1
|
Yu W, Luo D, Yang J, Yuan M, Yang Y, Gao Y. Immediate implant placement for chronic peri-apical periodontitis in the molar region: a randomised controlled trial. Int J Oral Maxillofac Surg 2024; 53:223-230. [PMID: 37673734 DOI: 10.1016/j.ijom.2023.08.005] [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: 03/21/2022] [Revised: 03/03/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
The aim of this study was to evaluate the feasibility of immediate implantation for chronic peri-apical periodontitis in the molar region. Seventy-four molars were selected and allocated randomly to two groups. The experimental group (n = 38) received immediate implantation by flap surgery and the control group (n = 36) received delayed implantation. CBCT was performed immediately after surgery (T1) and 12 months after the permanent repair (T3). The implant survival rate at T3 was 100% in both groups. There was no significant difference in buccal or lingual vertical marginal bone loss between the groups (P = 0.515, P = 0.736). However, the buccal horizontal margin bone loss was significantly greater in the experimental group: 0.98 ± 0.34 mm vs 0.77 ± 0.27 mm in the control group (P = 0.003). In the experimental group, the highest point of buccal and lingual implant-bone contact increased at T3. The buccal and lingual jump gap widths were 3.21 ± 1.10 mm and 2.92 ± 1.01 mm at T1, and CBCT showed no jump gap around the implants at T3. The clinical outcomes showed immediate implantation to be feasible for chronic peri-apical periodontitis in the molar region.
Collapse
Affiliation(s)
- W Yu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - D Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - J Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.
| | - M Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Y Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Y Gao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| |
Collapse
|
2
|
Zhang Y, Wu J, Yang Q, Zhou Y, Wang M, Zhang Z, Zou D. Bone formation in large/moderate gap after immediate implantation in response to different treatments: a pre-clinical study in the canine posterior mandible. Clin Oral Investig 2024; 28:181. [PMID: 38424389 DOI: 10.1007/s00784-024-05559-9] [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: 09/07/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES This study aims to investigate different treatments on new bone formation around immediate implants in the canine posterior mandible with varying sized mesial-distal gap. MATERIALS AND METHODS The 4th premolar and the 1st molar of six Labrador dogs were extracted from the mandible, and 4 dental implants were placed 1 mm below the level of the buccal bone crest. Moderate/large mesial-distal gaps between the implants and the sockets were treated with one of four methods and divided into the following groups: (1) the blank group, (2) the collagen membrane (CM) group, (3) the deproteinized bovine bone mineral (DBBM) group, and (4) the DBBM + CM group. Sequential fluorescent labeling was performed at 4, 8, and 10 weeks after the operation. After 12 weeks, the dogs were euthanized, and specimens were collected for micro-CT scanning and histological analysis. RESULTS The survival rate of immediate implant was 100%. Micro-CT showed significant differences in bone mineral density (BMD) and bone volume fraction (BVF) among groups (P = 0.040, P = 0.009); other indicators were not significantly different among groups. Histological analysis showed the proportion of new bone formation and bone-to-implant contact were not significantly different among groups. No significant difference in bone reduction height around dental implant among four groups and varied mesial-distal gap size. CONCLUSION Owing to the restricted sample size, this pilot study lacks conclusive findings. Within the limitation, this study demonstrated that although DBBM significantly increase BMD and BVF, the use of DBBM/CM didn't significantly improve bone formation and healing in extraction sockets around the implants in both moderate and large mesial-distal gap. CLINICAL RELEVANCE The use of deproteinized bovine bone in conjunction with collagen is a common practice in immediate implantation procedures in the posterior mandible. However, there is a lack of conclusive evidence regarding the timing and circumstances under which they should be employed.
Collapse
Affiliation(s)
- Yiwen Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China
- National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Shanghai, 200001, China
| | - Jing Wu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China
- National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Shanghai, 200001, China
| | - Qiutong Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China
- National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Shanghai, 200001, China
| | - Yong Zhou
- Department of Oral Implant, Key Lab. of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, 230032, China
| | - Mohan Wang
- Department of Oral Implant, Key Lab. of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, 230032, China
| | - Zhiyuan Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China
- National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Shanghai, 200001, China
| | - Duohong Zou
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China.
- National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences, Shanghai, 200001, China.
- Department of Oral and Maxillofacial Surgery, Collage of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| |
Collapse
|
3
|
Yang H, Luo D, Yuan MJ, Yang JJ, Wang DS. Five-year outcomes of immediate implant placement for mandibular molars with and without chronic apical periodontitis: A retrospective study. World J Clin Cases 2023; 11:5218-5229. [DOI: 10.12998/wjcc.v11.i22.5218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Most physicians consider molars with chronic apical periodontitis (CAP) lesions as contraindications for immediate implant placement. At the patient’s request, we perform immediate implant placement of the mandibular molars with CAP in clinical practice.
AIM To retrospectively analyze and compare the 5-year outcomes of immediate implant placement of the mandibular molars with CAP and those without obvious inflammation.
METHODS The clinical data of patients with immediate implant placement of the mandibular molars in the Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, from June 2015 to June 2017 were collected. The patients were divided into CAP (n = 52) and no-CAP (n = 45) groups. Changes in bone mineral density and bone mass around implants were analyzed 5 years after implant restoration.
RESULTS At 5 years after implantation, the peri-implant bone mineral density was 528.2 ± 78.8 Hounsfield unit (HU) in the CAP group and 562.6 ± 82.9 HU in the no-CAP group (P = 0.126). Marginal bone resorption around implants did not differ significantly between the two groups, including buccal (P = 0.268) or lingual (P = 0.526) resorption in the vertical direction or buccal (P = 0.428) or lingual (P = 0.560) resorption in the horizontal direction. Changes in the peri-implant jump space did not differ significantly between the two groups, including the buccal (P = 0.247) or lingual (P = 0.604) space in the vertical direction or buccal (P = 0.527) or lingual (P = 0.707) space in the horizontal direction. The gray value of cone-beam computed tomography measured using Image J software can reflect the bone mineral density. In the CAP area, the gray values of the bone tissue immediately and 5 years after implant placement differed significantly from those of the surrounding bone tissue (P < 0.01).
CONCLUSION The results of this study suggest that immediate implant placement of the mandibular molars with CAP can achieve satisfactory 5-year clinical results, without significant differences in the complications, survival rate, or bone tissue condition from the no-CAP mandibular molars.
Collapse
Affiliation(s)
- Hua Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Dan Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Mu-Jie Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Jian-Jun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Da-Shan Wang
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| |
Collapse
|
4
|
Yang H, Luo D, Yuan MJ, Yang JJ, Wang DS. Five-year outcomes of immediate implant placement for mandibular molars with and without chronic apical periodontitis: A retrospective study. World J Clin Cases 2023; 11:5224-5235. [PMID: 37621586 PMCID: PMC10445073 DOI: 10.12998/wjcc.v11.i22.5224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Most physicians consider molars with chronic apical periodontitis (CAP) lesions as contraindications for immediate implant placement. At the patient's request, we perform immediate implant placement of the mandibular molars with CAP in clinical practice. AIM To retrospectively analyze and compare the 5-year outcomes of immediate implant placement of the mandibular molars with CAP and those without obvious inflammation. METHODS The clinical data of patients with immediate implant placement of the mandibular molars in the Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, from June 2015 to June 2017 were collected. The patients were divided into CAP (n = 52) and no-CAP (n = 45) groups. Changes in bone mineral density and bone mass around implants were analyzed 5 years after implant restoration. RESULTS At 5 years after implantation, the peri-implant bone mineral density was 528.2 ± 78.8 Hounsfield unit (HU) in the CAP group and 562.6 ± 82.9 HU in the no-CAP group (P = 0.126). Marginal bone resorption around implants did not differ significantly between the two groups, including buccal (P = 0.268) or lingual (P = 0.526) resorption in the vertical direction or buccal (P = 0.428) or lingual (P = 0.560) resorption in the horizontal direction. Changes in the peri-implant jump space did not differ significantly between the two groups, including the buccal (P = 0.247) or lingual (P = 0.604) space in the vertical direction or buccal (P = 0.527) or lingual (P = 0.707) space in the horizontal direction. The gray value of cone-beam computed tomography measured using Image J software can reflect the bone mineral density. In the CAP area, the gray values of the bone tissue immediately and 5 years after implant placement differed significantly from those of the surrounding bone tissue (P < 0.01). CONCLUSION The results of this study suggest that immediate implant placement of the mandibular molars with CAP can achieve satisfactory 5-year clinical results, without significant differences in the complications, survival rate, or bone tissue condition from the no-CAP mandibular molars.
Collapse
Affiliation(s)
- Hua Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Dan Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Mu-Jie Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Jian-Jun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
| | - Da-Shan Wang
- School of Stomatology, Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| |
Collapse
|
5
|
Sun Y, Hu S, Xie Z, Zhou Y. Relevant factors of posterior mandible lingual plate perforation during immediate implant placement: a virtual implant placement study using CBCT. BMC Oral Health 2023; 23:76. [PMID: 36747164 PMCID: PMC9903431 DOI: 10.1186/s12903-022-02696-z] [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: 09/15/2022] [Accepted: 12/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To explore the influence of cross-sectional type and morphological parameters at the mandibular molar sites on lingual plate perforation (LPP) during the immediate implant placement (IIP). METHODS 181 implants were virtually placed in the mandibular molar sites on the cone beam computed tomography (CBCT). Each cross-section of the implantation site was divided into the Undercut (U)/Parallel (P)/Convex (C) types. Morphologically relevant parameters were measured on the cross-sections, including width of the upper end (Wb), width of the lower end (Wc), vertical height (V), angle between the natural crown axis and the alveolar bone axis (∠β), LC depth (LCD), LC height, and angle between the horizontal line and the line connecting the most prominent point and the most concave point of lingual plate (∠α). Besides, the distance from the end of the virtual implant and the lingual bone plate of the cross-section (DIL) was calculated. Relationships between all the morphologically relevant parameters and the DIL were further analyzed. RESULTS A total of 77 (42.5%) cross-sections were classified as U-type, which was the most common one, accounting for 63% of the second molar regions. All LPP cases and most of the nearly LPP (87.9%) cases occurred at the U-type cross-sections, and the relationship between the DIL and the morphological parameters can be expressed by a multivariate linear equation. CONCLUSIONS The occurrence rate of U-type cross-sections in the second molar region was very high, and the risk of LPP should be considered during IIP. Except for the U-type, significant large LCD, small Wc, and large ∠β were the important relevant factors. CBCT and multivariate linear equations could help to assess the LPP risk and provide a reference for implant placement design pre-surgery.
Collapse
Affiliation(s)
- Yingjia Sun
- grid.13402.340000 0004 1759 700XStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000 People’s Republic of China
| | - Sai Hu
- grid.13402.340000 0004 1759 700XThe Fourth Affiliated Hospital, Zhejiang University School of Medicine, N1 Shangcheng Road, Yiwu, 322000 Zhejiang People’s Republic of China
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, People's Republic of China.
| | - Yiqun Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, People's Republic of China.
| |
Collapse
|
6
|
Will MJ, Drago C. Survival Rate of Ultrawide Diameter Implants Placed into Molar Postextraction Sockets and in Function for Up to 144 Months. J Prosthodont 2023; 32:116-124. [PMID: 35567405 DOI: 10.1111/jopr.13534] [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: 03/12/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Innovations in macroimplant design, specifically ultrawide implants 7.0 mm or greater in diameter, have allowed immediate molar replacement. This is a retrospective study assessing the survival rates of ultrawide diameter implants (7.0, 8.0, 9.0 mm) immediately placed into molar extraction sockets. Implants were followed up to 144 months postplacement. MATERIALS AND METHODS A retrospective study was conducted of all patients treated in a private surgical practice between January 1, 2008 and December 31, 2020, who received ultrawide dental implants (7.0, 8,0, 9.0 mm.) placed immediately into molar extraction sockets. Wide diameter healing abutments were placed on all implants at the time of surgery. Abutments and crown restorations were fabricated after at least 4 months of unloaded healing. Patient age, sex, implant location and implant diameters were examined for survival. Insertion torque values at the time of placement and time in function were also evaluated. Biometric statistics were computed with p-values (<0.05. Descriptive and bivariate statistics were computed; p-values were set at 0.05. RESULTS Five hundred forty-four patients (225 males; 319 females) average age 62.5 years (range 27 to 95) had 563 implants placed. Five hundred thirty-five of five hundred sixty-three (535/563) implants survived; 28 failed [clinical survival rate (CSR) 95.03%]. Number and time in function were: 0 to 12 years 100%; 0 to 9 years 85%; 0 to 6 years 69%; 0 to 3 years 35% or 10 to 12 years 16%; 7 to 9 years 16%; 4 to 6 years 34%; 0 to 3 years 35%. No significant differences were found between sex and implant failures (p = 0.22). Maxillary (266/285; 93.3%) and mandibular (269/278; 96.8%) implant CSRs were not significantly different. Three implant diameters were used: 7.0 mm (206/563) [36.6%]; 8.0 mm (267/563) [47.4%]; 9.0 mm (90/563) [15.9%]. Clinical survival rates were: 7.0 mm (201/206) [97.6%]; 8.0 mm (252/267) [94.4%]; 9.0 mm (82/90) [91.1%]. Mean age for patients with failed implants did not show any significant differences (p = 0.1398). Fifteen of the 28 failed implants failed within 120 days of surgical placement (prior to definitive restoration; [53.6%]; 4 implants failed between 4 and 12 months [14.3%]; 9 implants failed at least 1-year postloading [32.1%]. CONCLUSIONS The results of this long-term retrospective study regarding ultrawide diameter implants suggested that these implants were viable treatment options for immediate molar replacement following tooth extraction in either jaw with an unloaded healing protocol. High clinical survival rates were reported over a 144-month (12-year) timeframe.
Collapse
Affiliation(s)
| | - Carl Drago
- Private Practice, Greenbrook Dental Group, Brookfield, WI
| |
Collapse
|
7
|
Smeets R, Matthies L, Windisch P, Gosau M, Jung R, Brodala N, Stefanini M, Kleinheinz J, Payer M, Henningsen A, Al-Nawas B, Knipfer C. Horizontal augmentation techniques in the mandible: a systematic review. Int J Implant Dent 2022; 8:23. [PMID: 35532820 PMCID: PMC9086020 DOI: 10.1186/s40729-022-00421-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive horizontal bone resorption, the bone volume needs to be augmented prior to or during implant placement in order to obtain dental rehabilitation and maximize implant survival and success. Methods Our aim was to systematically review the available data on lateral augmentation techniques in the horizontally compromised mandible considering all grafting protocols using xenogeneic, synthetic, or allogeneic material. A computerized and manual literature search was performed for clinical studies (published January 1995 to March 2021). Results Eight studies ultimately met the inclusion criteria comprising a total of 276 procedures of xenogeneic, allogeneic, or autogenous bone graft applications in horizontal ridge defects. Particulate materials as well as bone blocks were used as grafts with a mean follow-up of 26.0 months across all included studies. Outcome measures, approaches and materials varied from study to study. A gain of horizontal bone width of the mandible with a mean of 4.8 mm was observed in seven of eight studies. All but one study, reported low bone graft failure rates of 4.4% in average. Conclusions Only limited data are available on the impact of different horizontal augmentation strategies in the mandible. The results show outcomes for xenogeneic as well as autologous bone materials for horizontal ridge augmentation of the lower jaw. The use of allogeneic bone-block grafts in combination with resorbable barrier membranes must be re-evaluated. Randomized controlled clinical trials are largely missing. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-022-00421-7.
Collapse
|
8
|
Bungthong W, Amornsettachai P, Luangchana P, Chuenjitkuntaworn B, Suphangul S. Bone Dimensional Change Following Immediate Implant Placement in Posterior Teeth with CBCT: A 6-Month Prospective Clinical Study. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27030608. [PMID: 35163869 PMCID: PMC8838578 DOI: 10.3390/molecules27030608] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 02/01/2023]
Abstract
This prospective clinical study aimed to evaluate the peri-implant hard tissue dimensional change at 6 months of immediate implant placement with bone graft materials in the posterior area using cone-beam computed tomography (CBCT). Twelve dental implants were placed concurrently following tooth extraction in the posterior area and filled with xenograft particles. The CBCT images were taken immediately after surgical procedures and then at 6 months follow-up. To evaluate the hard tissue changes, the vertical and horizontal bone thickness were analyzed and measured using ImageJ software. Paired t-test or Wilcoxon match-pair signed-rank test was done to analyze the changes of hard tissue values at the same level between immediately and 6 months following immediate implant placement. Independent t-test or Mann-Whitney U test was used to analyze the dimensional change in the vertical and horizontal direction in buccal and lingual aspects. The level of significance was set at p value = 0.05. All implants were successfully osseointegrated. At 6 months follow-up, the vertical bone change at the buccal aspect was -0.69 mm and at the lingual aspect -0.39 mm. For horizontal bone thickness, the bone dimensional changes at 0, 1, 5, and 9 mm levels from the implant platform were -0.62 mm, -0.70 mm, -0.24 mm, and -0.22 mm, respectively. A significant bone reduction was observed in all measurement levels during the 6 months after implant placement (p value < 0.05). It was noted that even with bone grafting, a decrease in bone thickness was seen following the immediate implant placement. Therefore, this technique can be an alternative method to place the implant in the posterior area.
Collapse
Affiliation(s)
- Witchayani Bungthong
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Parinya Amornsettachai
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Penporn Luangchana
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand;
| | - Boontharika Chuenjitkuntaworn
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Suphachai Suphangul
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
- Correspondence: ; Tel.: +66-2200-7853
| |
Collapse
|
9
|
Cosyn J, Wessels R, Garcia Cabeza R, Ackerman J, Eeckhout C, Christiaens V. Soft tissue metric parameters, methods and aesthetic indices in implant dentistry: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:93-107. [PMID: 34642983 DOI: 10.1111/clr.13756] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/26/2021] [Accepted: 03/17/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The primary objective was to provide an overview of soft tissue metric parameters, methods, and aesthetic indices in implant dentistry. The secondary objective was to describe reliability and validity of aesthetic indices. MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase, and Cochrane databases up to October 2020 to identify studies on soft tissue metric parameters, methods, and aesthetic indices. Aesthetic indices were evaluated in terms of reliability and validity. Data extraction was performed by the same reviewers. RESULTS Five metric parameters (papilla height, linear changes in soft tissue level, color assessment, soft tissue thickness, and profilometric soft tissue changes) registered by means of several methods (intra-oral registrations, radiographic assessments, digital analyses, and ultrasonic assessments), and 15 aesthetic indices (Papilla Index (PI), ad hoc questions scored with Visual Analogue Scales, Pink Esthetic Score (PES), Implant Crown Aesthetic Index (ICAI), Implant Aesthetic Score (IAS), Rompen Index, Subjective Esthetic Score, White Esthetic Score, Copenhagen Index, Complex Esthetic Index, Californian Dental Association Index (CDAI), Peri-Implant, and Crown Index, Functional Implant Prosthodontic Score, Implant Restoration Esthetic Index (IREI), and Mucosal Scarring Index (MSI)) could be identified. With respect to metric parameters and methods, intra-oral registrations were least accurate whereas profilometric soft tissue changes on the basis of digital surface models were most accurate. Six aesthetic indices showed good inter-rater reliability (PI, PES, ICAI, CDAI, IREI, and MSI). Good validity could only be shown for two indices (PES and CEI). Given this and on the basis of ease of use and ease of interpretation, PES qualified best for clinical research on single implants. None of the indices fulfilled the quality criteria for clinical research on multiple implants. CONCLUSION Many soft tissue assessment methods with varying reliability and validity have been described and used, which hampers uniform reporting in implant dentistry. Clinical investigators are advised to measure linear and profilometric soft tissue changes using digital surface models, and to use a reliable and validated aesthetic index. Currently, PES qualifies best for aesthetic evaluation of single implants. An index is to be developed to assess the aesthetic outcome of rehabilitations on multiple implants.
Collapse
Affiliation(s)
- Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium.,Faculty of Medicine and Pharmacy, Oral Health Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Retief Wessels
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Ricardo Garcia Cabeza
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Julie Ackerman
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Célien Eeckhout
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
10
|
Chen H, Wang W, Gu X. Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study. BMC Oral Health 2021; 21:478. [PMID: 34579702 PMCID: PMC8474897 DOI: 10.1186/s12903-021-01849-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/16/2021] [Indexed: 12/20/2022] Open
Abstract
Background To elucidate the anatomical features of the mandibular molar region to allow safe immediate implant placement. Methods Cone-beam computed tomography images of 150 patients (600 teeth) were reviewed retrospectively. The virtual implants were placed in the mandibular first and second molar region. The anatomic structures of the mandible and inter-radicular septum were both categorized into three types. The relationship between implant and inferior alveolar nerve (IAN), and the horizontal distance from the implant surface to the bone wall were analyzed. Variables were compared using a student’s t-test, or Mann–Whitney U test. Results Type U (39.0%) and type S (56.0%) were the most common in the first molar, while type U (67.7%) and type M (54.7%) had the highest prevalence rate in the second molar. The mean distance from the level where the virtual implant was completely surrounded by bone to IAN was 7.06 mm. The mean horizontal widths from the implant to the mesial and distal socket wall were 1.59 mm and 1.89 mm. The widths of the inter-radicular septum and the distances from implant to the buccal and lingual plate on different sections were significantly associated with tooth position (P < .05). Conclusions In the first molar region, the implant is suggested to be placed in the center of the inter-radicular septum, while in the second molar region, the mesial root socket could be considered. Immediate implant placement in the mandibular second molar sockets shows a high risk of IAN injury, lingual perforation, and inadequate primary stability.
Collapse
Affiliation(s)
- Haida Chen
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Wei Wang
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
| |
Collapse
|
11
|
Wychowański P, Starzyńska A, Osiak M, Kowalski J, Jereczek-Fossa BA, Seklecka B, Morawiec T, Adamska P, Woliński J. The Anatomical Conditions of the Alveolar Process of the Anterior Maxilla in Terms of Immediate Implantation-Radiological Retrospective Case Series Study. J Clin Med 2021; 10:jcm10081688. [PMID: 33920026 PMCID: PMC8071063 DOI: 10.3390/jcm10081688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
The feasibility and the level of difficulty of immediate flapless implantation depend largely on the residual alveolar bone. The purpose of the study was to determine how often immediate flapless implantation in the anterior maxilla is feasible and assess the difficulty level using cone-beam computed tomography (CBCT) scans. A radiological retrospective case series study was conducted. In total, 1200 CBCT scans from 300 consecutive patients were analyzed with dedicated planning software. Immediate flapless implants were possible in 78.33% of cases. Drilling direction was either through the apex or the palatal slope. Bimodal was conducted in 9% of the cases; only through the apex in 13.08% of the cases and in 56.25% only in the slope. In 21.67%, immediate flapless implants were excluded. The feasibility and degree of difficulty differed statistically to the disadvantage of the lateral incisors compared to the central incisors. Drilling direction caused that BASE classification reflects the difficulty level of immediate implantation. CBCT is a helpful diagnostic tool for assessing the feasibility of immediate flapless implants due to the residual bone shape and volume. BASE classification helps to determine a challenge level that may also facilitate communication and result in comparison. The alveolar bone condition allows for immediate flapless implants in most cases in the aesthetic region of the maxilla, but they should be performed by an experienced specialist with regard to the bone and soft tissue quality.
Collapse
Affiliation(s)
- Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland; (P.W.); (M.O.)
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland;
- Correspondence:
| | - Martyna Osiak
- Department of Oral Surgery, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland; (P.W.); (M.O.)
| | - Jan Kowalski
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland;
| | - Barbara Alicja Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20-112 Milan, Italy;
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20-141 Milan, Italy
| | - Blanka Seklecka
- Early Clinical Trials Unit, University Clinical Centre, 17 Smoluchowskiego Street, 80-214 Gdańsk, Poland;
- Department of Oncology and Radiotherapy, Medical University of Gdansk, 3a M. Skłodowskiej-Curie Street, 80-210 Gdańsk, Poland
| | - Tadeusz Morawiec
- Department of Oral Surgery Silesian Medical University, 17 Plac Akademicki Street, 41-902 Bytom, Poland;
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland;
| | - Jarosław Woliński
- Department of Animal Physiology, The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, 3 Instytucka Street, 05-110 Jabłonna, Poland;
| |
Collapse
|