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Gurbuz E, Ceylan E, Ersoz MM, Keceli HG. Effect of Sagittal Root Position, Angle, and Bone Thickness on Peri-implant Tissue Phenotype and Bone Level in Socket Shield Technique: A Retrospective Case Series. J ORAL IMPLANTOL 2024; 50:308-316. [PMID: 38703004 DOI: 10.1563/aaid-joi-d-23-00104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
There were only a few studies investigating the effect of sagittal root position (SRP), sagittal root angle (SRA), and buccal bone thickness (BBT) on peri-implant tissues using the socket shield technique (SST). This retrospective case series aimed to evaluate the SRP, SRA, and BBT in socket shield cases and examine the effect of these anatomical factors on the peri-implant tissue phenotype and bone level. Data from 27 patients (14 women, 13 men) treated with SST in the maxillary esthetic region between July 2019 and September 2021 were included. Clinical indices (modified plaque and bleeding indices, probing depth, keratinized mucosa width, mucosal thickness) and periapical radiographic recordings (marginal bone level) taken immediately after permanent prosthesis placement and 1 year later were used. Cone beam computerized tomography images were used to examine BBT, SRP, and SRA before implant placement and horizontal and vertical bone levels before implant placement and 1 year after prosthetic rehabilitation. The data were divided into groups based on BBT (<1 and ≥1 mm) and SRA values (<10° and ≥10°). There were no significant differences in 1-year clinical factors between the SRA <10° and SRA ≥10° groups. However, higher vertical bone loss was found in the SRA ≥10° group (P = .01, d = 0.53). There were no significant differences in clinical or radiographic factors between the BBT <1 mm and BBT ≥1 mm groups. In conclusion, BBT showed no significant effect on tissue phenotype and bone level, but SRA affected bone level in socket shield cases.
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Affiliation(s)
- Ezgi Gurbuz
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Ezgi Ceylan
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Mehmet Meric Ersoz
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Huseyin Gencay Keceli
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
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Hedayatipanah M, Arasteh HK, Shokri A, Alafchi B, Baghdadi LS. Effect of vertical implant position on marginal bone loss: a randomized clinical trial. BMC Oral Health 2024; 24:727. [PMID: 38915016 PMCID: PMC11197272 DOI: 10.1186/s12903-024-04480-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/13/2024] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVES One of the most important factors that has influence on dental implants success rate is marginal bone loss. The purpose of this study is to investigate the effect of the implant's vertical position and the soft tissue's thickness on the rate of marginal bone loss of the dental implant. MATERIALS AND METHODS In this single-blind randomized clinical trial study, 56 implants placed in the posterior region of mandible of 33 patients (19 women, 14 men) were divided into two groups. The group of crestal (28 implants) and subcrestal (28 implants) implants, each group was divided into two sub-groups with soft tissue thickness of 2 mm and less than 2 mm (14 implants) and more than 2 mm (14 implants). The amount of marginal bone loss was measured by Scanora 5.2 program with radiographs Digital parallelism based on the effect of the vertical position of the implant, soft tissue thickness, three months after placement, and three months after loading implants (six months after implant placement). RESULTS The results showed that marginal bone loss in subcrestal implants is significantly more than crestal implants (p-value = 0.001), and also marginal bone loss in the soft tissue thickness group of 2 mm and less is significantly more than the group of soft tissue thickness more than 2 mm (p-value < 0.001). The amount of marginal bone loss three months after implant loading was significantly higher than three months after implant placement (p-value < 0.001). CONCLUSION The implant's vertical position and the soft tissue's thickness around the implant are effective factors in the amount of marginal bone loss. Marginal bone loss is more in subcrestal implants and in cases with less soft tissue thickness. The time factor significantly affects the amount of marginal bone loss. TRIAL REGISTRATION this clinical trial was registered at Iranian Registry of Clinical Trials, registration number IRCT20120215009014N415, registration date 20,220,110, (https//en.irct.ir/trial/60,991).
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Affiliation(s)
- Morad Hedayatipanah
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hadi Kokabi Arasteh
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Shokri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behnaz Alafchi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Shahsavand Baghdadi
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
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Park JW, Goodacre CJ, Kan JYK, Lozada J, Al-Ardah A. Proposal regarding horizontal and vertical positioning of single implants placed in healed sites: Effect on cervical crown form and the need for bone grafting. J Prosthet Dent 2024:S0022-3913(24)00381-0. [PMID: 38918155 DOI: 10.1016/j.prosdent.2024.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024]
Abstract
STATEMENT OF PROBLEM When single implants are placed in healed sites, guidelines are lacking on the horizontal and vertical implant positions that optimize cervical crown form and the implant locations that would require bone grafting to develop the optimal crown form. PURPOSE The purpose of this clinical study was to evaluate the cervical contour of wax patterns formed on casts of single implants placed in healed sites and to determine which horizontal and vertical implant positions produced the best cervical crown form and which indicated the need for bone grafting. MATERIAL AND METHODS Fifty-eight wax patterns were fabricated on casts where implants had been placed in healed sites without bone grafting. The wax patterns were subjectively assessed by 5 dental faculty members and 5 graduate students as having good, fair, or poor cervical crown form. Horizontal measurements were made between the facial surface of the implant and a round metal wire connecting the gingival zeniths of the adjacent teeth. Vertical measurements were also made between the wire and implant platform. The subjective assessments along with the horizontal and vertical implant position measurements were used to propose guidelines for optimal implant placement in healed sites. RESULTS Horizontal distances of 2.0 to 3.0 mm produced good cervical crown contours, with distances >3.0 mm and <2.0 mm resulting in fair or poor assessments. Vertical distances of 3.0 to 4.0 mm were judged to have good cervical crown contour, whereas depths of 1.0 mm or less were assessed as poor. CONCLUSIONS Based on the subjective assessment of wax patterns formed on casts of single implants placed in healed sites, a guideline of 2.0 to 3.0 mm is proposed for the horizontal distance between a line connecting the adjacent gingival zeniths and the facial surface of the implant. A vertical distance guideline of 3.0 to 4.0 mm is proposed between the adjacent gingival zeniths and the implant platform.
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Affiliation(s)
- Joon W Park
- Private practice, Fullerton, Calif.; and Former student, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Charles J Goodacre
- Distinguished Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif.
| | - Joseph Y K Kan
- Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Jaime Lozada
- Professor and Program Director, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
| | - Aladdin Al-Ardah
- Associate Professor, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif
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Marginal Bone Loss in Internal Conical Connection Implants Placed at the Crestal and Subcrestal Levels before Prosthetic Loading: A Randomized Clinical Study. MATERIALS 2022; 15:ma15103729. [PMID: 35629754 PMCID: PMC9145780 DOI: 10.3390/ma15103729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/04/2022]
Abstract
The vertical position concerning the bone in which the implants are placed has been related as one of the factors causing marginal bone loss. The objective of this study was to evaluate the bone loss that occurs before prosthetic loading around tapered internal connection (CIC) implants placed at the crestal (C) and subcrestal (S) levels. Method: A randomized clinical trial (RCT) was carried out, with a sample size of 62 implants placed in 27 patients who underwent radiological controls on the day of placement, at one month, and at 4 months, and stability was measured by resonance frequency analysis (RFA) on three occasions. Results: Bone loss in implants C and S from the time of placement (T0) and the month after (T1) was not significant (p = 0.54) (C = 0.19 mm and S = 0.15 mm). The difference between one month (T1) and four months (T2) (C = 0.17 mm and S = 0.22 mm) was not significant either (p = 0.26). The difference between the day of placement (T0) and the third and last measurement (T2) was almost null (p = 0.94) (C = 0.35 mm and S = 0.36). The overall success rate of the implants was 97.8%. The stability of the implants measured with RFA went from 70.60 (T0) to 73.16 (T1) and 74.52 (T2). Conclusions: No significant differences were found in the bone loss for implants placed at the C and S levels. The millimeters of bone loss detected in both vertical positions did not have a significant impact on the stability of the implants.
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Krennmair S, Malek M, Forstner T, Krennmair G, Stimmelmayr M, Hunger S. Immediately loaded implants simultaneously placed in fresh extraction and healed sites supporting four-implant-supported fixed mandibular prostheses using the all-on-4 concept: A 5-year prospective study. Clin Oral Implants Res 2021; 33:158-171. [PMID: 34800325 DOI: 10.1111/clr.13879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the peri-implant marginal bone level for immediately loaded implants placed simultaneously in both fresh extraction sites (FES) and healed sites (HS) supporting a 4-implant supported mandibular fixed prosthesis (4-ISFMP) using the all-on-4 concept. MATERIAL AND METHODS A 5-year prospective study was conducted in 24 patients (96 implants) treated with 4-ISFMP including 55 implants inserted in FES and 41 implants in HS. At implant placement (baseline) and at the 1st -, 3rd - and 5th -year follow-up examinations, peri-implant marginal bone level was evaluated radiographically and compared between placement in FES and HS. Marginal bone loss was calculated as the difference in the marginal bone level evaluated at the follow-up periods. Additionally, implant and prosthesis survival rates as well as the presence of peri-implant mucositis (bleeding on probing+[BOP]) and peri-implantitis (BOP+ >2 mm MBL) were evaluated. RESULTS 22/24 patients with 88/96 implants (dropout rate: 8.3%) were continually followed for 5 years (survival rate: 100%). Radiographically measured marginal bone level differed significantly between FES and HS at implant placement (1.46 ± 0.80 mm vs. 0.60 ± 0.70 mm; p < .001), at the 1-year (-0.04 ± 0.14 mm vs. -0.18 ± 0.20 mm; p = .002) and 3-year (-0.26 ± 0.49 mm vs. -0.58 ± 0.48 mm, p = .049), but not at the 5-year evaluation (-0.90 ± 0.66 mm vs. -1.00 ± 0.59 mm, p = .361). The marginal bone loss differed significantly (p < .001) between FES and HS between implant placement and the 1-year evaluation but not for the 1- to 3-year (p > .99) and the 3- to 5-year period (p = .082). At the 5-year follow-up evaluation, no implant/prosthesis failed (100% survival) and peri-implant mucositis and peri-implantitis were noted in 41.2% and 11.7% at patient level and in 17.6% and 4.5% at implant level respectively. CONCLUSION Implants placed in FES showed a prolonged peri-implant remodelling process but provided for similar peri-implant marginal bone levels as implants placed in HS at the 5-year evaluation for immediately loaded 4-ISFMP.
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Affiliation(s)
- Stefan Krennmair
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
| | - Michael Malek
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Forstner
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria.,Department of Applied Systems Research Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Gerald Krennmair
- Dental School, Sigmund Freud Private Medical University Vienna, Austria
| | | | - Stefan Hunger
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
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Aesthetic Outcomes and Peri-Implant Health of Angled Screw Retained Implant Restorations Compared with Cement Retained Crowns: Medium Term Follow-Up. J Funct Biomater 2021; 12:jfb12020035. [PMID: 34065705 PMCID: PMC8162333 DOI: 10.3390/jfb12020035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/02/2021] [Accepted: 05/10/2021] [Indexed: 12/27/2022] Open
Abstract
Single tooth implant restorations in the aesthetic area are a demanding challenge. If a complete osseointegration is mandatory, the final result has to result in a higher standard of biomimetic and soft tissue health among natural teeth. This outcome is traditionally pursued by cementing crowns over individualized abutments. However, in recent years, the need for controlling peri-implant health and the preference towards a retrievable solution has led to an increase in screw-retained crowns, which is not always applicable when the implant axis is not ideal. In the aesthetic area, the use of a novel technical solution represented by the angled screw channel (ASC) of the abutment has been proposed in order to match the advantages of the screwed solution with the aesthetic demands. The aim of this study was to compare ASC crowns to cemented crowns (CC) in single implant restorations using the white esthetic score (WES) and pink esthetic score (PES) at the crown delivery and at a follow-up of a minimum of 2 years. Peri-implant health and marginal bone loss (MBL) were also evaluated. The mean follow-up was 44.3 months, with a mean MBL of 0.22 mm in the ASC group and 0.29 mm in the CC group. The total WES/PES score was 16.6 for ASC, compared with 17.3 for CC at baseline, and 16.2 and 17.1, respectively, at follow-up. Both of the groups reached a high WES/PES, and this was maintained over time, without signs of peri-implant diseases or bone loss, regardless of the choice of connection. In conclusion, ASC can be adopted in cases where the implant axis is not ideal, with aesthetic and functional results that are comparable to implants restored by cemented crowns.
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Comparison of Success Rate of Dental Implants Placed in Autogenous Bone Graft Regenerated Areas and Pristine Bone. J Craniofac Surg 2021; 31:1572-1577. [PMID: 32282668 DOI: 10.1097/scs.0000000000006401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Autogenous bone grafting still has been considered as the "gold standard" and wildly used in the case of alveolar bone reconstruction. The aim of the present study is to evaluate the success rate of implants placed in autogenous block augmented ridges and implants placed in pristine bone (PB). This study included 113 patients. Fifty-three patients were treated with autogenous block grafts and particulate bone, after 6 months of healing implant placements were performed in autogenous bone augmented (ABA) areas. In 60 patients implant placement was performed, with no need for grafting and implants were placed into the PB. Follow-up data (pain, mobility, exudation from peri-implant space, success rate, marginal bone resorption) were collected after 5 years of prosthetic loading. The cumulative implant success rate at the 5-year examination was 92.45% for the ABA group and 85% for PB group. There were 3 failed implants in the ABA group and 3 in PB group. Average marginal bone loss was 1.47 mm on ABA group and 1.58 mm on PB group. No statistically significant differences for pain, exudation from peri-implant space, implant mobility, implant success, peri-implant bone loss parameters, and patient satisfaction level were found between groups. The obtained data demonstrated that the success rate of implants placed in regenerated areas are very similar to the success rate of implants those placed in PB.
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Factors Influencing Primary and Secondary Implant Stability—A Retrospective Cohort Study with 582 Implants in 272 Patients. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The success rate of dental implants depends on primary and secondary stability. We investigate predictive factors for future risk stratification models. We retrospectively analyze 272 patients with a total of 582 implants. Implant stability is measured with resonance frequency analysis and evaluated based on the implant stability quotient (ISQ). A linear regression model with regression coefficients (reg. coeff.) and its 95% confidence interval (95% CI) is applied to assess predictive factors for implant stability. Implant diameter (reg. coeff.: 3.28; 95% CI: 1.89–4.66, p < 0.001), implant length (reg. coeff.: 0.67, 95% CI: 0.26–1.08, p < 0.001), and implant localization (maxillary vs. mandibular, reg. coeff.: −7.45, 95% CI: −8.70–(−6.20), p < 0.001) are significant prognostic factors for primary implant stability. An increase in ISQ between insertion and exposure is significantly correlated with healing time (reg. coeff.: 0.11, 95% CI: 0.04–0.19). Patients with maxillary implants have lower ISQ at insertion but show a higher increase in ISQ after insertion than patients with mandibular implants. We observe positive associations between primary implant stability and implant diameter, implant length, and localization (mandibular vs. maxillary). An increase in implant stability between insertion and exposure is significantly correlated with healing time and is higher for maxillary implants. These predictive factors should be further evaluated in prospective cohort studies to develop future preoperative risk-stratification models.
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Saravi BE, Putz M, Patzelt S, Alkalak A, Uelkuemen S, Boeker M. Marginal bone loss around oral implants supporting fixed versus removable prostheses: a systematic review. Int J Implant Dent 2020; 6:20. [PMID: 32488421 PMCID: PMC7266905 DOI: 10.1186/s40729-020-00217-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
Aim The aim of this systematic review was to evaluate and compare the marginal bone loss (MBL) around implants of fixed (FISP) versus removable implant-supported prosthesis (RISP). Material and methods This review was conducted according to the PRISMA guidelines. A systematic search of the literature on Web of Science and Ovid (MEDLINE) was conducted in March 2019 to identify randomized controlled trials/quasi-randomized trials, prospective and retrospective studies written in German and English. Two reviewers screened the identified papers for eligibility and performed an independent data extraction. The Newcastle-Ottawa Scale was used to evaluate the level of evidence of the included studies. Results The search resulted in 2577 studies, of which 42 were selected for full-text evaluation. Finally, six studies were included in qualitative analyses, reporting results from 248 participants (81 FISP versus 167 RISP). Five of the included studies were prospective and one study was retrospective. MBL was highest in the first year after implant placement and ranged from 0.17 ± 0.07 mm to 2.1 ± 1.6 mm in FISP and from 0.22 ± 0.55 mm to 2.5 ± 2.7 mm in RISP. After 4 years, there was no statistically significant difference between the groups; MBL ranged from 0.36 ± 0.22 mm to 1.5 mm in FISP and 0.56 ± 0.45 mm to 1.4 mm in RISP. Of the six included studies, two each were rated as good quality, fair quality, and poor quality. Conclusion Fixed and removable implant-supported prostheses seem to have similar long-term outcomes regarding marginal bone loss. However, the evidence provided in this systematic review is limited due to the poor quality of two of the included studies. Future studies with study designs specified to the topic of this review are necessary to provide clear information about marginal bone level alterations in modern implant therapy.
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Affiliation(s)
- Babak E Saravi
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany.
| | - Maria Putz
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Sebastian Patzelt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Amir Alkalak
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Sara Uelkuemen
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
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Anitua E, Fernández-de-Retana S, Alkhraisat MH. Survival and Marginal Bone Loss of Dental Implants Supporting Cad-Cam Angled Channel Restorations: A Split-Mouth Retrospective Study. Eur J Dent 2020; 14:194-199. [PMID: 32447749 PMCID: PMC7274818 DOI: 10.1055/s-0040-1709895] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective
The aim of this study was to determine whether the screw emergence angulation correction by computer-aided design (CAD)-computer-aided manufacturing (CAM) can influence implant survival and marginal bone stability.
Materials and Methods
This was a controlled split-mouth retrospective study of angled channel restorations. The dental implants supporting the prosthesis were divided into the following two groups: the first group (Group 1) included the implants that required screw channel angulation, while the second group (Group 2) included the implants that did not require this correction to screw the prosthesis to the implant. The main outcome variables were implant survival and marginal bone loss (MBL).
Results
A total of 68 dental implants placed in 22 patients were included in the final cohort. The mean follow-up time was 39.65 ± 15.20 months. None of the studied implants failed during the follow-up period and the mean MBL was − 0.29 ± 0.51 mm at the end of the follow-up. No statistical differences in the MBL were observed between the two groups of the study (-0.18 ± 0.51 and − 0.23 ± 0.58 mm, respectively).
Conclusion
The angulation of the screw channel with CAD-CAM technology resulted in good clinical outcomes and did not affect MBL. Thus, the angulated screw channel might be considered an alternative to face undesired screw emergencies. Future prospective clinical studies should confirm these results.
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Affiliation(s)
- Eduardo Anitua
- Clínica Eduardo Anitua, Vitoria, Spain.,BTI Biotechnology Institute, Vitoria, Spain
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Effect of Implant-Abutment Connection Type on Bone Around Dental Implants in Long-Term Observation: Internal Cone Versus Internal Hex. IMPLANT DENT 2019; 28:430-436. [PMID: 31188171 DOI: 10.1097/id.0000000000000905] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the influence of the implant-abutment connection type on the bone level around dental implants in long-term observation and the survival rate for the different types of implant-abutment connections. MATERIALS AND METHODS Two groups of implants made of titanium grade 23 alloy and with sandblasted and acid-etched (SLA) surface were included in the study: (a) the internal hex implant-abutment connection group (480 SPI dental implants; Alpha-Bio Tec, Petach Tikwa, Israel, 184 patients) and (b) the internal cone implant-abutment connection group (60 C1 dental implants; MIS Implant Technologies, Shlomi, Israel, 34 patients). Certain inclusion and exclusion criteria were applied. Marginal bone loss (MBL) around the dental implants was measured in intraoral radiographs taken with parallel technique with a film holder and by bite recording index. X-rays were performed at the moment of functional loading, and at 12, 24, 36, and 60 months after loading. The digital analysis was conducted using Dental Studio 2.0 computer software. RESULTS Average MBL was significantly lower in the conical connection compared with internal hex group-0.68 ± 0.59 versus 0.99 ± 0.89 mm (12 months), 0.78 ± 0.80 versus 1.12 ± 1.00 mm (24 months), 0.83 ± 0.87 versus 1.22 ± 1.03 mm (36 months), and 0.96 ± 1.02 versus 1.30 ± 1.15 mm (60 months after loading). Both groups of implants achieved a 100% survival rate. CONCLUSION The internal cone connection reduced bone resorption compared with the internal hex. Both groups of implants had a 100% survival rate.
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Bone Loss in Implants Placed at Subcrestal and Crestal Level: A Systematic Review and Meta-Analysis. MATERIALS 2019; 12:ma12010154. [PMID: 30621286 PMCID: PMC6337530 DOI: 10.3390/ma12010154] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 11/23/2022]
Abstract
Background: To assess differences in marginal bone loss in implants placed at subcrestal versus crestal level. Methods: An electronic and a manual research of articles written in English from Jaunary 2010 to January 2018 was performed by two independent reviewers. Clinical trials comparing bone loss for implants placed at crestal and subcrestal level were included. Pooled estimates from comparable studies were analyzed using a continuous random-effects model meta-analysis with the objective of assessing differences in crestal bone loss between the two vertical positions. Results: 16 studies were included; 10 studies did not encounter statistically significant differences between the two groups with respect to bone loss. Three articles found greater bone loss in subcrestal implants; while 3 found more bone loss in crestal implants. A meta-analysis for randomized control trial (RCT) studies reported an average and non-statistically different crestal bone loss of 0.028 mm. Conclusions: A high survival rate and a comparable bone loss was obtained both for crestal and subcrestal implants’ placement. Quantitative analysis considering a homogenous sample confirms that both vertical positions are equally valid in terms of perimplant bone loss. However, with respect to soft tissue; in presence of a thin tissue; a subcrestal placement of the implant should be preferred as it may reduce the probability for the implant to become exposed in the future and thus avoid the risk of suffering from peri-implant pathologies.
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