1
|
Rushinek H, Cohen A, Casap N, Alterman M. The Effect of Implant-Associated Factors on the Long-Term Outcomes of Dental Implants. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00075-X. [PMID: 39384509 DOI: 10.1016/j.coms.2024.08.009] [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: 10/11/2024]
Abstract
The long-term outcomes of dental implants are influenced by a variety of factors, all of which play critical roles in their stability, functionality, and esthetic appeal. This review focuses on several key characteristics of dental implants that impact their success overtime: dimensional, morphologic, material, osseointegrative, and connective/prosthetic characteristics. This article synthesizes current literature to analyze how these factors influence the long-term success of dental implants, emphasizing the need for a comprehensive approach in implant selection and placement.
Collapse
Affiliation(s)
- Heli Rushinek
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Adir Cohen
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Nardy Casap
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Michael Alterman
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem 9112102, Israel; Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel.
| |
Collapse
|
2
|
Andrade CS, de Abreu Costa L, Menechelli LG, Lemos CAA, Okamoto R, Verri FR, de Souza Batista VE. Biomechanical effects of different materials for an occlusal device on implant-supported rehabilitation in a tooth clenching situation: A 3D finite element analysis. J Prosthodont 2024; 33:706-713. [PMID: 37675950 DOI: 10.1111/jopr.13763] [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: 04/19/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023] Open
Abstract
PURPOSE The purpose of this 3D finite element analysis was to evaluate the biomechanical effects of different materials used to fabricate occlusal devices to achieve stress distribution in simulated abutment screws, dental implants, and peri-implant bone tissue in individuals who clench their teeth. MATERIALS AND METHODS Eight 3D models simulated a posterior maxillary bone block with three external hexagon implants (Ø4.0 × 7.0 mm) supporting a 3-unit screw-retained metal-ceramic prosthesis with different crown connection (splinting), and the use of an occlusal device (OD). The OD was modeled to be 2-mm thick. ANSYS 19.2 software was used to generate the finite-element models in the pre-and post-processing phases. Simulated abutment screws and dental implants were evaluated by von Mises stress maps, and simulated bone was evaluated by maximum principal stress and microstrain maps by using a finite element software program. RESULTS The highest stress values in the dental implants and screws were observed in single crowns without OD (M1). Furthermore, the highest stress values and bone tissue strain were found in single crowns without OD (M1). The simulated material for the OD did not cause many discrepancies in terms of the stress magnitude in the simulated dental implant and abutment screw for both single and splinted crowns; however, more rigid materials exhibited lower stress values. CONCLUSION The use of OD was effective in reducing stress in the simulated implants and abutment screws and stress and strain in the simulated bone tissue. The material used to simulate the OD influenced the biomechanical behavior of implant-supported fixed prostheses, whereas splints with rigid materials such as PEEK and PMMA exhibited better biomechanical behavior.
Collapse
Affiliation(s)
- Carla Souza Andrade
- Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
| | - Luy de Abreu Costa
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Luana Gonçalves Menechelli
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora, Campus Avançado Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Universidade Estadual Paulista Júlio de Mesquita Filho, School of Dentistry at Araçatuba, Araçatuba, Brazil
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| | - Victor Eduardo de Souza Batista
- Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo - UNOESTE, Presidente Prudente, Brazil
- Postgraduate Program in Dentistry - Implantology concentration area, Araçatuba Dental School, São Paulo State University Júlio de Mesquita Filho-UNESP, Araçatuba, Brazil
| |
Collapse
|
3
|
Changrani R, Patankar A, Patankar SA, Kulkarni P, Sharma A. Short Implants and Indirect Sinus Lift Versus Direct Sinus Lift With Standard-Length Implants: A Case Report. Cureus 2024; 16:e65197. [PMID: 39176339 PMCID: PMC11340658 DOI: 10.7759/cureus.65197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/24/2024] Open
Abstract
The choice of implant length in relation to the available bone quality and quantity and biting force is a critical factor in the success of implants and longevity of the prosthesis. Long implants have always been considered more desirable in this respect but in patients with advanced alveolar bone resorption, their placement is problematic due to the anatomic boundaries. This holds more true in relation to the posterior maxilla wherein the residual crestal bone height is usually compromised due to pneumatizing sinus floor. In this study, we have incorporated the use of short implants in conjunction with indirect sinus lift for cases with severely resorbed posterior maxillary edentulous regions to avoid direct sinus lift surgery and increase patient comfort. A 63-year-old patient had tooth 16 missing and wanted implant rehabilitation. The residual alveolar bone height was 3 mm. Short implant placement after indirect sinus lift was achieved with good primary stability. Prosthetic loading was performed after six months. One year follow-up showed no complaints or discomfort. In cases where the residual alveolar bone height of the edentulous space in the posterior maxilla was less than 4 mm, the use of indirect sinus lift with placement of short implants (height < 6 mm) proved to be advantageous over a direct sinus lift procedure with delayed placement of standard-length implants. This technique was less time-consuming, less surgically morbid, and more economical. The patient compliance was superior and no complaints were faced in a one-year follow-up period.
Collapse
Affiliation(s)
- Rachel Changrani
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Amod Patankar
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Swapna A Patankar
- Oral Pathology and Microbiology, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Pranjali Kulkarni
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Amisha Sharma
- Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| |
Collapse
|
4
|
Rocha RS, Vianna CP, Trojan LC, Padovan LEM, Dos Santos MCGL. Comparison of sinusitis rate after sinus lift procedure and zygomatic implant surgery: a meta-analysis. Oral Maxillofac Surg 2024; 28:63-77. [PMID: 37266797 DOI: 10.1007/s10006-023-01159-1] [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: 01/19/2023] [Accepted: 05/13/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate and compare the reported sinusitis occurrence after the sinus lift procedure and zygomatic implant placement. METHODS This meta-analysis has been registered at PROSPERO. Studies were searched on six databases. Two authors screened titles and abstracts and fully analyzed the studies against the inclusion and exclusion criteria. The RoB 2.0 and the ROBINS-I tools were used to assess the quality and risk of bias of the included studies. The random-effects model was used for the meta-analysis. The prevalence of sinusitis was calculated based on the total of patients. Subgroup analysis was performed by sinus lift or zygomatic implant surgery technique. RESULTS The search identified 2419 references. After applying the inclusion criteria, 18 sinus lift and 9 zygomatic implant placement studies were considered eligible. The pooled prevalence of sinusitis after sinus lift procedure was 1.11% (95% CI 0.30-2.28). The prevalence after zygomatic implant placement was 3.76% (95% CI 0.12-10.29). In the subgroup analysis, the lateral window approach showed a prevalence of sinusitis of 1.35% (95% CI 0.34-2.8), the transcrestal technique of 0.00% (95% CI 0.00-3.18), and the SALSA technique of 1.20% (95% CI 0.00-5.10). Regarding the techniques for zygomatic implant placement, the sinus slot technique showed a prevalence of 21.62% (95% CI 9.62-36.52) and the intrasinus technique of 4.36% (95% CI 0.33-11.08), and the prevalence after the extrasinus technique was 0.00% (95% CI 0.00-1.22). CONCLUSION The sinusitis occurrence rate was higher after zygomatic implant placement than after sinus lift procedure and this occurrence was different depending on the used technique.
Collapse
Affiliation(s)
- Roberta Schroder Rocha
- Graduate Program in Cell and Molecular Biology, Cellular and Molecular Biology Department, Federal University of Paraná, Av. Cel. Francisco H. dos Santos, 100, Paraná, 81530-000, Curitiba, Brazil.
| | | | | | | | | |
Collapse
|
5
|
Bérczy K, Göndöcs G, Komlós G, Shkolnik T, Szabó G, Németh Z. Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study. Maxillofac Plast Reconstr Surg 2024; 46:6. [PMID: 38416263 PMCID: PMC10902233 DOI: 10.1186/s40902-024-00419-8] [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: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants. METHODS Patients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed. RESULTS Thirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally). CONCLUSIONS In this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.
Collapse
Affiliation(s)
- Kinga Bérczy
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary.
| | - György Göndöcs
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Komlós
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Tatiana Shkolnik
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Szabó
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Zsolt Németh
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| |
Collapse
|
6
|
Correia F, Gouveia S, Felino AC, Faria-Almeida R, Pozza DH. Maxillary Sinus Augmentation with Xenogenic Collagen-Retained Heterologous Cortico-Cancellous Bone: A 3-Year Follow-Up Randomized Controlled Trial. Dent J (Basel) 2024; 12:33. [PMID: 38392237 PMCID: PMC10887795 DOI: 10.3390/dj12020033] [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: 11/06/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
Sinus augmentation procedures have become a valuable solution for patients with posterior maxillary edentulism. The objective of this study was to explore the efficacy and safety of porcine xenograft with collagen supplementation as a potential alternative to autologous bone grafts in lateral sinus augmentation over a three-year follow-up period. Twelve patients, each with bilateral posterior maxillary edentulism, were enrolled and randomly allocated to receive either a porcine xenograft or an autologous graft. Comprehensive assessments, including clinical and radiographic evaluations, were conducted at specific intervals, including implant stability, marginal bone loss, prosthetic and biological complications, and patient preferences. The results demonstrated no significant differences between the two graft materials in terms of implant survival, marginal bone loss, and patient preferences after three years of follow-up. Only one implant was affected by peri-implantitis, and prosthesis-related complications were present in one patient possibly due to bruxism. In conclusion, these findings suggest that a porcine xenograft with collagen supplementation may be a viable alternative to an autograft in lateral sinus augmentation procedures. The high implant survival rate, minimal complications, and patient satisfaction indicate the potential clinical relevance of this graft material and should be further investigated to confirm these promising results.
Collapse
Affiliation(s)
- Francisco Correia
- Specialization in Periodontology and Implants, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Sónia Gouveia
- Department of Electronics, Telecommunications and Informatics (DETI), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, 3810-193 Aveiro, Portugal
- Intelligent Systems Associate Laboratory (LASI), Portugal, 4800-058 Guimarães, Portugal
| | - António Campos Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Ricardo Faria-Almeida
- Specialization in Periodontology and Implants, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
- Associated Laboratory for Green Chemistry (LAQV) of the Network of Chemistry and Technology (REQUIMTE), 4050-342 Porto, Portugal
| | - Daniel H Pozza
- Experimental Biology Unit, Department of Biomedicine, Faculty of Medicine of Porto, University of Porto, 4200-319 Porto, Portugal
- Institute for Research and Innovation in Health and IBMC (i3S), University of Porto, 4200-135 Porto, Portugal
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Lisa DK, Flore D, Gaetan VDV, Yannick S, Constantinus P. Survival rate of implants following maxillary sinus floor augmentation using freeze-dried allografts vs bovine derived xenografts: A retrospective multicenter study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101605. [PMID: 37573966 DOI: 10.1016/j.jormas.2023.101605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION This study aims to compare the surgical and clinical complications, and the dental implant survival rate after maxillary sinus floor augmentation using demineralized freeze-dried bone allografts (DFDBA) versus bovine derived xenografts. MATERIAL AND METHODS A retrospective study enrolled 107 patients (52 males and 55 females, mean age group 1: 54,4 years; group 2: 56,4 years) requiring maxillary bone reconstruction prior to implantation. A total of 141 sinuses were grafted and 191 implants were placed. Data on various variables, including patient characteristics, implant placement details, and outcomes, were collected through medical records and patient questionnaires. RESULTS The study found no significant differences in implant survival rates between the two groups (94,0% versus 94,4%; p = 0,919). Overall complications were observed in 19.6% of patients, with a higher incidence in the allograft group (23,6% versus 15,4%; p = 0,283). Multiple logistic regression analysis identified a two-stage surgical protocol (OR= 2,8; p = 0,045), and a preoperative alveolar ridge height of less than 4 mm (OR= 5,3; p = 0,004) as significant predictors of complications. The risk of implant failure was raised by a preoperative alveolar ridge height of less than 4 mm (OR= 6,1; p = 0,038) and smoking (OR= 5,8; p = 0,012). DISCUSSION DFDBA is a reliable treatment option for extensive rehabilitation of atrophic maxilla, with a success rate comparable to xenografts used in sinus augmentation. Implant failure was significantly correlated with smoking and a residual ridge height of less than 4 mm.
Collapse
Affiliation(s)
- De Kock Lisa
- Department of Oral and Maxillofacial Surgery, University hospital of Ghent, Ghent, Belgium.
| | - Dons Flore
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Van de Vyvere Gaetan
- Department of Oral and Maxillofacial Surgery, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium
| | - Spaey Yannick
- Department of Oral and Maxillofacial Surgery, Noorderhart Mariaziekenhuis, Pelt, Belgium
| | - Politis Constantinus
- OMFS-IMPATH research group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven and Maxillofacial Surgery Department, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
9
|
Anitua E, Eguia A, Alkhraisat MH. Extra-short implants (≤ 6.5 mm in length) in atrophic and non-atrophic sites to support screw-retained full-arch restoration: a retrospective clinical study. Int J Implant Dent 2023; 9:29. [PMID: 37702800 PMCID: PMC10499764 DOI: 10.1186/s40729-023-00499-7] [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: 05/26/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Increasing scientific evidence support extending the application of short dental implants to non-atrophic dental arches. The purpose of this study has been the evaluation of extra-short implants (≤ 6.5 mm in length) that were placed in atrophic and non-atrophic anatomical sites to support the same prosthesis. METHODS For that, a retrospective study was conducted by including complete dentures that were solely supported by extra-short implants in the maxilla and/or the mandible. Clinical data about patients, implants, anatomy, and prosthesis were obtained. Statistical analysis was performed to assess implant- and prosthesis-survival, changes in the marginal bone level and prosthetic complications. RESULTS A total of 87 implants in 15 screw-retained complete dentures were assessed. None of the prostheses nor the extra-short implant failed during the follow-up of 27.2 ± 15.4 months. The changes in the mesial and distal marginal bone level were + 0.15 ± 0.51 mm and + 0.11 ± 0.50 mm, respectively. Comparing the implants according to the availability of sufficient bone to place longer implants, indicated the absence of significant differences in the changes of the mesial marginal bone level. However, the changes in the distal marginal bone level showed a statistically significant difference in favor of implants that were placed in non-atrophic sites. Two events of screw loosening were reported that were resolved by retightening the screws. CONCLUSIONS Implant- and prosthesis-related outcomes support the use of extra-short implants in atrophic and non-atrophic site to support complete prosthesis.
Collapse
Affiliation(s)
- Eduardo Anitua
- Private Practice in Oral Implantology, Clínica Eduardo Anitua Foundation, C/ Jose Maria Cagigal 19, 01007, Vitoria, Spain.
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain.
- BTI Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- University of the Basque Country UPV/EHU, Leioa (Bizkaia), Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- BTI Biotechnology Institute, Vitoria, Spain
| |
Collapse
|
10
|
Cao R, Chen B, Xu H, Fan Z. Clinical outcomes of titanium-zirconium alloy narrow-diameter implants for single-crown restorations: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2023; 61:403-410. [PMID: 37331853 DOI: 10.1016/j.bjoms.2023.05.005] [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: 06/23/2022] [Revised: 02/26/2023] [Accepted: 05/07/2023] [Indexed: 06/20/2023]
Abstract
Evidence is limited on whether titanium-zirconium alloy, narrow-diameter implants (Ti-Zr NDIs) have promising clinical outcomes when used to support single crowns. The purpose of this systematic review and meta-analysis was to evaluate clinical evidence, including survival rates, success rates, and marginal bone loss (MBL) on Ti-Zr NDIs that support single crowns. An extensive search was performed in the databases of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library for studies published in English up to April 2022. Only peer-reviewed clinical studies with at least 10 patients and a follow-up time of at least 12 months were included. Risk of bias in each study was assessed and data extraction was carried out independently by two reviewers. The outcome variables were survival rates, success rates, and MBL. The search returned 779 results. Eight studies were identified for qualitative analysis and seven for quantitative synthesis. Overall, a total of 256 Ti-Zr NDIs were included. Cumulative implant survival rates and success rates were 97.5% (95% confidence interval (CI): 94.5% to 98.9%) and 97.2% (95% CI: 94.2% to 98.7%), respectively, over a maximum follow-up period of 36 months, with no difference between Ti-Zr NDIs and commercial pure titanium (cpTi) implants. Cumulative mean (SD) MBL was 0.44 (0.04) mm (95% CI: 0.36 to 0.52) after one year. Meta-analysis of MBL indicated a mean difference of 0.02 mm (95% CI: -0.23 to 0.10), with no differences between Ti-Zr NDIs and cpTi implants. Short-term results of Ti-Zr NDIs for single-crown restorations are quite promising, although the number of published studies and follow-up periods are insufficient to determine the real benefit for single crowns. Long-term, follow-up clinical studies are needed to verify the excellent clinical performance of Ti-Zr NDIs.
Collapse
Affiliation(s)
- Rongkai Cao
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Beibei Chen
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Hui Xu
- School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China
| | - Zhen Fan
- Department of Oral Implantology, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
| |
Collapse
|
11
|
Correia F, Gouveia SA, Pozza DH, Felino AC, Faria-Almeida R. A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1220. [PMID: 36770223 PMCID: PMC9919245 DOI: 10.3390/ma16031220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 ± 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 ± 0.126, and test group with a mean of 0.092 ± 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.
Collapse
Affiliation(s)
- Francisco Correia
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Sónia Alexandre Gouveia
- Intelligent Systems Associate Laboratory (LASI), Department of Electronics, Telecommunications and Informatics (DETI), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Daniel Humberto Pozza
- Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Histology, Faculty of Nutrition and Food Sciences, University of Porto, 4150-177 Porto, Portugal
- Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal
| | - António Campos Felino
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Ricardo Faria-Almeida
- Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| |
Collapse
|
12
|
The Effectiveness of a Bioactive Healing Abutment as a Local Drug Delivery System to Impact Peri-Implant Mucositis: A Prospective Case Series Study. Pharmaceutics 2022; 15:pharmaceutics15010138. [PMID: 36678767 PMCID: PMC9866183 DOI: 10.3390/pharmaceutics15010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023] Open
Abstract
Modern dental therapy makes use of prosthetic implant reconstructions, which are supported or retained on dental implants. The most frequent, long-term complications associated with these prosthetic implants include mucositis and peri-implantitis. Since mucositis is the initial inflammation of tissues supporting the dental implant, the management of this condition is thus crucial. The aim of the present study was to assess the effects of the placement of bioactive healing abutment for 48 h, in patients diagnosed with peri-implant mucositis. Moreover, the quantitative and qualitative shift in the bacterial profile of the biofilm present in the peri-implant pockets, was assessed by means of RT-PCR genotyping. Each patient was examined using a commercially available PET test protocol: the first sample was taken upon diagnosis (after which the bioactive healing abutment, with clindamycin at a dose of 30 mg, was used for 48 h and replaced with the prosthetic superstructure used so far by a patient); the second sample was taken two weeks after removal of the bioactive healing abutment. The effects of the intervention were clinically assessed using the PET test after the two weeks. A significant reduction in mucositis was observed following treatment, as measured by periodontal indices: modified Sulcus Bleeding Index—mBI (p < 0.001), modified Plaque Index—PLI (r = 0.69, Z= −4.43; p < 0.001) and probing depth—PD (Z = −4.61; p < 0.001). Significant differences in the occurrence of periopathogenic bacteria were also observed: Aggregatibacter actinomycetemcomitans (p < 0.014; Z = −2.45; r = 0.38), Treponema denticola (p < 0.005; Z = −2.83; r = 0.44), Tannerella forsythia (p < 0.001; Z = −4.47; r = 0.69) and Porphyromonas gingivalis (p < 0.132; Z = −1.51).
Collapse
|
13
|
Batista RG, Faé DS, Bento VAA, Rosa CDDRD, Souza Batista VED, Pellizzer EP, Lemos CAA. Impact of tilted implants for implant-supported fixed partial dentures: A systematic review with meta-analysis. J Prosthet Dent 2022:S0022-3913(22)00739-9. [PMID: 36567158 DOI: 10.1016/j.prosdent.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
STATEMENT OF PROBLEM The use of tilted implants has been considered a suitable option for completely edentulous patients. However, consensus on their clinical performance is lacking, specifically for partial rehabilitation. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the marginal bone loss and implant survival rate of tilted implants compared with those of axial implants for implant-supported fixed partial dentures (ISFPDs). MATERIAL AND METHODS A systematic search of the MEDLINE/PubMed, Web of Science, Embase, Cochrane, and ProQuest databases and reference lists for articles published until May 2022 was performed by 2 independent reviewers without language or publication date restrictions. A meta-analysis was performed using the RevMan version 5.4 program. Quality assessments were performed using the Newcastle-Ottawa scale. RESULTS Nine studies were included, totaling 258 participants and 604 implants (269 tilted implants and 335 axial implants). No significant differences were found between the tilted and axial implants for the implant survival rate (P=.81; risk ratio: 1.14). However, higher marginal bone loss values were observed for tilted implants (P=.001; mean difference: 0.12 mm). No significant heterogeneity was observed in either analysis. CONCLUSIONS No significant relationship was found between tilted and axial implants for ISFPD rehabilitation. However, tilted implants presented greater risks of marginal bone loss than axial implants.
Collapse
Affiliation(s)
- Rhaslla Gonçalves Batista
- Graduate student, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate student, Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Victor Augusto Alves Bento
- Postgraduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil
| | - Cléber Davi Del Rey Daltro Rosa
- Postgraduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil
| | - Victor Eduardo de Souza Batista
- Professor, Department Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil
| | - Eduardo Piza Pellizzer
- Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State Univeristy (UNESP), Araçatuba, SP, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil.
| |
Collapse
|
14
|
Wang X, Sun L, Wang L, Shi S, Zhang S, Song Y. Predictors of peri-implant bone remodeling outcomes after the osteotome sinus floor elevation: a retrospective study. BMC Oral Health 2022; 22:622. [PMID: 36539789 PMCID: PMC9764540 DOI: 10.1186/s12903-022-02592-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the radiographic outcomes of implants after osteotome sinus floor elevation (OSFE), and further identify the separate predictors for these radiographic outcomes. METHODS In this retrospective cohort study, a total of 187 implants were inserted into 138 patients using the OSFE technique. Seventy-four patients in the grafted group, and 64 patients in the non-grafted group completed this study. The vertical bone gain (VBG) and marginal bone loss (MBL) at 3 years following surgery were assessed as outcome variables. Based on extensive literature results, variables considered potential predictors of outcome variables included sex, age, tooth position, implant length, implant diameter, with or without grafting materials, residual bone height, sinus width, bone density, and sinus membrane thickness. Subsequently, the binary logistic regression analysis was applied with VBG and MBL as dependent variables, respectively. The receiver operating characteristic curve (ROC) with its area under the curve (AUC) was performed to further determine the predictive value of these predictors. RESULTS One hundred and six implants in grafted group and 81 implants in the non-grafted group were analyzed. The average VBG was 2.12 ± 1.94 mm for the grafted group and 0.44 ± 1.01 mm for the non-grafted group at 3 years (P < 0.05). The mean MBL was 1.54 ± 1.42 mm for the grafted group and 1.13 ± 1.69 mm for the non-grafted group at 3 years (P > 0.05). After the adjustment for confounders, logistic regression analysis demonstrated that implant length, grafting, residual bone height, and sinus membrane thickness were predictors of VBG. The odds ratio for VBG was 3.90, 4.04, 4.13 and 2.62, respectively. Furthermore, grafting exhibited the largest AUC at 0.80. While tooth position and implant length were predictors of MBL, the odds ratio for MBL was 3.27 and 7.85, respectively. Meanwhile, implant length exhibited the largest AUC at 0.72. CONCLUSIONS OSFE with or without simultaneous grafting materials both showed predictable clinical outcomes. Additionally, the present study is the first quantitative and significant verification that VBG has a significant association with sinus membrane thickness, as well as residual bone height, implant length and grafting. Whereas tooth position and implant length are markedly associated with MBL.
Collapse
Affiliation(s)
- Xingxing Wang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lijuan Sun
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Lei Wang
- grid.43169.390000 0001 0599 1243Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, 710004 Shaanxi People’s Republic of China
| | - Shaojie Shi
- 920th Hospital of Joint Logistics Support Force, Kunming, People’s Republic of China
| | - Sijia Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| | - Yingliang Song
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Oral Implants, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 Shaanxi People’s Republic of China
| |
Collapse
|
15
|
Grunau O, Terheyden H. Lateral augmentation of the sinus floor followed by regular implants versus short implants in the vertically deficient posterior maxilla: a systematic review and timewise meta-analysis of randomized studies. Int J Oral Maxillofac Surg 2022:S0901-5027(22)00466-0. [DOI: 10.1016/j.ijom.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
|
16
|
Tang C, Du Q, Luo J, Peng L. Simultaneous placement of short implants (≤ 8 mm) versus standard length implants (≥ 10 mm) after sinus floor elevation in atrophic posterior maxillae: a systematic review and meta-analysis. Int J Implant Dent 2022; 8:45. [PMID: 36197540 PMCID: PMC9535054 DOI: 10.1186/s40729-022-00443-1] [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: 07/29/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The objective of this meta-analysis was to compare the clinical outcomes of using short implants (≤ 8 mm) inserted with osteotome sinus floor elevation (OSFE) and standard implants (≥ 10 mm) inserted with sinus floor elevation (SFE) in atrophic posterior maxillae with insufficient residual bone height (RBH). Methods An electronic search was performed on PubMed, EMBASE, and the Cochrane Library from 1994 to July 2022, in combination with a manual search of references in relevant articles. Randomized controlled trials (RCTs) that compared the clinical results between short and standard implant placement with SFE were included. The primary outcomes were implant survival rate and marginal bone loss (MBL); the secondary outcome was complication rate. Results Three RCTs were included, totaling 138 short and 156 standard implants. The results of the meta-analysis showed no significant differences between the short and standard implant groups in survival rate (RR = 1.02, 95% CI 0.96–1.08, p = 0.570), MBL (MD = − 0.13, 95% CI − 0.32 to 0.07, p = 0.190) and complication rate (intra-surgical complication: RR = 1.14, 95% CI 0.46–2.83, p = 0.770; post-operative complication: RR = 1.34, 95% CI 0.71–2.55, p = 0.370). Conclusions Using short implants (≤ 8 mm) combined with OSFE might be an alternative to standard implants (≥ 10 mm) with SFE when the RBH of the posterior maxilla is insufficient. Based on a short-term clinical observation, short implants with OSFE show good results in terms of survival rate, MBL, and complication incidence. Graphical Abstract ![]()
Collapse
Affiliation(s)
- Chenxi Tang
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Qianhui Du
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jiaying Luo
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
| |
Collapse
|
17
|
Antiua E, Escuer V, Alkhraisat MH. Short Narrow Dental Implants versus Long Narrow Dental Implants in Fixed Prostheses: A Prospective Clinical Study. Dent J (Basel) 2022; 10:dj10030039. [PMID: 35323241 PMCID: PMC8947067 DOI: 10.3390/dj10030039] [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: 01/18/2022] [Revised: 02/17/2022] [Accepted: 03/01/2022] [Indexed: 12/10/2022] Open
Abstract
There is a paucity of studies that assess short and narrow dental implants. This prospective study aimed to evaluate the performance of both short (≤8 mm) and narrow (≤3.5 mm width) dental implants supporting fixed prostheses in the atrophic maxilla or mandible. Towards that aim, patients with short implants were included in the study. The control group was those with long and narrow dental implants (length > 8 mm and diameter ≤ 3.5 mm). Clinical and demographic variables were extracted from clinical records. During the follow-up, implant survival and marginal bone loss were evaluated and statistically analysed. Forty-one implants were included (18 and 23 implants in the test and control groups, respectively). The median follow-up time was 26 months since insertion in both groups. The results revealed that there was no implant failure and no statistically significant differences in terms of marginal bone loss. Only one screw-loosening effect occurred in the short implants group. Short, narrow dental implants could be an alternative for the restoration of severely resorbed jaws.
Collapse
Affiliation(s)
- Eduardo Antiua
- Clínica Eduardo Anitua, 01007 Vitoria, Spain;
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
- BTI Biotechnology Institute, 01005 Vitoria, Spain
- Correspondence: (E.A.); (M.H.A.)
| | - Virginia Escuer
- Clínica Eduardo Anitua, 01007 Vitoria, Spain;
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
| | - Mohammad H. Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU—Fundación Eduardo Anitua), 01007 Vitoria, Spain
- BTI Biotechnology Institute, 01005 Vitoria, Spain
- Correspondence: (E.A.); (M.H.A.)
| |
Collapse
|
18
|
de Oliveira Fernandes GV, Costa BMGN, Trindade HF, Castilho RM, Fernandes JCH. Comparative analysis between extra‐short implants (≤ 6mm) and 6mm‐longer implants: A
Meta‐Analysis
of Randomized Controlled Trial. Aust Dent J 2022; 67:194-211. [DOI: 10.1111/adj.12900] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Rogerio M. Castilho
- University of Michigan Periodontics and Oral Medicine Department Ann Arbor Michigan U.S.A
| | | |
Collapse
|
19
|
Lucena Alves CP, Vetromilla BM, Moreno LB, Helal L, Sarkis‐Onofre R, Pereira‐Cenci T. Systematic reviews on the success of dental implants present low spin of information but may be better reported and interpreted: An overview of systematic reviews with meta‐analysis. Clin Implant Dent Relat Res 2022; 24:105-115. [DOI: 10.1111/cid.13067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/22/2021] [Accepted: 12/31/2021] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Laura Barreto Moreno
- Graduate Program in Dentistry Federal University of Pelotas Pelotas Rio Grande do Sul Brazil
| | - Lucas Helal
- Centre for Journalology, Clinical Epidemiology Program Ottawa Hospital Research Institute, The Ottawa Hospital Ottawa Ottawa Canada
| | - Rafael Sarkis‐Onofre
- Graduate Program in Dentistry Meridional Faculty/IMED Passo Fundo Rio Grande do Sul Brazil
| | - Tatiana Pereira‐Cenci
- Graduate Program in Dentistry Federal University of Pelotas Pelotas Rio Grande do Sul Brazil
| |
Collapse
|
20
|
The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis. J Prosthet Dent 2021; 126:497-502. [DOI: 10.1016/j.prosdent.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/23/2023]
|
21
|
Posterior jaws rehabilitation with < 7mm-short implants. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e45-e56. [PMID: 34563727 DOI: 10.1016/j.jormas.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/23/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The results with shorter and shorter implants have been revolutionizing the implantology scenario and are worthy of being well-analyzed and understood. This review aims to add further knowledge about the last 10-years observation period on < 7mm-short implants in the posterior atrophic jaws, better defining the indication of their use. METHODS From a Medline database research, systematic reviews, controlled and no- controlled trials (CT, n-CT) with ≥ 3years-follow-ups on <7 mm / ≥ 5mm-short implants (group A), and clinical studies with ≥ 1year-follow-up on 4mm-short implants (group B) were considered. The outcomes, in terms of implant survival rate (SR), marginal bone loss (MBL), and complications were analyzed according to the duration of follow-ups, implant site (maxilla and mandible), type of prosthesis (single crown or splinted units), vertically impaired or normal sites. RESULTS Thirty-four trials (28 for group A and six for group B) were selected. Group A: a mean follow up of 5,8 (3-10) years came out; pre-and post-loading SR range was 94.4- 100% and 89.6-100%, respectively; the range of MBL was 0.12-1.49; 50% of CT found less statistically significant surgical complications in comparison with standard implants (ST) in reconstructed sites, while major prosthetic problems were recorded with short -implants (SH) in 37.5% of CT; in no atrophied sites, a mean SR range of 86.7-100 % vs. 88-100 % and a total bone loss of 2 vs.1.6 for SH vs.ST emerged. Group B: the overall mean follow-up period was 2,3 years, and the pre-and post- SR ranges were 93-100 % and 87.5-100 %, respectively. The MBL range was 0.02- 0.63 mm. All RCT reported significantly fewer surgical complications with SH than with ST in reconstructed mandibles within one year. No prosthetic complications were reported for up to 5 years using no pontics or cantilevers fixed bridges. CONCLUSIONS Similar or even better results for SH than ST in terms of post-loading SR and MBL came out for < 7mm/ ≥ 5mm-short implants in atrophic bone regardless of the prosthetic solutions, with less surgical complications but a few more prosthetic problems; the good results up to 5 years for 4mm-short implants in mandibles are associated with splinted and no-risk prosthetic solutions.
Collapse
|
22
|
Meng T, Zhang X. Accuracy of intentionally tilted implant placement in the maxilla using dynamic navigation: a retrospective clinical analysis. Int J Oral Maxillofac Surg 2021; 51:552-557. [PMID: 34561112 DOI: 10.1016/j.ijom.2021.09.004] [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: 03/02/2021] [Revised: 07/03/2021] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
The aim of this retrospective study was to investigate the accuracy of dynamic navigation for the placement of intentionally tilted implants in the posterior maxilla. The study included 12 patients with edentulism or continuous multiple tooth loss, who had 48 implants inserted under dynamic navigation guidance in the posterior maxilla. Twenty-four implants near maxillary sinuses were intentionally tilted. The average platform deviation was 1.3 ± 0.4 mm (range 0.8-2.3 mm), apex deviation was 1.1 ± 0.5 mm (range 0.2-2.3 mm), and axis deviation was 3.1 ± 1.0° (range 1.8-6.7°). The other 24 implants were axially positioned. The average platform deviation was 1.5 ± 0.5 mm (range 0.7-3.1 mm), apex deviation was 1.3 ± 0.7 mm (range 0.5-3.1 mm), and axis deviation was 3.2 ± 1.5° (range 1.5-7.7°). There was no significant difference in platform deviation, apex deviation, or axis deviation between the tilted implants and implants in the axial position (P > 0.05). This analysis indicates that a dynamic navigation system can be used as a method of guidance to place intentionally tilted implants as accurately as axially positioned implants in the posterior maxilla, thereby preventing damage to the maxillary sinuses and the need to graft bone.
Collapse
Affiliation(s)
- T Meng
- First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Centre for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China
| | - X Zhang
- First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Centre for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| |
Collapse
|
23
|
Postoperative Morbidity and Complications in Elderly Patients after Harvesting of Iliac Crest Bone Grafts. MEDICINA-LITHUANIA 2021; 57:medicina57080759. [PMID: 34440965 PMCID: PMC8401410 DOI: 10.3390/medicina57080759] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 02/01/2023]
Abstract
Background and objectives: In oral and maxillofacial operations, the iliac crest is a commonly used donor site from which to harvest bone for augmentation prior to dental implantation or for reconstruction of jaw defects caused by trauma or pathological lesions. In an aging society, the proportion of elderly patients undergoing iliac crest bone grafting for oral augmentation is growing. Although postoperative morbidity is usually moderate to low, the age and health of the patient should be considered as risk factors for complications and delayed mobilization after the operation. The aim of this retrospective study was to evaluate the postoperative morbidity and complications in elderly patients after the harvesting of iliac crest bone grafts for oral surgery. Material and Methods: Data were collected from a total of 486 patients (aged 7–85) who had a surgical procedure that included the harvesting of iliac crest bone grafts for intraoral transplantation. All patients were operated on between 2005 and 2021 in the Department for Oral and Maxillofacial Surgery of the University Hospital in Aachen, Germany. As parameters for postoperative morbidity and complications, gait disturbances, hypesthesia of cutaneous nerves, incision hernias, iliac crest fractures, delayed wound healing, and unfavorable scar formation at the donor site were all evaluated. Results: The study was performed with 485 patients due to the exclusion of one patient as the only one from whom grafts were taken from both sides. When younger and older patients were compared, neither gait disturbances (p = 0.420), nor hernias (p = 0.239), nor fractures (p = 0.239), nor hypesthesia (p = 0.297), nor wound healing delay (p = 0.294), nor scar problems (p = 0.586) were significantly different. However, the volume of the graft was significantly correlated with the duration of the hospital stay (ρ = 0.30; p < 0.01) but not with gait disturbances (ρ = 0.60; p = 0.597). Additionally, when controlling for age (p = 0.841), sex (p = 0.031), ASA class (p = 0.699), preexisting orthopedic handicaps (p = 0.9828), and the volume of the bone graft (p = 0.770), only male sex was associated with the likelihood of suffering gait disturbances (p = 0.031). Conclusions: In conclusion, harvesting bone grafts from the anterior iliac crest for intraoral augmentation is a safe procedure for both young and elderly patients. Although there is some postoperative morbidity, such as gait disturbances, hypesthesia, scar formation, or delayed wound healing at the donor site, rates for these minor complications are low and mostly of short duration. Major complications, such as fractures or incision hernias, are very rare. However, in our study, the volume of the bone graft was associated with a longer stay in hospital, and this should be considered in the planning of iliac crest bone graft procedures.
Collapse
|
24
|
Immediate Post-Extraction Short Implant Placement with Immediate Loading and without Extraction of an Impacted Maxillary Canine: Two Case Reports. MATERIALS 2021; 14:ma14112757. [PMID: 34071018 PMCID: PMC8197076 DOI: 10.3390/ma14112757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
For the treatment of impacted maxillary canines, traction associated with a complete orthodontic treatment is the first choice in young patients. However, in adults, this treatment has a worse prognosis. The surgical extraction of the impacted tooth can result in a series of complications and a compromised alveolar bone integrity, which may lead to the requirement of a bone regeneration/grafting procedure to replace the canine with a dental implant. These case reports aimed to describe an alternative treatment procedure to the surgical extraction of impacted maxillary canines in adults. Following clinical and computerized tomography-scan (CT-Scan) examination, the possibility of maintaining the impacted canine in its position and replacing the temporary canine present in its place with a dental implant was planned. A short dental implant with an immediate provisional crown was placed, without contacting the impacted canine. At 3 months follow-up, a definitive metal-ceramic restoration was placed. Follow-up visits were performed periodically. The implant site showed a physiological soft tissue color and firmness, no marginal bone loss, no infection or inflammation, and an adequate aesthetic result in all follow-up visits. These results suggest that the treatment carried out is a valid option to rehabilitate with an osseointegrated short implant area where a canine is included, as long as there is a sufficient amount of the remaining bone.
Collapse
|
25
|
Lin ZZ, Jiao YQ, Ye ZY, Wang GG, Ding X. The survival rate of transcrestal sinus floor elevation combined with short implants: a systematic review and meta-analysis of observational studies. Int J Implant Dent 2021; 7:41. [PMID: 34013452 PMCID: PMC8134646 DOI: 10.1186/s40729-021-00325-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/17/2021] [Indexed: 12/16/2022] Open
Abstract
Background Currently, insufficient bone volume always occurs in the posterior maxilla which makes implantation difficult. Short implants combined with transcrestal sinus floor elevation (TSFE) may be an option to address insufficient bone volume. Purpose The clinical performance of short implants combined with TSFE was compared with that of conventional implants combined with TSFE according to the survival rate. Method In this systematic review and meta-analysis, we followed the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Articles were identified through PubMed, Embase, the Cochrane Library, and manual searching. Eligibility criteria included clinical human studies. The quality assessment was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The odds ratio (OR) with its confidence interval (CI) was considered the essential outcome for estimating the effect of short implants combined with TSFE. Results The registration number is INPLASY202050092. Eleven studies met the inclusion criteria, including 1 cohort study and 10 cross-sectional studies. With respect to the 1-year survival rate, no significant effect was observed between short implants (length ≤ 8 mm) and conventional implants combined with TSFE (I2=0%, OR=1.04, 95% CI: 0.55-1.96). Similarly, no difference was seen between the two groups regarding the survival rate during the healing period (I2=10%, OR=0.74, 95% CI: 0.28-1.97) and 3-year loading (OR=1.76, 95% CI: 0.65-4.74). Conclusion There was no evidence that the survival rate of short implants combined with TSFE was lower or higher than that of conventional implants combined with TSFE when the residual bone height was poor and the implant protrusion length of short implants was less than or similar to conventional implants. Nevertheless, the results should be interpreted cautiously due to the lack of random controlled trials in our meta-analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00325-y.
Collapse
Affiliation(s)
- Zhe-Zhen Lin
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Yan-Qing Jiao
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Zhang-Yan Ye
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Ge-Ge Wang
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Xi Ding
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China.
| |
Collapse
|
26
|
Shpachynskyi O, Didkovskij V, Kopchak A. Radiological changes in maxillary sinus morphology after lateral sinus floor augmentation. Otolaryngol Pol 2021; 74:1-5. [PMID: 32831187 DOI: 10.5604/01.3001.0014.1679] [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: 11/13/2022]
Abstract
<b>Background:</b> Restoration of the masticatory function in patients with edentulous posterior maxilla is often challenging due to the severe atrophy of the alveolar ridges and proximity of the maxillary sinus, resulting in insufficient bone quantity for implant-supported dentures. <br><b>Aim:</b> The purpose of this study was to analyze the changes in Schneiderian membrane thickness after lateral sinus floor augmentation (LSFA) using cone beam computed tomography (CBCT). <br><b>Material and methods:</b> WLSFA procedures using different bone grafting materials were performed in 87 patients, operated on in two clinical institutions from 2016 to 2018. CBCT examination was performed in all patients before the LSFA procedure, at 1 month after surgery, and after 6 months, before implant placement or loading. <br><b>Results: </b>Minor r adiological changes in mucous membrane morphology were observed preoperatively in 17.1% of patients. Postoperative CBCT in the early postsurgical period demonstrated that the number of intact non-specific sinuses decreased significantly, i.e. from 86.7% to 26.7%. The number of cases with local hypertrophia of the mucous membrane increased from 20.3% to 26.7%. Mucosal thickening was observed in 41.7% vs 7.5%. The number of intact sinuses increased to 57.8%. The number of cases with local membrane hypertrophia also increased - to 37.4%. The number of cases with mucosal thickening or fluid accumulation decreased significantly to 11.8 and 5.3% respectively. In 2 cases the development of chronic sinusitis required secondary surgeries. <br><b>Conclusion:</b> The present retrospective study revealed that minor radiological changes in the morphology of the maxillary sinus mucosa were observed preoperatively in 17.1% of patients who underwent LSFA procedures. In the early and late postoperative period their frequency increased to 68.5% and 47.1%, respectively. However, the clinical signs of sinusitis developed only in 19.26% of patients. No significant correlations were found between the frequency and severity of postoperative radiological changes and residual bone height, sinus anatomy, initial state of the mucous membrane and type of the grafting material.
Collapse
Affiliation(s)
| | - Viacheslav Didkovskij
- Department of otorhinolaryngology Bogomolets National Medical University, Kyiv, Ukraine Katedra Otolaryngologii
| | - Andrii Kopchak
- Department of Dentistry of Postgraduate Education of Bogomolets National Medical University, Kyiv, Ukraine
| |
Collapse
|
27
|
Clinical Outcome of Dental Implants after Maxillary Sinus Augmentation with and without Bone Grafting: A Retrospective Evaluation. MATERIALS 2021; 14:ma14102479. [PMID: 34064784 PMCID: PMC8151007 DOI: 10.3390/ma14102479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022]
Abstract
(1) Background: The purpose of the present study was to retrospectively evaluate and compare the outcome of two sinus augmentation grafting protocols using a xenograft or blood clot alone over a 72-month follow-up. (2) Methods: Patients who received simultaneous lateral sinus floor augmentation and implant placement were included. Subjects were divided into two groups according to the grafting material, namely xenograft or blood clot, and into sub-groups based on the residual alveolar bone height (RABH) below the maxillary sinus, namely 4 to 6 mm or >6 mm. Kaplan-Meier survival estimates were calculated for each material group and for each sub-group at 1, 3, and 6 years. (3) Results: In total, 289 implants inserted in 136 patients with a one-stage procedure were considered. A total of 35 failures were registered. Overall survival rates were 94.2% for xenograft and 85.9% for blood clot alone at 1 year, 91.1% and 81.6% at 3 years, and 91.1% and 78.7% at 6 years. (4) Conclusions: In patients with 4-6 mm RABH, graftless interventions exploiting blood clot alone were not as successful as those using xenograft. When the RABH is low, sinus floor augmentation associated with grafting materials should be preferred whenever possible.
Collapse
|
28
|
Decision-Making in Implantology-A Cross-Sectional Vignette-Based Study to Determine Clinical Treatment Routines for the Edentulous Atrophic Mandible. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041596. [PMID: 33567592 PMCID: PMC7915536 DOI: 10.3390/ijerph18041596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 11/26/2022]
Abstract
This cross-sectional study aimed to investigate the influence of possible factors in the patient history on decision making in the therapy for a severely atrophied edentulous mandible. A vignette-based survey among 250 maxillofacial and oral surgeons was conducted. Determinants that could influence the therapy decision were patient age, smoking, fear of surgery, and radiotherapy in the head and neck area (the implant region is not in the direct radiation area). To achieve a suitable implant site, the options offered to the surgeons were bone split, bone block, augmentation with bone substitute material, and bone resection. There also was the option of rejecting any therapy. The response rate was 47%. Patient age, radiotherapy, and fear of surgery did not influence the approval of a therapy. Smoking was associated with a significantly lower endorsement of a treatment. Resection was preferred by a large majority to all other forms of therapy, regardless of the four determinants. Surgeons tend to refrain from bone block transplants in older patients. In summary, it can be said that, of the four determinants, only smoking influenced treatment refusal. Bone resection is the preferred therapy independent of all determinants.
Collapse
|
29
|
Chaware SH, Thakare V, Chaudhary R, Jankar A, Thakkar S, Borse S. The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: A systematic review and meta-analysis of randomized controlled clinical trial. J Indian Prosthodont Soc 2021; 21:28-44. [PMID: 33835066 PMCID: PMC8061432 DOI: 10.4103/jips.jips_400_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/08/2020] [Accepted: 10/03/2020] [Indexed: 01/23/2023] Open
Abstract
Aim The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. Setting and Design Systematic review and meta analysis. Materials and Methods Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972). Statistical Analysis Used Random-effect model, fixed-effect model, A funnel plot and the Egger's test. Results Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I2 = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I2 = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I2 = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I2 = 0%). Conclusion There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.
Collapse
Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Vrushali Thakare
- Department of Public Health Dentistry, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Ritu Chaudhary
- Department of Prosthodontics, Royal College of Surgeons England, Britannia Dental Surgery, Newport, UK
| | - Ajit Jankar
- Department of Prosthodontics, MIDSR Dental College, Latur, Maharashtra, India
| | - Smruti Thakkar
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Sidesh Borse
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| |
Collapse
|
30
|
Comparative Analysis of Peri-Implant Bone Loss in Extra-Short, Short, and Conventional Implants. A 3-Year Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249278. [PMID: 33322472 PMCID: PMC7764541 DOI: 10.3390/ijerph17249278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 02/02/2023]
Abstract
Objective: To evaluate the influence of implant length on marginal bone loss, comparing implants of 4 mm, 6 mm, and >8 mm, supporting two splinted crowns after 36-month functional loading. Materials and Methods: this retrospective clinical trial evaluated the peri-implant behavior of splinted crowns (two per case) on pairs of implants of the same length placed in the posterior maxilla (molar area). Implants were divided into three groups according to length (Group 1: extra-short 4 mm; Group 2: short 6 mm; Group 3: conventional length >8 mm). Marginal bone loss was analyzed using standardized periapical radiographs at the time of loading and 36 months later. Results: 24 patients (19 women and 5 men) were divided into three groups, eight rehabilitations per group, in the position of the maxillary first and second molars. The 48 Straumann® Standard Plus (Regular Neck (RN)/Wide Neck (WN)) implants were examined after 36 months of functional loading. Statistical analysis found no significant differences in bone loss between the three groups (p = 0.421). No implant suffered biological complications or implant loss. Long implants were associated with less radiographic bone loss. Conclusions: extra-short (4 mm); short (6 mm); and conventional length (>8 mm) implants in the posterior maxilla present similar peri-implant bone loss and 100% survival rates in rehabilitation, by means of two splinted crowns after 36 months of functional loading. Implants placed in posterior positions present better bone loss results than implants placed in anterior positions, regardless of the interproximal area where bone loss is measured. Conventional length (>8 mm) implants show better behavior in terms of distal bone loss than short (6 mm) and extra-short (4 mm) implants.
Collapse
|
31
|
Cruz RS, Lemos CAA, de Batista VES, Yogui FC, Oliveira HFF, Verri FR. Narrow-diameter implants versus regular-diameter implants for rehabilitation of the anterior region: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 50:674-682. [PMID: 33158693 DOI: 10.1016/j.ijom.2020.10.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/16/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022]
Abstract
The aim of this systematic review and meta-analysis was to evaluate studies comparing implant survival rates, marginal bone loss (MBL), and mechanical and biological complication rates between narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) used for oral rehabilitation in the anterior region. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases for studies published until May 2020. A total of 843 implants (484 NDIs and 359 RDIs) were included. No significant difference in implant survival rate (risk difference (RD) 0.01, 95% confidence interval (CI) -0.01 to 0.03; P=0.34), MBL (standardised mean difference -0.51mm, 95% CI -1.29 to 0.26mm; P=0.19), mechanical complications (RD 0.01, 95% CI -0.02 to 0.04; P=0.40), or biological complications (RD 0.01, 95% CI -0.09 to 0.11; P=0.85) was found between the implant groups. Within the limitations of this study, it is concluded that NDIs are an effective alternative to RDIs due to similar survival rates, MBL, and mechanical and biological complication rates. However, future studies are highly encouraged due to the small number of interventional studies on this topic.
Collapse
Affiliation(s)
- R S Cruz
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil.
| | - C A A Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, MG, Brazil
| | - V E S de Batista
- Department of Prosthodontics, Presidente Prudente Dental School, University of the West of São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - F C Yogui
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
| | - H F F Oliveira
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
| | - F R Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, UNESP - Universidade Estadual Paulista, Campus of Aracatuba, Sao Paulo, Brazil
| |
Collapse
|
32
|
Iezzi G, Perrotti V, Felice P, Barausse C, Piattelli A, Del Fabbro M. Are <7‐mm long implants in native bone as effective as longer implants in augmented bone for the rehabilitation of posterior atrophic jaws? A systematic review and meta‐analysis. Clin Implant Dent Relat Res 2020; 22:552-566. [DOI: 10.1111/cid.12946] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/12/2020] [Indexed: 08/30/2023]
Affiliation(s)
- Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
| | - Pietro Felice
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Carlo Barausse
- Oral Surgery, Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences University of Chieti‐Pescara “Gabriele D'Annunzio” Chieti Italy
- Biomaterials Engineering Catholic University of San Antonio de Murcia (UCAM) Murcia Spain
- Fondazione Villaserena per la Ricerca Città Sant'Angelo Pescara Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences University of Milan Milan Italy
- Dental Clinic IRCCS Orthopedic Institute Galeazzi Milan Italy
| |
Collapse
|
33
|
Vetromilla BM, Mazzetti T, Pereira-Cenci T. Short versus standard implants associated with sinus floor elevation: An umbrella review of meta-analyses of multiple outcomes. J Prosthet Dent 2020; 126:503-511. [PMID: 32951871 DOI: 10.1016/j.prosdent.2020.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM Bone loss in the edentulous posterior maxilla complicates dental implant placement. In spite of the evidence available, there is continued uncertainty about the benefit of short implants for different outcomes. PURPOSE The purpose of this review was to evaluate the existing evidence for short and standard implants in association with sinus floor elevation regarding implant survival, marginal bone loss, and complications by using an umbrella review of the evidence across meta-analysis of interventional studies. MATERIAL AND METHODS Medline, Scopus, and Cochrane Library were searched to identify systematic reviews and meta-analyses comparing short implants and standard implants associated with sinus floor elevation. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. Outcomes were categorized and tabulated to assess effectiveness. Qualitative data were analyzed using thematic synthesis. The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS From 2011 studies, 7 systematic reviews (66 studies) were included as per the eligibility criteria. There was no statistically significant difference between groups for implant survival (risk ratio=1.08; P=.79), and the qualitative analysis did not show differences for prosthetic outcomes. Standard implants were associated with fewer prosthetic complications in the quantitative analysis (risk ratio=3.27; P<.01), but no difference was found between the treatments in the qualitative analysis. Short implants showed reduced marginal bone loss (0.98 ±0.12 mm; mean difference=-0.22; P<.01) and better biologic outcomes (risk ratio=0.16; P<.01). Patient satisfaction was similar for both groups, whereas costs and time for the procedure favored short implants. The quality of the evidence was graded as "critically low" (57.1% of the reviews) and "low." There was a high certainty of evidence for implant survival, whereas marginal bone loss and complications had moderate certainty. CONCLUSIONS Short implants had a better or equal performance compared with standard implants for all outcomes assessed. However, assumptions were based on reviews with low or critically low quality of the evidence, suggesting the development of high-quality systematic reviews in this field.
Collapse
Affiliation(s)
- Bruna M Vetromilla
- Graduate student, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Thais Mazzetti
- Graduate student, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Tatiana Pereira-Cenci
- Associate Professor, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
34
|
Tian Y, Li Z, Chen J, Yuan X, Sadowsky SJ, Coyac BR, Brunski JB, Helms JA. Mechano-adaptive Responses of Alveolar Bone to Implant Hyper-loading in a pre-clinical in vivo model. Clin Oral Implants Res 2020; 31:1159-1172. [PMID: 32882082 DOI: 10.1111/clr.13662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/19/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Oral implants transmit biting forces to peri-implant bone. In turn, those forces subject peri-implant bone to mechanical stresses and strains. Here, our objective was to understand how peri-implant bone responded to conditions of normal versus hyper-loading in a mouse model. MATERIAL AND METHODS Sixty-six mice were randomly assigned to 2 groups; both groups underwent bilateral maxillary first molar extraction followed by complete healing. Titanium alloy implants were placed in healed sites and positioned below the occlusal plane. After osseointegration, a composite crown was affixed to the implant so masticatory loading would ensue. In controls, the remaining dentition was left intact but in the hyper-loaded (test) group, the remaining molars were extracted. 3D finite element analysis (FEA) calculated peri-implant strains resulting from normal and hyper-loading. Peri-implant tissues were analyzed at multiple time points using micro-computed tomography (µCT) imaging, histology, enzymatic assays of bone remodeling, and vital dye labeling to evaluate bone accrual. RESULTS Compared to controls, hyper-loaded implants experienced a 3.6-fold increase in occlusal force, producing higher peri-implant strains. Bone formation and resorption were both significantly elevated around hyper-loaded implants, eventually culminating in a significant increase in peri-implant bone volume/total volume (BV/TV). In our mouse model, masticatory hyper-loading of an osseointegrated implant was associated with increased peri-implant strain, increased peri-implant bone remodeling, and a net gain in bone deposition. CONCLUSION Hyper-loading results in bone strain with catabolic and anabolic bone responses, leading to a net gain in bone deposition.
Collapse
Affiliation(s)
- Ye Tian
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Zhijun Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinlong Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Xue Yuan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Steven J Sadowsky
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA.,Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, USA
| | - Benjamin R Coyac
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - John B Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Jill A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Palo Alto, CA, USA
| |
Collapse
|
35
|
Yogui FC, Verri FR, de Luna Gomes JM, Lemos CAA, Cruz RS, Pellizzer EP. Comparison between computer-guided and freehand dental implant placement surgery: A systematic review and meta-analysis. Int J Oral Maxillofac Surg 2020; 50:242-250. [PMID: 32921557 DOI: 10.1016/j.ijom.2020.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/05/2020] [Accepted: 08/12/2020] [Indexed: 11/15/2022]
Abstract
The purpose of this systematic review was to compare computer-guided (fully guided) and freehand implant placement surgery in terms of marginal bone loss, complications, and implant survival. This review followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42019135893). Two independent investigators performed the search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published up to April 2020 and identified 1508 references. After a detailed review, only four studies were considered eligible. These studies involved a total of 154 patients with 597 dental implants and a mean follow-up period of 2.25 years. There was no difference between computer-guided surgery and freehand surgery in terms of the marginal bone loss (mean difference -0.11mm, 95% confidence interval (CI) -0.27 to 0.04mm; P=0.16), mechanical complications (risk ratio (RR) 0.85, 95% CI 0.36-2.04; P=0.72), biological complications (RR 1.56, 95% CI 0.42-5.74; P=0.51), and implant survival rate (RR 0.53, 95% CI 0.11-2.43; P=0.41). This meta-analysis demonstrated that both computer-guided and freehand surgeries yielded similar results for marginal bone loss, mechanical and biological complications, and implant survival rate.
Collapse
Affiliation(s)
- F C Yogui
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil.
| | - F R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil
| | - J M de Luna Gomes
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil
| | - C A A Lemos
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil
| | - R S Cruz
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil
| | - E P Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Universidade Estadual Paulista, Araçatuba, Brazil
| |
Collapse
|
36
|
Short vs. Standard Length Cone Morse Connection Implants: An In Vitro Pilot Study in Low Density Polyurethane Foam. Symmetry (Basel) 2019. [DOI: 10.3390/sym11111349] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of the investigation was to evaluate the insertion torque, pull-out torque and implant stability quotient (ISQ) of short implants (SI) and standard length implants (ST) inserted into linearly elastic and constitutive isotropic symmetry polyurethane foam blocks. Short dental titanium implants with a Cone Morse connection and a conical shape (test implants: Test Implant A—diameter 5.5 mm and length 6 mm) (Test Implant B—diameter 5.5 mm and length 5 mm) were used for the present in vitro investigation. ST implants (4 mm diameter and 10 mm length), with a Cone Morse connection and a conical shape, were used as Control Implant A and as Control Implants B. These two latter implants had a different macro design. A total of 20 implants (5 Test A, 5 Test B, 5 Control A and 5 Control B) were used for the present research. The results were similar when comparing the Test A and Test B implants. The test implants had very good stability in polyurethane 14.88–29.76 kgm3 density blocks. The insertion torque values were very high for both types of test implant (25–32 Ncm on 14.88 kgm blocks, and up to 45 Ncm in 29.76 kgm3 blocks). The pull-out test values were very similar to the insertion torque values. The ISQ values were significantly high with 75–80 in 14.88 kgm3 blocks, and 78–83 in 29.76 kgm3 blocks. No differences were found in the values of the Control A and Control B implants. In both these implants, the insertion torque was quite low in the 14.88 kgm3 blocks (16–28 Ncm). Better results were found in the 29.76 kgm3 blocks. The pull-out values for these control implants were slightly lower than the insertion torque values. High ISQ values were found in both control implants (57–80). When comparing SI and ST implants, the SI had a similar if not better performance in low quality polyurethane foam blocks (14.88–29.76 kgm), corresponding to D3 and D4 bone.
Collapse
|
37
|
Comuzzi L, Iezzi G, Piattelli A, Tumedei M. An In Vitro Evaluation, on Polyurethane Foam Sheets, of the Insertion Torque (IT) Values, Pull-Out Torque Values, and Resonance Frequency Analysis (RFA) of NanoShort Dental Implants. Polymers (Basel) 2019; 11:polym11061020. [PMID: 31185590 PMCID: PMC6630510 DOI: 10.3390/polym11061020] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/05/2019] [Accepted: 06/07/2019] [Indexed: 12/16/2022] Open
Abstract
Objectives: The aim of this study was to investigate, in polyurethane foam sheets, the primary implant stability of a NanoShort implant compared to a self-condenser implant and to a standard, conventional implant. Materials and Methods: Three implant designs were evaluated in the present in vitro investigation: The Test implant (NanoShort), the Control A implant (self-condenser), and the Control B implant (standard design). The study was conducted by comparing the insertion torque values, the pull-out strength values, and the resonance frequency analysis (RFA) values of the Test and Control A and B implants inserted in polyurethane foam models of different thicknesses and densities. The foam densities were 10, 20, and 30 pounds per cubic foot (pcf). Three thicknesses of polyurethane foams (1, 2, 3 mm) were evaluated for a total of 640 experimental sites. Results: The Pearson correlation showed a moderate/strong correlation between all study groups (r > 0.3) for insertion torque and pull-out strength levels. Increased stability of the Test implants was obtained in 3 mm polyurethane sheets. The 2.5 and 3.5 mm Test implants presented good stability in 3 mm polyurethane sheets of 20–30 pcf densities. The Control implants showed better results compared to the Test implants in 1, 2, and 3 mm polyurethane sheets with densities of 10, 20, and 30 pcf. Conclusions: The NanoShort dental implant evaluated in this in vitro study showed a high level of stability in some experimental conditions, and could represent a useful tool, especially in the posterior mandible, as an alternative to vertical augmentation procedures.
Collapse
Affiliation(s)
- Luca Comuzzi
- Private practice, via Raffaello 36/a, 31020 San Vendemiano (TV), Italy.
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
- Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Av. de los Jerónimos, 135, 30107 Guadalupe, Murcia, Spain.
- Villaserena Foundation for Research, Via Leonardo Petruzzi 42, 65013 Città Sant'Angelo (PE), Italy.
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
| |
Collapse
|