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Arosio P, Sartori M, Arosio F, Garagiola U, Di Stefano DA. Using a Bone Density Measuring Micromotor to Distinguish Different Cortical/Cancellous Combinations in Vitro: A Study Using Polyurethane Foam Blocks. Int J Oral Maxillofac Implants 2024; 39:310-318. [PMID: 37910838 DOI: 10.11607/jomi.10467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
PURPOSE To assess whether a recently introduced implant placement micromotor that provides site-specific, operator independent cancellous bone density measurements can detect the presence of a cortical bone layer and measure its thickness and density. MATERIALS AND METHODS An in vitro experiment was performed on six double-layer polyurethane foam blocks mimicking the jawbone with different cortical thickness/cancellous density combinations. The densities were measured using the micromotor after either removing the cortical layer or leaving it intact, both with and without irrigation. RESULTS The results were compared by means of nonparametric statistical tests. Independent of irrigation, the micromotor detected the cortical layer when it was left intact and accurately estimated its thickness. The micromotor did not discriminate between blocks when they were considered separately, but it did when they were grouped into four or three classes. CONCLUSIONS The present study suggests that the micromotor may represent a valid device to quantitatively assess bone quality and density. If the micromotor can quantitatively distinguish different cortical/cancellous bone combinations in humans, it may be a helpful tool for performing finely tuned, patient-tailored preparations of the implant seat, making tooth rehabilitation in challenging clinical conditions more predictable.
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Park JY, Kwon YH, Song YW, Cha JK, Jung UW, Thoma D, Jung R. Is transmucosal healing of an implant as effective as submerged healing when simultaneous guided bone regeneration is performed? A preclinical study. J Clin Periodontol 2024; 51:330-337. [PMID: 38087817 DOI: 10.1111/jcpe.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/15/2023] [Accepted: 11/16/2023] [Indexed: 02/17/2024]
Abstract
AIM To investigate whether transmucosal healing is as effective as submerged healing in terms of buccal bone regeneration when guided bone regeneration (GBR) is performed simultaneously with implant placement. MATERIALS AND METHODS In six dogs, buccal dehiscence defects were created in the edentulous mandibular ridge, sized 5 × 5 × 3 mm (length × height × depth). In each defect, a bone-level implant was placed, and four experimental groups were randomly assigned as follows: (i) transmucosal healing with GBR (T-GBR), (ii) transmucosal healing without GBR (T-control), (iii) submerged healing with GBR (S-GBR) and (iv) submerged healing without GBR (S-control). Data analyses were based on histological slides 5 months after implant placement. RESULTS The T-GBR group showed significant differences compared to the control groups regarding defect height resolution, buccal bone thickness and mineralized tissue area (p < .05), but showed no significant differences when compared with the S-GBR group (p > .05). CONCLUSIONS The mode of healing (transmucosal vs. submerged) does not influence bone regeneration at implant sites. The clinician may therefore choose the approach based on further clinical and patient-specific parameters.
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Affiliation(s)
- Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Daniel Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Jain S, Hemavardhini A, Ranjan M, Pasricha N, Thakar SS, Soni KJ, Hassan S, Goyal K, Singh D. Evaluation of Survival Rates of Dental Implants and the Risk Factors: A Retrospective Follow-Up Study. Cureus 2024; 16:e55360. [PMID: 38562355 PMCID: PMC10982840 DOI: 10.7759/cureus.55360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The current research sets out to assess implant early survival rates and identify relevant parameters. Methods The research spanned the years 2021 and 2022 and included all individuals who had dental implants. Various criteria, such as age, sex, maxilla/mandible, implant location, immediate implant, implant diameter, implant length, and others, were used to determine the implant survival rate in the research. A multiple logistic regression model was used to show the risk variables for early survival rates of implants, and components with p < 0.05 were further included after the Chi-square test was employed to filter them. Results The current research included 128 patients who had a single implant procedure, including 70 males and 58 females. The early survival rate was 91.40%, and 117 implants were retained after implantation. Risk variables that were shown to be associated with early survival rates were patients aged 30-60 years (OR: 2.542), immediate implant placement (OR: 3.742), and implant length less than 10 mm (OR: 3.972). Conclusions Age, tooth location, implant length, and immediate implantation were risk variables that contributed to our subjects' above 91% early survival rate of implants.
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Affiliation(s)
- Shailesh Jain
- Department of Prosthodontics and Crown and Bridge, Sharda University, Greater Noida, IND
| | - Addugala Hemavardhini
- Department of Prosthodontics and Crown and Bridge, G.Pulla Reddy Dental College & Hospital, Kurnool, IND
| | - Maitreyi Ranjan
- Department of Microbiology, School of Dental Sciences, Sharda University, Greater Noida, IND
| | - Neeta Pasricha
- Department of Prosthodontics and Oral Implantology, Institute of Technology & Science (I.T.S) Dental College, Muradnagar, IND
| | - Sahil S Thakar
- Department of Public Health Dentistry, Himachal Dental College, Mandi, IND
| | - Keyur J Soni
- Department of Orthodontics and Dentofacial Orthopedics, Ahmedabad Dental College & Hospital, Ahmedabad, IND
| | - Sahba Hassan
- Department of Prosthodontics and Crown and Bridge, DJ College of Dental Sciences & Research, Ghaziabad, IND
| | - Keshav Goyal
- Department of Prosthodontics and Crown and Bridge, Shree Bankey Bihari Dental College, Ghaziabad, IND
| | - Diksha Singh
- Department of Periodontics and Implantology, Shree Bankey Bihari Dental College, Ghaziabad, IND
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Abu Alfaraj T, Al-Madani S, Alqahtani NS, Almohammadi AA, Alqahtani AM, AlQabbani HS, Bajunaid MK, Alharthy BA, Aljalfan N. Optimizing Osseointegration in Dental Implantology: A Cross-Disciplinary Review of Current and Emerging Strategies. Cureus 2023; 15:e47943. [PMID: 38034153 PMCID: PMC10685082 DOI: 10.7759/cureus.47943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
The paper explores the correlation between osteointegration and dental implant stability, investigating the relationship and its implications for successful outcomes in implant dentistry. Osteointegration, defined as the direct structural and functional connection between living bone and the implant surface, plays a crucial role in determining the stability and long-term success of dental implants. This review synthesizes current knowledge from scientific literature and clinical studies to elucidate the factors influencing osteointegration and their impact on implant stability. Surface characteristics of implants, such as topography and chemistry, as well as the surgical techniques employed during implant placement, are examined in detail, emphasizing their significant influence on osseointegration and subsequent implant stability. Additionally, host-related factors such as bone quality, systemic conditions, and patient-specific considerations are explored to further comprehend the complexity of the osteointegration process. The abstract underscores the importance of achieving an optimal bone-implant interface to ensure successful implant integration and stability. Furthermore, emerging technologies and materials, such as computer-guided implant placement and biomimetic surfaces, are discussed for their potential to enhance osteointegration and improve long-term implants.
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Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
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Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Kahn A, Masri D, Kats L, Kolerman R, Naishlos S, Shmuly T, Allon D, Chaushu L. Referral Patterns of General Dental Practitioners for Implant Surgery Procedures. Oral Health Prev Dent 2023; 21:325-330. [PMID: 37753854 DOI: 10.3290/j.ohpd.b4438887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
PURPOSE The growing demand for implants has led to their implementation by general dental practitioners (GDPs) in clinical practice. The present study assessed referral patterns of GDPs for the surgical phase of implant dental treatment. MATERIALS AND METHODS One hundred fifty GDPs were asked to fill out a structured questionnaire containing their demographic data and answer six questions characterising their referral patterns for implant dentistry. RESULTS Forty-one (41%) percent performed the surgical phase, and 87% provided implant restoration. Gender was the only influencing factor for the surgical phase, as 51.4% of male GDPs and 6.5% of female GDPs performed implant surgery themselves. Experience and practice set-up did not influence the referring decision. Fifty-four percent of the practitioners referred 0 to 5 patients per month, and the chosen specialists were: 80% oral and maxillofacial surgeon, 11% periodontist, and 9% selected a specialist depending on the individual case. The major reasons influencing the referral pattern were the complexity of the surgical procedure, followed by systemic medical compromise of the patient. CONCLUSIONS Most implant surgeries in Israel are still performed by specialists.
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Crespi R, Toti P, Covani U, Crespi G, Brevi BC, Menchini Fabris GB. Preformed customized healing abutments in biologically oriented preparation technique procedure: a 3-year retrospective case-control study. Int J Comput Dent 2023; 0:0. [PMID: 37417446 DOI: 10.3290/j.ijcd.b4200835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
AIM To determine the 3-year clinical and dimensional change of the soft tissue following implant placement in healed sites before and after loading with either customized or conventional healing abutments. MATERIALS AND METHODS Premolar/molar implants were immediately loaded with either provisional and customized abutments without finishing lines according to principles of the Biologically Oriented Preparation Technique (BOPT), test group, or conventional healing abutments, control group. Three months later, the definitive crowns were fabricated. Primary outcomes (changes in the soft tissue) and secondary outcomes (adverse events) had been registered. RESULT Fifty out of 87 subjects originally included were finally selected for this retrospective analysis: 23 in the test and 27 in the control group. During the first days after surgery 2 adverse events of mucositis, one for each group, occurred. A Few technical complications such as unscrewing 4 screw-retained crowns were recorded. A significant increase in the alveolar width was observed in both groups (test = +2.5±0.5mm, and control = +1.0±0.9mm). The widths appeared to not be merely changed from 3 months to 3 years in both groups. There were no significant differences regarding the width of the keratinized mucosa measured at baseline and after follow-up. Jemt papilla index showed a higher increase in the test group compared with that of the control group. CONCLUSION Within 3 years of the follow-up period, peri-implant soft tissue outcomes of single, immediately loaded implants with customized healing abutments showed better results in terms of thickness and width when they were compared with those of the conventional group. Side effects count (mucositis and dehiscence) appeared to be very similar between the two groups. In addition, customized healing abutments led to significant augmentation of the alveolar width more than twice that registered in the conventional group.
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Neves RG, Lazari-Carvalho PC, Carvalho MA, Carvalho AL, de Souza JB, Torres ÉM. Socket shield technique: Stress distribution analysis. J Indian Soc Periodontol 2023; 27:392-398. [PMID: 37593548 PMCID: PMC10431233 DOI: 10.4103/jisp.jisp_356_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 03/25/2023] [Accepted: 04/22/2023] [Indexed: 08/19/2023] Open
Abstract
Background To analyze through finite element analysis the stress distribution in peri-implant bone tissues, implants, and prosthetic components induced by the socket shield (SS) technique in comparison to other techniques used to treat tooth loss. Materials and Methods A three-dimensional model of a superior central incisor crown supported by implant was modeled and three different placement conditions were simulated: SS - 2.0-mm-thick root dentin fragment positioned between the alveolar buccal wall and implant; heterologous bone graft (HBG) - bovine bone graft positioned the alveolar buccal wall and implant; and control (C) - implant fully placed in bone tissue of a healed alveolus. The model was restricted at the lateral surfaces of the bone tissue and the following loads were simulated: Both oblique (45°) loads of 100 N on the lingual surface of the crown (maximal habitual intercuspation) and 25.5 N on the incisal edge of the crown (tooth contact during mandibular protrusion) were simultaneously applied. Tensile stress, shear stress, compression, and displacement were analyzed in the cortical bone, trabecular bone, dentin root fragment, and bone graft; while equivalent von Mises stresses were quantified in the implant and prosthetic components. Results Stress values of SS and HBG in the bone tissues were higher than C, while slight differences within models were observed for dentin root fragment, bone graft, implant, and prosthetic components. Conclusions The SS technique presented the highest stress concentration in the peri-implant tissues.
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Affiliation(s)
| | | | - Marco Aurélio Carvalho
- Department of Oral Rehabilitation, School of Dentistry, Evangelical University of Goias, Anápolis, GO, Brazil
| | | | - João Batista de Souza
- Department of Restorative Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Érica Miranda Torres
- Department of Oral Rehabilitation, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
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Unger S, Benic GI, Ender A, Pasic P, Hämmerle CHF, Stadlinger B. Computer-assisted bone augmentation, implant planning and placement: An in vitro investigation. Clin Oral Implants Res 2023. [PMID: 37248956 DOI: 10.1111/clr.14098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/19/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023]
Abstract
AIM To assess in vitro the workflow for alveolar ridge augmentation with customised 3D printed block grafts and simultaneous computer-assisted implant planning and placement. METHODS Twenty resin mandible models with an edentulous area and horizontal ridge defect in the region 34-36 were scanned with cone beam computed tomography (CBCT). A block graft for horizontal ridge augmentation in the region 34-36 and an implant in the position 35 were digitally planned. Twenty block grafts were 3D printed out of resin and one template for guided implant placement were stereolithographically produced. The resin block grafts were positioned onto the ridge defects and stabilised with two fixation screws each. Subsequently, one implant was inserted in the position 35 through the corresponding template for guided implant placement. Optical scans of the study models together with the fixated block graft were performed prior to and after implant placement. The scans taken after block grafting were superimposed with the virtual block grafting plan through a best-fit algorithm, and the linear deviation between the planned and the achieved block positions was calculated. The precision of the block fixation was obtained by superimposing the 20 scans taken after grafting and calculating the deviation between the corresponding resin blocks. The superimposition between the scans taken after and prior to implant placement was performed to measure a possible displacement in the block position induced by guided implant placement. The (98-2%)/2 percentile value was determined as a parameter for surface deviation. RESULTS The mean deviation in the position of the block graft compared to the virtual plan amounted to 0.79 ± 0.13 mm. The mean deviation between the positions of the 20 block grafts measured 0.47 ± 0.2 mm, indicating a clinically acceptable precision. Guided implant placement induced a mean shift of 0.16 ± 0.06 mm in the position of the block graft. CONCLUSIONS Within the limitations of this in vitro study, it can be concluded that customised block grafts fabricated through CBCT, computer-assisted design and 3D printing allow alveolar ridge augmentation with clinically acceptable predictability and reproducibility. Computer-assisted implant planning and placement can be performed simultaneously with computer-assisted block grafting leading to clinically non-relevant dislocation of block grafts.
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Affiliation(s)
- S Unger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - G I Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - A Ender
- Clinic for Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - P Pasic
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - C H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - B Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Asparuhova MB, Riedwyl D, Aizawa R, Raabe C, Couso-Queiruga E, Chappuis V. Local Concentrations of TGF-β1 and IGF-1 Appear Determinant in Regulating Bone Regeneration in Human Postextraction Tooth Sockets. Int J Mol Sci 2023; 24:ijms24098239. [PMID: 37175951 PMCID: PMC10179638 DOI: 10.3390/ijms24098239] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Healing after tooth extraction involves a series of reparative processes affecting both alveolar bone and soft tissues. The aim of the present study was to investigate whether activation of molecular signals during the healing process confers a regenerative advantage to the extraction socket soft tissue (ESsT) at 8 weeks of healing. Compared to subepithelial connective tissue graft (CTG), qRT-PCR analyses revealed a dramatic enrichment of the ESsT in osteogenic differentiation markers. However, ESsT and CTG shared characteristics of nonspecialized soft connective tissue by expressing comparable levels of genes encoding abundant extracellular matrix (ECM) proteins. Genes encoding the transforming growth factor-β1 (TGF-β1) and its receptors were strongly enriched in the CTG, whereas the transcript for the insulin-like growth factor-1 (IGF-1) showed significantly high and comparable expression in both tissues. Mechanical stimulation, by the means of cyclic strain or matrix stiffness applied to primary ESsT cells (ESsT-C) and CTG fibroblasts (CTG-F) extracted from the tissue samples, revealed that stress-induced TGF-β1 not exceeding 2.3 ng/mL, as measured by ELISA, in combination with IGF-1 up to 2.5 ng/mL was able to induce the osteogenic potential of ESsT-Cs. However, stiff matrices (50 kPa), upregulating the TGF-β1 expression up to 6.6 ng/mL, caused downregulation of osteogenic gene expression in the ESsT-Cs. In CTG-Fs, endogenous or stress-induced TGF-β1 ≥ 4.6 ng/mL was likely responsible for the complete lack of osteogenesis. Treatment of ESsT-Cs with TGF-β1 and IGF-1 proved that, at specific concentrations, the two growth factors exhibited either an inductive-synergistic or a suppressive activity, thus determining the osteogenic and mineralization potential of ESsT-Cs. Taken together, our data strongly warrant the clinical exploration of ESsT as a graft in augmentative procedures during dental implant placement surgeries.
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Affiliation(s)
- Maria B Asparuhova
- Laboratory of Oral Cell Biology, Dental Research Center, School of Dental Medicine, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - Dominic Riedwyl
- Laboratory of Oral Cell Biology, Dental Research Center, School of Dental Medicine, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - Ryo Aizawa
- Laboratory of Oral Cell Biology, Dental Research Center, School of Dental Medicine, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
- Department of Periodontology, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Clemens Raabe
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
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Quisiguiña Salem C, Ruiz Delgado E, Crespo Reinoso PA, Robalino JJ. Alveolar ridge preservation: A review of concepts and controversies. Natl J Maxillofac Surg 2023; 14:167-176. [PMID: 37661984 PMCID: PMC10474543 DOI: 10.4103/njms.njms_224_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 09/05/2023] Open
Abstract
The loss of thickness and height of the alveolar process after tooth extraction is a significant impediment to implant placement, which limits the aesthetic results of many restorative treatments. Alveolar ridge preservation can reduce bone resorption. Knowing how beneficial this procedure is can help clinicians decide if it is worth doing. The purpose of this article is to present a contemporary review of the different approaches to preserving the dimensions of the alveolar ridge. We analyze the alveolar healing process, atraumatic extraction techniques, graft materials, and controversies.
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Affiliation(s)
- Cinthya Quisiguiña Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
| | - Emilio Ruiz Delgado
- Department of Prosthodontics and Implantology, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - Pablo A. Crespo Reinoso
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - James Jerez Robalino
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
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Glenday J, Sivarasu S, Roche S, Kontaxis A. Development of a framework to assess the biomechanical impact of reverse shoulder arthroplasty placement modifications. J Orthop Res 2022; 40:2156-2168. [PMID: 34878675 DOI: 10.1002/jor.25238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 11/11/2021] [Accepted: 12/04/2021] [Indexed: 02/04/2023]
Abstract
Reverse shoulder arthroplasty biomechanics can be improved by modifying the placement of prosthesis. Biomechanical studies have quantified the impact of placement modifications on the mobility and stability of the reverse shoulder. While these studies have provided detailed insights, direct comparisons between their finding are obfuscated by their use of differing methodologies. The aim of our study was to develop an assessment framework which used musculoskeletal simulations to consistently evaluate the biomechanics of various placement modifications. We conducted musculoskeletal simulations of humeral elevations and rotations using 15 reverse shoulder models. For each model, these simulations were conducted for a reference configuration of the prosthesis, established using surgical guidelines, and 34 modified configurations, which were based on commonplace adaptations to the placement of the glenosphere and humeral tray. The effect of each modified configuration on deltoid elongation, deltoid moment arm (DMA), joint stability, and impingement-free range of motion (IFROM) was determined relative to the reference configuration. We found that 16 of the 34 modified placements had an overall beneficial impact on reverse shoulder biomechanics. Within this subset, we identified two biomechanical trade-offs. First, there is an antagonistic relationship between IFROM and both the DMA and joint stability. Second, functional requirements differ between humeral elevations and rotations. Furthermore, we found that posteromedial translation of the humeral tray had the most beneficial impact on joint stability and inferior translation of the glenosphere had the most beneficial impact on IFROM and DMA.
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Affiliation(s)
- Jonathan Glenday
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Biomechanics, Hospital for Special Surgery, New York, NY, USA
| | - Sudesh Sivarasu
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Stephen Roche
- Department of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa
| | - Andreas Kontaxis
- Leon Root Motion Analysis Laboratory, Rehabilitation Department, Hospital for Special Surgery, New York, NY, USA
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Lee KS, Shin SY, Hämmerle CHF, Jung UW, Lim HC, Thoma DS. Dimensional ridge changes in conjunction with four implant timing protocols and two types of soft tissue grafts: A pilot pre-clinical study. J Clin Periodontol 2022; 49:401-411. [PMID: 35066942 DOI: 10.1111/jcpe.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/25/2022]
Abstract
AIM To determine the effect of (1) implant placement timing and (2) the type of soft tissue graft in terms of ridge profile changes. MATERIALS AND METHODS Four implant treatment modalities were applied in the mesial root areas of the third and fourth mandibular premolars of 10 mongrel dogs alongside connective-tissue graft (CTG) and volume-stable cross-linked collagen matrix (VCMX): immediate, early, and delayed placement (DP), and DP following alveolar ridge preservation (ARP). All dogs were sacrificed 3 months after soft tissue augmentation. Standard Tessellation Language files from designated time points were analysed. RESULTS Compared with the pre-extraction situation, the median width of the ridge demontstrated a linear increase only in group ARP/CTG (0.07 mm at the 2-mm level), whereas all other groups showed a reduction (between -1.87 and -0.09 mm, p > .05). Groups ARP/CTG (0.17 mm) and DP/CTG (0.05 mm) exhibited a profilometric tissue gain in a set region of interest (p > .05). The net effect of CTG and VCMX ranged from 0.14 to 0.79 mm. CONCLUSIONS Dimensional ridge changes varied between treatment protocols. ARP with CTG led to the smallest difference in ridge profile between the pre-extraction and the study end time point. Both CTG and VCMX enhanced the ridge contour.
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Affiliation(s)
- Kwang-Seok Lee
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University, School of Dentistry, Seoul, Republic of Korea.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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14
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Emara AK, Samuel LT, Acuña AJ, Kuo A, Khlopas A, Kamath AF. Robotic-arm assisted versus manual total hip arthroplasty: Systematic review and meta-analysis of radiographic accuracy. Int J Med Robot 2021; 17:e2332. [PMID: 34528372 DOI: 10.1002/rcs.2332] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/14/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA). METHODS The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes. RESULTS Our analysis included 20 articles reporting on 4140 patients (RA-THA: n = 1228; mTHA: n = 2912). No differences were demonstrated for acetabular inclination or anteversion. However, RA-THA demonstrated higher rates of cup orientation within the Lewinnek and Callanan safe zones, improved femoral stem alignment, and lower global offset difference (GOD) and limb length discrepancy (all p-values <0.05). Superior femoral canal fill and combined offset were seen among RA-THA patients. CONCLUSION Our review found that the use of RA-THA yields superior radiographic outcomes compared to mTHA counterparts. This information can inform healthcare systems considering investing in and implementing these technologies.
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Affiliation(s)
- Ahmed K Emara
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
| | - Linsen T Samuel
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
| | - Alexander J Acuña
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
| | - Andy Kuo
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
| | - Anton Khlopas
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
| | - Atul F Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA
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15
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Lim JH, Bayarsaikhan E, Shin SH, Nam NE, Shim JS, Kim JE. Effects of Groove Sealing of the Posterior Occlusal Surface and Offset of the Internal Surface on the Internal Fit and Accuracy of Implant Placements Using 3D-Printed Surgical Guides: An In Vitro Study. Polymers (Basel) 2021; 13:polym13081236. [PMID: 33920389 PMCID: PMC8070577 DOI: 10.3390/polym13081236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
This study evaluated the internal fit and the accuracy of the implant placement position in order to determine how the surface shape of the tooth and the offset influence the accuracy of the surgical guide. The acquired digital data were analyzed in three dimensions using 3D inspection software. The obtained results confirmed that the internal fit was better in the groove sealing (GS) group (164.45 ± 28.34 μm) than the original shape (OS) group (204.07 ± 44.60 μm) (p < 0.001), and for an offset of 100 μm (157.50 ± 17.26 μm) than for offsets of 30 μm (206.48 ± 39.12 μm) and 60 μm (188.82 ± 48.77 μm) (p < 0.001). The accuracy of implant placement was better in the GS than OS group in terms of the entry (OS, 0.229 ± 0.092 mm; GS, 0.169 ± 0.061 mm; p < 0.001), apex (OS, 0.324 ± 0.149 mm; GS, 0.230 ± 0.124 mm; p < 0.001), and depth (OS, 0.041 ± 0.027 mm; GS, 0.025 ± 0.022 mm; p < 0.001). In addition, the entries (30 μm, 0.215 ± 0.044 mm; 60 μm, 0.172 ± 0.049 mm; 100 μm, 0.119 ± 0.050 mm; p < 0.001) were only affected by the amount of offset. These findings indicate that the accuracy of a surgical guide can be improved by directly sealing the groove of the tooth before manufacturing the surgical guide or setting the offset during the design process.
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Affiliation(s)
- Jung-Hwa Lim
- Department of Prosthodontics, Oral Research Science Center, BK21 FOUR Project, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (J.-H.L.); (S.-H.S.); (N.-E.N.)
| | - Enkhjargal Bayarsaikhan
- Department of Prosthodontics, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (E.B.); (J.-S.S.)
| | - Seung-Ho Shin
- Department of Prosthodontics, Oral Research Science Center, BK21 FOUR Project, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (J.-H.L.); (S.-H.S.); (N.-E.N.)
| | - Na-Eun Nam
- Department of Prosthodontics, Oral Research Science Center, BK21 FOUR Project, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (J.-H.L.); (S.-H.S.); (N.-E.N.)
| | - June-Sung Shim
- Department of Prosthodontics, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (E.B.); (J.-S.S.)
| | - Jong-Eun Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, Yonsei-ro 50-1, Seodaemun-gu, Seoul 03722, Korea; (E.B.); (J.-S.S.)
- Correspondence: ; Tel.: +82-2-2228-3160
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16
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Artzi Z, Shlafstein R. Monitoring crestal bone level of single- and two-stage implant placement modes up to final prosthetic delivery: an observational study. Quintessence Int 2021; 52:236-246. [PMID: 33117996 DOI: 10.3290/j.qi.a45423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To monitor and compare the nonsubmerged (single-stage, SS) and submerged (two-stage, TS) implant placement techniques up to the final prosthesis delivery. Marginal bone level and marginal bone loss rate of both surgical techniques were compared. METHOD AND MATERIALS Marginal bone level was measured, using an image processing program (ImageJ), from periapical radiographs at the times of placement (T0), exposure (Te), initial loading (T1), and at the final prosthetic delivery (T2), with a total time span of a mean of 13.2 ± 3.3 months. By timing normalization, marginal bone level and marginal bone loss rate (mm/month), following SS and TS implant placement techniques and other local and systemic parameters were analyzed. Asymmetric analyses using Mann-Whitney test followed by the correlation Pearson analyses were applied. A P value < .05 defined statistical significance. RESULTS In total, 268 implants (42 patients) were monitored. Marginal bone loss rate was 0.15 ± 0.13 mm and 0.13 ± 0.11 mm, between T0 and T2, for the SS and TS techniques, respectively. Marginal bone level and marginal bone loss rate were higher among smokers for both techniques at various time points. Bruxers had higher marginal bone loss rate than nonbruxers between T0 and T1, and T0 and T2. Marginal bone loss rate around implants that were placed at the posterior maxilla was higher than those at the posterior mandible between T1 and T2. Interproximal implant distance correlated negatively with marginal bone loss rate between T0 and T2 (P < .05). CONCLUSIONS The results suggest that both techniques achieved similar clinical outcome. Smoking, bruxism, anatomical location, and interproximal implant distance apparently affect the marginal bone level and marginal bone loss rate of both implant placement approaches. The implant placement surgical mode, combined with various systemic and/or anatomical factors could play a significant role in maintaining marginal osseous level around the implant neck.
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17
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Checchi V, Generali L, Generali P. Isolation through rubber dam to prevent COVID-19 exposure during flapless trans-crestal sinus lift procedures. J ORAL IMPLANTOL 2020; 47:442400. [PMID: 32780815 DOI: 10.1563/aaid-joi-d-20-00196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/31/2020] [Indexed: 11/22/2022]
Abstract
In 2020, a highly infective new pathogen (Sars-CoV-2) spread from China to the whole globe, and became responsible of an acute respiratory syndrome, often asymptomatic but potentially lethal, named COVID-19. Airborne and direct contact contamination are the major infection pathways of Sars-CoV-2 and it has been shown that virus spread can also happen in absence of clinical symptoms. SARS-CoV-2 transmission during dental procedures can happen through inhalation of droplets from infected patients or direct contact with mucous membranes, oral fluids, and contaminated instruments. Both sinus lift and implant surgeries often involve bleeding and exposure to oral fluids, and a rubber dam could be used to reduce direct contact and the amount of potentially infected aerosol. The aim of this short case presentation is to illustrate how the use of a rubber dam could be extremely useful in preventing COVID-19 exposure during flapless trans-crestal sinus lift procedures.
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Affiliation(s)
- Vittorio Checchi
- Universita degli Studi di Modena e Reggio Emilia CHIMOMO Via del Pozzo ITALY Modena Italy 41121 Universita degli Studi di Modena e Reggio Emilia
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18
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Galletti G, Alfonsi F, Raffaele A, Valente NA, Chatelain S, Kolerman R, Cinquini C, Romeggio S, Iezzi G, Barone A. Implant Placement in Patients under Treatment with Rivaroxaban: A Retrospective Clinical Study. Int J Environ Res Public Health 2020; 17:E4607. [PMID: 32604907 DOI: 10.3390/ijerph17124607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient’s physician.
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19
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Karabeg R, Jakirlic M, Karabeg A, Crnogorac D, Aslani I. The New Method of Pocket Forming for Breast Implant Placement in Augmentation Mammaplasty: Dual Plane Subfascial. Med Arch 2020; 73:178-182. [PMID: 31404122 PMCID: PMC6643325 DOI: 10.5455/medarh.2019.73.178-182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction: Breast augmentation is one of the most frequently performed aesthetic surgical procedures in the world. The most important preoperative decisions which influence the final appearance of the augmented breast are the breast implant pocket choice and selection of the most appropriate implant. Described pocket locations are subglandular, subfascial, partially retropectoral, totally submuscular and dual plane. Aim: We have introduced a new method of pocket forming for implant placement, which is combination of Tebbett’s dual-plane 2 or 3 and Graf’s subfascial. We named it as dual plane subfascial. Methods: Between January 2016 and April 2018, total of 27 patients were operated using dual plane subfascial breast augmentation. The pinch test in the medial pole less than 2,0 cm and in upper pole less than 2,5 cm are indications for this technique. In our modification, in primary cases a dissected flap in front of muscle is fasciocutaneous (not cutaneous as in Tebbett’s technique). It will be finally located caudally of pectoral muscle and in front of the lower pole of implant. Fasciocutaneous flap in primary cases and two independent levels of soft tissue coverage (fascial and cutaneous) in secondary cases (subglandular to dual plane subfascial conversion) in front of the lower pole of implants provide better coverage than cutaneous flap alone. Results: Hematoma and infection did not occur in any patient in our study. A capsular contracture grade I/II without the need for reoperation occurred in two patients. In one patient with secondary augmentation minimal bottoming out was noticed (before reoperation patient had significant bottoming out deformity). Minimal palpability of implants is recorded in three patients. Conclusion: Dual plane subfascial is a good option in primary breast augmentation with a well set indication especially in the breasts with the upper pinch test less than 25 mm and medial pinch test less than 20 mm. The idea can be followed even in secondary breast augmentation (subglandular to dual plane subfascial conversion). There is additional soft tissue in front of the implant which led to a less implant palpability, especially in thin patient with smaller amount of subcutaneous fat.
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Affiliation(s)
- Reuf Karabeg
- Private Surgical Clinic ,,Karabeg" Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Malik Jakirlic
- University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amela Karabeg
- Private Surgical Clinic ,,Karabeg" Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Danijela Crnogorac
- Private Surgical Clinic ,,Karabeg" Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ilijas Aslani
- University Clinical Centre Sarajevo, Sarajevo, Bosnia and Herzegovina
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20
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Romandini M, De Tullio I, Congedi F, Kalemaj Z, D'Ambrosio M, Laforí A, Quaranta C, Buti J, Perfetti G. Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta-analysis. J Clin Periodontol 2019; 46:382-395. [PMID: 30729548 DOI: 10.1111/jcpe.13080] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/28/2019] [Accepted: 02/02/2019] [Indexed: 11/29/2022]
Abstract
AIM This systematic review of randomized controlled trials (RCTs) aims to answer to the following question: "In patients undergoing dental implant placement, which is the best antibiotic prophylaxis protocol to prevent early failures?" MATERIALS AND METHODS The MEDLINE, SCOPUS, CENTRAL and Web of Knowledge electronic databases were searched in duplicate for RCTs up to July 2017. Additional relevant literature was identified through (i) handsearching on both relevant journals and reference lists, and (ii) searching in databases for grey literature. A network meta-analysis (NMA) was conducted, and the probability that each protocol is the "Best" was estimated. RESULTS Nine RCTs were included, with a total of 1,693 participants. Due to the few events reported, it was not possible to conduct a NMA for adverse events, therefore it was conducted only for implant failures (IF). The protocol with the highest probability (32.5%) of being the "Best" one to prevent IF was the single dose of 3 g of amoxicillin administered 1 hr pre-operatively. Even if the single pre-operative dose of 2 g of amoxicillin is the most used, it achieved only a probability of 0.2% to be the "Best" one. CONCLUSIONS Basing on the available RCTs, the use of antibiotic prophylaxis is protective against early implant failures. Whenever an antibiotic prophylaxis is needed, there is still insufficient evidence to confidently recommend a specific dosage. The use of post-operative courses does not seem however to be justified by the available literature. Prospero registration number: CRD42015029708.
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Affiliation(s)
- Mario Romandini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.,Institute of Dentistry and Maxillofacial, Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.,PhD Candidate and Postgraduate Student in the EFP Program in Periodontology at Complutense University, Madrid, Spain
| | - Ilaria De Tullio
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Francesca Congedi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | | | - Mattia D'Ambrosio
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.,Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | | | - Ciro Quaranta
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Jacopo Buti
- Unit of Periodontology, Eastman Dental Institute - University College London, London, UK
| | - Giorgio Perfetti
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
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Troiano G, Lo Russo L, Canullo L, Ciavarella D, Lo Muzio L, Laino L. Early and late implant failure of submerged versus non-submerged implant healing: A systematic review, meta-analysis and trial sequential analysis. J Clin Periodontol 2019; 45:613-623. [PMID: 29574852 DOI: 10.1111/jcpe.12890] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of this systematic review was to analyse current evidence regarding differences in early and late implant failure as well as in marginal bone level (MBL) changes between submerged and non-submerged healed dental implants. METHODS PUBMED, SCOPUS, EMBASE and Web of Science databases were searched for prospective randomized and non-randomized controlled studies addressing direct comparison between submerged and non-submerged implant healing, without performing immediate loading. Early and late implant failure (before or after 6 months from implant placement, respectively) together with MBL were the investigated outcomes. Risk of bias assessment was performed using the Cochrane Collaboration Tool for Randomized clinical trials. Meta-analysis was performed and the power of the meta-analytic findings determined by trial sequential analysis (TSA). RESULTS Eleven studies met the inclusion criteria and were included in the review. Results of this systematic review revealed a small higher rate (2%) of early implant failure when a non-submerged healing approach is performed. Late implant failure appears not to be different in submerged or non-submerged healing, but the power of evidence, as determined by TSA, is not high. If we consider MBL changes at 1 year from implant load, it seems that non-submerged healing may better preserve marginal bone, although with a small effect size (0.13 mm). CONCLUSIONS Implants placed with a non-submerged technique have a higher risk (2%) of early failure. The power of the evidence about the effects on MBL is low, but present results seem to favour non-submerged healing, although with a very small effect size.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Domenico Ciavarella
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania - Luigi Vanvitelli, Naples, Italy
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22
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Morton D, Gallucci G, Lin WS, Pjetursson B, Polido W, Roehling S, Sailer I, Aghaloo T, Albera H, Bohner L, Braut V, Buser D, Chen S, Dawson A, Eckert S, Gahlert M, Hamilton A, Jaffin R, Jarry C, Karayazgan B, Laine J, Martin W, Rahman L, Schlegel A, Shiota M, Stilwell C, Vorster C, Zembic A, Zhou W. Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clin Oral Implants Res 2019; 29 Suppl 16:215-223. [PMID: 30328196 DOI: 10.1111/clr.13298] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Working Group 2 was convened to address topics relevant to prosthodontics and dental implants. Systematic reviews were developed according to focused questions addressing (a) the number of implants required to support fixed full-arch restorations, (b) the influence of intentionally tilted implants compared to axial positioned implants when supporting fixed dental prostheses (FDPs), (c) implant placement and loading protocols, (d) zirconia dental implants, (e) zirconia and metal ceramic implant supported single crowns and (f) zirconia and metal ceramic implant supported FDPs. MATERIALS AND METHODS Group 2 considered and discussed information gathered in six systematic reviews. Group participants discussed statements developed by the authors and developed consensus. The group developed and found consensus for clinical recommendations based on both the statements and the experience of the group. The consensus statements and clinical recommendations were presented to the plenary (gathering of all conference attendees) and discussed. Final versions were developed after consensus was reached. RESULTS A total of 27 consensus statements were developed from the systematic reviews. Additionally, the group developed 24 clinical recommendations based on the combined expertise of the participants and the developed consensus statements. CONCLUSIONS The literature supports the use of various implant numbers to support full-arch fixed prostheses. The use of intentionally tilted dental implants is indicated when appropriate conditions exist. Implant placement and loading protocols should be considered together when planning and treating patients. One-piece zirconia dental implants can be recommended when appropriate clinical conditions exist although two-piece zirconia implants should be used with caution as a result of insufficient data. Clinical performance of zirconia and metal ceramic single implant supported crowns is similar and each demonstrates significant, though different, complications. Zirconia ceramic FDPs are less reliable than metal ceramic. Implant supported monolithic zirconia prostheses may be a future option with more supporting evidence.
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Affiliation(s)
- Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - German Gallucci
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland
| | - Waldemar Polido
- Department of Oral and Maxillofacial Surgery, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Stefan Roehling
- Clinic for Oral and Cranio-Maxillofacial Surgery, High-Tech Research Center, University of Basel, Basel, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University of Geneva, Geneva, Switzerland
| | - Tara Aghaloo
- Department of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, California
| | - Hugo Albera
- Faculty of Dentistry, Universidad Nacional de Cuyo, Mendoza, Argentina
| | - Lauren Bohner
- Department of Prosthodontics, University of Sao Paulo, Sao Paulo, Brazil
| | - Vedrana Braut
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland.,Private Practice, Rijeka, Croatia
| | - Daniel Buser
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Stephen Chen
- Private Practice, University of Melbourne, Melbourne, Vic., Australia
| | | | - Steven Eckert
- Department of Dental Specialties, Mayo Clinic School of Medicine, Rochester, Minnesota
| | - Michael Gahlert
- Private Practice, Munich, Germany.,Clinic for Oral and Cranio-Maxillofacial Surgery, High-Tech Research Center, University of Basel, Basel, Switzerland
| | - Adam Hamilton
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts
| | | | | | - Banu Karayazgan
- Department of Prosthodontics, Okan University, Istanbul, Turkey
| | - Juhani Laine
- Department of Oral and Maxillofacial Diseases, Turku University Hospital, Yurku, Finland
| | - William Martin
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, Florida
| | | | - Andreas Schlegel
- Private Practice, Munich, Germany.,Department of Maxillofacial Surgery, University of Erlangen, Erlangen, Germany
| | - Makato Shiota
- Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Charlotte Stilwell
- Private Practice, London, UK.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | | | - Anja Zembic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Wenjie Zhou
- Department of Restorative Dentistry, Harvard School of Dental Medicine, Boston, Massachusetts.,Ninth People's Hospital, Shanghai, China
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De Santis D, Sinigaglia S, Pancera P, Faccioni P, Portelli M, Luciano U, Cosola S, Penarrocha D, Bertossi D, Nocini R, Iurlaro A, Albanese M. An overview of socket preservation. J BIOL REG HOMEOS AG 2019; 33:55-59. [PMID: 30966733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Socket preservation is a surgical procedure whose aim is to limit the physiological resorption of the alveolar ridge that occurs after a dental extraction, in order to have sufficient bone to perform an implant placement. 16 articles regarding socket preservation procedures were identified through scientific archives and analysed. The biological rationale, the graft materials and the predictive factors are identified to help the clinicians in their practice. Socket preservation is an effective treatment to prevent bone resorption if performed after an atraumatic extraction with the use of biomaterials and membranes. It is also important not to forget local and systemic predictive factors.
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Affiliation(s)
- D De Santis
- Section of Oral and Maxillofacial Surgery; Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - S Sinigaglia
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - P Pancera
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - P Faccioni
- Department of Biomedical, Metabolic and Neural Sciences, Section of Human Morphology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Portelli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthodontics, School of Dentistry, University of Messina, Messina, Italy
| | - U Luciano
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - S Cosola
- Degree in Dental Surgery. Resident of the Master in Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain
| | - D Penarrocha
- Degree in Dental Surgery. Resident of the Master in Oral Surgery and Implantology, Valencia University Medical and Dental School, Valencia, Spain
| | - D Bertossi
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - R Nocini
- Section of ENT, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - A Iurlaro
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - M Albanese
- Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Zhu L, Yang J, Gong J, Zhang C, Wang H. Optimized beagle model for maxillary sinus floor augmentation via a mini-lateral window with simultaneous implant placement. J Int Med Res 2018; 46:4684-4692. [PMID: 30198388 PMCID: PMC6259364 DOI: 10.1177/0300060518796759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective This study was performed to establish an optimized beagle model for maxillary sinus floor augmentation via a mini-lateral window with simultaneous implant placement. Methods Twelve beagles underwent maxillary sinus floor augmentation via a mini-lateral window with simultaneous implant placement through sites selected by analyzing preoperative cone beam computed tomography (CBCT) images. During the experiment, no maxillary teeth were extracted and the infraorbital nerve was not severed. The osteotomy was only 5 mm in diameter. The implant stability quotient was measured, and postoperative CBCT was used to detect the condition of the sinus membrane and bone augmentation. Results The site corresponding to the tip of the highest dental cusp of the maxillary fourth premolar was suitable for the procedure, and the implant site was on the palatal bone plate. All implants achieved good primary stability. Postoperative CBCT showed no sinus membrane perforation, and the implants penetrated into the sinus cavity surrounded by bone substitute. Conclusion The herein-described optimized model with mini-lateral osteotomy and without extraction or severing of the infraorbital nerve was minimally invasive, retained more lateral bone of the sinus, and achieved good sinus floor-lifting results. This model is highly reproducible and merits wider application.
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Affiliation(s)
- Liqin Zhu
- 1 Department of Oral Implantology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China
| | - Jiakang Yang
- 2 The Affiliated Stomatology Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China
| | - Jiaxing Gong
- 2 The Affiliated Stomatology Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China
| | - Chenqiu Zhang
- 2 The Affiliated Stomatology Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China
| | - Huiming Wang
- 1 Department of Oral Implantology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China.,2 The Affiliated Stomatology Hospital, College of Medicine, Zhejiang University, Hangzhou, P. R. China
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J PC, Marimuthu T, C K, Devadoss P, Kumar SM. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study. Clin Implant Dent Relat Res 2018; 20:531-534. [PMID: 29624863 DOI: 10.1111/cid.12609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/07/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anterior loop of the mental nerve is a very important anatomic landmark in implant placement and anterior mandibular osteotomies. PURPOSE Two-dimensional imaging techniques are not competent enough to locate and measure the mental nerve loop in majority of the cases. Any injury to this loop results in pain/paresthesia/numbness in the region supplied by the mental nerve. The aim of this study is to analyze the prevalence and measure the length of the loop using cone beam computerized tomography (CBCT) and calculate the average length and prevalence so that a safe margin can be given while placing the implants or the osteotomy cuts in the premolar region. MATERIALS AND METHODS A cross-sectional study was done using CBCT images of 85 patients taken for impaction surgery. The length of the loop was measured in mm using standardized lines drawn along specific anatomic landmarks. RESULTS In our study 11.76% of patients had anterior loop in their mental nerve. Mean length of the mental nerve loop was calculated and found to be 2.79 mm. CONCLUSION A margin of 4 mm anterior to the mental foramen should be safe to avoid any damage to the mental nerve loop bundle in majority of the cases where the loop is present.
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Affiliation(s)
- Pradeep Christopher J
- Department of Oral and Maxillofacial Surgery, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, India
| | - Thenaruvi Marimuthu
- Department of Oral and Maxillofacial Surgery, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute (Deemed to be University), Chennai, India
| | - Krithika C
- Department of Oral Medicine and Radiology, Thai Moogambigai Dental College and Hospital, Chennai, India
| | - Poorna Devadoss
- Department of Orthodontics, Thai Moogambigai Dental College and Hospital, Chennai, India
| | - Santhosh M Kumar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, India
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Deana NF, Navarro P, Alves N. Morphometric study of lingual foramina in macerated mandibles to assist in implant placement in the anterior mandibular region. Folia Morphol (Warsz) 2017; 77:310-322. [PMID: 28933801 DOI: 10.5603/fm.a2017.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/25/2022]
Abstract
The object of our study was to contribute to anatomical knowledge of this region with data on the prevalence, number and location of lingual foramina (LF) in dentate and edentate macerated mandibles from Brazilian individuals, differen-tiating them by sex and race. In this way we hope to help dental surgeons with their planning prior to implant placement in the anterior mandibular region. 103 macerated mandibles were analysed. The prevalence, number and location of LF were analysed in the median (MLF) and lateral (LLF) regions and the median (AMLF) and lateral (ALLF) alveolar process regions. Measurements for their location were taken with a digital calliper. 99% of the mandibles presented at least 1 MLF, 82.5% at least 1 LLF, and the frequency of ALLF was 67%. In dentate mandibles, MLF were located in the region superior to the genial spine, and in edentate mandibles in the regions superior and inferior to the genial spine. LLF were located in the middle region in both dentate and edentate mandibles. The height of the symphysis was significantly greater in dentate than in edentate cases. The distance from the alveolar crest (AC) to the MLF was significantly greater in dentate than in edentate mandibles. LF are constant structures, with MLF found more frequently than LLF. Mandibles which present a smaller measured distance from the base of mandible to AC present MFL and LLF closer to AC, implying a greater risk of complication during implant placement. (Folia Morphol 2018; 77, 2: 310-322).
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Affiliation(s)
| | | | - N Alves
- Research Centre in Applied Morphology (CIMA), Dental School, Universidad de La Frontera.
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Park J, Tennant M, Walsh LJ, Kruger E. Is there a consensus on antibiotic usage for dental implant placement in healthy patients? Aust Dent J 2017; 63:25-33. [PMID: 28543332 DOI: 10.1111/adj.12535] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2017] [Indexed: 11/30/2022]
Abstract
This systematic review aimed to determine whether there is consensus for antibiotic prescription in healthy patients undergoing implant placement. A search of PubMed, Embase and Medline databases was conducted in January 2016 to find published journal articles on the use of antibiotics in implant placement, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were prospective human clinical trials investigating antibiotic usage during implant placement. Fifteen studies were deemed suitable. In 13 studies, no statistical difference was found between antibiotic use and the incidence of prosthetic failure, implant failure and early postoperative infections. These were rated as having low to high risk bias. Contrary results were reported in two studies, both of which were rated as having a high potential for bias. In conclusion, antibiotic use in healthy patients for the prophylaxis of surgical infection associated with dental implant placement does not appear to improve clinical outcomes. Practitioners should apply principles of antimicrobial stewardship and not use antibiotics as a routine measure in healthy patients.
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Affiliation(s)
- J Park
- School of Dentistry, The University of Western Australia, Perth, Western Australia, Australia
| | - M Tennant
- Department of Anatomy, Physiology and Human Biology, International Research Collaborative, Oral Health and Equity, The University of Western Australia, Perth, Western Australia, Australia
| | - L J Walsh
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - E Kruger
- Department of Anatomy, Physiology and Human Biology, International Research Collaborative, Oral Health and Equity, The University of Western Australia, Perth, Western Australia, Australia
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Andreasi Bassi M, Lopez MA, Andrisani C, Ormanier Z, Gargari M. Full arch rehabilitation in severe maxillary atrophy with palatal approach implant placement: a case report. Oral Implantol (Rome) 2017; 9:115-122. [PMID: 28042439 DOI: 10.11138/orl/2016.9.3.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The edentulous severely atrophic maxilla, as consequence of alveolar bone resorption and pneumatisation of the maxillary sinus, represents a serious limitation to the implant rehabilitation. Implants insertion via palatal approach (PA), in combination with relatively minimally invasive techniques aimed at increasing bone volume without the use of autologous bone harvesting is a valid alternative among the options for the rehabilitation of the upper jaw. CLINICAL CASE In a 70-year-old female, with a severe maxillary atrophy, 6 spiral taper implants were placed with the PA, combined with the bilateral transcrestal elevation of both the sinus floors and nasal cavities; a further GBR, with resorbable pericardium membrane covering a termoplastic allograft associated to a xenograft, was performed. The second stage was performed after 6 months. Implant prosthetic functionalization was carried out in 4 months by placing the removable prosthesis in direct contact with the healing cup screws. After that period the case was finalized with a hybrid prosthesis. Clinical and radiographic follow-ups were carried out at 6 months and at one year after prosthetic finalization, during which no pathological signs were recorded. CONCLUSIONS The PA implant insertion described by the Authors, combined with bone augmentation procedures, performed in the same stage, may represent a valid and reliable solution to rehabilitate maxillary edentulous patients.
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Affiliation(s)
| | | | | | - Z Ormanier
- Department of Oral Rehabilitation, Tel-Aviv University, Tel-Aviv, Israel
| | - M Gargari
- Department of Clinical Sciences and Translational Medicine, University of "Tor Vergata", Rome, Italy; Department of dentistry "Fra G.B. Orsenigo - Ospedale San Pietro F.B.F.", Rome, Italy
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Hartmann A, Welte-Jzyk C, Seiler M, Daubländer M. Neurophysiological changes associated with implant placement. Clin Oral Implants Res 2016; 28:576-581. [PMID: 27002225 DOI: 10.1111/clr.12837] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objective of the study was to evaluate the feasibility of a standardized Quantitative Sensory Testing (QST) protocol extra- and intraoral in patients to detect and quantify sensory disturbances of the inferior alveolar nerve due to the proximity of implantation procedures to the inferior alveolar nerve canal. MATERIAL AND METHODS Patients who had obtained an implant placement were examined by implementing a comprehensive QST protocol for extra- and intraoral use. The study included 33 patients after implant placement in the lower jaw and one patient suffering from an inferior alveolar nerve injury. Patients were tested bilaterally (chin and mucosal lower lip). RESULTS Comparing the implanted vs. the control side, QST parameters revealed no significant neurophysiological changes in all parameters. Evaluating the development of sensory disturbances in dependency of the proximity of the implant to the inferior alveolar nerve canal, mechanical QST parameters showed no significant correlation. The mean distance of the inserted implant to the inferior nerve canal was 2.65 ± 1.75 mm. In the case of one patient suffering from impairment of the nerve function due to implant placement, we found abnormal sensory responses to touch coexisting with numbness and temperature algesia. CONCLUSIONS Monitoring of trigeminal nerve fiber functions by QST intra- and extraoral is feasible to evaluate oral sensory pattern after implantation procedures. Sensory disturbances of the inferior alveolar nerve were shown to be avoided by keeping an average safety zone of 2.65 mm between implant and nerve.
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Affiliation(s)
- Amely Hartmann
- Private Practice Dr. Seiler und Kollegen, Filderstadt, Germany
| | - Claudia Welte-Jzyk
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marcus Seiler
- Private Practice Dr. Seiler und Kollegen, Filderstadt, Germany
| | - Monika Daubländer
- Department of Oral Surgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Jayaraman S. Interventions for replacing missing teeth: Antibiotics in dental implant placement to prevent complications: Evidence summary of Cochrane review. J Indian Prosthodont Soc 2016; 15:179-82. [PMID: 26929508 PMCID: PMC4762313 DOI: 10.4103/0972-4052.159974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The failure of dental implant can occurs at the preoperative planning stage, at the surgical stage, and at the postoperative stage. The success of this treatment can be increased if the clinical implant practice guidelines are prepared based on the recommendations from the highest level of research evidence (i.e.,) from systematic review of randomized controlled trials (RCTs) with meta-analysis. The Cochrane reviews of interventions are basically systematic reviews of RCTs with meta-analysis but follow a systematic methodological approach following the guidelines from Cochrane handbook for Systematic Reviews of Intervention. They give the current best evidence as they are updated every 2 years which is being the minimum period for an update. This evidence summary recommends the use of antibiotics, single dose of 2 g of amoxicillin 1 h prior to implant surgery to prevent implant failure, based on the body of evidence from the Cochrane review that was first published in 2003, 2008, and then updated twice in 2010 and 2013. The included studies are not from our population for the research question asked in this updated Cochrane review; hence, the need to do primary research in our population to support the available evidence is mandatory.
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Affiliation(s)
- Srinivasan Jayaraman
- Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Puducherry, India
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31
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Jayaraman S. Intervention for replacing missing teeth: Alveolar ridge preservation techniques for dental implant site development - evidence summary of Cochrane review. J Indian Prosthodont Soc 2016; 15:381-5. [PMID: 26929543 PMCID: PMC4762359 DOI: 10.4103/0972-4052.171824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Cochrane reviews have transparent reporting of the methodology to clarify the reader the methods used for writing the review; hence, each review becomes a large volume of scientific literature. This evidence summary of the Cochrane review published in 2015 for the question, what are the clinical effects (preservation of both width and height of bone, esthetic outcomes, complications, and failure of implant) for different alveolar ridge preservation techniques (ARP) and materials used in patients planning implant placement following extraction after 6 months follow-up. This review provides evidence for efficacy of different ARP techniques, materials, and superiority of one over the other. It also tries to settle the controversy of timing of placement of implant after grafting. Of the 8 included studies from 50, two trials provide moderate evidence for xenografts versus extraction favoring xenografts in preserving the width and height of bone by 1.97 mm (2.48-1.46) and 2.60 mm (3.43-1.76), respectively in pooled estimates of meta-analysis. Using different material, five-trial were found; of which, two trials provide moderate evidence for alloplast versus xenografts favoring alloplast in preserving the width by 0.44 mm (0.90-0.02) and low-grade evidence for height of bone by 0.35 mm (0.86-0.16) in pooled estimates of meta-analysis. There is a paucity of randomized controlled trial to address other primary and secondary outcomes addressed in this review.
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Affiliation(s)
- Srinivasan Jayaraman
- Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Pilliyarkuppam, Puducherry, India
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Mavriqi L, Baca E, Demiraj A. Sandwich osteotomy of the atrophic posterior mandible prior to implant placement. Clin Case Rep 2015; 3:610-4. [PMID: 26273452 PMCID: PMC4527806 DOI: 10.1002/ccr3.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 01/17/2015] [Accepted: 02/20/2015] [Indexed: 11/07/2022] Open
Abstract
Key Clinical Message The continuing resorption of the alveolar ridge will eventually result in insufficient bone height superior to the IAN, making dental implant placement impossible. The augmentation procedure above the IAN in terms of height provides sufficient bone for implant placement and allows long-term successful restoration of missing teeth with implant-supported prosthesis.
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Affiliation(s)
- Luan Mavriqi
- Departament of Periodontology, Albanian University and Private Practice Tirana, Albania
| | - Egresa Baca
- Albanian University, Brianza Dent Tirane, Albania
| | - Ariona Demiraj
- Nostra Signora del Buon Consiglio, Brianza Dent Tirane, Albania
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Flügge T, Nelson K, Nack C, Stricker A, Nahles S. 2-Dimensional changes of the soft tissue profile of augmented and non-augmented human extraction sockets: a randomized pilot study. J Clin Periodontol 2015; 42:390-7. [PMID: 25735565 DOI: 10.1111/jcpe.12386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 12/20/2022]
Abstract
AIM This study identified the soft tissue changes of the alveolar ridge at different time points within 12 weeks after tooth extraction with and without socket augmentation. MATERIALS AND METHODS In 38 patients with single tooth extractions, 40 sockets were augmented and 39 extraction sockets were not augmented. At 2, 4, 6, 8 and 12 weeks impressions were taken and casts digitized with a laser scanner. The horizontal and vertical changes were compared between augmented and non-augmented sites. A p-value <0.05 was considered statistically significant. RESULTS The mean changes of augmented sockets were between 0.4 mm (2 weeks) and 0.8 mm (12 weeks). In non-augmented sockets changes of 0.7 mm (2 weeks) and of 1.0 mm (12 weeks) were demonstrated. The mean values differed significantly between the buccal and oral region (p < 0.01). Overall, there were significant differences of the mean dimensional changes regarding time (p < 0.01) and augmentation (p < 0.01). CONCLUSIONS Augmented sockets showed less resorption within 4 weeks after extraction compared to non-augmented sockets. Non-augmented sockets showed a continuous dimensional loss with a great variation over 12 weeks whereas augmented sockets had the highest degree of resorption between 4 and 6 weeks. At 12 weeks a comparable resorption in augmented and non-augmented sockets was observed.
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Affiliation(s)
- Tabea Flügge
- Department of Oral and Maxillofacial Surgery, University Medical Center Freiburg, Freiburg, Germany
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Chipaila N, Marini R, Sfasciotti GL, Cielo A, Bonanome L, Monaco A. Graftless sinus augmentation technique with contextual placement of implants: a case report. J Med Case Rep 2014; 8:437. [PMID: 25515949 PMCID: PMC4301887 DOI: 10.1186/1752-1947-8-437] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/07/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The positioning of implants in the jaw bones with contextual graftless lateral approach sinus lifting is finding an increasingly broad consensus in the literature. Since the 1970s, various clinical research projects have been conducted on applications of biological and synthetic biomaterials in bone regenerative surgery, both in sinus lift procedures and in cystic cavity filling after cystectomy or in bone defects in regenerative periodontal surgery. Currently, we are finding that there is an increasing trend of clinicians aiming to adopt graftless techniques, with satisfactory results in terms of implant survival in the long term. In our study, through a case report, we describe a variant of graftless sinus augmentation technique with contextual implant placement, emphasizing the role of the blood clot, combined with collagen sponges, as a natural scaffold and the osteogenic potential of the subantral membrane in guided bone regeneration, with reduced morbidity of the patient. CASE PRESENTATION To describe the surgical technique, the clinical case of a 38-year-old Caucasian woman with a lateral posterior edentulism was selected. The rehabilitation was solved by a graftless sinus augmentation technique with a contextual implant placement. For each implant, a resonance frequency analysis evaluation was reported as implant stability quotient values. The performance of the implant stability quotient values followed a gradual increase from time zero to the sixth month, as the clot was differentiated into osteoid tissue and then into bone tissue, due to the scaffold effect conferred by the equine collagen sponge. The stabilization phase took place between the fourth and the sixth month, according to the implant stability quotient values. CONCLUSIONS Our graftless sinus augmentation technique seems to be very predictable thanks to the osteoconductive principles on which it is based, and in association with the proper management of peri-implant soft tissue, so as to increase the amount of keratinized tissue, which could represent the new gold standard for this type of rehabilitation in the future.
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Affiliation(s)
- Nicolae Chipaila
- />University of L’Aquila, Department of Life, Health and Environmental Sciences, Unit of Dentistry, Delta 6 building, Via Vetoio, 1, 67100 L’Aquila, Italy
| | - Roberta Marini
- />‘Sapienza’ University of Rome - Department of Oral and Maxillofacial Sciences, Via Caserta, 6, 00161 Rome, Italy
| | - Gian Luca Sfasciotti
- />‘Sapienza’ University of Rome - Department of Oral and Maxillofacial Sciences, Via Caserta, 6, 00161 Rome, Italy
| | | | - Laura Bonanome
- />‘Private Practice, Via Regina Elena 287/A, 00161 Rome, Italy
| | - Annalisa Monaco
- />University of L’Aquila, Department of Life, Health and Environmental Sciences, Unit of Dentistry, Delta 6 building, Via Vetoio, 1, 67100 L’Aquila, Italy
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Ben Hadj Hassine M, Bucci P, Gasparro R, Di Lauro AE, Sammartino G. Safe approach in "All-on-four" technique: a case report. Ann Stomatol (Roma) 2014; 5:142-145. [PMID: 25774250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The "All-on-Four" concept is based on the placement of four implants in the anterior part of fully edentulous jaws to support a provisional, fixed, and immediately loaded full-arch prosthesis. Combining tilted and straight implants for supporting fixed prostheses can be considered a viable treatment modality resulting in a more simple and less time consuming procedure, in significantly less morbidity, in decreased financial costs and a more comfortable postsurgical period for the patients. The authors present a case report with mandibular atrophy and left mental foramina on the top of the residual crest.
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Affiliation(s)
| | | | | | | | - Gilberto Sammartino
- Department of Oral Medicine and Oral Surgery, University of Dental Medicine, Monastir, Tunisia
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Nettem S, Nettemu SK, Basha K, Venkatachalapathi S. Implant-based oral rehabilitation of a variant model of type I dentinal dysplasia: A rare case report. Dent Res J (Isfahan) 2014; 11:513-7. [PMID: 25225567 PMCID: PMC4163832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dentin dysplasia is an exceptionally rare, autosomal-dominant, hereditary condition, primarily characterized by defective dentin formation affecting both the deciduous and permanent dentitions. The etiology remains imprecise to date, in spite of the numerous hypotheses put forward and the constant updates on this condition. This case report of type I dentin dysplasia exhibits radiographic findings that are unique and diverse from the classical findings of various subtypes of this disease reported to date. This article also depicts the implant-based oral rehabilitation of the young patient diagnosed with this variant model of dentin dysplasia type I. Early diagnosis and implementation of this preventive and curative therapy is vital for avoiding premature exfoliation of deciduous and permanent dentition and the associated residual ridge resorption, thereby overcoming functional and esthetic deficits and ensuring protection of the remaining dentition from further harm.
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Affiliation(s)
- Sowmya Nettem
- Department of Periodontology and Oral Implantology, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
| | - Sunil Kumar Nettemu
- Department of Periodontology and Oral Implantology, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
| | - K. Basha
- Jas Dento Medico Center, Bangalore, Karnataka, India
| | - S Venkatachalapathi
- Department of Oral and Maxillofacial Surgery, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
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Walter C, Dagassan-Berndt DC, Kühl S, Weiger R, Lang NP, Zitzmann NU. Is furcation involvement in maxillary molars a predictor for subsequent bone augmentation prior to implant placement? A pilot study. Clin Oral Implants Res 2013; 25:1352-8. [PMID: 24147971 DOI: 10.1111/clr.12275] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/26/2022]
Abstract
AIM The aim of this pilot study was to analyze the interfurcal bone height in relation to the possible need for subsequent sinus floor elevation in patients with advanced periodontitis and furcation involvement of first and/or second maxillary molars. MATERIAL AND METHODS Seventeen dentate patients, who received cone beam computed tomography (CBCT) for detailed preoperative diagnosis and planning of surgical interventions at periodontally involved maxillary molars (17 first and 15 second molars), were consecutively recruited for the study. The minimal bone height in the interfurcal region was measured from CBCT and related to furcation involvement, residual bone above the root tips, and the clinical probing pocket depth (PPD). RESULTS The minimal interfurcal bone height measured 4.1 ± 2.6 mm on average with 75% of maxillary molars having ≤ 6 mm and almost 60% having only ≤ 4 mm bone height left below the sinus floor. A higher risk for reduced interfurcal bone height of ≤ 4 mm was given when residual PPD of ≥ 6 mm was remaining at two or more tooth sites (OR 0.10; 0.11). CONCLUSIONS The majority of periodontally involved maxillary molars had a substantially reduced interfurcal bone height, particularly with at least two sites with residual PPD ≥ 6 mm. This was a predictor for a subsequent need for sinus floor elevation when tooth replacement with a dental implant is desired.
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Affiliation(s)
- Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University of Basel, Basel, Switzerland; Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK
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Verhamme LM, Meijer GJ, Boumans T, de Haan AFJ, Bergé SJ, Maal TJJ. A clinically relevant accuracy study of computer-planned implant placement in the edentulous maxilla using mucosa-supported surgical templates. Clin Implant Dent Relat Res 2013; 17:343-52. [PMID: 23879524 DOI: 10.1111/cid.12112] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the study is to determine the clinically relevant accuracy of implant placement in the edentulous maxilla using computer planning and a mucosa-supported surgical template. MATERIALS AND METHODS In each of in total 30 consecutive edentulous patients suffering from retention problems of their upper denture, two or four Brånemark MkIII Groovy (Nobel Biocare®, Zürich, Switzerland) implants in the maxilla were installed. Preoperatively, first, a cone-beam computer tomography (cone beam computer tomography) scan was acquired, followed by virtual implant planning. Hereafter, a surgical template was designed to allow flapless implant placement using the template as a guide. To inventory the accuracy of implant placement, a postoperative CBCT scan was obtained and matched to the preoperative scan. The accuracy of implant placement was validated three-dimensionally. The Implant Position Orthogonal Projection validation method was applied to measure the clinically relevant implant deviations (i.e., in both the bucco-lingual and mesio-distal plane). Also, the influence of type of surgery, use of fixation pins, and position on the dental arch were investigated with regard to implant deviations. RESULTS In total, 104 implants were installed. In bucco-lingual direction, a mean implant deviation of 0.67 mm was scored at the implant tip, of 0.51 mm at the shoulder, of -0.83 mm in depth, as also a mean deviation of angulation of 1.74°. In mesio-distal direction, a mean implant deviation of 0.75 mm was found at the implant tip, of 0.60 mm at the implant shoulder, of -0.75 mm in depth, and a deviation of angulation of 1.94°. Of all implants, 74% was placed not deep enough compared with the planning. Implant position on the dental arch, the use of fixation pins, and type of surgery showed no significant effect on implant deviations. However, a significant difference for implant deviations in both buccal and mesial direction was observed, explained by a nonoptimal positioning of the surgical template. CONCLUSIONS Computer-aided implant planning showed to be a clinically relevant tool for the placement of two or four implants in the maxilla of fully edentulous patients. Exact positioning of the surgical template in anterior/posterior direction is crucial in reducing implant deviations both in buccal and mesial direction.
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Affiliation(s)
- Luc M Verhamme
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Marković A, Mišić T, Mančić D, Jovanović I, Šćepanović M, Jezdić Z. Real-time thermographic analysis of low-density bone during implant placement: a randomized parallel-group clinical study comparing lateral condensation with bone drilling surgical technique. Clin Oral Implants Res 2013; 25:910-8. [PMID: 23710900 DOI: 10.1111/clr.12191] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare the effect of two surgical techniques, lateral condensation and bone drilling, on changes in temperature of the adjacent low-density bone during implant placement into posterior maxilla and to investigate the influence of the host factors - age, gender, region of implantation, bone density, and thickness of the cortical bone at the recipient sites. MATERIAL AND METHODS Local bone temperature was measured thermographically during implant placement into posterior maxilla following lateral bone condensing (test group) or bone drilling (controls). The main study outcomes were baseline bone temperature prior to implantation and maximum bone temperature recorded during implantation. Early implant success was evaluated after 6 months of healing. RESULTS A total of 40 implants were randomly allocated to test and control groups and placed into maxillary premolar and/or molar region of 18 participants of both genders and average age of 51.74 years. All recorded bone temperatures were below the threshold for thermal necrosis. Although both groups showed significant increase in bone temperature during implant placement procedure (P ≤ 0.0005), it was significantly higher for bone condensing compared with drilling (P ≤ 0.0005; 3.79 ± 1.54°C; 1.91 ± 0.70°C respectively). No host factor was singled out as a significant predictor of bone temperature changes, although trend of higher increase was observed in young patients, regardless of gender, during implant placement procedure into maxillary first premolar region with bone density type 3 and cortical layer thicker than 1 mm. Early implant success rate after 6 months follow-up was 100%. CONCLUSION Although both surgical techniques, bone condensing and bone drilling, can be considered safe regarding their thermal effect on the bone of posterior maxilla, bone drilling is associated with fewer local bone heating during implantation. Host factors do not affect the bone thermal changes significantly.
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Affiliation(s)
- Aleksa Marković
- Clinic of Oral Surgery, School of Dentistry, University of Belgrade, Belgrade, Serbia
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Abstract
This is the first comprehensive review of the classification, preventative measures, diagnosis, treatment methods, and determination of success criteria of buccal bone plate fenestrations (BPFs) secondary to posterior implant surgeries. The purpose of this review is to present and discuss the current literature from peer-reviewed journals, recent studies, and international implantology guidelines and to provide practitioners with guiding points to identify and understand whether BPFs are complications or accidents of implant surgeries. In addition, this review sets forth a detailed set of criteria for the evaluation and diagnosis of BPFs and for the subsequent classification of BPFs as either complications or accidents of posterior implant surgeries. From the literature analyzed, it is clear that BPFs are disqualified from the class of implant treatment failures because BPFs neither impair nor significantly delay treatment. A comprehensive outline of preventative measures and surgery aids to avoid fenestrating the buccal bone plate during implant placement, and a variety of repair methods are included in this review. Considerations of treatment outcomes and patient sensitivities are also included in this comprehensive review.
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Affiliation(s)
- Liviu Steier
- 1 Warwick Dentistry, Endodontics, Coventry, United Kingdom
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Verhamme LM, Meijer GJ, Boumans T, Schutyser F, Bergé SJ, Maal TJJ. A clinically relevant validation method for implant placement after virtual planning. Clin Oral Implants Res 2012; 24:1265-72. [PMID: 22905668 DOI: 10.1111/j.1600-0501.2012.02565.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 01/03/2023]
Abstract
PURPOSE To design a relevant method to compare the virtual planned implant position to the ultimately achieved implant position and to evaluate, in case of discrepancy, the cause for this. MATERIALS AND METHODS Five consecutive edentulous patients with retention problems of the upper denture received four implants in the maxilla. Preoperatively, first a cone-beam CT (CBCT) scan was acquired, followed by virtual implant planning. Then, a surgical template was designed and endosseous implants were flapless installed using the template as a guide. To inventory any differences in position, the postoperative CBCT scan was matched to the preoperative scan. The accuracy of implant placement was validated three-dimensionally (3D) and the Implant Position Orthogonal Projection (IPOP) validation method was applied to project the results to a bucco-lingual and mesio-distal plane. Subsequently, errors introduced by virtual planning, surgical instruments, and validation process were evaluated. RESULTS The bucco-lingual deviations were less obvious than mesio-distal deviations. A maximum linear tip deviation of 2.84 mm, shoulder deviation of 2.42 mm, and angular deviation of 3.41° were calculated in mesio-distal direction. Deviations included errors in planning software (maximum 0.15 mm), for surgical procedure (maximum 2.94°), and validation process (maximum 0.10 mm). CONCLUSIONS This study provides the IPOP validation method as an accurate method to evaluate implant positions and to elucidate inaccuracies in virtual implant planning systems.
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Affiliation(s)
- Luc M Verhamme
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Abstract
PURPOSE The aim of this study was to develop and evaluate a new stereoscopic technique for conversion of radiographic guide into surgical guide for dental implant placement. MATERIALS AND METHODS Ten partially dentate patients requiring 18 implants for tooth replacement were recruited. Radiographic guides were modified with the addition of index rods for double computed tomography scanning. Implant positions were planned with implant planning software, and the stereoscopic angulations were measured. The radiographic guides were converted into surgical guides using either a generic bench drill (Group A, n = 9) or a milling machine (Group B, n = 9). Stereolithographic surgical guides were also made for three patients (Group S, n = 5). Differences between the planned and actual angulations were tested by pair-sample t-test. Difference of mean angle deviation among groups was tested by Brown-Forsythe test. Differences were considered significant if p < .05. RESULTS Eighteen implant sites were successfully treated with the converted surgical guides. The mean angle deviation of Group A (1.3 ± 0.6°) was significantly greater than Group S (0.4 ± 0.6°), while no differences were found between Group B (0.9 ± 0.3°) and Group S. The linear error was greatest in Group A with 1.5 mm at the head and 1.8 mm at the apex of the implant. CONCLUSIONS The use of this new stereoscopic technique appears to be an acceptable alternative method for converting radiographic guide into surgical guide.
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Affiliation(s)
- Paul W K Chan
- Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
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