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Crespi R, Toti P, Covani U, Cosola S, Crespi G, Menchini-Fabris GB. Assessment of the alveolar bone loss in fresh socket implant procedures with immediate implant loading via temporary preformed anatomical healing caps: Comparison of two different lengths of the implant collar. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101582. [PMID: 37532082 DOI: 10.1016/j.jormas.2023.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023]
Abstract
PURPOSES The aim of the present clinical and radiologic retrospective study was to evaluate alveolar bone remodeling, in terms of alveolar width and peri‑implant bone level, two years after immediate implant positioning (with two different collar lengths, 0.8 mm and 2.0 mm) and loading of preformed healing cap. The Null hypothesis, H0 is: there was no difference between the two groups of implants. METHODS Patients suffering from single-tooth edentulous areas in premolar, cuspid, and incisive areas were treated with fresh-socket implants and immediate preformed anatomical healing caps. Each final crown restoration was fabricated 3 months later. Primary outcomes (related to loss of the alveolar width and peri‑implant bone level) and secondary outcomes (testing adverse events, and measuring implant/prosthesis survival) were acquired and analyzed. RESULTS A two-year retrospective analysis was conducted on 31 patients (19 female and 12 male), who underwent dental implant placement with implants having two different lengths of the collar: group A, 0.8 mm, and group B, 2.0 mm. As for the width of the alveolar crest, there was a negligible loss (less than half a millimeter) reported for both the groups, anyway reaching a statistical significance. Preoperative alveolar widths (9.50±0.67 mm and 9.45±0.90 mm, respectively for groups A and B) were different from the two-year alveolar widths (9.20±0.74 mm and 8.93±0.99 mm, respectively for groups A and B) with p-values ≤ 0.0049. When the marginal bone loss was assessed, significant differences were registered between the two procedure groups (-1.42±0.34 mm for group A and -0.11±0.15 mm for group B with a p-value < 0.0001). CONCLUSIONS The proper design of a healing abutment was very important to preserve the emergence profile immediately after extraction and implant placement. The length of the implant collar used with an immediate healing abutment appeared to affect the preservation of the alveolar crest with predictable final results.
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Affiliation(s)
- Roberto Crespi
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Paolo Toti
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy
| | - Ugo Covani
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Saverio Cosola
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy
| | - Giovanni Crespi
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy
| | - Giovanni-Battista Menchini-Fabris
- Versilia Hospital, Tuscan Stomatologic Institute, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
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Menchini-Fabris GB, Toti P, Covani U, Trasarti S, Cosola S, Crespi R. Volume assessment of the external contour around immediate implant with or without immediate tooth-like crown provisionalization: A digital intraoral scans study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101418. [PMID: 36758898 DOI: 10.1016/j.jormas.2023.101418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
PURPOSES To examine differences between immediate and delayed dental implant loading in maxillary aesthetic areas. METHODS In this retrospective controlled analysis, 43 subjects who underwent immediate placement of the dental implant in a post-extraction socket were ranked into either immediate (24 implants loaded with non-occlusal tooth-like profile provisional prostheses fabricated by virtual diagnostic impressions and an in-office dental milling machine) or delayed group (19 implants loaded with conventional cover screws and secondary intention healing). Intraoperatively and then four months later, scans of the external layers were acquired with an optical scanner. The width of the alveolar crest and Jemt papilla index were acquired. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS In both groups, the volumes and areas showed significant reductions from the baseline to the 4-month survey. Reductions in volume appeared to be statistically different between the two groups (-39±31 mm3 for the immediate and 89 ± 30 mm3 for the delayed group). The final Jemt papilla index appeared significantly different between the immediate (mesial, 2.5 and, distal, 3) and delayed groups (2 for both aspects). CONCLUSIONS Immediate provisionalization significantly reduced volume loss and area shrinkage at the external layer when data were compared to a delayed rehabilitation strategy.
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Affiliation(s)
- Giovanni Battista Menchini-Fabris
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; San Rossore Dental Unit, San Rossore Private Hospital, Pisa, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
| | - Paolo Toti
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Ugo Covani
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Stefano Trasarti
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Saverio Cosola
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Roberto Crespi
- Tuscan Dental Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
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Menchini-Fabris GB, Cosola S, Toti P, Hwan Hwang M, Crespi R, Covani U. Immediate Implant and Customized Healing Abutment for a Periodontally Compromised Socket: 1-Year Follow-Up Retrospective Evaluation. J Clin Med 2023; 12:jcm12082783. [PMID: 37109120 PMCID: PMC10144425 DOI: 10.3390/jcm12082783] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/02/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Immediate dental implant placement with or without immediate loading is reported in daily dentistry and implantology, but these procedures are not common in the case of periradicular and periapical lesions around the tooth needed to be replaced. In the following retrospective evaluation, 10 cases with a 1-year follow-up were selected to propose the technique of an immediate provisional non-loading prosthesis being delivered on the same day of the post-extraction implant placement in multiradicular teeth affected by chronic periradicular and periapical lesions. Post-extractive sockets underwent immediate dental implant placement by filling the empty space with sterile, re-absorbable gelatin sponges. The widths of the alveolar ridge were measured on three-dimensional radiographs before and after the operation, 4 and 12 months later. Non-parametric statistics were performed to compare the outcomes over time with a level of significance of 0.05. Comparing the preoperative cross-sectional images of cone beam computerized tomography (CBCT) scans to the postoperative ones, it was noted that changes in the crestal ridge width, ΔCW, (compared to baseline) were negligible and not clinically appreciable. However, while ΔCW at 4 months appeared to be negative (-0.17 ± 045 mm), crestal width at 12 months was at the same level as the baseline (ΔCW = 0.02 ± 0.48 mm), with a significant difference between 4 and 12 months (p-value = 0.0494). Immediate implant placement with an immediate non-loading provisional customized healing abutment of polyether-ether-ketone placed into the post-extractive sockets with asymptomatic and large chronic periapical and periradicular lesions could represent a further treatment strategy for patients' rehabilitation and soft tissue preservation to replace a hopeless tooth.
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Affiliation(s)
- Giovanni-Battista Menchini-Fabris
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- San Rossore Dental Unit, San Rossore Private Hospital, 56122 Pisa, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Saverio Cosola
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
| | - Paolo Toti
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Myoung Hwan Hwang
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- New Smiles Dental Implant Center Galleria, 2930 Chimney Rock Rd, Houston, TX 77057, USA
| | - Roberto Crespi
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy
- Department of Dentistry, Unicamillus International Medical University, 00100 Rome, Italy
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A Retrospective Digital Analysis of Contour Changing after Tooth Extraction with or without Using Less Traumatic Surgical Procedures. J Clin Med 2022; 11:jcm11040922. [PMID: 35207192 PMCID: PMC8875248 DOI: 10.3390/jcm11040922] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss. METHODS In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01. RESULTS significant reductions of anatomical features were observed four months later in all the groups (p-values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm3 for atraumatic extractions and 0.66 ± 0.19 cm3 for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = -0.30 ± 0.10 cm3 and ΔV% = -22.3 ± 8.4%) compared to the conventional extractions (ΔV = -0.59 ± 0.10 cm3 and ΔV% = -44.3 ± 5.8%) with p-values < 0.0001. CONCLUSIONS at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.
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Bennardo F, Barone S, Vocaturo C, Nucci L, Antonelli A, Giudice A. Usefulness of Magnetic Mallet in Oral Surgery and Implantology: A Systematic Review. J Pers Med 2022; 12:jpm12010108. [PMID: 35055423 PMCID: PMC8781210 DOI: 10.3390/jpm12010108] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 01/03/2023] Open
Abstract
This systematic review aimed to answer the question: “Is the use of magnetic mallet effective in oral and implant surgery procedures in terms of tissue healing, surgery outcome, and complication rate compared to traditional instruments?” A literature search of PubMed, Scopus, and Web of Science databases (articles published until 1 October 2021) was conducted, in accordance with the PRISMA statement, using the keywords “magnetic mallet”, “electric mallet”, “oral surgery”, “implantology”, and “dental implant”. Of 252 articles, 14 were included in the review (3 for teeth extraction, and 11 for implant dentistry). Out of a total of 619 dental extractions (256 patients) performed with the magnetic mallet (MM), no complications were reported. Implants inserted totaled 880 (525 patients): 640 in the MM groups (382), and 240 in control groups (133). The survival rate of implants was 98.9% in the MM groups, and 95.42% in the control groups. Seven patients experienced benign paroxysmal positional vertigo after implant surgery, all in control groups. Results are not sufficient to establish the effectiveness of MM in oral and implant surgery procedures. Randomized controlled trials with a large sample size are needed.
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Affiliation(s)
- Francesco Bennardo
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.B.); (A.G.)
- Correspondence: (F.B.); (A.A.); Tel.: +39-346-180-2826 (F.B.); +39-392-231-8180 (A.A.)
| | - Selene Barone
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.B.); (A.G.)
| | | | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Study of Campania, Luigi Vanvitelli, 80138 Naples, Italy;
| | - Alessandro Antonelli
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.B.); (A.G.)
- Correspondence: (F.B.); (A.A.); Tel.: +39-346-180-2826 (F.B.); +39-392-231-8180 (A.A.)
| | - Amerigo Giudice
- School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.B.); (A.G.)
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Variations in Soft and Hard Tissues following Immediate Implant Placement versus Delayed Implant Placement following Socket Preservation in the Maxillary Esthetic Region: A Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5641185. [PMID: 34646885 PMCID: PMC8505071 DOI: 10.1155/2021/5641185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 01/02/2023]
Abstract
Introduction Although retrospective analysis has shown immediate placement of implants (IIP) in the maxillary esthetic zone showing promising outcomes compared to delayed placement of implants following socket preservation (DIP), a direct comparison in a prospective, well-designed randomized fashion with adequate power analysis between the two implant placement protocols is still lacking. This study is aimed at radiographically evaluating the effect of IIP after extraction as compared to implant placed in preserved sockets 4 months following extraction (DIP) in terms of changes in buccal plate thickness(CBT) after 6 months of healing and evaluation of pink esthetic score (PES) for assessment of soft tissue changes and patient-related outcome measures (PROMs) using visual analogue scale (VAS). Materials and Methods 25 implants were placed immediately following extraction in the IIP group, and 25 implants were placed four months following socket preservation with demineralized bovine bone mineral (DBBM) and advanced platelet-rich fibrin (A-PRF) in the DIP group, control group, in the maxillary esthetic region. CBCT was taken preoperatively and 6 months postoperatively to assess the dimensional changes in the buccal bone plates(CBT). PES and PROMs for pain threshold and patient satisfaction using VAS were evaluated at the time of implant placement and 6 months postoperatively. Results Significant differences in mean reduction in buccal plate thickness (CBT) were found in the test group (IIP) 0.2 ± 0.02 compared to the control group (DIP) which showed a mean reduction in CBT of 0.4 ± 0.1 (p < 0.001) at the end of 6 months. Although there was no statistically significant difference in PES between the groups, there was a significant difference between the groups when individual values of PES were compared at p < 0.001. Conclusion The IIP group showed lesser reduction in CBT and a better PES which is an important clinical information which could be translated clinically in situations where implant placement is planned in the maxillary esthetic region. This trial is registered with CTRI/2019/06/019723.
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