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Bérczy K, Göndöcs G, Komlós G, Shkolnik T, Szabó G, Németh Z. Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study. Maxillofac Plast Reconstr Surg 2024; 46:6. [PMID: 38416263 PMCID: PMC10902233 DOI: 10.1186/s40902-024-00419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants. METHODS Patients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed. RESULTS Thirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally). CONCLUSIONS In this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.
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Affiliation(s)
- Kinga Bérczy
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary.
| | - György Göndöcs
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Komlós
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Tatiana Shkolnik
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - György Szabó
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
| | - Zsolt Németh
- Faculty of Dentistry, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária Street 52, 1085, Budapest, Hungary
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Romasco T, Pignatelli P, Tumedei M, Hossein HHS, Cipollina A, Piattelli A, Inchingolo F, Di Pietro N. The influence of truncated-conical implant length on primary stability in maxillary and mandibular regions: an in vitro study using polyurethane blocks. Clin Oral Investig 2023; 28:28. [PMID: 38147179 DOI: 10.1007/s00784-023-05444-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This in vitro study is aimed at assessing whether implant primary stability is influenced by implant length in artificial bone with varying densities. MATERIALS AND METHODS A total of 120 truncated-conical implants (60 long-length: 3p L, 3.8 × 14 mm; 60 short-length: 3p S, 3.8 × 8 mm) were inserted into 20, 30, and 40 pounds per cubic foot (PCF) density polyurethane blocks. The insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values were recorded for each experimental condition. RESULTS In 30 and 40 PCF blocks, 3p S implants exhibited significantly higher IT values (90 and 80 Ncm, respectively) than 3p L (85 and 50 Ncm, respectively). Similarly, RT was significantly higher for 3p S implants in 30 and 40 PCF blocks (57 and 90 Ncm, respectively). However, there were no significant differences in RFA values, except for the 20 PCF block, where 3pS implants showed significantly lower values (63 ISQ) than 3p L implants (67 ISQ) in both the distal and mesial directions. CONCLUSIONS These results demonstrated that the implant's length mainly influences the IT and RT values in the polyurethane blocks that mimic the mandibular region of the bone, resulting in higher values for the 3p S implants, while the RFA values remained unaffected. However, in the lowest density block simulating the maxillary bone, 3p L implants exhibited significantly higher ISQ values. CLINICAL RELEVANCE Therefore, our data offer valuable insights into the biomechanical behavior of these implants, which could be clinically beneficial for enhancing surgical planning.
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Affiliation(s)
- Tea Romasco
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio, University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Hamid Heydari Sheikh Hossein
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio, University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
- Villa Serena Foundation for Research, Via Leonardo Petruzzi 42, 65013, Città Sant'Angelo, Italy
| | | | - Adriano Piattelli
- School of Dentistry, Saint Camillus International, University of Health and Medical Sciences, Via di Sant'Alessandro 8, 00131, Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, Av. de los Jerónimos 135, 30107, Guadalupe de Maciascoque, Spain
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Piazza Umberto I, 70121, Bari, Italy
| | - Natalia Di Pietro
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio, University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy.
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy.
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Comuzzi L, Tumedei M, Di Pietro N, Romasco T, Heydari Sheikh Hossein H, Montesani L, Inchingolo F, Piattelli A, Covani U. A Comparison of Conical and Cylindrical Implants Inserted in an In Vitro Post-Extraction Model Using Low-Density Polyurethane Foam Blocks. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5064. [PMID: 37512339 PMCID: PMC10384017 DOI: 10.3390/ma16145064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023]
Abstract
Combining tooth extraction and implant placement reduces the number of surgical procedures that a patient must undergo. Thus, the present study aimed to compare the stability of two types of conical implants (TAC and INTRALOCK) and another cylindrical one (CYROTH), inserted with a range of angulation of 15-20 degrees in low-density polyurethane blocks (10 and 20 pounds per cubic foot, PCF) with or without a cortical lamina (30 PCF), which potentially mimicked the post-extraction in vivo condition. For this purpose, a total of 120 polyurethane sites were prepared (10 for each implant and condition) and the Insertion Torque (IT), Removal Torque (RT), and Resonance Frequency Analysis (RFA) were measured, following a Three-Way analysis of variance followed by Tukey's post hoc test for the statistical analysis of data. The IT and RT values registered for all implant types were directly proportional to the polyurethane density. The highest IT was registered by INTRALOCK implants in the highest-density block (32.44 ± 3.28 Ncm). In contrast, the highest RFA, a well-known index of Implant Stability Quotient (ISQ), was shown by TAC implants in all clinical situations (up to 63 ISQ in the 20 PCF block without the cortical sheet), especially in lower-density blocks. Although more pre-clinical and clinical studies are required, these results show a better primary stability of TAC conical implants in all tested densities of this post-extraction model, with a higher ISQ, despite their IT.
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Affiliation(s)
- Luca Comuzzi
- Independent Researcher, San Vendemiano-Conegliano, 31020 Treviso, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, 20122 Milan, Italy
- Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Tea Romasco
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
| | - Hamid Heydari Sheikh Hossein
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Center for Advanced Studies and Technology-CAST, "G. D'Annunzio" University of Chieti-Pescara, 66013 Chieti, Italy
- Villa Serena Foundation for Research, Via Leonardo Petruzzi 42, 65013 Città Sant'Angelo, Italy
| | | | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
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Heitzer M, Kniha K, Katz MS, Winnand P, Peters F, Möhlhenrich SC, Hölzle F, Modabber A. The primary stability of two dental implant systems in low-density bone. Int J Oral Maxillofac Surg 2022; 51:1093-1100. [PMID: 35339332 DOI: 10.1016/j.ijom.2022.02.012] [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: 04/06/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022]
Abstract
Primary stability in low-density bone is crucial for the long-term success of implants. Tapered implants have shown particularly favourable properties under such conditions. The aim of this study was to compare the primary stability of tapered titanium and novel cylindrical zirconia dental implant systems in low-density bone. Fifty implants (25 tapered, 25 cylindrical) were placed in the anterior maxillary bone of cadavers meeting the criteria of low-density bone. The maximum insertion (ITV) and removal (RTV) torque values were recorded, and the implant stability quotients (ISQ) determined. To establish the isolated influence of cancellous bone on primary stability, the implantation procedure was performed in standardized low-density polyurethane foam bone blocks (cancellous bone model) using the same procedure. The primary stability parameters of both implant types showed significant positive correlations with bone density (Hounsfield units) and cortical thickness. In the cadaver, the cylindrical zirconia implants showed a significantly higher mean ISQ when compared to the tapered titanium implants (50.58 vs 37.26; P < 0.001). Pearson analysis showed significant positive correlations between ITV and ISQ (P = 0.016) and between RTV and ISQ (P = 0.035) for the cylindrical zirconia implants; no such correlations were observed for the tapered titanium implants. Within the limitations of this study, the results indicate that cylindrical zirconia implants represent a comparable viable treatment option to tapered titanium implants in terms of primary implant stability in low-density human bone.
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Affiliation(s)
- M Heitzer
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany.
| | - K Kniha
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - M S Katz
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - P Winnand
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - F Peters
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - F Hölzle
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - A Modabber
- Department of Oral and Craniomaxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany
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Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study. MATERIALS 2021; 14:ma14071728. [PMID: 33915933 PMCID: PMC8036940 DOI: 10.3390/ma14071728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/14/2023]
Abstract
(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.
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Ibrahim A, Heitzer M, Bock A, Peters F, Möhlhenrich SC, Hölzle F, Modabber A, Kniha K. Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4349. [PMID: 33007841 PMCID: PMC7579538 DOI: 10.3390/ma13194349] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 12/12/2022]
Abstract
AIM This in vitro study aimed to evaluate the effects of implant designs on primary stability in different bone densities and bony defects. METHODS Five implant types (tapered-tissue-level, tissue-level, zirconia-tissue-level, bone-level, and BLX implants) were used in this assessment. The implants were inserted into four different artificial bone blocks representing varying bone-density groups: D1, D2, D3, and D4. Aside from the control group, three different types of defects were prepared. Using resonance frequency analysis and torque-in and -out values, the primary stability of each implant was evaluated. RESULTS With an increased defect size, all implant types presented reduced implant stability values measured by the implant stability quotient (ISQ) values. Loss of stability was the most pronounced around circular defects. Zirconia and bone-level implants showed the highest ISQ values, whereas tissue level titanium implants presented the lowest stability parameters. The implant insertion without any thread cut led to a small improvement in primary implant stability in all bone densities. CONCLUSIONS Compared with implants with no peri-implant defects, the three-wall and one-wall defect usually did not provide significant loss of primary stability. A significant loss of stability should be expected when inserting implants into circular defects. Implants with a more aggressive thread distance could increase primary stability.
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Affiliation(s)
- Ahmad Ibrahim
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | - Marius Heitzer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | - Anna Bock
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | - Florian Peters
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | | | - Frank Hölzle
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | - Ali Modabber
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
| | - Kristian Kniha
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074 Aachen, Germany; (A.I.); (M.H.); (A.B.); (F.P.); (F.H.); (A.M.)
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Evaluation of Insertion Energy as Novel Parameter for Dental Implant Stability. J Clin Med 2020; 9:jcm9092977. [PMID: 32942697 PMCID: PMC7565125 DOI: 10.3390/jcm9092977] [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: 08/21/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/17/2022] Open
Abstract
Insertion energy has been advocated as a novel measure for primary implant stability, but the effect of implant length, diameter, or surgical protocol remains unclear. Twenty implants from one specific bone level implant system were placed in layered polyurethane foam measuring maximum insertion torque, torque–time curves, and primary stability using resonance frequency analysis (RFA). Insertion energy was calculated as area under torque–time curve applying the trapezoidal formula. Statistical analysis was based on analysis of variance, Tukey honest differences tests and Pearson’s product moment correlation tests (α = 0.05). Implant stability (p = 0.01) and insertion energy (p < 0.01) differed significantly among groups, while maximum insertion torque did not (p = 0.17). Short implants showed a significant decrease in implant stability (p = 0.01), while reducing implant diameter did not cause any significant effect. Applying the drilling protocol for dense bone resulted in significantly increased insertion energy (p = 0.02) but a significant decrease in implant stability (p = 0.04). Insertion energy was not found to be a more reliable parameter for evaluating primary implant stability when compared to maximum insertion torque and resonance frequency analysis.
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