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Zuiderveld EG, Meijer HJA, Gareb B, Vissink A, Raghoebar GM. Single immediate implant placement in the maxillary aesthetic zone with and without connective tissue grafting: Results of a 5-year randomized controlled trial. J Clin Periodontol 2024; 51:487-498. [PMID: 38228860 DOI: 10.1111/jcpe.13918] [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: 09/04/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 01/18/2024]
Abstract
AIM To assess the 5-year effects of grafting connective tissue while undertaking single immediate implant placement and provisionalization at the mid-buccal mucosa level (MBML). Secondary outcomes were buccal bone wall thickness (BBT), marginal bone level (MBL) and patient satisfaction. MATERIALS AND METHODS Sixty patients with a single failing tooth in the maxillary anterior region were provided with an immediately placed and provisionalized implant. At implant placement, the patients randomly received either a connective tissue graft from the maxillary tuberosity (n = 30, test group) or no graft (n = 30, control group). The alveolar socket classification was mainly Type 2A. Data were collected before removing the failing tooth (T0 ), and at 1 (T1 ), 12 (T12 ) and 60 (T60 ) months after final crown placement. The primary outcome was the change in MBML compared with the pre-operative situation. Additionally, the change in BBT, MBL, aesthetics (using the Pink Aesthetic Score-White Aesthetic Score), soft-tissue peri-implant parameters and patient satisfaction were assessed. RESULTS At the 5-year follow-up, 27 patients could be analysed from each group. In each group, one implant was lost during the osseointegration period, within 3 months of placement, resulting in an implant survival rate of 96.7% in both groups. MBML change at T60 was -0.6 (-1.1 to -0.1) mm in the control group and 0.1 (-0.4 to 0.5) mm in the test group (p = .008). BBT and MBL, aesthetics, soft-tissue peri-implant parameters and patient satisfaction showed stable results and satisfied patients, without clinically relevant differences between the groups. CONCLUSIONS This 5-year follow-up study shows that grafting connective tissue when replacing a single failing tooth with immediately placed and provisionalized implant results in favourable peri-implant tissues and fewer MBML changes.
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Affiliation(s)
- Elise G Zuiderveld
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Prosthodontics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Rai D, Singh A, Tripathi G. Clinical Algorithm for the Management of Ipsilateral Proximal and Shaft Femur Fractures Using Single or Dual Implants. Cureus 2024; 16:e55359. [PMID: 38562363 PMCID: PMC10982125 DOI: 10.7759/cureus.55359] [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] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose of the study The current study had two goals: first, it compared the radiological and functional results of the ipsilateral shaft and proximal femur fractures treated by using two different methods, i.e., single implant vs dual implants. The second goal was to devise a clinical algorithm for guiding and managing such fractures. Methods This study was conducted in a level 1 trauma center and included 34 patients with concomitant ipsilateral fractures of the proximal femur and shaft of the femur. The patients were divided into two groups as per our clinical algorithm. Group I, comprising of 16 patients, were treated with a single implant like the proximal femoral nail (PFN) or proximal femoral nail antirotation (PFNA2). Group II of dual implants, comprising of 18 patients, were treated with two types of implants separately for proximal and shaft fracture. Results All patients were followed at monthly intervals up to six months, then at three monthly intervals up to one year, with a minimal follow-up of one year of every patient. On clinical evaluation by Friedman-Wyman criteria, in group I, seven patients had a fair outcome, eight patients had a good outcome, and one patient had a poor outcome, while in group II, eight patients had a fair outcome, nine patients had a good outcome, and one patient had a poor outcome. No patient developed non-union or avascular necrosis of the femoral head in any of the groups. Conclusion For concurrent ipsilateral diaphyseal and proximal femur fractures, both dual and single implants are equally effective alternatives if properly applied as per our clinical algorithm. Implant selection primarily depends on the pattern of injury, and our clinical algorithm can be a suitable guide for guiding the selection of implants.
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Affiliation(s)
- Deepak Rai
- Orthopedic Surgery, Institute Of Medical Sciences (IMS) Banaras Hindu University, Varanasi, IND
| | - Ajit Singh
- Orthopedic Surgery, Institute Of Medical Sciences (IMS) Banaras Hindu University, Varanasi, IND
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Tudts M, D'haese R, Hommez G, Christiaens V, Vandeweghe S. Proof of Concept of a New 3D-Guided System for a Single Implant Overdenture in the Mandible: An In Vitro Study. Int J Oral Maxillofac Implants 2024; 39:127-134. [PMID: 38416006 DOI: 10.11607/jomi.10301] [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: 02/29/2024] Open
Abstract
PURPOSE To evaluate the precision and efficiency of a novel guide system for single implant placement in the mandibular symphyses and to evaluate whether the outcome is affected by the level of operator experience. MATERIALS AND METHODS A total of 90 implants were placed in three different mandibular cast types (Cawood and Howell class III, IV, and V). For each model, a complete denture was 3D printed. A polyether ether ketone rail with a guide sleeve was embedded in the middle of the denture. To determine the ideal implant position, the sleeve could be moved in a buccolingual direction. Adjustment of implant angulation was possible, and an angle correction of 0, 12, or 24 degrees was available. A total of 30 clinicians were divided into three groups: group 1 (experienced, n = 10), group 2 (beginner, n = 10), and group 3 (inexperienced, n = 10). Each clinician was asked to plan and perform a guided flapless implant placement in the mandibular symphysis. Two preoperative CBCT scans were taken; the first was to verify the planning, and the second was to adjust the planning if needed. Finally, a postoperative CBCT scan was taken to compare the planning to the final implant position. RESULTS Based on the first CBCT, the clinicians adjusted their planning by an average of 1.66 ± 1.65 mm coronally, 2.41 ± 2.44 mm apically, and by a mean angular correction of 6.08 ± 0.77 degrees. After implant placement, the mean deviation from the planned implant position was 0.87 ± 0.58 mm at the coronal aspect and 0.98 ± 0.64 mm at the apical aspect. The mean angular deviation was 6.05 ± 0.71 degrees. Overall, there were no significant differences in coronal and apical deviation (P > .05) based on the level of experience. In terms of angulation, a significant difference was found in both planning (P = .049) and placement (P = .038) between beginners and experienced clinicians. CONCLUSIONS Guided implant placement of a single implant in the mandibular symphysis using a removable denture with guide sleeve had an acceptable level of accuracy. Clinicians with limited experience spent more time on the procedure, resulting in less angular deviation during implant planning and placement compared to experienced clinicians.
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Patil A, Adsare P, Raj P, Puranik S, Rajender K, Menga R. Comparison of Man Hours Utilized for Mandibluar Overdenture Treatment Retained by Single Implant with Bar Fabricated by CAD-CAM Process and Conventional Casting Processs - An Vivo Study. J Pharm Bioallied Sci 2024; 16:S948-S950. [PMID: 38595595 PMCID: PMC11001049 DOI: 10.4103/jpbs.jpbs_1123_23] [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: 10/30/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 04/11/2024] Open
Abstract
Introduction Both the population's average life expectancy and the number of patients without teeth are rising. A 2012 epidemiological survey in India found that 30% of the population is edentulous. The rehabilitation process with a set of removable maxillary and mandibular complete dentures is the standard treatment for patients who are edentulous. This study is the first to incorporate and compare a novel approach to a single implant-retained mandibular overdenture with a bar attachment fabricated by CAD-CAM and a casting process on a single implant in the symphysis region. Method Five maxillary and mandibular completely edentulous patients were enrolled in the study. Results Significant difference was seen in the conventional laboratory time and CAD-CAM time as P < 0.05. Conclusion Compared to the conventional casting process, the single implant-supported bar mandibular overdenture (SISBOD) with a novel bar required fewer man hours and was more convenient.
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Affiliation(s)
- Amit Patil
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | - Prashanti Adsare
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | - Pooja Raj
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | - Shivakumar Puranik
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | - Koineni Rajender
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
| | - Rajesh Menga
- Department of Prosthodontics and Implantology, H.K.E.s’ S. Nijalingappa’s Institute of Dental Sciences and Research, Kalaburagi, Karnataka, India
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Elawady D, Adam MA, Allam H, Mahmoud II, Alqutaibi AY, Shon AA. Single Implant-Retained Mandibular Overdentures: A Literature Review. Cureus 2024; 16:e52486. [PMID: 38371006 PMCID: PMC10874113 DOI: 10.7759/cureus.52486] [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: 01/18/2024] [Indexed: 02/20/2024] Open
Abstract
The absence of teeth, known as edentulism, poses considerable obstacles in prosthodontic care and greatly affects a person's well-being. Conventional complete dentures frequently lead to problems like instability and insufficient retention, especially in the lower jaw. Fortunately, the introduction of dental implants has transformed the way we approach edentulous patients, as they now offer support and enhanced retention for removable prostheses, thus revolutionizing their treatment. While a consensus exists on using two implants for retaining mandibular overdentures, the associated cost may be prohibitive for economically disadvantaged individuals. As a solution, the concept of single implant-retained mandibular overdentures has emerged, catering to individuals with limited financial resources and complete tooth loss. This review explores the efficacy and suitability of the single implant overdenture approach, along with an overview of treatment options for edentulous patients, including traditional dentures, tooth-supported overdentures, and implant-supported overdentures. The preservation of bone, improvements in functional abilities, and psychological benefits associated with overdentures are discussed. Moreover, various classifications and prosthetic options for implant overdentures, specifically for mandibular cases, are presented. This literature review aims to provide a comprehensive understanding of possible treatment options and focus on the single implant-retained mandibular overdenture approach and its implications in prosthodontic rehabilitation for edentulous patients.
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Affiliation(s)
- Dina Elawady
- Prosthodontics, October University for Modern Sciences and Arts, Cairo, EGY
| | - Maya Ali Adam
- Prosthodontics, October University for Modern Sciences and Arts, Cairo, EGY
| | | | | | - Ahmed Yaseen Alqutaibi
- Substitutive Dental Sciences, Taibah University, Madinah, SAU
- Prosthodontics, Ibb University, Ibb, YEM
| | - Ahmed Atef Shon
- Prosthodontics, Al-Azhar University, Cairo, EGY
- Prosthodontics, Al Mouwasat Hospital, Madinah, SAU
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Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained all-ceramic implant-supported crowns on zirconia abutment: A systematic review and meta-analysis. J Indian Prosthodont Soc 2024; 24:25-35. [PMID: 38263555 PMCID: PMC10896314 DOI: 10.4103/jips.jips_524_23] [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] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods. MATERIALS AND METHODS Independent search was conducted in Cochrane Library, EBSCO, and PubMed/PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications. RESULTS A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10). CONCLUSION The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.
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Affiliation(s)
- Shruti S. Potdukhe
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani M. Iyer
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B. Nadgere
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Mugri MH, Sayed ME, Bhandi S, A Alaqi HA, B Alsubeaie NH, Alsubaie SH, Varadarajan S, Raj AT, Yadalam PK, Khurshid Z, Balaji TM, Patil S. Success rate of immediately loaded implants in the posterior zone. Niger J Clin Pract 2023; 26:1215-1225. [PMID: 37794532 DOI: 10.4103/njcp.njcp_884_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.
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Affiliation(s)
- M H Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - M E Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - S Bhandi
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
| | - H A A Alaqi
- Private Practice, Jazan, Kingdom of Saudi Arabia
| | | | - S H Alsubaie
- Private Practice, Riyadh, Kingdom of Saudi Arabia
| | - S Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A T Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P K Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Z Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - T M Balaji
- Department of Periodontology, Tagore Dental College and Hospital, Chennai, India
| | - S Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
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Emam ANM, Kassem M, Harby N, Abdel-fattah Agha MS, Gad MM, Helal MA. Effect of Different Occlusal Tooth Forms of Mandibular Overdenture Retained by an Immediate Loaded Single Implant on the Masticatory Efficiency and Oral Health-Related Quality of Life. J Int Soc Prev Community Dent 2023; 13:394-401. [PMID: 38124728 PMCID: PMC10729887 DOI: 10.4103/jispcd.jispcd_64_23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 12/23/2023] Open
Abstract
Aim To study the masticatory efficacy and oral health-related quality of life (OHRQoL) of participants wearing a mandibular overdenture retained by an immediate loading single implant with different occlusal tooth forms. Materials and Methods For this nonrandomized controlled trial study, 27 edentulous participants were selected and randomly divided into three groups (n = 9) based on occlusal tooth forms of the mandibular implant overdenture (MIOD). Group I: participants received an MIOD with an anatomical tooth form; Group II: participants received an MIOD with a semianatomical tooth form; and Group III: participants received an MIOD with a nonanatomical tooth form. For each participant, a single implant (screw root form) was inserted into the midline of the mandibular ridge to support the MIOD. For each group, the masticatory efficiency was evaluated after 3 months, and the OHRQoL of the participants was evaluated after 3 and 6 months. One-way ANOVA and post hoc Tukey's test were used for data analysis (P < 0.05). Results The masticatory efficiency of the anatomic and semianatomic tooth forms was higher than that of the nonanatomic (P < 0.05). Moreover, the improvement in the participants' OHRQoL in the anatomic group was more significant than that of other groups (P < 0.05). Conclusion There was a greater improvement in masticatory efficiency and participants' OHRQoL when fitted with an anatomic tooth form mandibular overdenture retained by an immediate loading single implant than with a semianatomic or nonanatomic tooth form.
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Affiliation(s)
- Abdel-Naser M Emam
- Department of Prosthetic Dental Science, Faculty of Dentistry, Najran University, Najran, Kingdom of Saudi Arabia
| | - Mohamed Kassem
- Department of Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Nehad Harby
- Department of Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Mohammed M Gad
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohamed Ahmed Helal
- Department of Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
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Naeini EN, Atashkadeh M, Jacquet W, D'Haese J, De Bruyn H. Incidence of Peri-Implantitis, Technical and Biological Complications of Single Implants Placed with Flap or Flapless Surgery-A 10-12-Year Case-Series. J Clin Med 2023; 12:jcm12113668. [PMID: 37297870 DOI: 10.3390/jcm12113668] [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: 03/19/2023] [Revised: 04/13/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Long-term follow-up of single implants and crowns is scarce, especially when inserted using flapless surgery. AIM Evaluate survival, peri-implantitis incidence, and technical/biologic complications of solitary implants/crowns after 10-12 years of function. MATERIAL AND METHODS 49 patients with 53 single implants, initially operated with a one-stage flap (F) or flapless (FL) surgery and delayed loading, were recalled. Implant survival, radiographic bone-level changes compared to baseline, peri-implant health, and soft tissue aesthetics were registered. Differences in implant level between and within groups were statistically tested using the Mann-Whitney U-Test and Wilcoxon Signed Ranks Test, respectively. RESULTS 36 patients with 40 implants were reassessed, yielding 100% implant and 97.5% crown survival. The bone loss in F (n = 19) was 0.56 mm (SD 0.89; range -0.9-2.02) and -0.85 mm (SD 0.98; range -2.84-0.53) in FL (n = 21), indicative of bone gain in FL (p = 0.003), the latter due to a difference at baseline but bone-level was comparable (p = 0.126). Groups were comparable for probing pocket depth (PPD); (3.32 vs. 3.19 mm), Bleeding Index (BI); (0.15 vs. 0.22), and gingival recession; (0.38 vs. 0.17 mm). According to international criteria, the peri-implantitis incidence was 0%, but 32.5% of the implants/crowns experienced biological or technical complications irrespective of surgical technique. CONCLUSIONS Solitary implants and crowns show good long-term clinical outcomes and peri-implant health. Flapless surgery is a good alternative to conventional in straightforward cases with sufficient bone volume and proper treatment planning.
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Affiliation(s)
- Emitis Natali Naeini
- Department of Periodontology and Implantology, Department of Dentistry, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | | | - Wolfgang Jacquet
- Department of Surgical Clinical Sciences CHIR-ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jan D'Haese
- Department of Periodontology and Implantology, Department of Dentistry, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Hugo De Bruyn
- Department of Periodontology and Implantology, Department of Dentistry, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, University of Ghent, 9000 Gent, Belgium
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D'Albis G, D'Albis V, Palma M, Nizar AK. Single-implant-supported zirconia fixed partial denture with a mesial cantilever extension: a case report. Gen Dent 2023; 71:62-65. [PMID: 37083616] [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: 04/22/2023]
Abstract
A 50-year-old man sought treatment for missing maxillary second premolar and first molar teeth. Treatment planning software demonstrated that the mesiodistal space of the edentulous ridge was insufficient to receive 2 implants. A screw-retained, single-implant-supported zirconia fixed partial denture with a mesial cantilever extension was used to replace the 2 missing posterior teeth. This prosthesis, produced with a computer-aided design/computer-aided manufacturing workflow and consisting of monolithic zirconia with a connector cross-sectional area of 16 mm2, offered adequate resistance to chewing loads and still provided satisfactory esthetics at a 2-year follow-up examination.
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Carosi P, Lorenzi C, Di Gianfilippo R, Papi P, Laureti A, Wang HL, Arcuri C. Immediate vs. Delayed Placement of Immediately Provisionalized Self-Tapping Implants: A Non-Randomized Controlled Clinical Trial with 1 Year of Follow-Up. J Clin Med 2023; 12:jcm12020489. [PMID: 36675417 PMCID: PMC9861545 DOI: 10.3390/jcm12020489] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to examine the clinical and esthetic outcomes of immediately provisionalized self-tapping implants placed in extraction sockets or healed edentulous ridges one year after treatment. Sixty patients in need of a single implant-supported restoration were treated with self-tapping implants (Straumann BLX) and immediate provisionalization. The implant stability quotient (ISQ) and insertion torque were recorded intraoperatively. After one year in function, the implant and prosthesis survival rate, pink esthetic score (PES), white esthetic score (WES), and marginal bone levels (MBL) were assessed. Sixty patients received 60 self-tapping implants. A total of 37 implants were placed in extraction sockets and 23 in edentulous ridges, and then all implants were immediately provisionalized. All implants achieved a high implant stability with a mean insertion torque and ISQ value of 58.1 ± 14.1 Ncm and 73.6 ± 8.1 Ncm, respectively. No significant differences were found between healed vs. post-extractive sockets (p = 0.716 and p = 0.875), or between flap vs. flapless approaches (p = 0.862 and p = 0.228) with regards to the insertion torque and ISQ value. Nonetheless, higher insertion torque values and ISQs were recorded for mandibular implants (maxilla vs. mandible, insertion torque: 55.30 + 11.25 Ncm vs. 62.41 + 17.01 Ncm, p = 0.057; ISQ: 72.05 + 8.27 vs. 76.08 + 7.37, p = 0.058). One implant did not osseointegrate, resulting in an implant survival rate of 98.3%. All implants achieved PES and WES scores higher than 12 at the 1-year follow-up. The clinical use of newly designed self-tapping implants with immediate temporization was safe and predictable. The implants achieved a good primary stability, high implant survival rate, and favorable radiographic and esthetic outcomes, regardless of the immediate or delayed placement protocols.
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Affiliation(s)
- Paolo Carosi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Claudia Lorenzi
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Piero Papi
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Laureti
- Department of Chemical Science and Technologies, PhD in Materials for Health, Environment and Energy–Dentistry, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Claudio Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Tor Vergata, 00133 Rome, Italy
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12
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Puisys A, Auzbikaviciute V, Vindasiute-Narbute E, Pranskunas M, Razukevicus D, Linkevicius T. Immediate implant placement vs. early implant treatment in the esthetic area. A 1-year randomized clinical trial. Clin Oral Implants Res 2022; 33:634-655. [PMID: 35318752 DOI: 10.1111/clr.13924] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/08/2021] [Accepted: 01/24/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To assess the impact of implant placement and temporization timing on esthetic outcomes of single maxillary anterior implants with intact bone walls and interproximal bone. MATERIALS AND METHODS Test group patients received an immediate implant with immediate provisional restoration and socket preservation, while patients in the control group received an early implant placement with guided bone regeneration and delayed loading. Patients were followed for 1 year after final prosthetic and pink esthetic score (PES), mid-buccal mucosal level (MBML), crestal bone changes (CBC), and peri-implant soft tissue parameters, and patient chair time was recorded. RESULTS Fifty patients received the intended treatment (25 test and 25 control). No implants failed. PES after 1 year was 12.8 ± 1.19 for the test group and 12.5 ± 1.36 for the control group (p = .362). MBML difference between baseline (after final crown delivery) and the 1-year follow-up was gain of 0.2 ± 1.02 mm for the test group (p = .047) and no change in the control group. CBC after 1 year were 0.1 mm ± 0.21 mm (mesial) and 0.2 mm ± 0.22 mm (distal) for the test group and 0.2 mm ± 0.25 mm (mesial) and 0.3 mm ± 0.19 mm (distal) for the control group, p = .540 (mesial) and p = .462 (distal). Test group required half the chair time (127 ± 13 min) when compared to the control group (259 ± 15 min, p < .001). CONCLUSIONS Within the limits of this trial, both treatment protocols resulted in excellent esthetic outcomes with PES >12 after 1-year follow-up.
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Affiliation(s)
- Algirdas Puisys
- Vilnius Research Group, Private Practice VIC Clinic, Vilnius, Lithuania
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13
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Capparé P, Ferrini F, Ruscica C, Pantaleo G, Tetè G, Gherlone EF. Digital versus Traditional Workflow for Immediate Loading in Single-Implant Restoration: A Randomized Clinical Trial. Biology (Basel) 2021; 10:1281. [PMID: 34943196 PMCID: PMC8698626 DOI: 10.3390/biology10121281] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.
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Affiliation(s)
- Paolo Capparé
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Francesco Ferrini
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Corrado Ruscica
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
| | - Giuseppe Pantaleo
- UniSR-Social.Lab, Faculty of Psychology, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Giulia Tetè
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
| | - Enrico Felice Gherlone
- Dental School, Vita-Salute San Raffaele University, IRCCS San Raffaele, 20132 Milan, Italy; (F.F.); (C.R.); (E.F.G.)
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita-Salute San Raffaele University, 20123 Milan, Italy;
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14
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Barack D, Rubinstein S, Milin K, Wang Y, Neiva R. Immediate single-tooth replacement with acellular dermal matrix allogeneic bone on sloped platform-switching implants: A case series. Int J Oral Implantol (Berl) 2021; 14:213-222. [PMID: 34006082] [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: 06/12/2023]
Abstract
Achieving predictable success with implants in the aesthetic zone is essential for clinicians. Promoting marginal bone and stability of the gingival environment is key to obtaining a predictable aesthetic outcome. The present study aimed to describe a technique that combines a flapless approach to immediate extraction and placement of sloped implants, using an acellular dermal matrix to contain the coronal aspect of a deproteinised bovine bone mineral graft. This minimally invasive technique results in stable augmentation of soft tissue thickness to ensure predictable aesthetic results. A collection of case reports with a follow-up period of up to 45 months is presented to demonstrate the surgical technique. Clinical presentation showed relative stability of the soft tissue margins during the evaluation period.
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15
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de Oliveira NRC, Pigozzo MN, Sesma N, Laganá DC. Clinical efficiency and patient preference of digital and conventional workflow for single implant crowns using immediate and regular digital impression: A meta-analysis. Clin Oral Implants Res 2020; 31:669-686. [PMID: 32329094 DOI: 10.1111/clr.13604] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/19/2020] [Accepted: 04/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess whether digital workflow gives better results than the conventional one in the single implant crowns, when analyzing the impression time, patient preference, time efficiency, and adjustment time. MATERIAL AND METHODS MEDLINE, Embase, and Cochrane were searched and supplemented via hand search up to June 19, 2019. Only clinical trials assessing conventional versus digital workflows for single implant crowns were included. Impression time was evaluated using random effects meta-analysis, while patient preference, adjustment time, and time efficiency were reported descriptively. RESULTS Among 1,334 publications identified, ten studies were included. The random effects models revealed statistically significant reduction in time in the digital impression group when compared to the conventional group by the mean meta-analysis (MD: 8.22 [95% CI: 5.48, 10.96]). Analysis from immediate digital impression versus conventional (MD: 3.84 [95% CI: 3.30, 4.39]) and regular digital impression versus conventional (MD:10.67 [95% CI: 5.70, 15.65]) showed statistically significant reduction in time on using the digital impression. Impression time in the digital process ranged between 6 min 39 s and 20 min, whereas for conventional, it was between 11.7 and 28.47 min. Patients showed greater preference for digital impression. Adjustment time in the digital process ranged between 1.96 and 14 min, whereas for conventional, it was between 3.02 and 12 min. Time efficiency in the digital process ranged between 36.8 and 185.4 min, whereas for conventional, it was between 55.6 and 332 min. CONCLUSION The digital workflow has demonstrated better clinical efficiency considering impression time, patient preference, and time efficiency. According to the adjustment time, different results were presented.
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Affiliation(s)
| | - Monica N Pigozzo
- Department of Prosthodontics, School of Dentistry, University of São Paulo, Butantã, São Paulo, Brazil
| | - Newton Sesma
- Department of Prosthodontics, School of Dentistry, University of São Paulo, Butantã, São Paulo, Brazil
| | - Dalva Cruz Laganá
- Department of Prosthodontics, School of Dentistry, University of São Paulo, Butantã, São Paulo, Brazil
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16
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Oh SL, Chung MK. Creeping attachment following free gingival grafts around dental implants exhibiting mucosal recession with a lack of keratinised mucosa: A case series. Int J Oral Implantol (Berl) 2020; 13:401-409. [PMID: 33491370] [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: 06/12/2023]
Abstract
Purpose: Few case reports have been published on creeping attachment around dental implants. This study aimed to assess changes in the level of the mucosal margin following placement of free gingival grafts around single implants exhibiting mucosal recession with < 2 mm keratinised mucosa compared to that of implants with ≥ 2 mm keratinised mucosa. Materials and methods: A total of 12 subjects with one or more implants were included. Nineteen implants displaying implant thread and/or prosthetic abutment exposure with < 2 mm keratinised mucosa were treated using free gingival grafts (FGG group), and 11 implants exhibiting ≥ 2 mm keratinised mucosa did not receive free gingival grafts (control group). The width of keratinised mucosa and the amount of mucosal recession were measured by a blind evaluator (MC). Results: A continual reduction in mucosal recession was observed at the 6- and 12-month followups in all except two of the FGG group implants, while no change in the level of the mucosal margin was observed in the control group. This postoperative coronal migration of the mucosal margin resulted in a 0.7-mm mean reduction in mucosal recession after 12 months in the FGG group. Conclusion: The level of the mucosal margin around implants exhibiting mucosal recession along with a lack of keratinised mucosa migrated coronally following free gingival grafts, and creeping attachment was observed in a number of patients.
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17
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Pérez León P, Bartolomé JF, Lombardía C, Pradíes G. Mechanical fatigue behaviour of different lengths screw-retained restorations connected to two designs prosthetic connection level. J Oral Rehabil 2019; 46:747-755. [PMID: 31050014 DOI: 10.1111/joor.12809] [Citation(s) in RCA: 5] [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: 10/17/2018] [Revised: 03/27/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
The aim of this work is to compare the mechanical fatigue behaviour of different crown heights of single crown implant restorations made over two different internal hexagonal titanium dental implant connection levels. Two different groups of internal hexagonal connection were studied: (a) TL group (N = 26) included implants with a transmucosal connection (12.2 mm height and 4.8 mm width) and (b) BL group (N = 26) composed by implants at a bone level connection (10 mm height and 3.8 mm width). Two subgroups (N = 13) were established for each connection level according to crown heights (TL10 = 10 mm, TL15 = 15 mm, BL12 = 12 mm, BL17 = 17 mm). Dynamic load tests were carried out according to ISO Norm 14801. Failed samples and fracture surfaces were analysed with an optical and scanning electron microscope (SEM). The fatigue limit and the fatigue strength degradation (fatigue strength exponent) decreases with increasing crown height (5 mm) in both groups of internal hexagonal titanium dental implant connection levels. Consequently, the mechanical integrity of internal hexagonal dental implants varies with the height of the crown. An increase of 5 millimetres in the crown height appears to significantly decrease the fatigue life of both types of dental implants.
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Affiliation(s)
- Patricia Pérez León
- Department of Buccofacial Prosthesis, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - José F Bartolomé
- Instituto de Ciencia de Materiales de Madrid (ICMM), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Carlos Lombardía
- Department of Buccofacial Prosthesis, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Guillermo Pradíes
- Department of Buccofacial Prosthesis, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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18
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Priest G. The treatment dilemma of missing maxillary lateral incisors-Part II: Implant restoration. J ESTHET RESTOR DENT 2019; 31:319-326. [PMID: 31033174 DOI: 10.1111/jerd.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/09/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This second of a two-part series reviews the single dental implant as the most current treatment alternative for replacement of a missing or lost maxillary lateral incisor. Assessments of dental maturity for implant placement, implant space requirements, surgical and restorative influence on soft tissue profiles, and implant success are reviewed. OVERVIEW Recent data indicates that implant success rates are high, and esthetics and soft tissue profiles appear to be stable for maxillary lateral incisor implants. Implant placement should be assessed by dental maturity of the specific patient as opposed to chronological age, and implant spacing should be developed and assessed by all team members. CONCLUSIONS Implant replacement of a missing lateral incisor is a predictable treatment mode if implant placement is deferred until dental maturity and then accurately placed in a well-developed site. Treatment involves more complicated planning and execution from team members than other alternatives, but innovations in techniques and materials render it a favorable alternative for lateral incisor replacement. CLINICAL SIGNIFICANCE Implant restoration of a missing or lost maxillary lateral incisor is surgically and restoratively more complex than space closure or a resin-bonded fixed dental prosthesis but demonstrates high success rates and high esthetic potential when team members follow strict treatment protocols.
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19
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Ramaglia L, Di Spirito F, Sirignano M, La Rocca M, Esposito U, Sbordone L. A 5-year longitudinal cohort study on crown to implant ratio effect on marginal bone level in single implants. Clin Implant Dent Relat Res 2019; 21:916-922. [PMID: 30907504 DOI: 10.1111/cid.12757] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 11/30/2018] [Revised: 02/06/2019] [Accepted: 03/03/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND A 5-year longitudinal cohort study was carried out to evaluate the influence of anatomical crown to implant ratio (CIR) on peri-implant marginal bone level (MBL) in single implants. MATERIALS AND METHODS The longest possible implants, according to the availability of pristine bone, were inserted, one per patient, among periodontally healthy teeth in consecutively recruited subjects. CIR and MBL changes were measured on standardized radiographs. The relationship between MBL and multiple predictors was investigated. A statistical analysis suitable for mixed type distributions was conducted: for the discrete component a logistic regression model was used and for the continuous component the impact of the variables on MBL was examined by using robust nonparametric comparison tests. RESULTS Seventy-eight dental implants were inserted in 34 mandibles and 44 maxillae, with one stage procedure in 40 cases and two stage in 38 cases. Thirty-five implants were <10 mm, while 43 were ≥ 10 mm long; 28 implants had a CIR ≤1 and 50 had a CIR >1. No drop-outs or implant loss were observed. Bone loss occurred only in a few cases, measuring less than 0.5 mm and being significantly more pronounced for implant length ≥10 mm, for lower CIR values and for the two stage procedure. CONCLUSION Higher CIR values were not related to increased peri-implant bone loss; a <10 mm long implant insertion may be safely considered for reduced bone heights.
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Affiliation(s)
- Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.,Clinical Department of Head and Neck, University of Naples "Federico II", Naples, Italy
| | - Federica Di Spirito
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Massimiliano Sirignano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Michele La Rocca
- Department of Economics and Statistics, University of Salerno, Fisciano (Salerno), Italy
| | | | - Ludovico Sbordone
- Department of Medicine, Surgery and Dentistry "Schola Medica Salernitana", University of Salerno, Salerno, Italy
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20
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Naeini EN, Dierens M, Atashkadeh M, De Bruyn H. Long-term clinical outcome of single implants inserted flaplessly or conventionally. Clin Implant Dent Relat Res 2018; 20:829-837. [PMID: 30110136 DOI: 10.1111/cid.12654] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 06/13/2018] [Accepted: 06/20/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Flapless implant surgery is mostly performed using guided surgical protocols, however, long-term studies on free-handed flapless surgery for single implants are lacking. PURPOSE This prospective study evaluates bone level changes, peri-implant health, and complications of solitary implants placed using a conventional flap (F) or flaplessly (FL) after 6-9 years. MATERIALS AND METHODS Fifty-three single TiUnite Brånemark implants were originally inserted in 49 patients using an one-stage delayed loading protocol with flap (n = 27, F) or flaplessly (n = 26, FL) based on available bone volume and surgeon's decision-making. Thirty-six patients with 37 implants participated in the prospective follow-up investigation 6-9 years later whereby survival, bone level changes, peri-implant health, and complications were assessed. RESULTS After 88 months (range 76-107), all implants were survived. For F and FL combined, the overall average radiographic bone level was above the first implant thread, 1.26 mm apical of the implant-abutment junction (SD 1.08; 0-4.9) and statistically comparable. Bone loss from time of loading was 0.49 mm (SD 1.1; -1.3 to 2.8) for F and -0.89 mm (SD 1.0; -2.8 to 0.7) for FL (P < .01), suggesting regrowth of bone in FL due to initial countersinking. One implant (2.7%) had a probing depth above 5 mm. CONCLUSION Free-handed flapless implant surgery for single implants with neighboring teeth is a predictable long-term treatment provided when there is sufficient bone volume.
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Affiliation(s)
- Emitis N Naeini
- Department of Periodontology, Oral Implantology, Removable & Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Melissa Dierens
- Department of Periodontology, Oral Implantology, Removable & Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mandana Atashkadeh
- Periodontology and Oral Implantology, All Saints Green Dental Practice, Norwich, United Kingdom
| | - Hugo De Bruyn
- Department of Periodontology, Oral Implantology, Removable & Implant Prosthodontics, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Periodontology and Implantology, College of Dental Science, Radboud University Medical Centre, Nijmegen, The Netherlands
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21
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Pour NN, Ghaedi B, Sohrabi M. Soft-tissue esthetic outcome of single implants: Immediate placement in fresh extraction sockets versus conventional placement in healed sockets. J Indian Soc Periodontol 2018; 22:249-253. [PMID: 29962705 PMCID: PMC6009153 DOI: 10.4103/jisp.jisp_21_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 11/18/2022] Open
Abstract
Background: Immediate implant placement has advantages such as requiring fewer surgical procedures and decreased treatment time; however, unpredictable soft- and hard-tissue outcome is a problem. This study aimed to compare the soft-tissue esthetic outcome of single implants placed in fresh extraction sockets versus those placed in healed sockets. Materials and Methods: This cross-sectional, retrospective study was performed on 42 patients who received single implants. Twenty-two patients with a mean age of 40.14 years received immediate implants while 18 patients with a mean age of 43.40 years were subjected to conventional (delayed) implant placement. The mean follow-up time was 14.42 ± 8.37 months and 18.25 ± 7.10 months in the immediate and conventional groups, respectively. Outcome assessments included clinical and radiographic examinations. The esthetic outcome was objectively rated using the pink esthetic score (PES). Results: All implants fulfilled the success criteria. The mean PES was 8.54 ± 1.26 and 8.10 ± 1.65 in the immediate and conventional groups, respectively. This difference was not statistically significant (P = 0.329). The two PES parameters, namely, the facial mucosa curvature and facial mucosa level had the highest percentage of complete score. Conclusions: Immediate and conventional single implant treatments yielded comparable esthetic outcomes.
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Affiliation(s)
- Nima Naddaf Pour
- Department of Periodontology, Dental School, Islamic Azad University, Tehran, Iran
| | - Baharak Ghaedi
- Periodontist, Private Practice, Tehran University of Medical Science, Tehran, Iran
| | - Mona Sohrabi
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
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22
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Zuiderveld EG, Meijer HJA, den Hartog L, Vissink A, Raghoebar GM. Effect of connective tissue grafting on peri-implant tissue in single immediate implant sites: A RCT. J Clin Periodontol 2017; 45:253-264. [PMID: 28941303 DOI: 10.1111/jcpe.12820] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [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: 09/19/2017] [Indexed: 11/30/2022]
Abstract
AIM To assess the effect of connective tissue grafting on the mid-buccal mucosal level (MBML) of immediately placed and provisionalized single implants in the maxillofacial aesthetic zone. MATERIALS AND METHODS Sixty patients with a failing tooth were provided with an immediately placed and provisionalized implant. During implant placement, patients randomly received either a connective tissue graft from the maxillary tuberosity (n = 30, test group) or no graft (n = 30, control group). Follow-up visits were at one (T1 ) and twelve months (T12 ) after final crown placement. The primary outcome measure was any change in MBML compared to the pre-operative situation. In addition, gingival biotype, aesthetics (using the Pink Esthetic Score-White Esthetic Score), marginal bone level, soft tissue peri-implant parameters and patient satisfaction were assessed. RESULTS The mean MBML change at T12 was -0.5 ± 1.1 mm in the control group and 0.1 ± 0.8 mm in the test group (p = .03). No significant differences regarding other outcome variables were observed, neither was gingival biotype associated with a gain or loss in MBML. CONCLUSIONS This one-year study shows that connective tissue grafting in single, immediately placed and provisionalized implants leads to less recession of the peri-implant soft tissue at the mid-buccal aspect, irrespective of the gingival biotype (www.trialregister.nl: TC3815).
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Affiliation(s)
- Elise G Zuiderveld
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Laurens den Hartog
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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23
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DI Girolamo M, Arullani CA, Calcaterra R, Manzi J, Arcuri C, Baggi L. Preservation of extraction socket in immediate implant placement: a clinical study. Oral Implantol (Rome) 2017; 9:222-232. [PMID: 28042451 DOI: 10.11138/orl/2016.9.4.222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM The objective of this study was to compare different approaches temporary restoration in an immediate implant placement. To determine the respective influence of each parameter, two treatment groups were formed; a strict and standardized study protocol was applied to minimize the influence of bias and confounding factors. The Pink Esthetic Score (PES) - the esthetic out-come of soft tissue appearance was evaluated. MATERIAL AND METHODS Sixteen patients with a single failing tooth in the maxilla and a natural contralateral site were randomly distributed into two groups. Treatment variations affected the provisional restorative in detail, group 1 with immediate implant placement and immediate temporary restoration with the simulation of the first three mm of the root and the seal of the socket, group 2 with immediate implant placement and immediate temporary restoration without the seal of the socket. All patients received the final prosthetic restoration 10-12 weeks after implant placement. Standardized photographs were taken eight months after tooth extraction. Five competent observers analyzed the esthetic outcome according to the PES. RESULTS The overall scores of the four treatment groups revealed PES values of 8.47 (SD 2.08, group 1), 6.62 (SD 3.24, group 2). The differences between groups 1 and 2 and were statistically significant (P=0.015 and P=0.047). The single parameter analysis displayed a certain range of fluctuation and heterogeneity. CONCLUSIONS Immediate implant placement and restoration appear to be a suitable alternative to early implant placement if an experienced surgeon is entrusted with the implantation procedure.
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Affiliation(s)
- M DI Girolamo
- School of Dentistry, University of Rome "Tor Vergata", Rome, Italy
| | | | - R Calcaterra
- Department of Social Dentistry, National Institute for Health, Migration and Poverty - School of Dentistry, University of Rome "Tor Vergata", Rome, Italy
| | - J Manzi
- School of Dentistry, University of Rome "Tor Vergata", Rome, Italy
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - L Baggi
- Department of Social Dentistry, National Institute for Health, Migration and Poverty - School of Dentistry, University of Rome "Tor Vergata", Rome, Italy
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Wang F, Huang W, Zhang Z, Wang H, Monje A, Wu Y. Minimally invasive flapless vs. flapped approach for single implant placement: a 2-year randomized controlled clinical trial. Clin Oral Implants Res 2016; 28:757-764. [PMID: 27198588 DOI: 10.1111/clr.12875] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 04/26/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this 2-year randomized controlled clinical trial was to assess the differences in implant survival rates, soft tissue preservation, patient centered outcome and crestal bone changes applying the minimally invasive (MI) flapless approach for single implant placement compared to flapped implant surgery (FS). MATERIALS AND METHODS Subjects eligible for this study were randomly assigned into two groups: MI or FS. Items of evaluation were the following: implant installation position, soft tissue healing, post-surgical pain, soft tissue outcome, marginal bone loss (MBL), and implant survival rate. RESULTS Forty subjects (14 women and 26 men, 20 in MI group and 20 in FS group with a mean of 39 ± 13.2 years old) were included in the study. None of the implants demonstrated dehiscence or loss during the follow-up. Subjects in MI group showed significantly lower post-surgical pain and significantly less wound healing index scores at 1-week follow-up. The width of keratinized mucosa decreased from a mean of 4.2 ± 1.6 mm pre-surgically to 3.7 ± 1.1 mm at crown delivery but remained stable at 2-year follow-up in MI group. At every appointment in the study, no statistical significant difference of PD and MBL was found between the two groups. CONCLUSION Compared with FS, single implants placed applying the MI technique in selected subjects showed advantages in improving patient comfort and decreasing post-implant placement soft tissue reaction. Meanwhile, implants with MI approach have the same level of MBL and high success rates as FS procedure at 2-year follow-up. The deduction of keratinized mucosa is very limited and the width of KM remained stable with MI approach at 2-year follow-up.
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Affiliation(s)
- Feng Wang
- Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Huang
- Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiyong Zhang
- Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Haowei Wang
- Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Yiqun Wu
- Department of Oral Implantology, Ninth People's Hospital, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, China
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Srinivasan M, Makarov NA, Herrmann FR, Müller F. Implant survival in 1- versus 2-implant mandibular overdentures: a systematic review and meta-analysis. Clin Oral Implants Res 2016; 27:63-72. [PMID: 25350235 DOI: 10.1111/clr.12513] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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] [Accepted: 09/16/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This systematic review was performed to compare the survival of 1- vs. 2-implant overdentures (IODs) in the edentulous mandible. MATERIALS AND METHODS Manual and electronic database (PubMed, EMBASE and CENTRAL) searches were performed to identify scientific articles, published in English, reporting on mandibular IODs utilizing unsplinted attachments. Studies were included if they were prospective human studies reporting on two-piece microrough surface implants with a diameter ≥3 mm. Data were extracted by two independent investigators, and an overall inter-investigator kappa score was calculated. A meta-analysis was performed on the included comparative studies. RESULTS The search shortlisted 30 prospective studies for data extraction and statistical analysis. The included studies comprised of only two randomized controlled trials (RCTs) comparing 1- vs. 2-IODs, and a further 28 prospective studies. The kappa score calculated was between 0.86 and 1 for the various parameters. One RCT favored 1-IODs (RD: 0.08, 95% CI: 0.01, 0.14) while the other favored 2-IODs (RD:-0.04, 95% CI: -0.27, 0.19). However, the overall random effects model did not reveal a significant risk difference (RD) for implant failure between the two interventions (I(2) = 36.6%, P = 0.209; RD: 0.05, 95% CI: -0.07, 0.18). CONCLUSIONS The results of this meta-analysis conclude that the postloading implant survival of 1-IODs is not significantly different from 2-IODs. However, the existing scientific evidence in the literature in terms of prospective comparative studies is scarce. Hence, before recommending the 1-IOD as a treatment modality, long-term observations are needed and a larger range of functional, prosthodontic, and patient-centered outcome measures should be considered.
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Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Nikolay A Makarov
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
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Morimoto T, Tsukiyama Y, Morimoto K, Koyano K. Facial bone alterations on maxillary anterior single implants for immediate placement and provisionalization following tooth extraction: a superimposed cone beam computed tomography study. Clin Oral Implants Res 2014; 26:1383-9. [PMID: 25179799 DOI: 10.1111/clr.12480] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 07/24/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this cone beam computed tomography (CBCT) study was to describe the facial bone changes around single implants for immediate placement and provisionalization following tooth extraction in the maxillary anterior. MATERIAL AND METHODS The data between 2008 and 2013 were collected retrospectively. Superimposed facio-palatal cross-sectional CBCT images for the implants were derived from preoperative and postoperative radiographs via standardized CBCT processes. Horizontal and vertical facial measurements on the implants were identified at preoperative and approximately 1-year postoperative follow-ups. Correlation coefficient for those parameters was evaluated. RESULTS A total of 12 single implants in 12 patients were included in this study. The mean loading period was 13.3 months (range 12-15 months). The median data of preoperative bone thickness 0.54 mm (A), preoperative vertical bone level 1.46 mm (B), postoperative bone thickness 1.77 mm (C), postoperative vertical bone level 1.08 mm (D), horizontal distance from outer surface of preoperative facial bone to implant surface 2.08 mm (E), horizontal gap distance 1.41 mm (E-A), horizontal bone resorption -0.26 mm (E-C), and vertical bone resorption -0.25 mm (B-D) were obtained. The data at the implant platform level (IPL) were selected for the horizontal measurements. Spearman's analysis demonstrated statistically significant correlations between B and D, C and E, E and E-A, and B and E-C (P < 0.01). Significant correlations between C and B, D, and E-A were also found, respectively (P < 0.05). CONCLUSIONS Immediate placement and provisionalization of single implants procedure in the maxillary anterior showed excellent outcomes with the small facial bone alterations around the implants. Neither preoperative facial bone thickness nor horizontal gap distance influenced the amount of facial bone resorptions.
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Affiliation(s)
- Taichiro Morimoto
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Tsukiyama
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Keizo Morimoto
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kiyoshi Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Sun SP, Moon IS, Park KH, Lee DW. Effect of Crown to Implant Ratio and Anatomical Crown Length on Clinical Conditions in a Single Implant: A Retrospective Cohort Study. Clin Implant Dent Relat Res 2013; 17:724-31. [PMID: 24238214 DOI: 10.1111/cid.12175] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this retrospective cohort study was to evaluate the long-term influence of the crown-to-implant (C/I) ratio and anatomical crown length on clinical conditions around Astra single dental implants placed in the premolar and molar regions. MATERIALS AND METHODS Seventy-six subjects were selected from patients who had been treated with single Astra implants for replacement of missing premolars and molars. The peri-implant marginal bone level change was assessed 1 year after functional loading and 6 years after functional loading. To predict the peri-implant marginal bone level change using clinical and radiographic data, a multiple linear regression model was applied. The Wilcoxon rank sum test was used to analyze difference median in technical complications. RESULTS The C/I ratio and anatomical crown length were not associated with peri-implant marginal bone loss or changes in the bone level at 6 years (p = .48, p = .31). However, the modified plaque index, modified sulcus bleeding index, and smoking status influenced the peri-implant marginal bone loss (p < .05, r(2) = 0.54). In addition, the patient with technical complication group did show significantly increased anatomical crown length (p < .05) CONCLUSIONS: The higher C/I ratio and anatomical crown length did not increase the risk of peri-implant marginal bone loss during 6 years of functional loading. In addition, higher anatomical crown lengths are associated with higher technical complications.
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Affiliation(s)
- Shan-Pao Sun
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ik-Sang Moon
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral & Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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