dreyhaupt
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie [Ulm University, Institute of Epidemiology and Medical Biometry], Schwabstr. 13, 89075, Ulm, Germany
| | - Heike Rudolph
- Department for Dentistry, Clinic for Prosthodontics, Universität Ulm, Department für Zahnheilkunde, Klinik für Zahnärztliche Prothetik [Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Ralph G Luthardt
- Department for Dentistry, Clinic for Prosthodontics, Universität Ulm, Department für Zahnheilkunde, Klinik für Zahnärztliche Prothetik [Ulm University, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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