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Cobo-Vázquez CM, Molinero-Mourelle P, Romeo-Rubio M, Guisado-Moya BF, Del Río-Highsmith J, López-Quiles J. Prospective clinical-radiological study of the survival and behavior of short implants. J Prosthet Dent 2024:S0022-3913(24)00559-6. [PMID: 39266420 DOI: 10.1016/j.prosdent.2024.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 09/14/2024]
Abstract
STATEMENT OF PROBLEM Short implants are a therapeutic alternative for edentulous patients with severe bone resorption. Differences in peri-implant bone loss and complications of short implants depending on the type of connection are unclear. PURPOSE The main purpose of this clinical study was to evaluate the survival rate after 2 years of the short implants in the Oxtein system (Proclinic). Secondary objectives were to compare implant survival, peri-implant bone loss, peri-implant mucosal status, and associated complications in internal hexagonal connection versus external hexagonal connection implants. MATERIAL AND METHODS A randomized clinical trial was carried out in 14 patients with a mean age of 62.7 ±8.5 years, with a total of 61 Oxtein L35 and L6 Proclinic implants being placed at the Faculty of Dentistry. A descriptive analysis, simple binary logistic regression model using generalized estimating equations. and Kaplan-Meier survival analysis were carried out (α=.05). RESULTS Implant survival was 85.2% (52/61). Failure of all implants occurred before prosthetic loading; bleeding after probing occurred in 28 implants, being greater among external connection implants (57.6%) P=.025. The presence of plaque appeared in 36 of the implants, without statistically significant differences between external connection (72.8%) and internal connection (60.0%) (P>.05). A total of 28 implants had at least 2 mm of keratinized mucosa, without statistically significant differences between external connection (63.6%) and internal connection (35.0%) P=.200. A total of 8 complications (13.1%) were recorded, including connection fractures, screw fracture, framework fracture, and buccal fenestrations. CONCLUSIONS Short implants are a therapeutic solution to more complex surgical techniques. However, as lower survival has been reported, the characteristics of the implants and operator experience are important factors for their success.
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Affiliation(s)
- Carlos M Cobo-Vázquez
- Associate Professor, Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain.
| | - Pedro Molinero-Mourelle
- University Collaborating Professor, Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marta Romeo-Rubio
- Titular Professor, Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Blanca Flora Guisado-Moya
- Titular Professor, Department of Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Jaime Del Río-Highsmith
- Titular Professor and Title of Specialist in Implant Prosthetics Head, Department of Clinical Specialities, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Juan López-Quiles
- Titular Professor and Master of Oral Surgery and Implantology Head, Department of Clinical Specialities, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
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Peixoto RF, Tonin BSH, Pinto-Fiamengui LMS, Freitas-Pontes KM, Regis RR, Mattos MDGCD. Analysis of implant-supported cantilever fixed partial denture: An in vitro comparative study on vertical misfit, stress distribution, and cantilever fracture strength. J Prosthodont 2024; 33:584-592. [PMID: 37470305 DOI: 10.1111/jopr.13739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/23/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE To evaluate the vertical misfit, stress distribution around dental implants, and cantilever fracture strength of 3-unit implant-supported cantilever fixed partial dentures (FPDs) using frameworks made from different materials and manufacturing techniques. MATERIALS AND METHODS Forty FPDs were fabricated and divided into 5 groups (n = 8) based on the framework material used: LAS Co-Cr (Conventional casting-laser welding); TIG Co-Cr (Conventional casting -TIG welding); OP Co-Cr (Conventional casting-one-piece); CAD Co-Cr (CAD-CAM); and CAD Zr (CAD-CAM ZrO2). The vertical misfit was evaluated before porcelain application (T1) and before (T2), and after thermomechanical cycling (T3) by stereomicroscopy. Cantilever fracture strength was tested with a 50 kN (5000 kgf) load cell at a crosshead speed of 0.5 mm/min. Qualitative and quantitative photoelastic analysis was performed to evaluate stress distribution at seven specific points in five FPDs (n = 1/group) subjected to occlusal loading. RESULTS Only the molar showed interaction among the three factors (G × S × T; F(20.932) = 1.630; p = 0.044). Thermomechanical cycling (T2 vs. T3) had a significant effect on intra-group vertical misfit in molar, especially in LAS Co-Cr (Δ = 5.87; p = 0.018) and OP Co-Cr (Δ = 5.39; p = 0.007), with no significant effect in premolar (p > 0.05). Ceramic application combined with thermomechanical cycling (T1 vs. T3) caused a significant intra-group increase in vertical misfit in all groups, both in the molar and premolar (p < 0.05). OP Co-Cr was associated with greater vertical misfit and stress concentration. Frameworks manufactured by the CAD-CAM system exhibited lower vertical misfit and better stress distribution. FPDs with metal frameworks (>410.83 ± 72.26 N) showed significantly higher fracture strength (p < 0.05) than zirconia (277.47 ± 39.10 N), and the first signs of ceramic veneering fracture were observed around 900 N. CONCLUSIONS FPDs with frameworks manufactured using a CAD-CAM system appear to be associated with lower vertical misfit and better stress distribution, although the section of the frameworks followed by welding may be a viable alternative. In addition, metal frameworks exhibit high fracture strength.
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Affiliation(s)
- Raniel Fernandes Peixoto
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (FFOE/UFC), Fortaleza, Ceará, Brazil
| | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo (FORP/USP), Ribeirão Preto, São Paulo, Brazil
| | - Lívia Maria Sales Pinto-Fiamengui
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (FFOE/UFC), Fortaleza, Ceará, Brazil
| | - Karina Mattes Freitas-Pontes
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (FFOE/UFC), Fortaleza, Ceará, Brazil
| | - Rômulo Rocha Regis
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará (FFOE/UFC), Fortaleza, Ceará, Brazil
| | - Maria da Glória Chiarello de Mattos
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo (FORP/USP), Ribeirão Preto, São Paulo, Brazil
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Guljé FL, Raghoebar GM, Gareb B, Vissink A, Meijer HJA. Single crown restorations supported by 6-mm implants in the resorbed posterior mandible: A 10-year prospective case series. Clin Implant Dent Relat Res 2024; 26:642-650. [PMID: 38534097 DOI: 10.1111/cid.13326] [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: 12/27/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE To assess marginal bone level changes, implant and restoration survival, condition of the peri-implant mucosa, and the patient's satisfaction with the single restoration supported by a 6-mm long implant in the posterior mandible after 10 years in function. MATERIALS AND METHODS Twenty-one consecutive patients missing premolars or molars in the posterior mandible, with a bone volume consisting of a width of at least 6 mm and an estimated height of 8 mm between the top of the ridge and alveolar nerve, were included. Each patient received one or more 6-mm implants. After 3 months, the implants were restored with custom-made titanium abutments and cemented zirconia-based porcelain crowns. The clinical examination and radiograph data were assessed at restoration placement and after 12, 60, and 120 months. The patients answered a questionnaire to score their satisfaction before treatment and after 12, 60, and 120 months with the restoration in function. RESULTS A total of 31 implants were placed. Implant survival was 100%. The 10-year mean marginal bone loss was 0.18 mm (SE: 0.08). The plaque, calculus, gingiva, and bleeding indices scores were low as was the mean pocket probing depth. The patients' satisfaction was high. CONCLUSION The 10-year follow-up data of this limited case series study reveal that 6-mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restorations.
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Affiliation(s)
- Felix L Guljé
- Referral practice for implant dentistry, Center for Dental Implants De Mondhoek, Apeldoorn, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Aliberti SM, Funk RHW, De Stefano M, Hoffmann T, Capunzo M. An epidemiological qualitative/quantitative SWOT-AHP analysis in order to highlight the positive or critical aspects of dental implants: A pilot study. Clin Exp Dent Res 2024; 10:e2836. [PMID: 38450945 PMCID: PMC10918715 DOI: 10.1002/cre2.836] [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: 08/24/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES In recent years, dental implants are increasing in popularity due to their high success rate, demonstrated functionality, and aesthetic treatment results. Scientific research is very active in proposing improvements in the quality and survival of implants, taking into consideration various aspects. The objective of this study was to provide a holistic epidemiologic view of the state of dental implants, using a systematic approach based on a multimethod SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis and AHP (analytical hierarchical process) qualitative-quantitative analysis to identify the characteristics that can determine their success or failure. MATERIALS AND METHODS The study used the hybrid method of SWOT-AHP. RESULTS Analysis of the results showed that among strengths, the skill of the dentist was considered the most important factor, followed by the success of dental implants in the old people; among weaknesses, bruxism and chronic diseases were highlighted; for opportunities, biomechanical behavior, in terms of good mechanical strength and good tribological resistance to chemical and physical agents in the oral cavity, were considered the most important factors; finally, among threats, medical liability and biomechanical problems had equal weight. CONCLUSIONS This study applied a multimethod SWOT-AHP approach to bring out favorable or critical evidence on the topic of dental implants. In accordance with the result of the strategic vector identified in the Twisting zone Adjustment type section, showed that implant surgery is a widespread technique but always needs improvement to increase the likelihood of success and reduce the complications that can lead to implant failure.
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Affiliation(s)
- Silvana Mirella Aliberti
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
| | - Richard H. W. Funk
- Institute of AnatomyTechnische Universität (TU) DresdenDresdenGermany
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Marco De Stefano
- Department of Industrial EngineeringUniversity of SalernoSalernoItaly
| | - Thomas Hoffmann
- Division of Preventive MedicineDresden International University (DIU)DresdenGermany
| | - Mario Capunzo
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”University of SalernoSalernoItaly
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Malchiodi L, Fiorino A, Merlino L, Cucchi A, Zotti F, Nocini PF. Analysis of ultra-short implants with different angulations: a retrospective case-control study with 2 to 9 years of follow-up. Clin Oral Investig 2024; 28:79. [PMID: 38183469 DOI: 10.1007/s00784-023-05460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVES Does the angulation of ultrashort implants influence the stability of the peri-implant bone? The present study aimed to evaluate the effectiveness of non-axial ultrashort implants after 2 to 9 years of follow-up in resorbed alveolar ridges. MATERIALS AND METHODS All partially edentulous patients with ultrashort implants (< 6 mm) used in the posterior region of an atrophic mandible or maxilla, to support partial dentures in conjunction with standard implants, were included in this study. Peri-implant bone loss, success and survival rates, crestal bone levels, crown-to-implant ratio and implant angulation were measured for each implant. Implants were divided into two groups: straight implants with angulation < 17° (control group) and tilted implants with angulation > 17° (test group). Statistical analysis was used to find any significant differences between the two study groups and to investigate significant linear correlations among all the variables (p = 0.05). RESULTS A total of 42 ultrashort implants with a mean of 4 years of follow-up were included: 20 ultrashort axially loaded implants and 22 tilted implants. Mean crestal bone levels from baseline loading to maximum follow-up did not reveal statistical differences in regard to PBL; mean success and survival rates were 100% in all groups. CONCLUSIONS PBL, success and survival rates of axial ultrashort implants and tilted ultrashort implants are comparable to those of conventional implants. CLINICAL RELEVANCE This retrospective study revealed that ultrashort implants, even when placed with an angulation > 17°, can safely be used to support partial fixed prostheses. Further prospective clinical studies with larger samples and prospective design are needed to confirm these findings.
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Affiliation(s)
- Luciano Malchiodi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Antonino Fiorino
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University, Via S. Pansini 5, 80131, Naples, Italy.
| | | | | | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
| | - Pier Francesco Nocini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Piazzale A. Scuro 10, 37134, Verona, Italy
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Durrani F, Karthickraj SM, Imran F, Ahlawat S, Kumari E, Vani SUG. Comparative evaluation of hard and soft tissue parameters by using short implants and standard long implants with sinus lift for prosthetic rehabilitation of posterior maxilla. J Indian Soc Periodontol 2024; 28:106-112. [PMID: 38988954 PMCID: PMC11232800 DOI: 10.4103/jisp.jisp_436_23] [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: 09/04/2023] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 07/12/2024] Open
Abstract
Objective The objective is to compare and evaluate the hard and soft tissue parameters by using short and standard long implants with sinus lifting in the posterior maxilla. Materials and Methods Eleven patients with complaints of missing upper back teeth were enrolled in the study for implant-supported rehabilitation and were categorized into two groups: Group long (GL): longer implant (>8 mm) placement, preceded by Sinus Augmentation. Group short (GS): short implant (≤8 mm) placement, without sinus augmentation. The primary outcome measured was cumulative survival rate (CSR) in the compromised partial edentulous posterior maxilla. Secondary outcomes measured were implant stability (IS), marginal bone level alterations (MBL), pocket probing depth (PPD), crown-to-implant ratio, and any complications. Results The difference in CSR between the groups was not statistically significant (P = 0.317). High stability was achieved immediately after the placement of the implants, in both groups (GS: 64 ± 4.07, GL: 65.58 ± 9.75); this difference in the mean ISQ (IS quotients) values was not found to be statistically significant at implant placement (P = 0.7). The mean MBL reported in the study at the end of 12 months of prosthesis function was - 0.762 ± 0.48 mm and - 0.7 ± 0.34 mm for GS and GL, respectively. The mean PPD measurements in GS and GL groups were 1.917 ± 0.68 mm and 1.833 ± 0.38 mm, respectively, and it was not statistically significant (P = 0.8). Conclusion Within the limitations of the present study, the obtained results indicate that short implants provided a similar clinical and radiographic performance compared to long implants placed in combination with a sinus augmentation procedure (lateral window) up to 12 months after prosthetic loading.
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Affiliation(s)
- Farhan Durrani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S M Karthickraj
- Reader, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Fouzia Imran
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shweta Ahlawat
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ekta Kumari
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S U Gokila Vani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Anitua E. [5.5 mm implant. A solution for severe atrophies without sacrificing predictability]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 10:e137. [PMID: 38390603 PMCID: PMC10880715 DOI: 10.21142/2523-2754-1004-2022-137] [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: 08/26/2022] [Accepted: 10/25/2022] [Indexed: 02/24/2024] Open
Abstract
The rehabilitation of areas of the maxilla and mandible with extreme resorption is a fact of increased presence in our dental practice. Surgical techniques such as short and extra-short implants facilitate the resolution of these clinical cases. In this clinical case report we develop a case rehabilitated using a 5.5 mm long implant and we provide a biomechanical study of the behaviour of implants with these characteristics.
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Affiliation(s)
- Eduardo Anitua
- Private practice in oral implantology, Eduardo Anitua Institute, Vitoria, Spain. Private practice in oral implantology Eduardo Anitua Institute Vitoria Spain
- Clinical researcher, Eduardo Anitua Foundation, Vitoria, Spain. Clinical researcher, Eduardo Anitua Foundation Vitoria Spain
- University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain. University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua) Vitoria Spain
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Cheng Y, Xiao C, Zhu Y, Chen Q, Zhang L, Zhang Y, Gao M, Li X, Zhou Y, Song G, Zhang T, Pei R. Three-year observations on the effect of different cusp inclinations on the restoration of short maxillary first molar implants: A randomized controlled trial. Front Physiol 2023; 13:992800. [PMID: 36685182 PMCID: PMC9845769 DOI: 10.3389/fphys.2022.992800] [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: 07/13/2022] [Accepted: 10/11/2022] [Indexed: 01/06/2023] Open
Abstract
Objective: To investigate the effect of different cusp inclination on short implant prosthesis of maxillary first molar after 3 years of weight-bearing in biology and mechanics. Methods: The clinical patients were randomly selected from the database and divided into four groups A, B, C, and D according to the cusp inclination of the maxillary first molar short implant restoration (4.8 mm × 8 mm, Dentium). 20 cases in each group. The cusp inclination was 10 degrees-15 degrees, 15 degrees-20 degrees, 20 degrees-25 degrees, 25 degrees-30 degrees. After 3 years of weight-bearing, cone beam computed tomography (CBCT) and Florida probe were used to measure and observe the height of alveolar bone (H), periodontal probing depth (PD) and modified sulcus bleeding index (MBI). Visual analogue scale (VAS) was used to evaluate the overall satisfaction of patients, and the mechanical complications of each group within 3 years of implant weight-bearing were counted. Results: The H and PD of group D were 1.09 ± 0.23 and 2.19 ± 0.11 respectively, which were significantly higher than those of group A, B and C (p < 0.05). There was no significant difference in MBI between groups A-D (p > 0.05). The VAS scores of group B and group C were 88.36 ± 5.12 and 88.70 ± 4.52 respectively, which were higher than those of group A and group D (p < 0.05). The incidence of food impaction, porcelain collapse and abutment loosening in group D were 40.0%, 25.0% and 15.0% respectively, which were higher than those in group B and C (p < 0.05). Conclusion: The risk of biological and mechanical complications increases after long-term weight-bearing of maxillary first molar short implant prostheses with high cusp inclination. The cusp inclination of short implant prostheses should be designed as low as 25 degrees.
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Affiliation(s)
- Yuye Cheng
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Cong Xiao
- Department of Orthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yu Zhu
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Qiuyan Chen
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Longbo Zhang
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yanshu Zhang
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Meiqin Gao
- Department of Orthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xinpei Li
- Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yan Zhou
- Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Guiqiang Song
- Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Tiecheng Zhang
- Department of Anesthesiology, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China
| | - Runsheng Pei
- Department of Prosthodontics, Nantong Stomatological Hospital, The Affiliated Nantong Stomatological Hospital of Nantong University, Nantong, Jiangsu, China,*Correspondence: Runsheng Pei,
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Lombardo G, Signoriello A, Pardo A, Serpa Romero XZ, Vila Sierra LA, Arévalo Tovar L, Marincola M, Nocini PF. Short and ultra-short (<6-mm) locking-taper implants supporting single crowns in posterior areas (part II): A 5-year retrospective study on periodontally healthy patients and patients with a history of periodontitis. Clin Implant Dent Relat Res 2022; 24:455-467. [PMID: 35635514 PMCID: PMC9546440 DOI: 10.1111/cid.13103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
Background Short and ultra‐short implants implants supporting single crowns seem to demonstrate high percentages of survival and stable marginal bone levels at a mid‐term follow‐up. Nevertheless, insurgence of peri‐implant complications still represents a critical issue, especially for patients with history of periodontitis. Purpose The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri‐implant complications in 333 short and ultra‐short implants, placed in periodontally healthy patients and patients with a history of periodontitis. Materials and Methods Implants were placed in the maxillary and mandibular posterior regions of 142 patients with (PP) and without (NPP) a history of periodontitis. Clinical and radiographic examinations were performed at 5‐year recall appointments. Results Implants respectively placed in PP and NPP were: 35.68% and 42.50% in 8.0 mm‐length group, 33.33% and 36.67% in 6.0 mm‐length group, and 30.99% and 20.83% in 5.0 mm‐length group. Implant‐based survival after 5 years of follow‐up was 95.77% for PP and 96.67% for NPP (p = 0.77). Regarding crestal bone level variations, average crestal bone loss was statistically different (p = 0.04) among PP (0.74 mm) and NPP (0.61 mm). Implants presenting signs of mucositis were 6.86% in PP and 7.76% in NPP (p = 0.76). Setting the threshold for excessive bone loss at 1 mm after 60 months, peri‐implantitis prevalence was 7.84% in PP and 2.59% in NPP (p = 0.08). Overall implant success was 92.16% and 97.41%, respectively, for PP and NPP. Conclusions Under strict maintenance program, five‐year outcomes suggest that short and ultra‐short locking‐taper implants can be successfully restored with single crowns in the posterior jaws both in PP and NPP.
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Affiliation(s)
- Giorgio Lombardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | - Annarita Signoriello
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | - Alessia Pardo
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
| | | | | | - Luisa Arévalo Tovar
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Mauro Marincola
- Research Department, Dental Implant Unit, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Pier Francesco Nocini
- School of Dentistry, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Verona
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Clinical, radiographic and restorative parameters for short tuberosity implants placed in smokers: a retrospective study with 5 year follow-up. Odontology 2021; 109:979-986. [PMID: 34240298 DOI: 10.1007/s10266-021-00623-2] [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: 03/20/2021] [Accepted: 06/03/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to estimate and compare the clinical, radiographic, and restorative parameters around short tuberosity implants (STIs) placed in cigarette smokers (CS) and never smokers (NS). In this 60-month follow-up retrospective study, a total of 50 (37 males + 13 females) individuals who had received 82 dental implants were included. These participants were categorized into two groups as follows: (i) Group-1: 25 self-reported systemically healthy CS with 43 STIs; and (ii) Group-2: 25 self-reported systemically healthy NS with 39 STIs. In both groups, peri-implant plaque index (PI), probing depth (PD), bleeding on probing (BOP), and crestal bone loss (CBL) and restorative parameters were measured at 12 and 60 months of follow-up. Group comparisons were performed utilizing the Kruskal-Wallis test. The significance level was set at p < 0.05. In CS and NS, the mean age of participants was 58.5 and 60.7 years, respectively. No statistically significant differences were observed in the overall mean levels of PD and CBL around STIs among CS and NS. However, a statistically significant increase was observed in the mean scores of BOP and PI around STIs in the NS and CS at 12 and 60 months follow-up, respectively. In both groups, the loosening of the implant was the most frequently encountered type of STI failure. The outcomes of the present study suggest that STIs placed in maxillary tuberosity can show reliable clinical, radiographic, and restorative stability among cigarettes smokers and non-smokers. However, the role of smoking status and oral hygiene cannot be disregarded in this scenario.
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Negoro M, Kanazawa M, Sato D, Shimada R, Miyayasu A, Asami M, Katheng A, Kusumoto Y, Abe Y, Baba K, Minakuchi S. Patient-reported outcomes of implant-assisted removable partial dentures with magnetic attachments using short implants: A prospective study. J Prosthodont Res 2021; 65:554-558. [PMID: 34193745 DOI: 10.2186/jpr.jpr_d_20_00221] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Implant-assisted removable partial dentures (IARPDs) with short implants improve the oral functions of removable partial dentures (RPDs). This study aimed to compare the patient-reported outcomes of RPDs and IARPDs with short implants retained by magnetic attachments. METHODS We recruited 30 participants with mandibular Kennedy Class I or II and distal extension defects of three or more teeth. RPDs, IARPDs with a healing cap, and IARPDs with a magnetic attachment were evaluated across stages using patient-reported outcomes. All participants completed questionnaires (oral health-related quality of life [OHRQoL], patient general satisfaction, and patient's denture assessment [PDA]) at each stage. The OHRQoL was evaluated using the Oral Health Impact Profile-J 54 (OHIP-J 54) score. The general patient satisfaction was evaluated using a 100 mm visual analog scale. The Wilcoxon signed-rank test and Bonferroni correction were used to evaluate differences between the groups (α=0.05). RESULTS The OHRQoL of IARPDs was significantly higher than that of RPDs. IARPDs with a magnetic attachment had significantly better patient general satisfaction and PDA than IARPDs with a healing cap. CONCLUSIONS The OHRQoL, patient general satisfaction, and PDA were improved by IARPD with a short implant using a magnetic attachment.
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Affiliation(s)
- Masatoshi Negoro
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo
| | - Ryo Shimada
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Anna Miyayasu
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Mari Asami
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Awutsadaporn Katheng
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Yuriko Kusumoto
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Yuka Abe
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
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Muallah D, Sembdner P, Holtzhausen S, Meissner H, Hutsky A, Ellmann D, Assmann A, Schulz MC, Lauer G, Kroschwald LM. Adapting the Pore Size of Individual, 3D-Printed CPC Scaffolds in Maxillofacial Surgery. J Clin Med 2021; 10:jcm10122654. [PMID: 34208695 PMCID: PMC8233728 DOI: 10.3390/jcm10122654] [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: 05/25/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/26/2022] Open
Abstract
Three dimensional (3D) printing allows additive manufacturing of patient specific scaffolds with varying pore size and geometry. Such porous scaffolds, made of 3D-printable bone-like calcium phosphate cement (CPC), are suitable for bone augmentation due to their benefit for osteogenesis. Their pores allow blood-, bone- and stem cells to migrate, colonize and finally integrate into the adjacent tissue. Furthermore, the pore size affects the scaffold’s stability. Since scaffolds in maxillofacial surgery have to withstand high forces within the jaw, adequate mechanical properties are of high clinical importance. Although many studies have investigated CPC for bone augmentation, the ideal porosity for specific indications has not been defined yet. We investigated 3D printed CPC cubes with increasing pore sizes and different printing orientations regarding cell migration and mechanical properties in comparison to commercially available bone substitutes. Furthermore, by investigating clinical cases, the scaffolds’ designs were adapted to resemble the in vivo conditions as accurately as possible. Our findings suggest that the pore size of CPC scaffolds for bone augmentation in maxillofacial surgery necessarily needs to be adapted to the surgical site. Scaffolds for sites that are not exposed to high forces, such as the sinus floor, should be printed with a pore size of 750 µm to benefit from enhanced cell infiltration. In contrast, for areas exposed to high pressures, such as the lateral mandible, scaffolds should be manufactured with a pore size of 490 µm to guarantee adequate cell migration and in order to withstand the high forces during the chewing process.
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Affiliation(s)
- David Muallah
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (D.M.); (G.L.)
| | - Philipp Sembdner
- Department of Mechanical Engineering, Institute of Machine Elements and Machine Design, Technische Universität Dresden, 01062 Dresden, Germany; (P.S.); (S.H.)
| | - Stefan Holtzhausen
- Department of Mechanical Engineering, Institute of Machine Elements and Machine Design, Technische Universität Dresden, 01062 Dresden, Germany; (P.S.); (S.H.)
| | - Heike Meissner
- Department of Prosthetic Dentistry, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany;
| | - André Hutsky
- Organical CAD/CAM, Ruwersteig 43, 12681 Berlin, Germany; (A.H.); (D.E.)
| | - Daniel Ellmann
- Organical CAD/CAM, Ruwersteig 43, 12681 Berlin, Germany; (A.H.); (D.E.)
| | - Antje Assmann
- Zahntechnik Schönberg, Altseidnitz 19, 01277 Dresden, Germany;
| | - Matthias C. Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany;
| | - Günter Lauer
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (D.M.); (G.L.)
| | - Lysann M. Kroschwald
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany; (D.M.); (G.L.)
- Centre for Translational Bone, Joint and Soft Tissue Research, University Hospital “Carl Gustav Carus”, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
- Correspondence:
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Moraschini V, Mourão CFDAB, Montemezzi P, Kischinhevsky ICC, de Almeida DCF, Javid K, Shibli JA, Granjeiro JM, Calasans-Maia MD. Clinical Comparation of Extra-Short (4 mm) and Long (>8 mm) Dental Implants Placed in Mandibular Bone: A Systematic Review and Metanalysis. Healthcare (Basel) 2021; 9:healthcare9030315. [PMID: 33809203 PMCID: PMC7998998 DOI: 10.3390/healthcare9030315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 01/05/2023] Open
Abstract
This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration’s tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.
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Affiliation(s)
- Vittorio Moraschini
- Periodontology Department, Dental Research Division, School of Dentistry, Veiga de Almeida University, Rio de Janeiro 20271-020, Brazil;
| | | | | | | | - Daniel Costa Ferreira de Almeida
- Graduate Program, Dentistry School, Universidade Federal Fluminense, Niteroi 24020-140, Brazil; (I.C.C.K.); (D.C.F.d.A.); (K.J.)
| | - Kayvon Javid
- Graduate Program, Dentistry School, Universidade Federal Fluminense, Niteroi 24020-140, Brazil; (I.C.C.K.); (D.C.F.d.A.); (K.J.)
| | - Jamil Awad Shibli
- Periodontology and Oral Implantology Department, University of Guarulhos, Guarulhos 07023-070, Brazil;
| | - José Mauro Granjeiro
- Bioengineering Laboratory, National Institute of Metrology, Quality and Technology (INMETRO), Duque de Caxias 25250-020, Brazil;
- Dental School, Fluminense Federal University, Niterói 24020-140, Brazil
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Safety and Efficacy Results of BonoFill First-in-Human, Phase I/IIa Clinical Trial for the Maxillofacial Indication of Sinus Augmentation and Mandibular Bone Void Filling. J Oral Maxillofac Surg 2020; 79:787-798.e2. [PMID: 33434518 DOI: 10.1016/j.joms.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The gold standard for bone regeneration of bone deficiencies is still an autologous bone graft, which has considerable disadvantages; namely, the need for a second major surgery and the limited volume of bone available for harvesting. BonoFill (BF) is a novel, tissue-engineered, bone graft with intrinsic osteoinductive, osteoconductive, and osteogenic properties, consisting of the patient's own adipose tissue-derived mesenchymal stem cells, attached to hydroxyapatite particles. Here, we present the safety and efficacy results of BF first-in-human clinical study for maxillofacial bone tissue regeneration. MATERIALS AND METHODS Eleven eligible male and female subjects, aged 49-65 years, were enrolled into the clinical study in 2 clinical indications: Bone augmentation and bone void grafting in the jaws. Clinical follow-up was performed throughout a period of 6 months after BF treatment and included clinical examination, blood tests, CT scans, and biopsies collected from the transplantation site to assess chronic bone infection, changes in complete blood count, and adequate bone augmentation for implant placement. RESULTS The study results demonstrated that BF promoted adequate bone tissue regeneration without complications. Per our evaluation, there were no incidents of chronic bone infection, or significant changes in complete blood count, and the patients reported overall good health for the duration of the study. At trial end, in the sinus augmentation indication, the BF treated sites residual bone was augmented at an average of 6.36 mm (Δ new bone, n = 10) and the total bone height at the treated area was on average 11.44 mm (n = 10). In the indication of filling of bone voids, the patient's average residual bone height of 2.91 mm was 15.76 mm (n = 1) at trial end. CONCLUSIONS BF treatment was shown to be safe and resulted in newly generated bone, which provided adequate bone height for placement of dental implants. Thus, BF is a promising novel autologous bone graft for bone tissue repair.
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Assessment of Peri-Implant Soft Tissues Conditions around Short and Ultra-Short Implant-Supported Single Crowns: A 3-Year Retrospective Study on Periodontally Healthy Patients and Patients with a History of Periodontal Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249354. [PMID: 33327506 PMCID: PMC7764932 DOI: 10.3390/ijerph17249354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/01/2020] [Accepted: 12/11/2020] [Indexed: 01/01/2023]
Abstract
The aim of this retrospective study was to evaluate implant survival, marginal bone loss and peri-implant complications in 326 short and ultra-short implants. Implants were placed in the maxillary and mandibular posterior regions of 140 patients with (PP) and without (NPP) a history of periodontal disease. Clinical and radiographic examinations were performed at 3-year recall appointments. The 8.0, 6.0 and 5.0 mm-length implants placed in PP and NPP were respectively 43.75% and 38.46%, 35.10% and 34.19%, 21.15% and 27.35%; 325 implants (one early failure) were rehabilitated with single crowns in 139 patients. Overall implant survival after 3 years of follow-up was 97.55%, 98.08% and 96.61% for PP and NPP (p = 0.46). Crestal bone level variations were not statistically different among PP and NPP; 15.41% of implants presented signs of mucositis, 14.71% and 16.67% in PP and NPP (p = 0.64). Setting the threshold for bone loss at 2 mm after 36 months, peri-implantitis prevalence was 2.2%, 1.96% and 2.63% in PP and NPP (p = 0.7). Overall implant success was 82.39%, 83.33% and 80.7% for PP and NPP (p = 0.55). Short-term outcomes suggest that short and ultra-short locking-taper implants can successfully be restored with single crowns in the posterior jaws both in PP and NPP.
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Guljé FL, Meijer HJA, Abrahamsson I, Barwacz CA, Chen S, Palmer PJ, Zadeh H, Stanford CM. Comparison of 6-mm and 11-mm dental implants in the posterior region supporting fixed dental prostheses: 5-year results of an open multicenter randomized controlled trial. Clin Oral Implants Res 2020; 32:15-22. [PMID: 33025645 PMCID: PMC7821315 DOI: 10.1111/clr.13674] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022]
Abstract
Objective The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6‐mm or 11‐mm implants, placed in the posterior maxilla and mandible, during a 5‐year follow‐up period. Materials and methods Ninety‐five patients with adequate bone height for 11‐mm implants, were randomly allocated to a 6‐mm group (test group with short implants) or an 11‐mm group (control group with standard‐length implants). Two or three implants of the same length were placed in each patient and after 6 weeks loaded with a splinted provisional restoration. This was followed by definitive splinted restoration 6 months after implant placement. Clinical and radiographic parameters, including the occurrence of complications were recorded. Results A total of 49 patients were enrolled to receive 6‐mm implants (n = 108) and 46 patients to receive 11‐mm implants (n = 101). Three implants (two of 6 mm and one of 11 mm in length) were lost before loading and one 6‐mm implant after 15 months of function, and one 11‐mm implant was lost during the first year of function. The 5‐year survival rates were 96.0% and 98.9% in the 6‐mm and 11‐mm group, respectively. The mean marginal bone level changes 5 years post‐loading were 0.01 ± 0.45 mm (bone gain) in the 6‐mm group and −0.12 ± 0.93 mm (bone loss) in the 11‐mm group (p = .7670). Clinical parameters, including plaque, bleeding on probing and pocket probing depth were not significantly different between the groups, and also technical complications were low. Conclusion The clinical and radiographic outcomes of 6‐mm short and 11‐mm standard‐length implants were not different during a 5‐year evaluation period.
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Affiliation(s)
- Felix L Guljé
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Dental Implants, De Mondhoek, Apeldoorn, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ingemar Abrahamsson
- Department of Periodontology, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden
| | - Christopher A Barwacz
- Department of Family Dentistry, University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA, USA
| | - Stephen Chen
- Department of Periodontics, Melbourne, School of Dental Science, University of Melbourne, Melbourne, Vic., Australia
| | - Paul J Palmer
- King's College London Dental Institute at Guy's King's and St Thomas' Hospitals, London, UK
| | - Homayoun Zadeh
- VISTA Institute for Therapeutic Innovations, Woodland Hills, CA, USA
| | - Clark M Stanford
- Department of Restorative Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
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Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
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Abstract
The purpose of this article is not to discuss the success of short dental implants versus standard/long dental implants, but to compare short dental implants with standard/long dental implants in areas that necessitated adjunctive bone grafting or augmentation procedures and as a way to avoid the need for advanced surgical procedures and their associated risks. It can be concluded that short dental implants are a viable alternative in sites that would have required additional complex and costly augmentation procedures. Short dental implants resulted in comparable survival and success rates with faster, less expensive treatment with fewer surgical complications and morbidity.
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Affiliation(s)
- Steven R Schwartz
- Private Practice: NY Oral & Maxillofacial Surgeon, PC, 2844 Ocean Parkway, Brooklyn, NY 11235, USA; Department of Oral & Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway 2c320, Brooklyn, NY 11206, USA.
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Ortega-Mejia H, Estrugo-Devesa A, Saka-Herrán C, Ayuso-Montero R, López-López J, Velasco-Ortega E. Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review. MATERIALS 2020; 13:ma13030622. [PMID: 32019255 PMCID: PMC7040697 DOI: 10.3390/ma13030622] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (−) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.
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Affiliation(s)
- Holmes Ortega-Mejia
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (H.O.-M.); (C.S.-H.)
| | - Albert Estrugo-Devesa
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
| | - Constanza Saka-Herrán
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (H.O.-M.); (C.S.-H.)
| | - Raúl Ayuso-Montero
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
| | - José López-López
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain; (A.E.-D.); (R.A.-M.)
- Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, 08970 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-402-42-71; Fax: +34-93-402-42-48
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain
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Peixoto RF, Tonin BSH, Martinelli J, Macedo AP, de Mattos MDGC. In vitro digital image correlation analysis of the strain transferred by screw-retained fixed partial dentures supported by short and conventional implants. J Mech Behav Biomed Mater 2019; 103:103556. [PMID: 31785542 DOI: 10.1016/j.jmbbm.2019.103556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE This study used digital image correlation (DIC) to evaluate the strain transferred by splinted and non-splinted screw-retained fixed partial dentures (FPDs) supported by short and conventional implants. MATERIAL AND METHODS Four polyurethane models were fabricated to simulate half of the mandibular arch with acrylic resin replicas of the first premolar. Short (5 mm) and/or conventional (11 mm) implants replaced the second premolar and the first and second molars. Groups were: G1, two conventional (second premolar and first molar) and one short (second molar) implant; G2, one conventional (second premolar) and two short (first and second molar) implants; G3, three short implants; and G4, three conventional implants. Splinted (S) and non-splinted (NS) FPDs were screwed to the implant abutments. Occlusal load and a single point load on the second premolar, both of 250 N, were applied. Strain in the horizontal direction (Ɛxx) was calculated and compared using the DIC software. RESULTS Splinted crowns presented the highest strain magnitudes of all tested groups (p < 0.05). The strain was concentrated near the short implants and presented a higher magnitude compared to conventional implants, especially in G2S (-560.13 μS), G3S (-372.97 μS), and G4S (-356.67 μS). CONCLUSIONS Splinted crowns presented a higher strain concentration around the implants, particularly near the implant replacing the first molar. A combination of short and conventional implants seems to be a viable alternative for the rehabilitation of the posterior edentulous mandible with reduced bone height.
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Affiliation(s)
- Raniel Fernandes Peixoto
- Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
| | - Bruna Santos Honório Tonin
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janisse Martinelli
- School of Dentistry, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil
| | - Ana Paula Macedo
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, SP, Brazil
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21
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Yan Q, Wu X, Su M, Hua F, Shi B. Short implants (≤6 mm) versus longer implants with sinus floor elevation in atrophic posterior maxilla: a systematic review and meta-analysis. BMJ Open 2019; 9:e029826. [PMID: 31662363 PMCID: PMC6830603 DOI: 10.1136/bmjopen-2019-029826] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/06/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare the use of short implants (≤6 mm) in atrophic posterior maxilla versus longer implants (≥10 mm) with sinus floor elevation. DESIGN A systematic review and meta-analysis based on randomised controlled trials (RCTs). DATA SOURCES Electronic searches were conducted in PubMed, Embase and the Cochrane CENTRAL. Retrospective and prospective hand searches were also performed. ELIGIBILITY CRITERIA RCTs comparing short implants (≤6 mm) and longer implants (≥10 mm) with sinus floor elevation were included. Outcome measures included implant survival (primary outcome), marginal bone loss (MBL), complications and patient satisfaction. DATA EXTRACTION AND SYNTHESIS Risks of bias in and across studies were evaluated. Meta-analysis, subgroup analysis and sensitivity analysis were undertaken. Quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS A total of seven RCTs involving 310 participants were included. No significant difference in survival rate was found for 1-3 years follow-up (RR 1.01, 95% CI 0.97 to 1.04, p=0.74, I²=0%, moderate-quality evidence) or for 3 years or longer follow-up (RR 1.00, 95% CI 0.97 to 1.04, p=0.79, I²=0%, moderate-quality evidence). However, short implants (≤6 mm) showed significantly less MBL in 1-3 years follow-up (MD=-0.13 mm, 95% CI -0.21 to 0.05; p=0.001, I²=87%, low-quality evidence) and in 3 years or longer follow-up (MD=-0.25 mm, 95% CI -0.40 to 0.10; p=0.001, I²=0%, moderate-quality evidence). In addition, short implant (≤6 mm) resulted in fewer postsurgery reaction (RR 0.11, 95% CI 0.14 to 0.31, p<0.001, I²=40%, moderate-quality evidence) and sinus perforation or infection (RR 0.11, 95% CI 0.02 to 0.63, p=0.01, I²=0%, moderate-quality evidence). CONCLUSIONS For atrophic posterior maxilla, short implants (≤6 mm) are a promising alternative to sinus floor elevation, with comparable survival rate, less MBL and postsurgery reactions. Additional high-quality studies are needed to evaluate the long-term effectiveness of short implants (≤6 mm). TRIAL REGISTERATION NUMBER The protocol has been registered at PROSPERO (CRD42018103531).
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Affiliation(s)
- Qi Yan
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xinyu Wu
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Meiying Su
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Cochrane Oral Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Bin Shi
- Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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22
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Kang DY, Kim M, Lee SJ, Cho IW, Shin HS, Caballé-Serrano J, Park JC. Early implant failure: a retrospective analysis of contributing factors. J Periodontal Implant Sci 2019; 49:287-298. [PMID: 31681486 PMCID: PMC6819696 DOI: 10.5051/jpis.2019.49.5.287] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/19/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. Methods Patients who received implant treatment with a single implant system (Luna®, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. Results This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47–61 years) and were followed up for a median of 7.2 months (IQR, 5.6–9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37–5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12–4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). Conclusions Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.
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Affiliation(s)
- Dae-Young Kang
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Myeongjin Kim
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Sung-Jo Lee
- Department of Periodontology, Sejong Dental Hospital, Dankook University College of Dentistry, Sejong, Korea
| | - In-Woo Cho
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Hyun-Seung Shin
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
| | - Jordi Caballé-Serrano
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, School of Dental Medicine, Barcelona, Spain
| | - Jung-Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Cheonan, Korea
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23
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Guljé FL, Raghoebar GM, Vissink A, Meijer HJA. Single crown restorations supported by 6-mm implants in the resorbed posterior mandible: A five-year prospective case series. Clin Implant Dent Relat Res 2019; 21:1017-1022. [PMID: 31353837 PMCID: PMC6899810 DOI: 10.1111/cid.12825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/17/2019] [Accepted: 07/08/2019] [Indexed: 12/19/2022]
Abstract
Purpose To assess clinical performance of single restorations supported by 6‐mm long implants in the posterior mandible after 5 years in function. Materials and Methods Twenty‐one consecutive patients with the absence of premolars or molars in the posterior mandible and an estimated bone volume of at least 6 mm in width and an estimated height of 8 mm between the top of the ridge and alveolar nerve were included. Each patient received one or more 6‐mm implants. Custom‐made titanium abutments with cemented zirconia‐based porcelain crowns were placed after a 3‐month osseointegration period. Data of clinical examinations and radiographs were assessed at placement of the restoration and 12 and 60 months thereafter. The patients answered a questionnaire to score the satisfaction before treatment and after 12 and 60 months with the restoration in function. Results Implant survival was 100%. Five‐years' mean marginal bone loss was 0.14 mm (SD: 0.4). Indices scores for plaque, calculus, gingiva, and bleeding were low as well as mean pocket‐probing depth. Patients' satisfaction was high. Conclusion Five‐year follow‐up data of this limited case series study revealed that 6‐mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restoration.
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Affiliation(s)
- Felix L Guljé
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Dental Implants De Mondhoek, Apeldoorn, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Center for Dentistry and Oral Hygiene, Dental School, Department of Implant Dentistry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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24
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Yu SJ, Lee YH, Lin CP, Wu AYJ. Computed tomographic analysis of maxillary sinus anatomy relevant to sinus lift procedures in edentulous ridges in Taiwanese patients. J Periodontal Implant Sci 2019; 49:237-247. [PMID: 31485374 PMCID: PMC6713807 DOI: 10.5051/jpis.2019.49.4.237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 01/19/2023] Open
Abstract
Purpose To analyze the maxillary sinus anatomy over edentulous ridges in the bilateral posterior maxillary area in Taiwanese patients using cone-beam computed tomography (CBCT). Methods In total, 101 anatomical sites from 61 patients, including 32 premolar and 69 molar regions, were analyzed using CBCT. Measurements were made of the width and height of edentulous ridges, the thickness of the lateral wall of the maxillary sinus, and the presence of a sinus septum and the posterior superior alveolar artery (PSAA). A statistical analysis of the measurements was performed, and correlations among the measurements were assessed. Results The average ridge width was 10.26±3.16 mm, with a significantly greater ridge width in the second molar region than in the premolar region. The mean residual ridge height was 8.55±4.09 mm, and ridge height showed an opposite trend from ridge width for the premolar and molar regions. A sinus septum was present at 5.9% of the sites, and the PSAA was observed in 24.5%. The average thickness of the lateral wall of the maxillary sinus was 2.08±0.94 mm, with no significant difference between the tooth position and lateral wall thickness. Conclusions This study presents the anatomical features of the maxillary sinus, which should be considered in sinus lift procedures for implant placement, in the Taiwanese population. The use of CBCT is recommended to avoid intraoperative complications.
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Affiliation(s)
- Shun-Jen Yu
- Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Hao Lee
- Department of Orthodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Ping Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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25
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Gargallo-Albiol J, Sinjab KH, Barootchi S, Chan HL, Wang HL. Microscope and micro-camera assessment of Schneiderian membrane perforation via transcrestal sinus floor elevation: A randomized ex vivo study. Clin Oral Implants Res 2019; 30:682-690. [PMID: 31059148 DOI: 10.1111/clr.13453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We sought to assess the effectiveness of using a microscope and non-invasive camera for assessing sinus membrane perforations during transcrestal sinus floor elevation (TSFE). MATERIALS AND METHODS Five fresh human cadaver heads corresponding to eight maxillary sinuses (six bilateral and two unilateral) underwent 4 TSFEs per sinus (a total of 32 single site elevations). Each elevation was randomly assigned to receive a three or six mm membrane elevation height (MEH). A microscope and micro-camera were used to assess the sinus membrane perforation. Afterwards, radiological and clinical membrane perforation assessments were performed. The statistical analysis results are expressed using the means, standard deviations, range values of the residual ridge height (RRH), residual ridge width (RRW), sinus membrane thickness (SMT) and incidence of perforation (IoP). Generalized linear methods were used to test for the correlation of RRH and MEH to the microscope and micro-camera perforation assessments and the correlation of microscope and micro-camera assessments with the post-operative CBCT and crestal liquid evaluation. RESULTS The cumulative percentage of IoP was 40.62%, (23.07% with 3 mm MEH, and 76.92% with 6 mm MEH, p < 0.05). The perforation assessed using either the microscope or micro-camera coincided with the post-operative CBCT and crestal liquid assessment in 87.55% sites. No significant correlation was found between the microscope or micro-camera assessments with RRH or MEH. CONCLUSION Application of a microscope and micro-camera during transcrestal sinus floor elevation may allow the detection of the integrity of the Schneiderian membrane with greater than 85% accuracy in this ex vivo model.
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Affiliation(s)
- Jordi Gargallo-Albiol
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan.,Oral and Maxillo-facial Surgery Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Khaled H Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
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26
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Abstract
Edentulous sites are often characterized by inadequate bone volume for dental implant therapy. Bone augmentation procedures for site development involve longer healing period and are often invasive, costly, and associated with postoperative morbidity. This article discusses alternatives to invasive bone grafting procedures that are often used to develop implant sites. Owing to the broad nature of this topic, it is presented in two articles. In part I, the use of short and narrow-diameter implants are discussed. Part II reviews the use of tilted as well as fewer implants to support a prosthesis.
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27
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Larsen PE, Kennedy KS. Managing the Posterior Maxilla with Implants Using Bone Grafting to Enhance Implant Sites. Oral Maxillofac Surg Clin North Am 2019; 31:299-308. [DOI: 10.1016/j.coms.2019.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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28
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Fresh Frozen Allogeneic Bone Block in Maxillary Sinus Floor Elevation: Histomorphometric Analysis of a Bone Specimen Retrieved 15 Years after Grafting Procedure. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9061119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nowadays implant-prosthetic rehabilitations are one of the best solutions for rehabilitating our patients. These allow obtaining rehabilitations with optimal functional and aesthetic performances. Often patients, who undergo implant-prosthetic therapy, have the conditions of edentulias, single or multiple, that have been going on for some time. This, according to the literature, produces resorption of the alveolar bone, a process that is complicated in the posterior area of the upper arch by a pneumatization of the maxillary sinuses. The loss of vertical height, so that the implant fixtures can be inserted, requires a maneuver called maxillary sinus floor elevation. This procedure, now safely performed with piezoelectric instruments, allows increasing bone height through bone grafting. In this study, the tissue obtained from a patient, after 15 years from the intervention, was evaluated by histological and SEM analyses. The bone healing in the patient has led to a perfect integration between the patient’s bone and the fresh frozen allograft used, however still present and detectable after 15 years.
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29
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Meijer HJA, Boven C, Delli K, Raghoebar GM. Is there an effect of crown-to-implant ratio on implant treatment outcomes? A systematic review. Clin Oral Implants Res 2019; 29 Suppl 18:243-252. [PMID: 30306696 PMCID: PMC6221159 DOI: 10.1111/clr.13338] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES High crown-to-implant ratios may lead to complications due to unfavorable occlusal forces, including nonaxial forces, on the bone surrounding the neck of the implant and within the connection of the crown and implant itself. The aim of this study was to perform a systematic review on the influence of crown-to-implant ratio of single-tooth, nonsplinted, implants on biological and technical complications. MATERIALS AND METHODS MEDLINE (1950-January 2018), EMBASE (1966-January 2018), and Cochrane Central Register of Controlled Trials database (1800-January 2018) were searched to identify eligible studies. Inclusion criteria were as follows: crown-to-implant ratio of single-tooth, nonsplinted, implant-supported restorations in the posterior maxilla or mandible and follow-up of at least 1 year. Main outcome measures were as follows: implant survival rate, marginal bone level changes, biological complications, and technical complications. Two reviewers independently assessed the articles. A meta-analysis was carried out for implant survival rate and peri-implant bone changes. RESULTS Of 154 primarily selected articles, eight studies fulfilled the inclusion criteria. Study groups presented a mean crown-to-implant ratio varying from 0.86 (with 10-mm implants) to 2.14 (with 6-mm implants). The meta-analysis showed an implant survival of more than 99% per year and mean peri-implant bone changes of <0.1 mm per year. Limited biological and technical complications were reported. CONCLUSION Data reviewed in the current manuscript on crown-to-implant ratio, ranging from 0.86 to 2.14, of single-tooth, nonsplinted, implants did not demonstrate a high occurrence of biological or technical complications.
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Affiliation(s)
- Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Carina Boven
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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30
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Schwimer CW, Gluckman H, Salama M, Nagy K, Du Toit J. The socket-shield technique at molar sites: A proof-of-principle technique report. J Prosthet Dent 2019; 121:229-233. [DOI: 10.1016/j.prosdent.2018.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/27/2022]
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31
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Evaluation of the Cortical Deformation Induced by Distal Cantilevers Supported by Extra-Short Implants: A Finite Elements Analysis Study. Symmetry (Basel) 2018. [DOI: 10.3390/sym10120762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of the study was to analyze the distribution of stresses caused by an axial force in a three-dimensional model with the finite element method in the implant-supported fixed partial denture with distal overhang (PPFIVD) on short dental implants in the posterior edentulous maxilla. Methods: geometrical models of the maxilla with a bone remnant of 9 and 5 mm were created. Straumann SP® (Base, Switzerland) implants were placed in the premolar area. Two groups with subgroups were designed. Group A (GA): PPFIVD on two implants (GA1: 4.1 × 8 mm and GA2: 4.1 × 4 mm); Group B (GB): PPFIVD on the single implant (GB1: 4.1 × 8 mm and GB2: 4.1 × 4 mm). It was applied to a static force of 100 N to 30°. Results: PPFIVD on two implants reached the maximum tension in GA2 with respect to GA1; the difference was not significant in implants. In the maxilla GA2 was lower in relation to GA1; the difference was not significant. In PPFIVD over an implant, the stress was greater in GB2 with respect to GB1; the difference was significant in maxilla and implants. Peri-implant bone micro deformations and prosthesis-implant displacements were observed. Conclusions: PPFIVD over short splinted implants could be viable in the maxilla with reduced bone height, being an option when lifting the floor of the maxillary sinus. The rehabilitation with unitary implant (4 mm) did not provide adequate results. The dominant tensions evidenced bone micro-distortions with a displacement of the prosthesis-implant set. The real statement of this paper was to define that short splinted implants can be used in soft bone with high success rate in reducing bending forces.
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Hattingh A, Hommez G, De Bruyn H, Huyghe M, Vandeweghe S. A prospective study on ultra-wide diameter dental implants for immediate molar replacement. Clin Implant Dent Relat Res 2018; 20:1009-1015. [PMID: 30255544 DOI: 10.1111/cid.12666] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/13/2018] [Accepted: 06/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although wide diameter implants are well documented, little is known about ultra-wide diameter implants (>6 mm). This study evaluates the clinical outcome of ultra-wide diameter implants, placed in molar extraction sockets. MATERIALS AND METHODS Ultra-wide diameter implants (7-9 mm) were placed immediately after molar extraction in a 1-stage protocol, without raising a flap or using any bone grafts. After 4 months, the implant was loaded with a single screw-retained crown. Bone loss was evaluated using peri-apical radiographs. Plaque and bleeding were recorded. Crown and papilla dimensions were measured and compared with the contra-lateral tooth. RESULTS Fifty-one patients (36 male and 15 female), mean ages 61 years old, were treated with 26 implants in the maxilla and 25 implants in the mandible. The majority had a thick (#19) or medium (#31) biotype. After a mean-follow-up period of 23 months, the mean bone level was located 1.16 mm apical of the implant-abutment junction (SD 0.42, range 0.00-2.45) while the actual bone remodeling associated with socket healing resulted in a mean coronal movement of the bone level of 0.15 mm. The mean insertion torque was 116 Ncm (SD 53, range 10-250). There were no differences in papilla height (P = .55), crown length (P = .32), zenith (P = .84), and bucco-palatal dimensions (P = .38). There was a significant difference in the mesio-distal dimension (P = .01). Mean probing depth was 2.59 mm at the implant and 2.23 mm at the contra-lateral tooth (P = .001). There was significantly more plaque at the tooth compared to the implant (P = .01), but there was no significant difference in terms of bleeding on probing (P = .08). Patient satisfaction was high with 72.5% of the patients experiencing no problems at all. CONCLUSIONS Ultra-wide diameter implants have a predictable outcome, demonstrating very little bone loss. Papilla and crown dimensions were comparable to the contra-lateral natural tooth.
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Affiliation(s)
- André Hattingh
- Research Cluster Periodontology, Oral Implantology, Removable and Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Private Practice for Periodontology and Oral Implantology, United Kingdom
| | - Geert Hommez
- Research Cluster Periodontology, Oral Implantology, Removable and Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hugo De Bruyn
- Research Cluster Periodontology, Oral Implantology, Removable and Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Marie Huyghe
- Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stefan Vandeweghe
- Research Cluster Periodontology, Oral Implantology, Removable and Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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33
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Abstract
Dental implants are a mainstream treatment protocol to replace missing teeth. Patient and clinician demands have led to shorter length and narrower diameter implants, immediately placed implants into infected sites, and the use of implants in children. This article reviews some of the controversial topics in implant dentistry, and presents the evidence that supports and challenges these newer techniques. Because long-term studies are often not available, especially for implants in infected sites, mini implants, and implants in the growing patient, the field continues to evolve.
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Starch-Jensen T, Nielsen HB. Prosthetic Rehabilitation of the Partially Edentulous Atrophic Posterior Mandible with Short Implants (≤ 8 mm) Compared with the Sandwich Osteotomy and Delayed Placement of Standard Length Implants (> 8 mm): a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2018; 9:e2. [PMID: 30116514 PMCID: PMC6090250 DOI: 10.5037/jomr.2018.9202] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 01/26/2023]
Abstract
Objectives Test the hypothesis of no difference in prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) compared with the sandwich osteotomy and delayed placement of standard lengths implants (> 8 mm). Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search was conducted by including studies published in English. No year of publication restriction was applied. Results Six randomized controlled trials characterized by low or moderate risk of bias fulfilled the inclusion criteria. There were no statistically significant differences (P > 0.05) in the survival rate of suprastructures and implants between the two treatment modalities after one year. Sandwich osteotomy and delayed implant placement demonstrated statistically significant higher long-term peri-implant marginal bone loss as well as biological and technical complications compared with short implants (P < 0.0001). Moreover, patients significantly favoured prosthetic rehabilitation with short implants (P < 0.0001). Conclusions Short implants and the sandwich osteotomy with delayed placement of standard length implants appear to result in predictable outcomes in terms of high survival rate of suprastructures and implants after prosthetic rehabilitation of the partially edentulous atrophic posterior mandible. However, further long-term randomized controlled trials assessing donor site morbidity, an economic perspective, professional and patient-related outcome measures with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of short implants for prosthetic rehabilitation of the partially edentulous atrophic posterior mandible compared with the sandwich osteotomy and delayed placement of standard length implants.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
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35
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Adánez MH, Brezavšček M, Vach K, Fonseca M, Att W. Clinical and Radiographic Evaluation of Short Implants Placed in the Posterior Mandible: A 1-Year Pilot Split-Mouth Study. J ORAL IMPLANTOL 2018; 44:250-259. [PMID: 29717922 DOI: 10.1563/aaid-joi-d-18-00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In many cases, due to anatomical limitations, the placement of regular-length implants cannot be facilitated without the performance of advanced surgical procedures. However, these are associated with morbidity, prolonged treatment time, and costs. To overcome such disadvantages, short implants were introduced. The aim of this prospective pilot split-mouth study was to compare the clinical outcome between short implants (7 mm) and regular-length (≥10 mm) implants placed in the posterior mandible after 1 year of prosthetic delivery. Ten patients received 4 implants in the posterior mandible. Two short implants were placed in one side and 2 regular-length implants were placed contralaterally. These were restored by means of splinted screw-retained metal-ceramic crowns. Marginal bone loss (MBL) and soft-tissue parameters were compared. No implant failed. Both types of implants showed success rates of 90% and survival rates of 100%. From prosthetic delivery to 1 year post-loading a bone gain of +0.29 mm for short implants and +0.19 mm for regular-length implants was present without showing any statistically significant differences in MBL between the 2 implant types ( P > .05). Bleeding on probing, clinical attachment level, probing depth, and crown-to-implant ratio did not show any statistically significant differences between the 2 implant lengths ( P > .05). One case of chipping occurred in the regular-length implant group, leading to a prosthetic survival rate of 95%. Short implants showed a prosthetic survival rate of 100%. After 1 year, short implants showed comparable clinical outcomes to that of regular-length implants, making them a viable treatment option in the posterior mandible.
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Affiliation(s)
- Mireia Haro Adánez
- 1 Department of Prosthetic Dentistry, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | - Kirstin Vach
- 3 Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Manrique Fonseca
- 4 Department of Prosthetic Dentistry, School of Dentistry, University Hospital Bern, Switzerland
| | - Wael Att
- 5 Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Al-Harbi FA. Mandibular Implant-supported Overdentures: Prosthetic Overview. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2017; 6:2-7. [PMID: 30787808 PMCID: PMC6196685 DOI: 10.4103/sjmms.sjmms_101_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Implant-supported overdentures are becoming the treatment of choice for the completely edentulous mandible. They significantly improve the quality of life in edentulous patients. For this review article, the literature was searched to identify pertinent studies. No meta-analysis was conducted because of high heterogeneity within the literature. Accordingly, in this review article, the author provides an update on implant-supported mandible overdentures with regard to the number of implants, type of loading, stress-strain distribution, mode of implant-to-denture attachment, occlusal considerations and complications.
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Affiliation(s)
- Fahad A Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Abstract
The oral rehabilitation of a patient with atrophic maxilla is one of the main challenges in implant-supported rehabilitations. The implant placement in the posterior region of the maxilla is limited by a deficiency of bone quantity and quality, besides the anatomic restriction of the maxillary sinus. The use of zygoma fixtures, anchoraged in the zygomatic bone, is a useful technique to enable the full arch rehabilitation. However, complications related to this procedure bring a lot of difficulty in solving. This study presents the use of extra-short implants as a strategy to treat a patient in whom the zygoma fixture and the fixed prosthesis failed, associated with sinusitis and alveolar bone loss.
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Cumulative Success Rate of Short and Ultrashort Implants Supporting Single Crowns in the Posterior Maxilla: A 3-Year Retrospective Study. Int J Dent 2017; 2017:8434281. [PMID: 28751913 PMCID: PMC5511658 DOI: 10.1155/2017/8434281] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/23/2017] [Indexed: 12/14/2022] Open
Abstract
AIM To determine cumulative success rate (CSR) of short and ultrashort implants in the posterior maxilla restored with single crowns. PATIENTS AND METHODS We performed a retrospective study in 65 patients with 139 implants. 46 were ultrashort and 93 short. Implants were placed with a staged approach and restored with single crowns. Success rate, clinical and radiographic outcomes, and crown-to-implant ratio (CIR) were assessed after three years. Statistical analysis was performed by descriptive and inferential statistics. A log-binomial regression model where the main outcome was implant success was achieved. Coefficients and 95% confidence intervals were reported. Analyses were performed with Stata 13.2 for Windows. RESULTS 61.54% of patients were female and mean overall age was 51.9 ± 11.08 years old. Overall CSR was 97.1% (95% CI: 92.4-98.9): 97.9 and 95.1% for short and ultrashort, respectively (P value: 0.33). Four implants failed. Covariates were not associated with CSR (P value > 0.05). Regression model showed coefficients correlated with implant success for ultrashort implants (0.87) and most of covariates but none were statistically significant (P values > 0.05). CONCLUSIONS Our results suggest that short and ultrashort implants may be successfully placed and restored with single crowns in the resorbed maxillary molar region.
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