Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up

A Case of Accelerated Rehabilitation: Immediate Loading of Full Mouth Basal Implants

Basal implantology, also known as bi-cortical implantology, is an advanced system using the dense basal cortical bone for anchoring dental implants, ideal for patients with severe bone loss. Unlike traditional implants that require healthy cancellous bone, basal implants engage with the cortical bone, providing superior stability and durability. These implants can be immediately loaded due to their load-bearing capacity, making them a quick and effective solution for full mouth rehabilitation. A case report of a 55-year-old male with significant bone resorption illustrates the benefits of basal implants. Conventional endosteal implants were not viable, so nine basal implants in the mandible and a combination of basal, pterygoid, and zygomatic implants in the maxilla were used. Within 72 hours, the patient experienced significant improvements in chewing, aesthetics, and overall oral function. Basal implants offer a reliable alternative for patients with challenging anatomical conditions, demonstrating excellent functional and aesthetic outcomes.

Basal Implant Placement in the Anterior Aesthetic Zone: A Case Report

Aesthetics are one of the primary goals of restorative care. Teeth that are traumatized in the anterior maxilla usually avulse or require extraction due to fractures. Rehabilitation is challenging in such a therapeutic state since it presents several anatomical and aesthetic issues. There are circumstances in which traditional implant placement is problematic. There must be enough bone for implant placement to be uneventful and successful. Other surgical therapies may be necessary in addition to implant placement for certain operations, such as extensive grafting, direct or indirect sinus lifts, and nerve lateralization. Certain procedures are required for these operations but are not always achievable. Because single-piece basal implants provide immediate temporization and loading while receiving adequate anchoring from the basal cortical bone, they have been extensively used to rehabilitate resorbed ridges. This case report demonstrates the placement of the basal implant in the anterior zone.

Guided Full Mouth Implant Rehabilitation in Atrophic Alveolar Ridges Using TTPHIL ALL TILT® Protocol: A Case Report With Three Years Follow-Up

Computer-assisted implant planning has become a key diagnostic and therapeutic tool in modern dentistry. This case report emphasizes the possibilities in modern implantology combining virtual implant planning, guided surgery with surgical templates, and immediate function. A 75-year-old female presented with maxillary and mandibular dentures and wanted fixed replacement in minimal appointments. Diagnosis, decision-making, and treatment approaches were based on clinical findings and detailed virtual three-dimensional implant planning. Guided implant placement of six implants in each arch using Tall and Tilted Pin Hole Immediate Loading Technique (TTPHIL ALL TILT®), and immediate loading with a provisional fixed dental prosthesis (FDP) was performed fulfilling patient's functional and esthetic demands in a minimally invasive manner. The final computer-assisted design/computer-assisted manufacturing (CAD/CAM) FDP with a titanium framework and ceramic layering was delivered after six months. At the three-year recall, the implant-supported FDP was free of any complications. Uneventful osseointegration of the dental implants and a healthy peri-implant mucosa were observed. Computer-assisted TTPHIL ALL TILT® technique including three-dimensional virtual implant planning, guided surgery, and CAD/CAM fabrication of provisional and final reconstructions allowed for a concise treatment workflow with favorable esthetic and functional outcomes in this maxillary and mandibular full-mouth case without the need of multiple surgeries in a short treatment time.

Clinical outcomes of implant-supported prosthetic rehabilitation of severely atrophic maxilla: A systematic review

Aim

The purpose of this systematic review is to evaluate the clinical outcomes for the various methods of rehabilitation of a severely atrophic maxilla with the help of implant-supported fixed prosthesis.

Materials and Methods

The relevant publications published between 2013 and 2022 and written only in English were identified using an electronic search. The primary research question for this study was developed based on the PICO framework, which stands for population, intervention, control, and outcomes which was "What are the clinical outcomes of implant-supported prosthetic rehabilitation in patients with severely atrophic maxilla?" The relevancy of the articles was confirmed by examining their titles, abstracts, and complete texts to determine whether they satisfied the requirements for inclusion. Utilizing specialized study design-related bias assessment forms, the risk of bias was evaluated.

Results

The database search resulted in 1568 results; however, 1529 of them were eliminated because of insufficient, duplicate, or missing data. Additionally, manual searching yielded 11 articles. After 50 full-text papers were assessed for eligibility, 17 articles were eliminated. Thus, 33 studies in total are included in the current systematic review. Risk of bias analysis and GRADE evidence analysis were performed. Data were found to be heterogeneous and thus meta-analysis could not be done and narrative synthesis is presented.

Conclusion

The patient's condition and the clinician's expertise play a role in taking the decision on choice of technique for the fixed implant-supported rehabilitation of the severely atrophic maxilla. A high success and survival rate is produced by the majority of fixed implant-assisted prostheses despite the biologic and prosthetic problems. A single approach cannot be recommended as the gold standard. The choice is dependent on the patient's biological factors as well as the clinician's expertise. The included studies were assessed using GRADE criteria. The quality of evidence is low-medium. Therefore, to better comprehend the clinical effectiveness of the treatment alternatives, more well-designed randomized controlled trials with longer follow-up period are required.

An Evaluation of the Efficacy and Acceptability of Basal Implants in Traumatically Deficient Ridges of the Maxilla and the Mandible

Background and objective Rehabilitation of edentulous jaw areas is a complex procedure that has witnessed numerous advancements in technique and materials for better functional and aesthetic outcomes over the years. Dental implants have emerged as a cutting-edge, cost-effective, and non-invasive alternative to traditional removable partial dentures (RPDs), fixed partial dentures (FPDs), and full dentures. In this study, the basal implant was tested in traumatically deficient ridges on the mandible and the maxilla to determine its effectiveness and acceptability. Materials and methods The purpose of this research was to determine whether basal implants might be successfully used to restore traumatized ridges in the maxilla and mandible. Eleven individuals aged 20-55 years participated in the trial, and a total of 30 implants were used. All patients were evaluated for pain, soft tissue health around the basal implant, and patient satisfaction, with follow-ups on the third day and at three and six months postoperatively. Results The mean pain score measured using the visual analog scale (VAS) of patients during follow-ups was 2.00 ±1.15 on the third day, 0.40 ±0.84 at three months, and 0.00 ±0.00 at six months postoperatively. The mean gingival index score of patients was 1.30 ±0.48 on the third day, 0.10 ±0.31 at three months, and 0.00 ±0.00 at six months postoperatively. The mean patient satisfaction score was 34.77±5.54 on the third day, 41.11 ±6.27 at three months, and 40.7 7±10.91 at six months postoperatively. The mean immediate postoperative marginal bone level was 12.33 ±2.26 mm, and it was 10.85 ±2.29 mm after six months postoperatively. The mean preoperative crestal bone level was 10.76 ±1.77 mm and it was 9.70 ±1.79 mm after six months postoperatively. Conclusion Due to the fact that basal implantology does not involve extensive augmentation procedures necessary for the placement of conventional implants, it plays an important role in the rehabilitation of edentulous maxillary and mandibular arches, especially in traumatic, moderate to severely atrophic maxillary and mandibular arches.

The Sympathetic Nervous System in Dental Implantology

The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure.

Single Tooth Replacement Using Immediately Loaded Basal Implant-Supported Fixed Prosthesis in a Hyperdense Lesion: A Case Report

Osseous modifications in the periapical areas are related to chronic endodontic infections. Often, teeth with periapical infections and hopeless prognosis are removed and replaced with dental implants. In this clinical report, a patient with a radiopaque lesion on the root apex of the mandibular right first molar root is presented. Bone- and tissue-borne lesions were the differential diagnoses for the radiopaque mass. Based on the clinical and radiological characteristics, condensing osteitis (CO) was the final diagnosis of osseous growth (bone density and trabeculation of the bone). Under local anesthesia, tooth 46 was atraumatically extracted, and the immediate basal implant was placed. This case report investigated the effectiveness and safety of dental implantation in the vicinity of hyperdense lesions.

Mandibular reconstruction using single piece zygomatic implant in conjunction with a reinforcing Fibular Graft Union: A case report

Presenting to our knowledge, for the first time in literature, a case report on the long term follow-up of an implant retained fixed prosthesis on free fibular reconstruction with a single piece zygomatic implant and single piece bicortical implant via a flapless approach and immediate functional rehabilitation. The technique involved the concept of "Remote Bone Anchorage" in conjunction with the union of grafted free fibula flap with the native mandible. It was facilitated with a single piece zygomatic implant engaged in the mandible and splinted with single piece implants on the grafted fibula as needed for prosthetic functional reconstruction. The author has reported a unique concept of immediate functional rehabilitation in the fibular graft therefore providing additional splinting of the vascularized free fibula to the mandible by splinting them with single piece zygomatic cortical implant.

Immediate Functional Loading: Results for the Concept of the Strategic Implant®

Background

Immediate functional loading of one-piece dental implants has become an accepted treatment modality for fixed restorations in fully edentulous mandibles and maxillae. Nevertheless, studies regarding immediate loading procedures in extraction sites in both the jaws, as well as in segment reconstructions and single-tooth replacements, are limited.

Purpose

The purpose of this study was to evaluate the presently used protocol for immediate functional loading (within maximum 3 days) of one-piece implants which are placed according to the following methods as published by the IF.

Materials and Methods

This prospective cohort study included totally 87 consecutively treated patients who receive 1169 immediately loaded one-piece Strategic Implant^®, supporting fixed complete-arch maxillary or mandibular metal-ceramic bridges or segment reconstructions in both the jaws. All implants were placed by one treatment provider, who delivered also the prosthetics and controlled all cases himself over the years. Data were extracted by an experienced dentist from the patient records and from panoramic X-rays. A number of patients were interviewed at the end of the observation period. Although a total of 5100 implants were placed and observed for 12 - 57 months totally (with 105 implants out of these, having failed), this article reports the detailed results only for 1169 implants which have been followed for at least 48 months.

Results

Immediate functional loading of using multiple, cortically anchored basal screw implants as a support for fixed full-arch and segment prosthesis in the upper and lower jaw demonstrated a high cumulative implant survival rate after an observation period of up to 57 months. Neither hypertension nor diabetes and neither smoking nor bending of the implant's neck had an influence on the success of the implants observed in this study. Within the limits of this study (5100 Strategic Implants were observed over a period of up to 57 months), "peri-implantitis" was not observed at all.

Conclusion

The treatment concept developed for the technology of the Strategic Implant® is safe and effective and it avoids bone augmentations and "peri-implantitis".