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Brauer HU, Mamar AK, Bartols A, Korsch M. All-on-4 Concept With Use Of Zygoma Implants for Rehabilitation in the Severely Atrophied Maxilla With a Definitive Immediate Restoration. J ORAL IMPLANTOL 2024; 50:173-177. [PMID: 38530850 DOI: 10.1563/aaid-joi-d-23-00130] [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: 03/28/2024]
Abstract
This case report of a 45-year-old patient at initial presentation shows an illustration of the limitations of periodontal maintenance therapy and subsequent implant prosthetic therapy. In close consultation with the patient, treatment strategies were adopted to maximize the preservation of prognostically questionable teeth. Eight years later, the patient had a highly atrophied maxilla that could be successfully restored with implants. This was achieved with 2 zygoma implants and 2 anterior conventional implants, which were immediately loaded according to the All-on-4 concept and immediately provided with a definitive prosthetic restoration. The case report demonstrates to the general practitioner that using zygoma implants in such constellations may offer a solution to achieve a fixed, rapid, and financially acceptable prosthetic rehabilitation.
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Affiliation(s)
- Hans Ulrich Brauer
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
| | - Abdel-Karim Mamar
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
| | - Andreas Bartols
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
| | - Michael Korsch
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
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2
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Manfredini M, Pellegrini M, Rigoni M, Veronesi V, Beretta M, Maiorana C, Poli PP. Oral health-related quality of life in implant-supported rehabilitations: a prospective single-center observational cohort study. BMC Oral Health 2024; 24:531. [PMID: 38704566 PMCID: PMC11069144 DOI: 10.1186/s12903-024-04265-y] [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: 06/29/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Oral Health-Related Quality of Life (OHRQoL) is a comprehensive concept covering daily comfort, self-esteem, and satisfaction with oral health, including functional, psychological, and social aspects, as well as pain experiences. Despite abundant research on OHRQoL related to oral diseases and hygiene, there is limited data on how patients perceive changes after implant-prosthetic rehabilitation. This study aimed to evaluate OHRQoL and aesthetic perception using OHIP-14 and VAS scales respectively, before (baseline-TB), during (provisional prostheses-TP), and after (definitive prostheses-TD) implant-prosthetic rehabilitation. It also explored the impact of biological sex, substitution numbers, and aesthetic interventions on OHRQoL and VAS scores, along with changes in OHIP-14 domains. METHODS A longitudinal prospective single-center observational cohort study was conducted with patients requiring implant-prosthetic rehabilitation. Quality of life relating to dental implants was assessed through the Italian version of Oral Health Impact Profile-14 (IOHIP-14), which has a summary score from 14 to 70. Patients' perceived aesthetic was analyzed through a VAS scale from 0 to 100. Generalized Linear Mixed Effect Models, Linear Mixed Effect Models, and Friedman test analyzed patient responses. RESULTS 99 patients (35 males, 64 females) aged 61-74, receiving various prosthetic interventions, were enrolled. Both provisional and definitive prosthetic interventions significantly decreased the odds of a worse quality of life compared to baseline, with odds ratios of 0.04 and 0.01 respectively. VAS scores increased significantly after both interventions, with estimated increases of 30.44 and 51.97 points respectively. Patient-level variability was notable, with an Intraclass Correlation Coefficient (ICC) of 0.43. While biological sex, substitution numbers, and aesthetic interventions didn't significantly affect VAS scores, OHRQoL domains showed significant changes post-intervention. CONCLUSIONS These findings support the effectiveness of implant-prosthetic interventions in improving the quality of life and perceived aesthetics of patients undergoing oral rehabilitation. They have important implications for clinical practice, highlighting the importance of individualized treatment approaches to optimize patient outcomes and satisfaction in oral health care.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Matteo Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy.
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy.
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Valentina Veronesi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
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3
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Fernandes G, Aras M, Chitre V, Coutinho I, Mascarenhas K. Rehabilitation of Edentulous Arch Using All-on-Four Treatment Protocol: A Case Report. Cureus 2024; 16:e58919. [PMID: 38800271 PMCID: PMC11121617 DOI: 10.7759/cureus.58919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.
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Affiliation(s)
- Grazina Fernandes
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Panaji, IND
| | - Meena Aras
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Panaji, IND
| | - Vidya Chitre
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Panaji, IND
| | - Ivy Coutinho
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Panaji, IND
| | - Kennedy Mascarenhas
- Department of Prosthodontics and Crown and Bridge, Goa Dental College and Hospital, Panaji, IND
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Giovanella F, Bezerra F, Dantas Soares MA, Oliveira G, Ghiraldini B. A Technical Note on a Modified Subcrestal Buccal Flap Approach to All-on-Four: A Case Report. Cureus 2024; 16:e58453. [PMID: 38765329 PMCID: PMC11100272 DOI: 10.7759/cureus.58453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
This case report describes a dual full-arch rehabilitation focusing on a modified buccal incision for installation of four implants for full-arch rehabilitation of an edentulous maxilla. A modified buccal incision was performed in the subcrestal buccal region to promote direct access to the periosteum without incising the muscles in the region. For the installation of anterior implants, an 8.5 mm implant was locked in the cortical bone of the alveolar ridge and in the cortical bone of the floor of the pyriform cavity. The drilling point of the posterior implants was defined using the anterior implants as a visual reference, and the entry point could be visually estimated from the topography of the palatal surface of the maxilla. After bone leveling, the drilling enlargement sequence was carried out using drills that allowed the installation of long implants (18 mm). Straight mini-abutments were installed in the anterior implants and angled at 30º in the posterior implants. The flap was then perforated in the exact region where the mini-abutments were located. The buccal incision line was sutured with continuous 5-0 nylon suture. On the following day, aesthetic tests were carried out with teeth mounting. The patient presented minimal edema, and the lip motricity and smile width were completely preserved. The prosthesis was delivered five days after surgery. The suture was removed, and the prosthesis was installed while maintaining compression on the gingival tissue. The patient reported no pain during the prosthesis installation. The modified buccal flap enables implant placement for full-arch rehabilitation of an edentulous maxilla.
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Affiliation(s)
| | - Fábio Bezerra
- Biotechnology, Universidade Estadual Paulista (UNESP), São Paulo, BRA
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5
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Minase DA, Sathe S, Borle A, Pathak A, Jaiswal T. Less Is More: A Case Report on All-on-4 Prosthesis. Cureus 2024; 16:e54873. [PMID: 38533146 PMCID: PMC10964220 DOI: 10.7759/cureus.54873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
Severe alveolar ridge atrophy following tooth removal poses a common and worsening issue in edentulous jaws, affecting patient comfort and quality of life. The All-on-4 approach involves axially positioning two anterior implants and distally orienting two posterior implants, reducing cantilever length and enabling prostheses with 12 teeth. This less invasive option, utilizing distal tilting of implants at 30°, offers biomechanical advantages and has shown short-term success, though long-term research is limited. Immediate-loading treatments are gaining popularity for their high survival rates. Understanding the biomechanics of implant-supported prostheses is crucial for long-term success, emphasizing the importance of optimal occlusal schemes. Challenges such as bone defects and surgical complexity have led to the exploration of achieving full-arch fixed restorations with fewer implants, building upon Brånemark's early work with four implants. The All-on-4 concept, originating in 1999, proves to be a viable treatment option, providing excellent long-term results and improved load distribution in challenging clinical circumstances. This case report explores the successful rehabilitation of a jaw using the All-on-4 implant prosthesis concept, a technique strategically placing four implants in completely edentulous jaws to support a fixed, immediately loaded prosthesis.
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Affiliation(s)
- Dhanashree A Minase
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Seema Sathe
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anjali Borle
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ankita Pathak
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tanvi Jaiswal
- Prosthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Nagib MA, Ibrahim AM, Abdel-Rahman FH, Hegazy SA, Habib A. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024; 25:141-147. [PMID: 38514411 DOI: 10.5005/jp-journals-10024-3632] [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: 03/23/2024]
Abstract
AIM To compare between the rehabilitation of atrophied maxilla with fixed prosthesis using two posterior zygomatic implants and two conventional anterior implants or four implants inserted according to the all-on-four concept regarding the patient quality of life and satisfaction after one year of prosthesis insertion. MATERIALS AND METHODS Thirty-six patients with atrophic edentulous maxillae were randomized into two groups: Group I (rehabilitated with fixed prostheses supported by two zygomatic and two conventional implants in the anterior region) and group II (fixed prostheses on four implants in the anterior region following an all-on-four concept). One year after the placement of the definitive prostheses, patients completed oral health impact profile-14 and satisfaction questionnaires. RESULTS All patients were satisfied regarding retention, stability, occlusion, comfort, cleaning, speaking, chewing, bolus quality, appearance, handling, prosthesis apart, and embarrassing, with no significant significance between two groups except satisfaction with surgical procedures and healing period. CONCLUSIONS Using two distally tilted zygomatic implants or all-on-four concept to rehabilitate atrophied maxilla by fixed detachable prosthesis could be considered a promising functional and esthetic treatment option regarding the patient satisfaction. CLINICAL SIGNIFICANCE Traditionally, treatment of maxillary atrophied ridges was done by bone grafting or sinus-lifting techniques; however, using all-on-four concept or zygomatic implants was a successful treatment as it has high success rates and highly satisfied by the patients. How to cite this article: Nagib MA, Ibrahim AM, Abdel-Rahman FH, et al. Evaluation of Quality of Life and Satisfaction with Fixed Prostheses on Zygomatic Implants vs All-on-Four Concept: A Randomized Clinical Study. J Contemp Dent Pract 2024;25(2):141-147.
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Affiliation(s)
- Mohamed A Nagib
- Department of Prosthodontics, Delta University for Science and Technology, Dakahlia, Mansoura, Egypt, e-mail:
| | - Abdullah M Ibrahim
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
| | | | - Salah A Hegazy
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
| | - Ahmed Habib
- Department of Prosthodontics, Mansoura University, Dakahlia, Mansoura, Egypt
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Szabó ÁL, Matusovits D, Slyteen H, Lakatos ÉI, Baráth Z. Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA). Dent J (Basel) 2023; 11:261. [PMID: 37999025 PMCID: PMC10670282 DOI: 10.3390/dj11110261] [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: 09/13/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1-LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1-where masticatory forces covered the entire mesio-distal surface of the denture, including the cantilever-was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97-15.87% and 87.96-94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.
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Affiliation(s)
- Árpád László Szabó
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Danica Matusovits
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Haydar Slyteen
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Éva Ilona Lakatos
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
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Sanavia C, Vallerga E, Alessi F, Tealdo T, Bevilacqua M, Alberti C, Menini M, Pesce P. Five Steps for the Maintenance and Interception of Complications in Zygomatic Implants. Dent J (Basel) 2023; 11:226. [PMID: 37886911 PMCID: PMC10605483 DOI: 10.3390/dj11100226] [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: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Zygomatic implants are used for the rehabilitation of the upper jaw of patients with severe and moderate bone atrophy. Possible post-surgical complications include soft tissue dehiscence, sinusitis, and prosthodontic fractures, and maintaining an accurate control is crucial. Additionally, zygomatic implants have a unique peri-implant anatomy, making traditional periodontal parameters unsuitable. The present paper aims to provide guidelines for the maintenance and interception of complications in patients rehabilitated with these kinds of implants. The proposed protocol includes: 1. intra/extraoral and temporo-mandibular joint examination; 2. soft tissue and transmucosal path observation with magnifiers; 3. peri-implant health indices and digital stimulation of tissues; 4. examination of prosthodontic devices; and 5. photographic recording. These steps facilitate the comprehensive evaluation and monitoring of clinical conditions of zygomatic-supported rehabilitations, including dehiscence and occlusal wear during follow-up appointments.
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Affiliation(s)
- Consuela Sanavia
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | | | - Fanny Alessi
- Independent Researcher, 36027 Rosà, Italy; (F.A.); (C.A.)
| | - Tiziano Tealdo
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | - Marco Bevilacqua
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
| | | | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy;
| | - Paolo Pesce
- Department of Surgical Sciences, University of Genoa, 16126 Genoa, Italy; (C.S.); (T.T.); (M.B.)
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Polido WD, Machado-Fernandez A, Lin WS, Aghaloo T. Indications for zygomatic implants: a systematic review. Int J Implant Dent 2023; 9:17. [PMID: 37391575 DOI: 10.1186/s40729-023-00480-4] [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: 02/06/2023] [Accepted: 05/09/2023] [Indexed: 07/02/2023] Open
Abstract
PURPOSE The purpose of this systematic review was to assess the evidence regarding the indications for placement of zygomatic implants to rehabilitate edentulous maxillae. MATERIAL AND METHODS A focused question using the PIO format was developed, questioning "in patients in need of an implant-supported rehabilitation of the edentulous maxillae, what are the indications for the use of zygomatic implants''. The primary information analyzed and collected was a clear description of the indication for the use of zygomatic implants. RESULTS A total of 1266 records were identified through database searching. The full-text review was conducted for 117 papers, and 10 were selected to be included in this review. Zygomatic implant indications were extreme bone atrophy or deficiency secondary to different factors. The quad zygoma concept (two zygomatic implants bilaterally placed and splinted) was applied to 107 patients, the classic zygoma concept (one zygomatic implant bilaterally placed and splinted to standard anterior implants) was used in 88 patients, and the unilateral concept (one zygomatic implant on one side, splinted with one or more conventional implants) was employed in 14 patients. CONCLUSIONS The main indication for the use of zygomatic implants was considered extreme maxillary bone atrophy, resulting from many factors. The clear definition of what was considered "extreme bone atrophy" is not uniquely defined in each paper. Further studies are needed to develop clear indications for zygomatic implants.
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Affiliation(s)
- Waldemar D Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, USA.
| | | | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Tara Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
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10
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Kämmerer PW, Fan S, Aparicio C, Bedrossian E, Davó R, Morton D, Raghoebar GM, Zarrine S, Al-Nawas B. Evaluation of surgical techniques in survival rate and complications of zygomatic implants for the rehabilitation of the atrophic edentulous maxilla: a systematic review. Int J Implant Dent 2023; 9:11. [PMID: 37198345 DOI: 10.1186/s40729-023-00478-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023] Open
Abstract
PURPOSE To assess the outcome [zygomatic implant (ZI) survival] and complications of the original surgical technique (OST) and an Anatomy-Guided approach (AGA) in the placement of ZI in patients with severely atrophic maxillae. METHODS Two independent reviewers conducted an electronic literature search from January 2000 to August 2022. The inclusion criteria were articles reporting at least five patients with severely atrophic edentulous maxilla undergoing placement OST and/or AGA, with a minimum of 6 months of follow-up. Number of patients, defect characteristics, number of ZI, implant details, surgical technique, survival rate, loading protocol, prosthetic rehabilitation, complications, and follow-up period were compared. RESULTS Twenty-four studies comprised 2194 ZI in 918 patients with 41 failures. The ZI survival rate was 90.3-100% in OST and 90.4-100% in AGA. Probability of complications with ZI with OST was as follows: sinusitis, 9.53%; soft tissue infection, 7.50%; paresthesia, 10.78%; oroantral fistulas, 4.58%; and direct surgical complication, 6.91%. With AGA, the presenting complications were as follows: sinusitis, 4.39%; soft tissue infection, 4.35%; paresthesia, 0.55%; oroantral fistulas, 1.71%; and direct surgical complication, 1.60%. The prevalence of immediate loading protocol was 22.3% in OST and 89.6% in the AGA. Due to the heterogeneity of studies, statistical comparison was only possible after the descriptive analysis. CONCLUSIONS Based on the current systematic review, placing ZI in severely atrophic edentulous maxillae rehabilitation with the OST and AGA is associated with a high implant survival rate and surgical complications within a minimum of 6 months follow-up. Complications, including sinusitis and soft tissue infection around the implant, are the most common. The utilization of immediate loading protocol is more observed in AGA than in OST.
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Affiliation(s)
- Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, School of Medicine Second Dental Clinic, Ninth People's Hospital, National Clinical Research Center for Oral Disease, College of Stomatology, Shanghai Jiao Tong University, 200011, Shanghai, China
| | - Carlos Aparicio
- Indiana University School of Dentistry, Indianapolis, USA
- Zygomatic Unit at Hepler Bone Clinic, ZAGA Center Barcelona, Barcelona, Spain
| | - Edmond Bedrossian
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, USA
| | - Rubén Davó
- Department of Implantology and Maxillofacial Surgery, Vithas Davó Instituto Dental, Alicante, Spain
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, USA
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | | | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
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11
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Patient Satisfaction and Impact on Oral Health after Maxillary Rehabilitation Using a Personalized Additively Manufactured Subperiosteal Jaw Implant (AMSJI). J Pers Med 2023; 13:jpm13020297. [PMID: 36836531 PMCID: PMC9965586 DOI: 10.3390/jpm13020297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Subperiosteal implants (SIs) were first developed by Dahl in 1941 for oral rehabilitation in case of severe jaw atrophy. Over time, this technique was abandoned due to the high success rate of endosseous implants. The emergence of patient-specific implants and modern dentistry allowed a revisitation of this 80-year-old concept resulting in a novel "high-tech" SI implant. This study evaluates the clinical outcomes in forty patients after maxillary rehabilitation with an additively manufactured subperiosteal jaw implant (AMSJI®). The oral health impact profile-14 (OHIP-14) and numerical rating (NRS) scale were used to assess patient satisfaction and evaluate oral health. In total, fifteen men (mean age: 64.62 years, SD ± 6.75 years) and twenty-five women (mean age: 65.24 years, SD ± 6.77 years) were included, with a mean follow-up time of 917 days (SD ± 306.89 days) after AMSJI installation. Patients reported a mean OHIP-14 of 4.20 (SD ± 7.10) and a mean overall satisfaction based on the NRS of 52.25 (SD ± 4.00). Prosthetic rehabilitation was achieved in all patients. AMSJI is a valuable treatment option for patients with extreme jaw atrophy. Patients enjoy treatment benefits resulting in high patient satisfaction rates and impact on oral health.
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Beleva N. Change in hospital admissions in dental diseases before and during the COVID-19 pandemic. APPLIED NANOSCIENCE 2023; 13:2179-2185. [PMID: 35155059 PMCID: PMC8820364 DOI: 10.1007/s13204-021-02106-w] [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: 07/30/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022]
Abstract
In this retrospective cross-sectional study, it was aimed to evaluate the negative effects of the pandemic process in the field of oral health by revealing the characteristics of applications made to a hospital related to oral health before and during the pandemic. Patient records who applied to Cyprus Science University Dentistry Hospital between October 2019 and March 2021 were included in the study. Gender, age, applied unit, applying frequency and procedure records were evaluated. Ethical approval was taken from Cyprus Science University. Patient records were divided into two groups as before pandemic (n = 338) and during pandemic (n = 1517). Results of the study showed that gender, age and applied unit distributions were not significantly different between before and during pandemic (p > 0.05). Female and prosthesis applied patients were more common before and after COVID-19 pandemic. Detertrage, tooth extraction, night plaque, temporary cron, metal supported porcelain crown on implant, compomer filler and orthodontic diagnosis rates were decreased during pandemic, compared to before pandemic. Panaromic X-ray was the most common process before and during the pandemic. The differences between before and during pandemic were statistically significant (p < 0.05). The results of the research show that the pandemic process in terms of oral health caused significant differences in the reasons for application, even in the population aged 34-36, the majority of whom are women.
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Affiliation(s)
- Nadejda Beleva
- Health and Social Sciences, University of Cyprus, Nicosia, Cyprus
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Abd El Rahim NS, Ashour AA. Assessment of Quality of Life and Supporting Structures in Implant Retained Mandibular Overdenture: A 5-Year Cohort Study. Clin Cosmet Investig Dent 2022; 14:171-182. [PMID: 35722442 PMCID: PMC9198266 DOI: 10.2147/ccide.s364814] [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: 03/02/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Aim To assess oral health-related quality of life (OHRQoL), marginal bone loss (MBL), and changes in soft tissue including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods. Methods Forty completely edentulous patients with age 51-64 years were recruited for that longitudinal cohort study. Complete dentures were performed for all participants. Two implants (3.6 × 11.5 mm) were installed in the canine areas of the mandible. OHRQoL and MBL measures were performed every 1 year for 5 years, while clinical measures were made every 6 months for 60 months. Data were examined using repeated ANOVA and Friedman test. Results Thirty-seven patients had 74 implants; with mean age 56 ± 3.6 years; 43% females (n = 16) and 57% males (n = 21) accomplished the study. There were statistically significant differences in OHRQoL, MBL, and changes in soft tissue, including probing pocket depth and implant stability in 2 implants retained mandibular overdentures during 5 years follow-up periods, p ≤ 0.05. Conclusion Mandibular overdentures retained by 2 implants provide a positive long-term effect on OHRQoL, MBL, probing pocket depth, and implant stability.
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Affiliation(s)
- Neveen S Abd El Rahim
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Cairo, Egypt.,Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - Asmaa A Ashour
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al- Azhar University, Cairo, Egypt
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Grecchi F, Grecchi E, Del Fabbro M, Goker F. Simultaneous Le Fort I osteotomy and zygomatic implant placement. J Craniomaxillofac Surg 2021; 50:114-123. [PMID: 34895830 DOI: 10.1016/j.jcms.2021.12.003] [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: 01/22/2021] [Revised: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 11/26/2022] Open
Abstract
The aim of this retrospective study was to evaluate the outcomes of simultaneous LeFort I osteotomy and zygomatic/dental implant placement for oral rehabilitation of patients with extremely atrophic/dysmorphic edentulous maxilla. Simultaneous LeFort I osteotomy and zygomatic/dental implant placement was performed with patient-specific anatomical models and surgical guides produced through three-dimensional virtual planning methods. All patients received their final prosthesis, with immediate loading, on the day after surgery. The primary outcome variables were the implant survival rate, and the incidence of intra/postoperative complications. In total, 15 zygomatic implants and 33 conventional dental implants were inserted in eight patients. The mean follow-up of the patients was 38.5 months. The implant survival rate was 93.3% for zygomatic implants and 100% for dental implants. No intra/postoperative complications were observed. Simultaneous LeFort I osteotomy associated with zygomatic/dental implant surgery can be considered as a valuable treatment option for rehabilitation of patients with extremely atrophic edentulous maxilla and esthetic issues of the face.
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Affiliation(s)
- Francesco Grecchi
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi, 4, 20161, Milano, Italy.
| | - Emma Grecchi
- University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy.
| | - Massimo Del Fabbro
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi, 4, 20161, Milano, Italy; University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy.
| | - Funda Goker
- University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy.
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