1
|
Pascoal ALDB, Paiva KRG, Marinho LCN, Bezerra ADS, Calderon PDS. Impact of splinting implant-supported crowns on the performance of adjacent posterior implants: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00373-1. [PMID: 38955598 DOI: 10.1016/j.prosdent.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/24/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024]
Abstract
STATEMENT OF PROBLEM While rehabilitation with implant-supported crowns in the posterior region is widely practiced, guidance on clinical considerations when choosing between splinted or nonsplinted implant-supported crowns is limited. PURPOSE The purpose of this systematic review with meta-analysis was to assess whether adjacent implants with internal connections in the posterior region should be treated with splinted or nonsplinted crowns. MATERIAL AND METHODS The systematic review was registered on the prospective register of systematic reviews (PROSPERO) under the code, CRD42021248525. Two authors searched 4 electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) independently for articles published up to December 2023. Additionally, a hand search was conducted in the nonpeer-reviewed literature and the reference lists of included articles. Only clinical studies comparing splinted and nonsplinted hexagonal or conical internal connection adjacent implants in the posterior region were considered. A single-arm meta-analysis was conducted using RevMan. Risk of bias and quality were assessed using the Cochrane Collaboration's Tool for Assessing Risk and the Newcastle-Ottawa scale. RESULTS Qualitative synthesis included 17 studies, and quantitative synthesis involved 13 studies. A total of 2085 implants (1244 splinted and 841 nonsplinted) were inserted in 1027 participants, with observation times ranging from 5 months to 16 years. Thirteen studies related the type of crown retention (cemented or screw-retained). Only 2 studies related annual bone loss results considering the type of crown retention, but whether they were splinted or nonsplinted crowns and significant differences were not specified. The meta-analysis revealed no statistical differences between splinted and nonsplinted implants for biological complications (P=.95, I2=0%). However, the nonsplinted implants exhibited significantly more mechanical complications than the splinted implants (P<.001, I2=1%, RR 0.37; 95% IC [0.26-0.54]). The studies included demonstrated a low risk of bias and were of good quality. CONCLUSIONS Splinting was not found to affect the incidence of biological complications in posterior adjacent implants. However, more mechanical complications occurred in nonsplinted crowns than splinted ones.
Collapse
Affiliation(s)
- Ana Luísa de Barros Pascoal
- Temporary Assistant Professor, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | | | | | - Aliane da Silva Bezerra
- Postgraduate student, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.
| | | |
Collapse
|
2
|
Ahumada-DeGirolamo D, Azocar A, Delpiano-Mesina C, Maldonado-Cortés P, Muñoz MA, Luque-Martínez I, Bravo-Gallardo F. Splinting or non-splinting of fixed prostheses on adjacent implants: A critical review. J Prosthodont Res 2024; 68:206-214. [PMID: 37648482 DOI: 10.2186/jpr.jpr_d_22_00220] [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] [Indexed: 09/01/2023]
Abstract
PURPOSE The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted. STUDY SELECTION A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart. RESULTS A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design. CONCLUSIONS The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
Collapse
Affiliation(s)
| | - Andrea Azocar
- Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Carlos Delpiano-Mesina
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Pedro Maldonado-Cortés
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| | - Miguel Angel Muñoz
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Issis Luque-Martínez
- Dental Materials Department, Research Center in Dental and Medical Sciences, Faculty of Dentistry, Universidad de Valparaíso, Valparaíso, Chile
| | - Francisco Bravo-Gallardo
- Oral Rehabilitation Department, Faculty of Dentistry, Universidad de Valparaiso, Valparaíso, Chile
| |
Collapse
|
3
|
Al-Juboori MJ, Al-Attas MA, Minichetti J, Akhikar J. The Use of Splinted Versus Nonsplinted Prosthetic Design in Dental Implants: A Literature Review. J ORAL IMPLANTOL 2024; 50:50-64. [PMID: 38329841 DOI: 10.1563/aaid-joi-d-23-00077] [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] [Indexed: 02/10/2024]
Abstract
The choice of a splinted or nonsplinted implant-supported prosthesis should be based on solid scientific evidence that considers the conditions and needs of each patient. This review elaborates on the factors that directly influence clinical decisions between splinted or nonsplinted dental implants. Digital and manual searches of the published literature were conducted to identify studies that examined splinted prostheses (SPs) and nonsplinted prostheses (NSPs). The search terms used, alone or in combination, were "splinting prosthesis," "nonsplinting prosthesis," "prosthetic design," "stress distribution in dental implant," "implant loading," "implant occlusion," and "crestal bone resorption." Ninety-four studies were selected to compare and address the details emphasized in this study. Thirty-four reported articles were not directly related to restoration design but were reviewed to better understand the influence of mechanical risk factors, finite element analysis limits, and criteria for implant survival and treatment success. There are advantages and disadvantages of splinting implants together. NSPs are the ideal choice because they resemble natural teeth. Splinting a restored implant will cause the implant to appear as part of one unit and is indicated in more compromised situations, unfavorable conditions, or when pontic spaces and cantilevers are needed in implant prostheses.
Collapse
Affiliation(s)
| | | | - John Minichetti
- Department of Dentistry, Englewood Hospital, Englewood, NJ, USA
| | | |
Collapse
|
4
|
Barman S, Singh N, Pant VA, Aamir M, Biswas S. A naïve comparison to assess the success of ultra-short implants. Natl J Maxillofac Surg 2024; 15:121-130. [PMID: 38690245 PMCID: PMC11057602 DOI: 10.4103/njms.njms_82_22] [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: 05/25/2022] [Revised: 02/12/2023] [Accepted: 04/06/2023] [Indexed: 05/02/2024] Open
Abstract
Introduction Conventional implants are associated with ridge augmentation/sinus lift procedures in vertically insufficient ridges, which increase morbidity and healing time. Short implants provided some hope in this context. The present study considered the use of ultra-short implants in vertically insufficient posterior mandibular ridges and evaluated their success. Hence, study was done to evaluate the success of ultra-short implants in partially edentulous posterior mandible clinically and radiographically. Materials and Methods The study is a "Naïve direct comparison" of ultra-short implants to conventional implants for assessing their success in vertically insufficient posterior mandibular ridges. A total of 10 ultra-short implants were placed in a partially edentulous posterior mandibular ridge with at least 8-mm horizontal (at crest) and vertical dimensions. A delayed loading was done at three-month follow-up. Data acquisition was done at baseline (immediately after loading), 6-, 9-, 12-month intervals. Parameters assessed were marginal bone loss (MBL), probing pocket depth reduction (PPDR), modified plaque index (mPI), modified gingival index (mGI). Results All the placed 10 implants survived, and no failure was observed. "Independent sample t-test" and "paired sample t-test" was done for intergroup and intragroup analysis, respectively. Intergroup comparison between the ultra-short and conventional implants presented a statistically insignificant difference between all the parameters at all the follow-up visits (baseline, 6-, 9-, 12 months). Conclusions Within the limitations, it was thus concluded that ultra-short implants may be considered as a viable treatment option for vertically insufficient mandibular ridge. Further, long-term randomized controlled trials are required to establish the evidence.
Collapse
Affiliation(s)
- Sangeeta Barman
- Department of Periodontology and Implantology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Neelesh Singh
- Department of Periodontology and Implantology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Vandana A. Pant
- Department of Periodontology and Implantology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Mohammad Aamir
- Department of Periodontology and Implantology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Snigdha Biswas
- Department of Periodontology and Implantology, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
5
|
Lin GH, Tran C, Brzyska K, Kan JY, Wang HL, Curtis DA, Kao RT. The significance of vertical platform discrepancies and splinting on marginal bone levels for adjacent dental implants. Clin Implant Dent Relat Res 2023; 25:321-329. [PMID: 36593583 DOI: 10.1111/cid.13176] [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: 10/14/2022] [Revised: 12/02/2022] [Accepted: 12/24/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aim of this retrospective study was to investigate the influence of vertical platform discrepancies for splinted and non-splinted adjacent implants on radiographic marginal bone loss (RMBL). METHODS Data from January 2000 to February 2021 were collected from the electronic charts of 156 patients with 337 implants at the UCSF School of Dentistry. Five different implant restoration categories were evaluated for radiographic evidence of proximal RMBL. Patients with (1) two adjacent single crowns, (2) two adjacent splinted crowns, (3) three-unit bridges supported by two implants, (4) three adjacent single crowns, and (5) three adjacent splinted crowns. Inclusion required baseline radiograph taken at the time of prosthesis delivery or final impression, and follow-up radiographs at least 12 months after restorations have been in function. Measurements assessed included vertical distance between adjacent implant platforms and proximal RMBL around implants. Odds ratios (ORs) and 95% confidence interval (95% CI) of implants with ≥1 mm RMBL between different type of restorations were calculated. RESULTS In general, prostheses supported by splinted adjacent implants demonstrated a significant association with the presence of ≥1 mm RMBL (OR = 2.55, 95% CI = 1.17-5.17, p = 0.018) when compared to prostheses supported by non-splinted adjacent implants. In addition, prostheses with a vertical platform discrepancy ≥0.5 mm demonstrated a significant association with the presence of ≥1 mm RMBL (OR = 4.30, 95% CI = 1.85 to 10.01, p = 0.007) when compared to prostheses with a vertical platform discrepancy <0.5 mm. When adjacent implants had ≥0.5 mm vertical platform discrepancy, the majority (66.67%) of three splinted adjacent crowns had at least one implant with ≥1 mm RMBL. This was followed by two splinted adjacent crowns (58.97%), three-unit bridge (25.93%), two single adjacent crowns (24.24%), and three single adjacent crowns (18.18%). When adjacent implants had ≥1 mm vertical platform discrepancy, there was an increased percentage of implants with ≥1 mm RMBL. The restorative design associated with the highest percent of implants with bone loss was three splinted adjacent crowns (70%), two splinted adjacent crowns (61.11%), three single adjacent crowns (40%), and three-unit bridge and two single adjacent implants (21.05%). Three splinted adjacent crowns were significantly associated with ≥1 mm RMBL when compared to three-unit bridge (OR 6.56, 95% CI 1.59-27.07). Similarly, two splinted crowns were significantly associated with ≥1 mm RMBL when compared to two single crowns (OR = 2.50, 95% CI = 1.08-5.79). CONCLUSION Two or three adjacent implants placed with a vertical platform discrepancy, when splinted together, are associated with higherincidence of ≥1 mm RMBL than non-splinted restorations.
Collapse
Affiliation(s)
- Guo-Hao Lin
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Christine Tran
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Karolina Brzyska
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Joseph Y Kan
- Department of Restorative Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Donald A Curtis
- Division of Prosthodontics, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| | - Richard T Kao
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
6
|
Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D’Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227995. [PMID: 36431480 PMCID: PMC9695726 DOI: 10.3390/ma15227995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/31/2023]
Abstract
Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.
Collapse
Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Mauro Marincola
- Dental Implant Unit, Research Department, Faculty of Dentistry, University of Cartagena, Cartagena 130001, Colombia
| | - Pietro Liboni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Paolo Faccioni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio D’Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| |
Collapse
|
7
|
Short Implants versus Longer Implants with Sinus Floor Elevation: A Systemic Review and Meta-Analysis of Randomized Controlled Trials with a Post-Loading Follow-Up Duration of 5 Years. MATERIALS 2022; 15:ma15134722. [PMID: 35806845 PMCID: PMC9267683 DOI: 10.3390/ma15134722] [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: 02/24/2022] [Revised: 06/08/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
This study compared the outcome of fixed prostheses supported by short implants (<8 mm) and longer implants (≥8 mm) with an elevated sinus floor after 5 years of follow-up. The literature searches were performed electronically and manually in PubMed, EMBASE, and Web of Science databases to identify relevant articles published from 1 January 2013 to 31 January 2020. We selected eligible studies using inclusion criteria and assessed their quality. From 1688 identified studies, five randomized controlled trials were included. Between the short implant group and the control group, the implant failure-related pooled risk ratio (RR) was 3.64 (p = 0.07). The RR for technical complications was 2.61 (p = 0.0002), favoring longer implants. Marginal peri-implant bone loss after 1 and 5 years of function showed statistically significant less bone loss at short implants (1 year: mean difference = 0.21 mm; p < 0.00001; 5 years: mean difference = 0.26 mm; p = 0.02). The implant failure and the biological failure of both groups were similar after 5 years of follow-up. Short implants could be an alternative to long implants with an elevated sinus floor for atrophic maxillae in aging populations. Studies with larger trials and longer periods of follow-up (10 years) remain essential.
Collapse
|
8
|
Lombardo G, Signoriello A, Pardo A, Serpa Romero XZ, Vila Sierra LA, Arévalo Tovar L, Marincola M, Nocini PF. Short and ultra-short (<6-mm) locking-taper implants supporting single crowns in posterior areas (part II): A 5-year retrospective study on periodontally healthy patients and patients with a history of periodontitis. Clin Implant Dent Relat Res 2022; 24:455-467. [PMID: 35635514 PMCID: PMC9546440 DOI: 10.1111/cid.13103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
Background Short and ultra‐short implants implants supporting single crowns seem to demonstrate high percentages of survival and stable marginal bone levels at a mid‐term follow‐up. Nevertheless, insurgence of peri‐implant complications still represents a critical issue, especially for patients with history of periodontitis. Purpose The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri‐implant complications in 333 short and ultra‐short implants, placed in periodontally healthy patients and patients with a history of periodontitis. Materials and Methods Implants were placed in the maxillary and mandibular posterior regions of 142 patients with (PP) and without (NPP) a history of periodontitis. Clinical and radiographic examinations were performed at 5‐year recall appointments. Results Implants respectively placed in PP and NPP were: 35.68% and 42.50% in 8.0 mm‐length group, 33.33% and 36.67% in 6.0 mm‐length group, and 30.99% and 20.83% in 5.0 mm‐length group. Implant‐based survival after 5 years of follow‐up was 95.77% for PP and 96.67% for NPP (p = 0.77). Regarding crestal bone level variations, average crestal bone loss was statistically different (p = 0.04) among PP (0.74 mm) and NPP (0.61 mm). Implants presenting signs of mucositis were 6.86% in PP and 7.76% in NPP (p = 0.76). Setting the threshold for excessive bone loss at 1 mm after 60 months, peri‐implantitis prevalence was 7.84% in PP and 2.59% in NPP (p = 0.08). Overall implant success was 92.16% and 97.41%, respectively, for PP and NPP. Conclusions Under strict maintenance program, five‐year outcomes suggest that short and ultra‐short locking‐taper implants can be successfully restored with single crowns in the posterior jaws both in PP and NPP.
Collapse
Affiliation(s)
- Giorgio Lombardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | - Annarita Signoriello
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | - Alessia Pardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | | | | | - Luisa Arévalo Tovar
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pier Francesco Nocini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| |
Collapse
|
9
|
Comparison of stress distribution between zirconia/alloy endocrown and CAD/CAM multi-piece zirconia post-crown: three-dimensional finite element analysis. Clin Oral Investig 2022; 26:5007-5017. [PMID: 35352185 DOI: 10.1007/s00784-022-04470-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate a digital multi-piece zirconia post-crown to restore a mandibular second molar with extensive coronal loss and limited restoration space, and to compare the stress distribution between endocrowns made of zirconia or alloy and CAD/CAM multi-piece zirconia post-crowns. MATERIAL AND METHODS Four three-dimensional finite element analysis models of a mandibular second molar with extensive coronal loss and limited restoration space were created as follows: (A) intact molar; (B) zirconia endocrown restored molar; (C) multi-piece post-crown restored-molar with tapered nail; (D) multi-piece post-crown restored molar with T-shaped nail. Models C and D were divided into two subgroups according to the material type: C1/D1, zirconia; C2/D2, NiCr alloy. The maximum modified von Mises failure criterion (mvM) stresses were calculated, and the stress distribution was recorded to analyze the effects of the restoration and material types on the biomechanical properties of dentin and prosthesis. RESULTS The maximum mvM stress of dentin in model B (33.80 MPa) was lower compared with models C (C1, 37.81 MPa; C2, 36.36 MPa) and D (D1, 36.34 MPa; D2, 34.97 MPa) under vertical load, but the opposite was observed under oblique load. The highest mvM stress was concentrated in the nail region located in the root canal, and the T-shaped nail values were greater than the tapered nail, whereas model D with T-shaped nail showed a lower mvM stress level in dentin compared with Model C with tapered nail. CONCLUSIONS The digital multi-piece zirconia post-crown is a potential approach to restore mandibular second molars with extensive coronal loss and limited restoration space. CLINICAL RELEVANCE The digital multi-piece zirconia post-crown has potential to restore mandibular second molars with extensive coronal loss and limited restoration space using an innovative approach.
Collapse
|
10
|
Shah AH, Patel P, Trivedi A, Shah A, Desai N, Talati M. A comparison of marginal bone loss, survival rate, and prosthetic complications in implant-supported splinted and nonsplinted restorations: A systematic review and meta-analysis. J Indian Prosthodont Soc 2022; 22:111-121. [PMID: 36511022 PMCID: PMC9132503 DOI: 10.4103/jips.jips_365_21] [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: 12/30/2022] Open
Abstract
Aim To compare marginal bone loss (MBL), implant survival rate and prosthetic complications of implant-supported splinted and non-splinted restorations (NSR). Settings and Design This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The PROSPERO registry, which keeps track of prospective systematic reviews, also received this paper (CRD42021229477). Material and Methods An electronic search was done in PubMed, the Cochrane Central Trials Register, Scopus, Science Direct, and Google Scholar searches were carried out. The search was limited to articles published in English and covered the period from January 2010 to August 2020. Statistical Analysis Used To conduct the meta analysis, researchers employed methodologies such as continuous measurement and odds ratios. Results For both qualitative and quantitative analysis, 19 scientific studies were chosen. 3682 implants were placed in 2099 patients with a mean age of 59 years (splinted, 2529; non-splinted, 1153); the mean age was not provided in 5 trials. For splinted restorations, there were statistically significant differences in MBL, indicating the former has less MBL than for NSR. Splinted restorations had much greater survival rates than NSR, according to a qualitative study. Rest prosthesis complications with or without splinting were essentially the same. Conclusions Splinted implant restorations lost less bone than non-splinted implant restorations, according to this meta analysis. This was particularly true for posterior restorations. Lower implant failure was associated with splinted restorations. Restorations with and without splinting had the same level of prosthetic problems.
Collapse
Affiliation(s)
- Aesha Harsh Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India,Address for correspondence: Dr. Aesha Harsh Shah, Department of Prosthodontics, Goenka Research Institute of Dental Science, Pethapur - Mahudi Road, Gandhinagar District, Near G.G.S, Piplaj, Ahmedabad, Gujarat - 382 610, India. E-mail:
| | - Pankaj Patel
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Aumkar Trivedi
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Adit Shah
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Nikki Desai
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| | - Mitangi Talati
- Department of Prosthodontics and Crown and Bridge, Gandhinagar, Gujarat, India
| |
Collapse
|
11
|
de Faria Almeida DA, Verri FR, Lemos CAA, de Souza Batista VE, Santiago Júnior JF, Rosa CDDRD, Noritomi PY, Pellizzer EP. Effect of Splinting of Tilted External Hexagon Implants on 3-Unit Implant-Supported Prostheses in the Posterior Maxilla: A 3D Finite Element Analysis. J Prosthodont 2021; 31:697-704. [PMID: 34859540 DOI: 10.1111/jopr.13460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To assess the effects of tilted external hexagon implants and splinted restorations in terms of stress distribution on the bone tissue, implants, and prosthetic screws, using three-dimensional finite element analysis. MATERIALS AND METHODS Six models were used to simulate a posterior maxilla bone block (type IV) from the first premolar to the first molar. Each model included three 4.1-mm-diameter external hexagon implants with varying inclinations (0°, 17°, and 30°) and crown designs (splinted and nonsplinted restorations). The forces applied were as follows: 400 N axially (50 N for each slope of the cusp) and 200 N obliquely (45° only on the buccal slope of the cusp). Stress distribution on the implants and prosthetic screw was evaluated using Von Mises stress, while the maximum principal stress was used to evaluate the stress distribution in the bone tissue. RESULTS The oblique load increased the stress on all the structures in all the models. Increased inclination of the implants resulted in higher stress concentration in the bone tissue, implants, and prosthetic screws. However, splinted restorations contributed to reduction of the stress for the oblique loading, mainly in the bone tissue and prosthetic screw of the first molar, as the stress was shared between the first and second premolar restorations. CONCLUSIONS Tilted implants increased proportionally the stress on bone tissue and prosthetic screws of models. Additionally, splinting restorations reduced the stress concentration area in the simulated bone tissue, implants, and prosthetic screws in the first molar, as the stress was shared with the adjacent implants.
Collapse
Affiliation(s)
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Cleidiel A A Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF-GV), Governador Valadares, Minas Gerais, Brazil
| | - Victor E de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, University of the West of São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Joel F Santiago Júnior
- Department of Health Sciences, Sagrado Coração University (USC), Bauru, Sao Paulo, Brazil
| | - Cleber D D R D Rosa
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| | - Pedro Y Noritomi
- Renato Archer's Information Technology Center, Campinas, Sao Paulo, Brazil
| | - Eduardo P Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, Sao Paulo, Brazil
| |
Collapse
|
12
|
Lombardo G, Signoriello A, Marincola M, Liboni P, Bonfante EA, Nocini PF. Survival rates of ultra-short (<6 mm) compared with short locking-taper implants supporting single crowns in posterior areas: A 5-year retrospective study. Clin Implant Dent Relat Res 2021; 23:904-919. [PMID: 34796619 PMCID: PMC9299664 DOI: 10.1111/cid.13054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/22/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022]
Abstract
Background Short and ultra‐short implants represent a predictable treatment, in terms of implant survival, with patients presenting insufficient available bone volumes. Moreover, single crown restorations represent a gold standard in terms of oral hygiene. Purpose The aim of this retrospective study was to evaluate implant survival, marginal bone loss, and peri‐implant complications in 333 locking‐taper short and ultra‐short implants. Materials and Methods Implants were placed in the maxillary and mandibular posterior regions of 142 patients. Clinical and radiographic examinations were performed at 5‐year recall appointments. Results All implants placed consisted of 8.0‐, 6.0‐, and 5.0‐mm length, 38.14%, 34.53%, and 27.33%, respectively. Three hundred thirty‐two implants (one early failure) were rehabilitated with single crowns in 141 patients. In 45.48% of the implants the crown‐to‐implant ratio was ≥2, with a mean value of 1.94. Overall implant‐based survival after 5 years of follow‐up was 96.10%: 96.85%, 95.65%, and 95.60% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.82). Overall patient‐based survival was 91.55%. Regarding crestal bone level variations, average crestal bone loss and apical shift of the “first bone‐to‐implant contact point” position were 0.69 and 0.01 mm, respectively. Setting the threshold for excessive bone loss at 1 mm, during the time interval from loading to follow‐up, 28 implants experienced loss of supporting bone greater than 1 mm: 19 of them (67.85%) were surgically treated with a codified surgical regenerative protocol. After 60 months, a peri‐implantitis prevalence of 5.94% was reported, with an overall implant success of 94.06%: 95.93%, 92.73%, and 93.10% for 8.0‐, 6.0‐, and 5.0‐mm length implants, respectively (p = 0.55). Conclusion Long‐term outcomes suggest that short and ultra‐short locking‐taper implants can be successfully restored with single crowns in the posterior area of the maxilla and mandible.
Collapse
Affiliation(s)
- Giorgio Lombardo
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Annarita Signoriello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pietro Liboni
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Pier F Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), School of Dentistry, University of Verona, Verona, Italy
| |
Collapse
|
13
|
Li QL, Yao MF, Cao RY, Zhao K, Wang XD. Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis. J Prosthodont 2021; 31:9-21. [PMID: 34160869 DOI: 10.1111/jopr.13402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.
Collapse
Affiliation(s)
- Qiu-Lan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Mian-Feng Yao
- Xiangya Hospital Central South University, Department of Stomatology, Changsha, Hunan, China
| | - Ruo-Yan Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Ke Zhao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiao-Dong Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| |
Collapse
|
14
|
Biomechanical effect of an occlusal device for patients with an implant-supported fixed dental prosthesis under parafunctional loading: A 3D finite element analysis. J Prosthet Dent 2021; 126:223.e1-223.e8. [PMID: 34099274 DOI: 10.1016/j.prosdent.2021.04.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Whether providing an occlusal device for a patient with bruxism and an implant-supported fixed dental prosthesis leads to improved biomechanics is unclear. PURPOSE The purpose of this 3D finite element analysis (FEA) study was to evaluate the biomechanical behavior of 3-unit implant-supported prostheses under parafunctional forces with and without an occlusal device. MATERIALS AND METHODS Eight 3D models consisting of a posterior (type IV) maxillary bone block with 3 external hexagon implants (Ø4.0×7.0 mm) and 3-unit implant-supported prostheses with different crown connections (splinted or unsplinted) and an occlusal device under functional and parafunctional loading were simulated. The abutment screws were evaluated by von Mises stress maps, and the bone tissue by maximum principal stress and microstrain maps by using a finite element software program. RESULTS An occlusal device improved the biomechanical behavior of the prostheses by reducing stress in the abutment screws and stress and strain in the bone tissue. However, the use of an occlusal device was not sufficiently effective to negate the biomechanical benefit of splinting. CONCLUSIONS The use of splinted crowns in the posterior maxillary region with an occlusal device was the most effective method of reducing stress in the abutment screws and stress and strain in the bone tissue when parafunction was modeled.
Collapse
|
15
|
Canallatos P, Jayanetti J, Beumer J. An implant-retained auricular prosthesis complicated by a modified temporal bone resection. J Prosthet Dent 2021; 128:1375-1379. [PMID: 33879317 DOI: 10.1016/j.prosdent.2021.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
A patient underwent a modified temporal bone resection and total auriculectomy to remove a sebaceous carcinoma arising from the tragus of the right auricle that extended into the external auditory meatus. Because the tumor extended into the temporal bone, the osseous sites originally selected for immediate placement of the craniofacial implants were resected and no longer available. Subsequently, after an appropriate period of healing, implants were placed into the residual temporal bone, considerably more superior and posterior to the external auditory meatus such that they emerged through hair-bearing skin. The purpose of this report was to describe the fabrication of an implant-retained auricular prosthesis with implants in suboptimal positions. Challenges included optimization of the stability and retention of the prosthesis, effectively managing the prosthetic space without compromising the esthetic outcome, providing adequate hygiene access for the implant connecting bar, and maintaining the health of the peri-implant tissues when the implant emerged through hair-bearing skin.
Collapse
Affiliation(s)
- Paul Canallatos
- Fellow, Maxillofacial Prosthetics Fellowship, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif; Maxillofacial Prosthodontist, Department of Oral Oncology and Maxillofacial Prosthetics, Erie County Medical Center, Buffalo, NY.
| | - Jay Jayanetti
- Associate Director of Maxillofacial Prosthetics, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif
| | - John Beumer
- Professor Emeritus, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, Calif
| |
Collapse
|
16
|
Alhammadi SH, Burnside G, Milosevic A. Clinical outcomes of single implant supported crowns versus 3-unit implant-supported fixed dental prostheses in Dubai Health Authority: a retrospective study. BMC Oral Health 2021; 21:171. [PMID: 33794841 PMCID: PMC8017629 DOI: 10.1186/s12903-021-01530-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 03/22/2021] [Indexed: 01/16/2023] Open
Abstract
Background This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). Methods This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. Results A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient’s age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). Conclusions Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.
Collapse
Affiliation(s)
- Sara Hussain Alhammadi
- Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Girvan Burnside
- Department of Health Data Science, University of Liverpool, Waterhouse Building Block F, 1-5 Brownlow Street, Liverpool, L69 3GL, UK
| | - Alexander Milosevic
- Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE.
| |
Collapse
|
17
|
Yu W, Chen S, Li X, Ma X, Xu X. Evaluation of 1-Piece Versus 3-Piece Framework Designs for the Edentulous Mandible with Fixed Implant-Supported Prostheses: A Clinical, Occlusal and Biomechanical Study. J Prosthodont 2021; 30:290-297. [PMID: 33448507 DOI: 10.1111/jopr.13320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to evaluate the clinical, occlusal and biomechanical performance of 1-piece and 3-piece designs for implant-supported fixed dentures in the edentulous mandible. MATERIALS AND METHODS A total of 65 patients with edentulous mandibles who underwent fixed implant-supported restorations were recruited and subsequently assigned to 1 of 2 groups based on the framework design (1-piece or 3-piece). The participants underwent clinical and occlusal examination using a periodontal probe, T-Scan III system, and electromyography 12 months after prosthesis delivery. Two mandibular finite element models were created to evaluate stress values and their distribution during function. RESULTS Ninety-five point four percent (n = 62) of participants in the follow-up period underwent clinical and occlusal examination after prosthesis delivery. Clinical examination revealed a trend towards increased inflammation around the implants in the 1-piece prostheses. Occlusal parameters indicated that the 1-piece design was superior for the masticatory system than the 3-piece design. Biomechanical analysis revealed the highest stress values in the posterior region of the 3-piece design. CONCLUSIONS On the basis of ease of ensuring oral hygiene, when compared to the 3-piece design, the 1-piece framework design might be the superior therapy for restoring an edentulous mandible, based on occlusal and biomechanical outcomes.
Collapse
Affiliation(s)
- Wenqian Yu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Siyi Chen
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoqian Li
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xiaoni Ma
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| |
Collapse
|
18
|
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
|
19
|
Sadowsky SJ. Comments regarding: de Souza Batista et al. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2019;121:41-51. J Prosthet Dent 2020; 124:818. [DOI: 10.1016/j.prosdent.2020.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 11/25/2022]
|
20
|
de Souza Batista VE, Verri FR, Lemos CA, Cruz RS, Oliveira HF, Gomes JM, Pellizzer EP. Response to Letter to the Editor regarding “de Souza Batista et al. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2019;121:41-51”. J Prosthet Dent 2020; 124:819. [DOI: 10.1016/j.prosdent.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
|
21
|
Short versus standard implants for single-crown restorations in the posterior region: A systematic review and meta-analysis. J Prosthet Dent 2020; 124:530-538. [DOI: 10.1016/j.prosdent.2019.09.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 01/10/2023]
|
22
|
Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
Collapse
Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| |
Collapse
|
23
|
Kadkhodazadeh M, Moscowchi A, Zamani Z, Amid R. Clinical and Radiographic Outcomes of a Novel Transalveolar Sinus Floor Elevation Technique. J Maxillofac Oral Surg 2020; 21:548-556. [DOI: 10.1007/s12663-020-01439-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023] Open
|
24
|
Yi Y, Koo K, Schwarz F, Ben Amara H, Heo S. Association of prosthetic features and peri‐implantitis: A cross‐sectional study. J Clin Periodontol 2020; 47:392-403. [DOI: 10.1111/jcpe.13251] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/11/2019] [Accepted: 01/04/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Yuseung Yi
- Department of Prosthodontics Seoul National University Dental Hospital Seoul Korea
| | - Ki‐Tae Koo
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE) College of Dentistry Seoul National University Seoul Korea
| | - Frank Schwarz
- Department of Oral Surgery and Implantology Goethe‐University Frankfurt Frankfurt Germany
| | - Heithem Ben Amara
- Department of Periodontology and Dental Research Institute Translational Research Laboratory for Tissue Engineering (TTE) College of Dentistry Seoul National University Seoul Korea
| | - Seong‐Joo Heo
- Department of Prosthodontics Seoul National University Dental Hospital Seoul Korea
| |
Collapse
|
25
|
Virtual Bone Augmentation in Atrophic Mandible to Assess Optimal Implant-Prosthetic Rehabilitation—A Finite Element Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10010401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The scope of our study was to analyze the impact of implant prosthetic rehabilitation, in bilateral terminal partial edentulism with mandibular bone atrophy, and potential benefits of mandibular bone augmentation through finite element analysis. A 3D mandible model was made using patient-derived cone-beam computed tomography (CBCT) images, presenting a bilateral terminal edentation and mandibular atrophy. A virtual simulation of bone augmentation was then made. Implant-supported restorations were modeled for each edentulous area. Forces corresponding to the pterygoid and the masseter muscles, as well as mastication conditions for each quadrant, were applied. The resorbed mandible presented high values of strain and stress. A considerable variation between strain values among the two implant sites in each quadrant was found. In the augmented model, values of strain and stress showed a uniformization in both quadrants. Virtually increasing bone mass in the resorbed areas of the mandible showed that enabling larger implants drastically reduces strain and stress values in the implant sites. Also, although ridge height difference between the two quadrants was kept even after bone augmentation, there is a uniformization of the strain values between the two implant sites in each of the augmented mandible quadrants.
Collapse
|
26
|
Bitaraf T, Keshtkar A, Rokn AR, Monzavi A, Geramy A, Hashemi K. Comparing short dental implant and standard dental implant in terms of marginal bone level changes: A systematic review and meta‐analysis of randomized controlled trials. Clin Implant Dent Relat Res 2019; 21:796-812. [DOI: 10.1111/cid.12774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Tahereh Bitaraf
- Dental Implant Research Center, Dental FacultyTehran Medical Sciences, Islamic Azad University Tehran Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education DevelopmentSchool of Public Health, Tehran University of Medical Sciences Tehran Iran
| | - Amir Reza Rokn
- Dental Implant Research Center, Dental Research Institute, Department of Periodontics of Dental SchoolTehran University of Medical Sciences Tehran Iran
| | - Abbas Monzavi
- Dental Research Institute, Department of ProsthodonticsTehran University of Medical Sciences Tehran Iran
| | - Allahyar Geramy
- Dental Research Center, Department of Orthodontics, Faculty of DentistryTehran University of Medical Sciences Tehran Iran
| | - Kazem Hashemi
- Dental Implant Research CenterDental Research Institute, Tehran University of Medical Sciences Tehran Iran
| |
Collapse
|
27
|
Ravidà A, Saleh MHA, Muriel MC, Maska B, Wang HL. Biological and Technical Complications of Splinted or Nonsplinted Dental Implants: A Decision Tree for Selection. IMPLANT DENT 2018; 27:89-94. [PMID: 29283896 DOI: 10.1097/id.0000000000000721] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To present an in-depth review on splinting versus nonsplinting the restorations of adjacent dental implants, in addition to discussing biological and technical complications associated with either choice; and to provide the clinician with a decision tree that serves in everyday judgments when it comes to addressing this issue. MATERIALS AND METHODS A comprehensive literature review was performed for articles comparing success of splinted versus nonsplinted dental implants. RESULTS There is no evidence to suggest that implementing either prosthetic design results in higher implant survival. Both designs tend to have their own set of complications, but there is compelling evidence to suggest that splinted restorations generally have less technical complications. CONCLUSION Either splinting or nonsplinting are valid options for restoring adjacent implants, but each tend to face different biological and technical complications. Knowing which patients are more likely to face particular complications is strategic to provide patients with successful restorations.
Collapse
Affiliation(s)
- Andrea Ravidà
- Post-Doctoral Student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Muhammad H A Saleh
- Post-Doctoral Student, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | | | - Bartosz Maska
- Graduate Resident, Deparment of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Professor and Director of Graduate Periodontics, Deparment of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| |
Collapse
|
28
|
Splinted and Nonsplinted Crowns with Different Implant Lengths in the Posterior Maxilla by Three-Dimensional Finite Element Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:3163096. [PMID: 30254726 PMCID: PMC6140271 DOI: 10.1155/2018/3163096] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/30/2018] [Indexed: 02/06/2023]
Abstract
The aim of this study was to evaluate stress distribution in the implants/components and bone tissue for splinted and nonsplinted prostheses with different lengths of implants using three-dimensional finite element analysis. Six models from the posterior maxillary area were used in simulations. Each model simulated three Morse taper implants of 4.0 mm diameter with different lengths, which supported metal-ceramic crowns. An axial load of 400 N and an oblique load of 200 N were used as loading conditions. Splinted prostheses exhibited better stress distribution for the implants/components, whereas nonsplinted prostheses exhibited higher stress in the first molar under axial/oblique loading. Implant length did not influence stress distribution in the implants/components. In cortical bone tissue, splinted prostheses decreased the tensile stress in the first molar, whereas nonsplinted prostheses were subjected to higher tensile stress in the first molar; implant length had no influence on stress distribution. Within the limitations of this study, we conclude that splinted prostheses contributed to better stress distribution in the implant/abutment and cortical bone tissue; however, the reduction in the implant length did not influence the stress distribution.
Collapse
|
29
|
de Souza Batista VE, Verri FR, Lemos CAA, Cruz RS, Oliveira HFF, Gomes JML, Pellizzer EP. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent 2018; 121:41-51. [PMID: 29961632 DOI: 10.1016/j.prosdent.2018.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/02/2018] [Accepted: 03/02/2018] [Indexed: 10/28/2022]
Abstract
STATEMENT OF PROBLEM The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. MATERIAL AND METHODS This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was "Should the restoration of adjacent implants be splinted or nonsplinted?" The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. RESULTS Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. CONCLUSIONS Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure.
Collapse
Affiliation(s)
- Victor E de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil.
| | - Fellippo R Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Cleidiel A A Lemos
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Ronaldo S Cruz
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Hiskell F F Oliveira
- Doctoral student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica M L Gomes
- Graduate student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Eduardo P Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School, São Paulo State University (UNESP), Araçatuba, Brazil
| |
Collapse
|
30
|
Kim SY, Ku JK, Kim HS, Yun PY, Kim YK. A retrospective clinical study of single short implants (less than 8 mm) in posterior edentulous areas. J Adv Prosthodont 2018; 10:191-196. [PMID: 29930788 PMCID: PMC6004347 DOI: 10.4047/jap.2018.10.3.191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 12/23/2017] [Accepted: 02/27/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The goal of this study was to evaluate the clinical outcome of single short implants, less than 8 mm in length, placed in the posterior area. MATERIALS AND METHODS A total of 128 patients (75 male and 53 female, mean age: 52.6±11.2 years) with 154 implants participated. Implant marginal bone loss, and survival and success rates were measured. RESULTS The mean follow-up period was 51.35±24.97 months. A total of 128 implants, 8 mm in length, were placed in patients who had mean marginal bone loss of 0.75 mm. These implants had a survival rate of 95.3%. Twenty-six implants, 7 mm in length, were placed in areas with a mean marginal bone loss of 0.78 mm and had a survival rate of 96.2%. Both marginal bone loss and survival rate were not statistically different among the groups. In the maxilla, 34 implants showed a mean marginal bone loss of 0.77 mm and a survival rate of 97.1%. In the mandible, 120 implants showed a mean marginal bone loss of 0.75 mm and a survival rate of 95.0%. The average marginal bone loss around all implants was 0.76±0.27 mm at the last follow-up review after functional loading. The survival rate was 95.6% and success rate was 93.5%. CONCLUSION In our study, single short implants less than 8 mm in length in the posterior areas had favorable clinical outcomes.
Collapse
Affiliation(s)
- Sang-Yun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun-Suk Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
31
|
Adánez MH, Brezavšček M, Vach K, Fonseca M, Att W. Clinical and Radiographic Evaluation of Short Implants Placed in the Posterior Mandible: A 1-Year Pilot Split-Mouth Study. J ORAL IMPLANTOL 2018; 44:250-259. [PMID: 29717922 DOI: 10.1563/aaid-joi-d-18-00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In many cases, due to anatomical limitations, the placement of regular-length implants cannot be facilitated without the performance of advanced surgical procedures. However, these are associated with morbidity, prolonged treatment time, and costs. To overcome such disadvantages, short implants were introduced. The aim of this prospective pilot split-mouth study was to compare the clinical outcome between short implants (7 mm) and regular-length (≥10 mm) implants placed in the posterior mandible after 1 year of prosthetic delivery. Ten patients received 4 implants in the posterior mandible. Two short implants were placed in one side and 2 regular-length implants were placed contralaterally. These were restored by means of splinted screw-retained metal-ceramic crowns. Marginal bone loss (MBL) and soft-tissue parameters were compared. No implant failed. Both types of implants showed success rates of 90% and survival rates of 100%. From prosthetic delivery to 1 year post-loading a bone gain of +0.29 mm for short implants and +0.19 mm for regular-length implants was present without showing any statistically significant differences in MBL between the 2 implant types ( P > .05). Bleeding on probing, clinical attachment level, probing depth, and crown-to-implant ratio did not show any statistically significant differences between the 2 implant lengths ( P > .05). One case of chipping occurred in the regular-length implant group, leading to a prosthetic survival rate of 95%. Short implants showed a prosthetic survival rate of 100%. After 1 year, short implants showed comparable clinical outcomes to that of regular-length implants, making them a viable treatment option in the posterior mandible.
Collapse
Affiliation(s)
- Mireia Haro Adánez
- 1 Department of Prosthetic Dentistry, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | - Kirstin Vach
- 3 Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Manrique Fonseca
- 4 Department of Prosthetic Dentistry, School of Dentistry, University Hospital Bern, Switzerland
| | - Wael Att
- 5 Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| |
Collapse
|
32
|
Lemos CAA, Verri FR, Santiago Júnior JF, Almeida DADF, Batista VEDS, Noritomi PY, Pellizzer DP. Retention System and Splinting on Morse Taper Implants in the Posterior Maxilla by 3D Finite Element Analysis. Braz Dent J 2018; 29:30-35. [DOI: 10.1590/0103-6440201801492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 09/11/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract The purpose of this study was to evaluate different retention systems (cement- or screw-retained) and crown designs (non-splinted or splinted) of fixed implant-supported restorations, in terms of stress distributions in implants/components and bone tissue, by 3-dimensional (3D) finite element analysis. Four 3D models were simulated with the InVesalius, Rhinoceros 3D, and SolidWorks programs. Models were made of type III bone from the posterior maxillary area. Models included three 4.0-mm-diameter Morse taper (MT) implants with different lengths, which supported metal-ceramic crowns. Models were processed by the Femap and NeiNastran programs, using an axial force of 400 N and oblique force of 200 N. Results were visualized as the von Mises stress and maximum principal stress (σmax). Under axial loading, there was no difference in the distribution of stress in implants/components between retention systems and splinted crowns; however, in oblique loading, cemented prostheses showed better stress distribution than screwed prostheses, whereas splinted crowns tended to reduce stress in the implant of the first molar. In the bone tissue cemented prostheses showed better stress distribution in bone tissue than screwed prostheses under axial and oblique loading. The splinted design only had an effect in the screwed prosthesis, with no influence in the cemented prosthesis. Cemented prostheses on MT implants showed more favorable stress distributions in implants/components and bone tissue. Splinting was favorable for stress distribution only for screwed prostheses under oblique loading.
Collapse
|
33
|
de Souza Batista VE, Verri FR, Almeida DADF, Santiago Junior JF, Lemos CAA, Pellizzer EP. Evaluation of the effect of an offset implant configuration in the posterior maxilla with external hexagon implant platform: A 3-dimensional finite element analysis. J Prosthet Dent 2017; 118:363-371. [DOI: 10.1016/j.prosdent.2016.10.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
|
34
|
Abstract
PURPOSE Occlusal overload may cause implant biomechanical failures, marginal bone loss, or even complete loss of osseointegration. Thus, it is important for clinicians to understand the role of occlusion in implant long-term stability. This systematic review updates the understanding of occlusion on dental implants, the impact on the surrounding peri-implant tissues, and the effects of occlusal overload on implants. Additionally, recommendations of occlusal scheme for implant prostheses and designs were formulated. MATERIALS AND METHODS Two reviewers completed a literature search using the PubMed database and a manual search of relevant journals. Relevant articles from January 1950 to September 20, 2015 published in the English language were considered. RESULTS Recommendations for implant occlusion are lacking in the literature. Despite this, implant occlusion should be carefully addressed. CONCLUSION Recommendations for occlusal schemes for single implants or fixed partial denture supported by implants include a mutually protected occlusion with anterior guidance and evenly distributed contacts with wide freedom in centric relation. Suggestions to reduce occlusal overload include reducing cantilevers, increasing the number of implants, increasing contact points, monitoring for parafunctional habits, narrowing the occlusal table, decreasing cuspal inclines, and using progressive loading in patients with poor bone quality. Protecting the implant and surrounding peri-implant bone requires an understanding of how occlusion plays a role in influencing long-term implant stability.
Collapse
|
35
|
Thoma DS, Cha JK, Jung UW. Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone. J Periodontal Implant Sci 2017; 47:2-12. [PMID: 28261519 PMCID: PMC5332331 DOI: 10.5051/jpis.2017.47.1.2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 01/22/2017] [Indexed: 11/25/2022] Open
Abstract
The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.
Collapse
Affiliation(s)
- Daniel Stefan Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| |
Collapse
|
36
|
P53 and SOX2 Protein Expression Predicts Esophageal Adenocarcinoma in Response to Neoadjuvant Chemoradiotherapy. Ann Surg 2017; 265:347-355. [DOI: 10.1097/sla.0000000000001625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
37
|
Al Amri MD, Kellesarian SV. Crestal Bone Loss Around Adjacent Dental Implants Restored with Splinted and Nonsplinted Fixed Restorations: A Systematic Literature Review. J Prosthodont 2016; 26:495-501. [PMID: 27996179 DOI: 10.1111/jopr.12556] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this systematic review was to compare the crestal bone loss around splinted and nonsplinted adjacent implants. MATERIALS AND METHODS To address the focused question, "Is crestal bone loss around adjacent implants different with splinted from that with nonsplinted restorations?," indexed databases were searched from 1965 up to and including May 2016 using various combinations of the following keywords: "implant," "splinted," "nonsplinted," "unsplinted," "connected," "unconnected," "nonconnected," and "bone loss." Letters to the editor, commentaries, historic reviews, case reports, case series, animal studies, and studies on full-arch rehabilitation were excluded. RESULTS Six studies were included with titanium implants ranging from 114 to 1187 implants. All studies had nonsplinted and splinted restorations that ranged from 20 to 234 restorations and from 60 to 970 restorations, respectively. In all the studies, the follow-up period after the restoration placement ranged between 1 and 22 years, with a mean follow-up ranging between 3 and 10.18 ± 3.18 years. In all studies, the mean crestal bone loss for implants restored with nonsplinted restorations ranged between 0.30 ± 0.65 and 1.3 ± 0.2 mm, whereas the mean crestal bone loss for implants restored with splinted restorations ranged between 0.50 ± 0.8 and 1.22 ± 0.95 mm. CONCLUSION Within the limitations of this review it is concluded that adjacent implants restored with splinted and nonsplinted fixed restorations did not exhibit a difference in crestal bone loss. The evidence from this systematic review suggests further investigation.
Collapse
Affiliation(s)
- Mohammad D Al Amri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | |
Collapse
|
38
|
Sierra-Sánchez JL, García-Sala-Bonmatí F, Martínez-González A, García-Dalmau C, Mañes-Ferrer JF, Brotons-Oliver A. Predictability of short implants ( < 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review. Med Oral Patol Oral Cir Bucal 2016; 21:e392-402. [PMID: 26946199 PMCID: PMC4867215 DOI: 10.4317/medoral.20949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 11/20/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Short implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. Although such implants are now widely used, there is controversy regarding their clinical reliability. The purpose of this paper is to evaluate the predictability of short implants as an alternative to technically more complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in peri-implant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants. MATERIAL AND METHODS A Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted. RESULTS A total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed. CONCLUSIONS Based on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants.
Collapse
Affiliation(s)
- J-L Sierra-Sánchez
- Clínica Universitaria Odontológica, Universidad Europea de Valencia, C/ Alfambra, 4- bajo, 46009- Valencia, Spain,
| | | | | | | | | | | |
Collapse
|
39
|
Short dental implants versus standard dental implants placed in the posterior jaws: A systematic review and meta-analysis. J Dent 2016; 47:8-17. [PMID: 26804969 DOI: 10.1016/j.jdent.2016.01.005] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The purpose of the present systematic review and meta-analysis was to compare short implants (equal or less than 8mm) versus standard implants (larger than 8mm) placed in posterior regions of maxilla and mandible, evaluating survival rates of implants, marginal bone loss, complications and prosthesis failures. DATA This review has been registered at PROSPERO under the number CRD42015016588. Main search terms were used in combination: dental implant, short implant, short dental implants, short dental implants posterior, short dental implants maxilla, and short dental implants mandible. SOURCE An electronic search for data published up until September/2015 was undertaken using the PubMed/Medline, Embase and The Cochrane Library databases. STUDY SELECTION Eligibility criteria included clinical human studies, randomized controlled trials and/or prospective studies, which evaluated short implants in comparison to standard implants in the same study. CONCLUSION The search identified 1460 references, after inclusion criteria 13 studies were assessed for eligibility. A total of 1269 patients, who had received a total of 2631 dental implants. The results showed that there was no significant difference of implants survival (P=.24; RR:1.35; CI: 0.82-2.22), marginal bone loss (P=.06; MD: -0.20; CI: -0.41 to 0.00), complications (P=.08; RR:0.54; CI: 0.27-1.09) and prosthesis failures (P=.92; RR:0.96; CI: 0.44-2.09). Short implants are considered a predictable treatment for posterior jaws. However, short implants with length less than 8 mm (4-7 mm) should be used with caution because they present greater risks to failures compared to standard implants. CLINICAL SIGNIFICANCE Short implants are frequently placed in the posterior area in order to avoid complementary surgical procedures. However, clinicians need to be aware that short implants with length less than 8mm present greater risk of failures.
Collapse
|
40
|
Calvo-Guirado JL, López Torres JA, Dard M, Javed F, Pérez-Albacete Martínez C, Maté Sánchez de Val JE. Evaluation of extrashort 4-mm implants in mandibular edentulous patients with reduced bone height in comparison with standard implants: a 12-month results. Clin Oral Implants Res 2015; 27:867-874. [PMID: 26431917 DOI: 10.1111/clr.12704] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this research was to evaluate the primary stability, the marginal bone loss, the survival, and the success criteria, of 4-mm-length implants compared with implants of conventional length supporting fixed prostheses. MATERIALS AND METHODS Ten patients were selected for treatment of their atrophic edentulous jaws. Each patient received the following treatment: six dental implants were inserted, two anterior implants of conventional length (10-mm) in the interforaminal area and four posterior short implants of 4-mm length (Standard Plus, Roxolid, SLActive, Institut Straumann AG). The implants supported screw-retained fixed complete dentures. Examinations were conducted at day 0, three, six, and twelve months after surgery for the evaluation of the implant primary stability, secondary stability, crestal bone loss and survival by clinical evaluations, insertion torque values, resonance frequency analysis (RFA), and periapical radiography, respectively. RESULTS Sixty implants were inserted in ten patients. Mean insertion torque was slightly lower for 4-mm implants than 10-mm implants (38.1 Ncm vs. 42.2 Ncm) but without statistically significant difference. Implant stability was similar for extrashort and conventional implants. Marginal bone loss was similar for both groups for all the time periods. One short implant was lost before loading. The survival rates twelve months after implant placement were of 97.5% and 100% for short and conventional implants, respectively. Similarly, implant stability as measured by RFA was nonsignificantly lower for the 4-mm implants compared to the 10-mm implants. The marginal bone loss was lower for short implants three, six, and twelve months after the surgery without statistical significant difference. CONCLUSIONS Within the limitations of this study, we conclude that short dental implants (8 mm or less in length) supporting single crowns or fixed bridges are a feasible treatment option with radiographic and clinical success rates similar to longer implants for patients with compromised ridges. Long-term data with larger number of implants and subjects are needed to confirm these preliminary results.
Collapse
Affiliation(s)
- José Luis Calvo-Guirado
- International Dentistry Research Cathedra, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
| | - José Alberto López Torres
- International Dentistry Research Cathedra, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain
| | | | - Fawad Javed
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | | | | |
Collapse
|
41
|
Chrcanovic BR, Albrektsson T, Wennerberg A. Dental implants inserted in male versus female patients: a systematic review and meta-analysis. J Oral Rehabil 2015; 42:709-22. [PMID: 25989467 DOI: 10.1111/joor.12308] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2015] [Indexed: 12/14/2022]
Affiliation(s)
- B. R. Chrcanovic
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - T. Albrektsson
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Biomaterials; Göteborg University; Göteborg Sweden
| | - A. Wennerberg
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| |
Collapse
|
42
|
Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: A systematic review and meta-analysis. J Dent 2015; 43:487-98. [PMID: 25778741 DOI: 10.1016/j.jdent.2015.03.003] [Citation(s) in RCA: 189] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022] Open
|