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Böse MWH, Beuer F, Naumann M, Spies BC, Neumeyer S, Hildebrand D, Bruhnke M. Root-analogue implants compared to forced orthodontic extrusion: a retrospective analysis of clinical, radiological and esthetic outcomes after restoration. Clin Oral Investig 2023; 27:5875-5886. [PMID: 37581766 PMCID: PMC10560152 DOI: 10.1007/s00784-023-05198-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVES To assess clinical, radiological and esthetic outcomes of restorations supported by root-analogue implants (RAIs) or roots of severely damaged teeth after forced orthodontic extrusion (FOE). MATERIALS AND METHODS Clinical data regarding milled one-piece (titanium/zirconia roots and zirconia abutments) RAIs (REPLICATE™ System) and FOE were recorded and retrospectively evaluated for 40 patients by two investigators. Strict inclusion and exclusion criteria were applied. Functional and esthetic outcomes were assessed for n = 20 pre-molars and n = 20 anterior teeth via comparison of radiographic and digital images applying the novel Functional Implant Prosthodontic Score (FIPS). Krippendorff's alpha coefficient was calculated to assess inter-rater reliability. Mann-Whitney-U-Test was used to compare the assessed parameters. Level of significance was set to p < 0.05. RESULTS After a mean observation period of 18.4 ± 5.7 months for restorations supported by RAIs and 43.9 ± 16.4 months for restorations after FOE, mean FIPS scores were 9.2/8.8 ± 1.1/1.2 (RAIs) and 7.4/7.7 ± 1.3/1.5 (FOE), respectively. Krippendorff's alpha coefficients did not reveal unacceptable inter-rater reliabilities regarding the investigators and applicability of FIPS. Significant differences were documented when comparing restorations after FOE or supported by RAIs regarding bone loss (p < 0.01), presence of papillae (p < 0.05) and quality and quantity of mucosa (p < 0.02) in favor of FOE. CONCLUSIONS Within the main limitations of sample size and the retrospective study design, both concepts seem to provide clinically acceptable results. CLINICAL RELEVANCE Bone- and tissue-preserving characteristics regarding the concept of FOE are promising. It could be applicable for socket preservation and subsequent conventional implant placements in an adapted workflow.
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Affiliation(s)
- Mats Wernfried Heinrich Böse
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Stefan Neumeyer
- Private Dental Practice, Gemeinschaftspraxis Dr. Stefan Neumeyer & Partner, Leminger Str. 10, 93458, Eschlkam, Germany
| | - Detlef Hildebrand
- Private Dental Practice, Dr. Detlef Hildebrand, Westhafenstraße 1, 13353, Berlin, Germany
| | - Maria Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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Dantas TA, Carneiro Neto JP, Alves JL, Vaz PCS, Silva FS. In silico evaluation of the stress fields on the cortical bone surrounding dental implants: Comparing root-analogue and screwed implants. J Mech Behav Biomed Mater 2020; 104:103667. [PMID: 32174425 DOI: 10.1016/j.jmbbm.2020.103667] [Citation(s) in RCA: 8] [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] [Received: 11/13/2019] [Revised: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 02/06/2023]
Abstract
Tooth loss is a problem that affects both old and young people. It may be caused by several conditions, such as poor oral hygiene, lifestyle choices or even diseases like periodontal disease, tooth grinding or diabetes. Nowadays, replacing a missing tooth by an implant is a very common process. However, many limitations regarding the actual strategies can be enumerated. Conventional screwed implants tend to induce high levels of stress in the peri-implant bone area, leading to bone loss, bacterial bio-film formation, and subsequent implant failure. In this sense, root-analogue dental implants are becoming promising solutions for immediate implantation due to their minimally invasive nature, improved bone stress distribution and because they do not require bone drilling, sinus lift, bone augmentation nor other traumatic procedures. The aim of this study was to analyse and compare, by means of FEA, the stress fields of peri-implant bone around root-analogue and screwed conventional zirconia implants. For that purpose, one root-analogue implant, one root-analogue implant with flaps, two conventional implants (with different threads) and a replica of a natural tooth were modelled. COMSOL was used to perform the analysis and implants were subjected to two simultaneous loads: 100 N axially and 100 N oblique (45°). RESULTS: revealed that root-analogue implants, namely with flaps, should be considered as promising alternatives for dental implant solutions since they promote a better stress distribution in the cortical bone when compared with conventional implants.
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Affiliation(s)
- T A Dantas
- CMEMS - Center for MicroElectroMechanical Systems, University of Minho, Portugal; MIT Portugal Program - School of Engineering, University of Minho, Portugal.
| | - J P Carneiro Neto
- CMEMS - Center for MicroElectroMechanical Systems, University of Minho, Portugal
| | - J L Alves
- CMEMS - Center for MicroElectroMechanical Systems, University of Minho, Portugal
| | - Paula C S Vaz
- Fixed Prosthodontics, Genetics- Faculty of Dental Medicine, University of Porto, Portugal
| | - F S Silva
- CMEMS - Center for MicroElectroMechanical Systems, University of Minho, Portugal
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