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da Rosa de Souza PT, Manfro R, de Salles Santos FAO, Garcia GFF, Macedo NF, de Macedo BESF, Ignácio SA, Rosa EAR, de Souza EM, Azevedo-Alanis LR. Analysis of osseointegration of implants with macrogeometries with healing chambers: a randomized clinical trial. BMC Oral Health 2024; 24:1114. [PMID: 39300380 DOI: 10.1186/s12903-024-04857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 09/03/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. METHODS In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. RESULTS The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). CONCLUSION Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. TRIAL REGISTRATION This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.
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Affiliation(s)
| | - Rafael Manfro
- Graduate Program in Dentistry, Universidade do Sul de Santa Catarina, Palhoça, Santa Catarina, Brazil
| | | | | | - Nayara Flores Macedo
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | | | - Sérgio Aparecido Ignácio
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | | | - Evelise Machado de Souza
- Graduate Program in Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Kanayama M, Ferri M, Guzon FMM, Asano A, Alccayhuaman KAA, Rossi EFD, Botticelli D. Influence on marginal bone levels at implants equipped with blades aiming to control the lateral pressure on the cortical bone. An experimental study in dogs. Oral Maxillofac Surg 2024; 28:1139-1149. [PMID: 38429433 DOI: 10.1007/s10006-024-01228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND To avoid cortical compression, several implant systems have included in the protocol dedicated drills aimed at widening the cortical region of osteotomy. However, the manual execution of this operation does not guarantee the necessary precision. Hence, the present study aimed to determine the optimal size of the recipient site at the level of the alveolar crest in relation to the size of the coronal region of the implant to achieve the best healing result. MATERIALS AND METHODS Blades of different diameters were incorporated into the coronal part of the implant to prepare the cortical region of the mandibular alveolar bone crest in different dimensions in relation to the collar of the implant. The differences in diameter of the blades in relation to the collar of the implant were as follows: one control group, -175 μm, and three test groups, 0 μm, + 50 μm, or + 200 μm. RESULTS The marginal bone loss (MBL) at the buccal aspect was 0.7 mm, 0.5 mm, 0.2 mm, and 0.7 mm in the - 175 μm, 0.0 μm, + 50 μm, + 200 μm groups, respectively. The differences were statistically significant between group + 50 μm and control group - 175 μm (p = 0.019), and between + 50 μm and + 200 μm (p < 0.01) groups. The level of osseointegration at the buccal aspect was more coronally located in the test groups than in the control group, whereas the bone-to-implant contact percentage was higher in the + 50 μm and + 200 μm groups. However, these differences were not statistically significant. CONCLUSIONS The lowest bone crest resorption and highest levels of osseointegration were observed in the 0.0 μm and + 50 μm groups. The cortical region where the blades had performed their cutting action showed regular healing with perfect hard and soft tissues sealing in all the groups. Cortical blades gathered bone particles, particularly in the + 200 μm group, which were incorporated into the newly formed bone. The results from the present experiment provide support to the use of blades that produce a marginal gap of 50 μm after implant insertion.
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Affiliation(s)
| | - Mauro Ferri
- Private Practice, Cartagena de Indias, 130001, Colombia
| | - Fernando M Muñoz Guzon
- Ibonelab SL, Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Akihisa Asano
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
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Herreira-Ferreira M, Bonfante EA, Conti PCR, Araújo-Júnior ENSD, Machado CM, Alves PHM, Costa YM, Bonjardim LR. Somatosensory alterations after single-unit dental implant immediate loading: A 1-year follow-up study. J Dent 2024; 147:105148. [PMID: 38909648 DOI: 10.1016/j.jdent.2024.105148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVE This cohort study aimed to assess the incidence of somatosensory alterations after implant surgery using standardized quantitative and qualitative sensory testing. METHODS 33 participants with single-tooth loss, undergoing immediate implant loading were included. Quantitative Sensory Testing (QST) and Qualitative Sensory Testing (QualST) were conducted at eight time points over a year (baseline to 1 year). Two-Way Repeated Measures ANOVA and post hoc Tukey test were used on QST values and Cochran Q test on QualST. RESULTS The study revealed significant increase in thermal thresholds overtime. At the operated side, overall Cold Pain Threshold (extraoral: p = 0.030; intraoral: p < 0.001), and Cold Detection Threshold (intraoral: p < 0.001) increased overtime. In contralateral region, maxilla Cold Detection Threshold (extraoral: p = 0.024; intraoral: p = 0.031), Warm Detection Threshold (extraoral: p = 0.026; intraoral: p = 0.047) and overall Cold Pain Threshold (extraoral and intraoral: p < 0.001) also increased. QualST showed extraoral pinprick (p = 0.032) and intraoral pinprick (p = 0.000), cold (p = 0.000) and touch (p = 0.002) stimuli abnormalities overtime. CONCLUSIONS Somatosensory alterations after implant surgery were detected in both quantitative and qualitative sensory assessments, but rapidly decreased during the first follow-ups, and then continuously until 1-year. CLINICAL SIGNIFICANCE This study provides clinical and controlled evidence on the real effect of the somatosensory alterations overtime, leading to a better understanding of neurosensory behaviour after single-tooth dental implant rehabilitation.
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Affiliation(s)
- Matheus Herreira-Ferreira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Paulo César Rodrigues Conti
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Camila Moreira Machado
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Patrick Henry Machado Alves
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Yuri Martins Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Marković A, Todorović A, Glišić M, Marković J, Ilić B, Janjić B, Mišić T, Trifković B, Vučić U, Šćepanović M, Dard MM. Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up. Clin Implant Dent Relat Res 2024; 26:688-703. [PMID: 38693759 DOI: 10.1111/cid.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/21/2024] [Accepted: 04/12/2024] [Indexed: 05/03/2024]
Abstract
This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.
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Affiliation(s)
- Aleksa Marković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Todorović
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Mirko Glišić
- Clinic of Prosthodontics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Marković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branislav Ilić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojan Janjić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Tijana Mišić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Branka Trifković
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Uroš Vučić
- Clinic of Oral surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Miodrag Šćepanović
- Implant Center, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Michel M Dard
- Columbia University, College of Dental Medicine, New York, New York, USA
- Institut Straumann, Basel, Switzerland
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Ramesh R, Sasi A, Mohamed SC, Joseph SP. "Compression Necrosis" - A Cause of Concern for Early Implant Failure? Case Report and Review of Literature. Clin Cosmet Investig Dent 2024; 16:43-52. [PMID: 38469322 PMCID: PMC10926919 DOI: 10.2147/ccide.s453798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose Compression necrosis refers to bone tissue damage that can occur when excessive pressure or force is applied to surrounding bone during implant placement. This pressure can compromise blood supply to the bone, leading to necrosis. Compression necrosis is a concern, because it can affect the stability and long-term success of dental implant. Patients and Methods This case report highlights a case of early bone loss and implant failure possibly due to compression necrosis. Clinical data, photographs, radiographs, blood examination report and histology were presented to document the early failure of an implant placed in the mandibular left posterior region of a 33-year-old female patient. Results Radiograph taken six weeks after implant placement showed severe angular defect. Therefore, the implant was surgically removed. Histological examination of the area showed bony trabeculae with an absence of osteoblastic riming, suggestive of necrotic bone. Conclusion Using excessive torque values when placing implants in dense bones can increase the risk of implant failure due to bone over compression. Dental professionals must follow the manufacturer's instructions and employ quality surgical techniques during implant placement into dense cortical bone to minimise risks.
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Affiliation(s)
- Roshni Ramesh
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Anoop Sasi
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Shahana C Mohamed
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Sonia P Joseph
- Department of Periodontology, Government Dental College, Thiruvananthapuram, Kerala, India
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Olmedo-Gaya MV, Romero-Olid MN, Ocaña-Peinado FM, Vallecillo-Rivas M, Vallecillo C, Reyes-Botella C. Influence of different surgical techniques on primary implant stability in the posterior maxilla: a randomized controlled clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04962-y. [PMID: 36977760 DOI: 10.1007/s00784-023-04962-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND AND OBJECTIVE Primary stability (PS) is remarkable for secondary stability and implant success. Surgical technique modifications seem to improve primary stability, especially in poor quality bone. The aim of this study was to compare the insertion torque (IT) and implant stability quotients (ISQ) of implants placed with underpreparation, expanders, and standard surgical instrumentation in different bone types. MATERIAL AND METHODS This randomized controlled clinical trial enrolled 108 patients (n=108 implants) distributed in three study groups: group 1 (n=36) underpreparation technique, group 2 (n=36) expander technique, and group 3 (n=36) conventional drilling. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery. RESULTS ISQ values were associated with the patient's bone quality and were higher in bone quality type II (76.65) and type III (73.60) and lower in bone quality type IV (67.34), with statistically significant differences (p<0.0001). Lower stability results were obtained when conventional drilling (69.31) was used compared to the use of underpreparation (74.29) or expanders (73.99) with a level of significance of p=0.008 and p=0.005, respectively. CONCLUSIONS The surgical technique influences the PS when there is low-quality bone. In low-quality bones, conventional drilling obtains lower ISQ values. CLINICAL RELEVANCE Replace the conventional drilling technique for an alternative, underpreparation or expanders, in low-quality bone in order to achieve greater primary stability.
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Affiliation(s)
| | | | | | | | - Cristina Vallecillo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.
- Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071, Granada, Spain.
| | - Candela Reyes-Botella
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
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Evaluation of Change in Radiographic Fractal Dimension around Dental Implants Placed with Low-Speed Drilling and Standard Drilling Protocols. J Clin Med 2023; 12:jcm12062244. [PMID: 36983245 PMCID: PMC10058604 DOI: 10.3390/jcm12062244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Osseointegration is a process that depends on a multitude of factors, including the type of drilling, whether biological or conventional. Objective: Establish box-counting dimension values for radiological images in patients with implants placed with both drilling methods. Material and method: The sample included 129 implants corresponding to 50 patients. A double-blind study of data collection was carried out with the subsequent analysis of the fractal dimension as a comparative value of the state of the trabecular architecture. Results: We found no significant differences (p ≥ 0.05) between the two study groups comparing both drilling techniques. The values for the conventional drilling technique are 0.24 ± 0.07 and for biological drilling: 0.19 ± 0.11 with a p-value of 0.767. Conclusions: The drilling technique does not influence the success of the procedure and the osseointegration process.
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Canullo L, Iacono R, Pires Godoy E, Punzo A, Cavicchia A, Gianfreda F, Bollero P. Hybrid Funnel Technique: A Novel Approach for Implant Site Preparation: A Pilot Study. Dent J (Basel) 2022; 10:dj10090157. [PMID: 36135152 PMCID: PMC9497956 DOI: 10.3390/dj10090157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Different techniques and tools have been developed for implant site preparation. In this clinical scenario, Hybrid Funnel Technique (HFT), a novel osteotomy procedure, has been proposed. (2) Aim: The aim of this retrospective observational study was to consider the different responses to compression of the histological bony compartments (cancellus and cortical). HFT involves the use of multiple drills for the cortical layer preparation and of an osteotome for the osteocompaction of the cancellous bone. (3) Materials and Methods: Following computer-supported implant planning and guided surgery, 10 osteotomies with HFT were performed and 10 implants with the same length and diameter were placed in seven healthy and no daily smoking patients. Periapical X-ray and intraoral photographs were performed at baseline and after 12 months of follow-up to evaluate marginal bone level (MBL) changes and aesthetic results obtained from implant prosthetic rehabilitation. (4) Results: At 1 year of follow-up, 100% of the implants were successfully integrated, MBL change mean value was 0.17 mm ± 0.21. No differences in terms of MBL were noted between thin and thick biotypes. Pink esthetic score (PES) and white esthetic score (WES), assessed one year after definitive restoration placement, were 7.5 ± 2.3 and 8.5 ± 1.1, respectively. (5) Conclusions: Based on the findings of this preliminary clinical study, HFT has led to stability of peri-implant tissues and could represent a reliable technique for surgical preparation of the implant site.
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Affiliation(s)
- Luigi Canullo
- Department of Periodontology, University of Bern, 3012 Bern, Switzerland
| | - Roberta Iacono
- F.A.S Screening for Prevention and Oral Health, Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil
| | | | - Alessio Cavicchia
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence:
| | - Patrizio Bollero
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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