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Maarse F, Fennis WMM, Twisk JWR, Korfage A, Santing H, den Hartog L, Muradin MSM, Maningky M, Raghoebar GM, Vissink A, Brand HS, Jager DHJ. Dental implants in dentate primary and secondary Sjögren's syndrome patients: A multicenter prospective cohort study. Clin Oral Implants Res 2022; 33:1157-1170. [PMID: 36136091 PMCID: PMC9827828 DOI: 10.1111/clr.13998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/12/2022] [Accepted: 08/18/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To prospectively assess the clinical performance and patient-reported outcomes of dental implants in dentate patients with primary and secondary Sjögren's syndrome (pSS and sSS, respectively) compared to patients without SS. MATERIALS AND METHODS Thirty-seven implants were placed in 17 patients with pSS/sSS and 26 implants in 17 non-SS patients to replace missing (pre)molars. Clinical performance, marginal bone-level changes, patient satisfaction, and oral health-related quality of life (OHRQoL) were assessed at 1 (T1), 6 (T6), 12 (T12), and 18 (T18) months after placement of the superstructure. Marginal bone-level changes were measured on standardized dental radiographs. Clinical parameters included implant and crown survival, plaque, bleeding and gingival indices, and probing depth. Patient satisfaction and OHRQoL were assessed with validated questionnaires. RESULTS Implant survival at T18 was 100% in the patients with pSS/sSS and 96.2% in the non-SS group. Mean marginal bone loss at T18 did not differ between patients with pSS/sSS and non-SS patients, 1.10 ± 1.04 and 1.04 ± 0.75 mm, respectively (p = .87). Clinical performance was good with no differences between the groups for all outcome measures (p > .05). OHRQoL in patients with pSS/sSS had improved significantly after placement of implant supported crowns at all measuring moments compared to baseline (p < .05). Nevertheless, patient satisfaction and OHRQoL remained significantly higher for patients without SS at all measuring moments (p < .05). CONCLUSION Dental implants can be successfully applied in dentate patients with pSS/sSS and have a positive effect on OHRQoL.
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Tilkema MT, Raghoebar GM, Doff JJ, Vissink A. [A large maxillary fibroepithelial polyp: a lump in the throat]. Ned Tijdschr Tandheelkd 2022; 129:289-292. [PMID: 35670462 DOI: 10.5177/ntvt.2022.06.21117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 55-year-old woman was seen at an oral and maxillofacial surgery department because of a large oral swelling and complaints about difficulty eating, nasal speech and fatigue. She had full dentures in her upper jaw. Intraorally, a pain-free, pedunculated, combined solid-elastic and bone-hard tumour was found in the left maxillary tubercle region. A large, fibroepithelial polyp was diagnosed based on clinical and histopathological findings. Six weeks post-operatively, the complaints had disappeared. Chronic irritation of the oral mucosa can result in an oral fibroepithelial polyp that can be distinguished from peripheral ossifying fibroma or giant cell fibroma after histopathological examination. Such a polyp can grow to a large size if the source of irritation is not removed.
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Vosselman N, Glas HH, Merema BJ, Kraeima J, Reintsema H, Raghoebar GM, Witjes MJH, de Visscher SAHJ. Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy. J Pers Med 2022; 12:jpm12040588. [PMID: 35455704 PMCID: PMC9027393 DOI: 10.3390/jpm12040588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 12/27/2022] Open
Abstract
Zygomatic implants are used in patients with maxillary defects to improve the retention and stability of obturator prostheses, thereby securing good oral function. Prosthetic-driven placement of zygomatic implants is even difficult for experienced surgeons, and with a free-hand approach, deviation from the preplanned implant positions is inevitable, thereby impeding immediate implant-retained obturation. A novel, digitalized workflow of surgical planning was used in 10 patients. Maxillectomy was performed with 3D-printed cutting, and drill guides were used for subsequent placement of zygomatic implants with immediate placement of implant-retained obturator prosthesis. The outcome parameters were the accuracy of implant positioning and the prosthetic fit of the obturator prosthesis in this one-stage procedure. Zygomatic implants (n = 28) were placed with good accuracy (mean deviation 1.73 ± 0.57 mm and 2.97 ± 1.38° 3D angle deviation), and in all cases, the obturator prosthesis fitted as pre-operatively planned. The 3D accuracy of the abutment positions was 1.58 ± 1.66 mm. The accuracy of the abutment position in the occlusal plane was 2.21 ± 1.33 mm, with a height accuracy of 1.32 ± 1.57 mm. This feasibility study shows that the application of these novel designed 3D-printed surgical guides results in predictable zygomatic implant placement and provides the possibility of immediate prosthetic rehabilitation in head and neck oncology patients after maxillectomy.
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Pol CWP, Raghoebar GM, Cune MS, Meijer HJA. Three-unit fixed dental prostheses supported by either two abutment implants or two abutment teeth: A comparative retrospective cohort study. Clin Exp Dent Res 2022; 8:497-505. [PMID: 35384361 PMCID: PMC9033541 DOI: 10.1002/cre2.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES In general, similar restorative constructions are made on natural teeth and on dental implants. The assumption is made that implants and their restoration perform the same as natural roots and their prosthetic restoration. Evaluating cohorts of three-unit bridges on teeth and on implants, this retrospective clinical study aimed to compare implants and teeth as supporting units, including the reconstructions, in terms of survival, success, clinical, radiographic, and patient-reported outcomes. MATERIAL AND METHODS From an 8-year period, all patients treated with a posterior three-unit fixed reconstruction on either implants or teeth, with a follow-up of at least 2 years, were identified. For each implant-supported reconstruction, a comparable tooth-supported reconstruction was selected, based on the length of follow-up, the material of the reconstruction, and the location in either the maxilla or mandible. RESULTS For the Implant-group, 24 patients could be matched with 24 best matching patients with tooth-supported fixed dental prostheses (FPDs). Supporting implants and implant-supported reconstructions were all in function with a mean follow-up of 52 ± 23 months. Two tooth-supported reconstructions had been replaced (91.7% survival) (mean follow-up: 52 ± 19 months). Radiographic bone levels and soft tissue conditions were favorable in both groups with minor differences. There was no significant difference in overall patient satisfaction. The modified USPHS-score revealed an 87.5% overall success in the Implant-group and 91.7% in the Tooth-group. CONCLUSIONS Implant-supported three-unit FDPs are a reliable treatment option with survival and success rates not significantly different from the results of tooth-supported three-unit FDPs.
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Onclin P, Slot W, Vissink A, Raghoebar GM, Meijer HJA. Incidence of peri-implant mucositis and peri-implantitis in patients with a maxillary overdenture: A sub-analysis of two prospective studies with a 10-year follow-up period. Clin Implant Dent Relat Res 2022; 24:188-195. [PMID: 35137509 PMCID: PMC9304206 DOI: 10.1111/cid.13071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/07/2021] [Accepted: 01/23/2022] [Indexed: 02/05/2023]
Abstract
Background Though studies on maxillary overdentures show satisfying results on implant survival, patient‐related outcomes and prosthetic complications, the epidemiology of peri‐implant diseases in this specific group of patients has hardly been reported. While the general patient‐level prevalence of peri‐implant mucositis and peri‐implantitis are estimated at ~45% and ~20%, respectively, the risk of developing these diseases within a specific period is less clear. To fully appreciate the epidemiology of peri‐implant diseases, more long‐term data on incidence of peri‐implant diseases are needed. Purpose The purpose of this sub‐analysis of two prospective studies was to assess the incidence of peri‐implant mucositis and peri‐implantitis in fully edentulous patients with implant‐retained maxillary overdentures during a 10‐year follow‐up period. Materials and Methods One hundred and sixteen patients treated with implant‐supported maxillary overdentures were available from two clinical trials. Data on biological complications, clinical and radiographical parameters were collected for 106 patients at 5‐year, for 82 patients at 10‐year follow‐up. The incidence was calculated following the consensus of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Extent and severity then were calculated to enable an appropriate epidemiological description of peri‐implantitis. Results The patient‐level incidence of peri‐implant mucositis was 37.7% after 5 years and 64.6% after 10 years whereas the patient‐level incidence of peri‐implantitis was 10.4% after 5 years and 19.5% after 10 years. After 10 years, the extent of peri‐implant mucositis and peri‐implantitis is 52.8% and 43.8%, respectively. In terms of severity, 26.5% of all affected implants suffered from >3 mm bone loss and 17.6% of all affected implants was lost. Conclusion Three of five fully edentulous patients with implant‐supported maxillary overdentures experience peri‐implant mucositis after 10 years. Peri‐implantitis occurs in one of five patients after 10 years. In spite of these incidence rates, implant survival remains high.
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Bakker MH, Vissink A, Raghoebar GM, Peters LL, Visser A. [General health, healthcare costs and dental care use of elderly with differing oral status]. Ned Tijdschr Tandheelkd 2022; 129:87-93. [PMID: 35133739 DOI: 10.5177/ntvt.2022.02.21115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cross-sectional studies have shown that elderly with a natural dentition or implant-retained overdenture have better general health outcomes than elderly with conventional dentures. It is not known whether these findings would be confirmed in longitudinal studies of such groups of elderly. Therefore, in this study a large group of elderly (aged 75 and over) with a natural dentition (n = 143,199), an implant-retained overdenture (n = 6,503) or conventional denture (n=18,420) were followed over a period of 8 years. Elderly with conventional dentures had chronic conditions more often, used more medication and had higher healthcare costs. Remarkably, the general health outcomes of elderly with an implant-retained overdenture declined over the period of 8 years. At the time the implant-retained overdenture was placed, their general health profile seemed comparable to that of elderly with a natural dentition, but as time progressed it declined to the level of elderly with conventional dentures.
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Donker VJJ, Raghoebar GM, Jensen‐Louwerse C, Vissink A, Meijer HJA. Monolithic zirconia single tooth implant‐supported restorations with
CAD
/
CAM
titanium abutments in the posterior region: A 1‐year prospective case series study. Clin Implant Dent Relat Res 2022; 24:125-132. [PMID: 35075756 PMCID: PMC9303442 DOI: 10.1111/cid.13069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Purpose To assess the clinical, radiographic, and patient‐reported outcome measures, including the success of screw‐retained monolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments in the posterior region during a 1‐year follow‐up. Methods In a prospective case series, 50 molar sites in the posterior region of 46 patients with a minimum age of 18 years and sufficient bone volume and anatomical conditions for placing an implant (≥8 mm) and an anatomical restoration were included. Parallel‐walled implants with a conical connection were inserted in a two‐stage surgical procedure. Implant uncovering and healing abutment placement occurred 12 weeks after insertion. Two weeks after mucosa healing, a screw‐retained monolithic zirconia restoration with a CAD/CAM titanium abutment was placed. Clinical, radiographic, and patient‐reported outcome measures were collected at baseline before implant placement and then during the 1 month and 1 year follow‐ups. Results At the 1 year follow‐up, 49 restorations could be evaluated. The plaque accumulation, presence of calculus, bleeding tendency and peri‐implant inflammation indices were low, representing healthy peri‐implant conditions. The mean marginal bone level change between the 1 month and the 1 year follow‐up was −0.17 ± 0.46 mm. The mean patient satisfaction was high. The restoration success was, according to the modified USPHS criteria, 95.9%. Conclusion Monolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments have very good clinical, radiographic and patient‐reported outcomes after 1 year in function.
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Meijndert CM, Raghoebar GM, Vissink A, Meijer HJ. Bone Level Tapered Implants in the Maxillary Esthetic Zone: A 1-Year Prospective Case Series in Healed Sites. Int J Oral Maxillofac Implants 2022; 37:120-127. [PMID: 35235630 DOI: 10.11607/jomi.9163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Bone level tapered implants have an advantage in terms of stability and less need for additional bone augmentation procedures in healed sites, which might be advantageous for the esthetic zone. The aim of this study was to assess the clinical, radiographic, and esthetic performance of bone level tapered implants placed in healed sites in the maxillary esthetic region during a 1-year evaluation period. MATERIALS AND METHODS Thirty participants (15 male, 15 female) with a single-tooth diastema that had healed without an alveolar ridge preservation procedure received a bone level tapered implant. Buccal bone augmentation procedures were performed at implant placement if the labial bone wall thickness was < 2 mm. A provisional crown was connected after a healing phase of 3 months. A definitive crown was placed 3 months after the provisional restoration. Implant stability, peri-implant soft and hard tissue health, esthetics, and patient-reported outcomes were recorded. RESULTS All the placed implants demonstrated good stability. A labial bone augmentation technique was needed in 23 of the 30 cases. The median implant stability quotient value was 73 (68;76) at implant placement and had increased to 79 (76;81) when the definitive restoration was inserted (P < .005). All patients were present at the 1-year evaluation, and none had lost an implant. The mean loss of marginal bone was 0.07 ± 0.10 mm. The midbuccal mucosa-level recession was 0.14 ± 0.40 mm. There was an overall gain in papilla height: +0.05 ± 0.60 mm mesially and +0.06 ± 0.53 mm distally. Median values of the pink esthetic score and white esthetic score were 6 (4;7 interquartile range) and 8 (7;8.3 interquartile range), respectively. The participants' mean overall satisfaction was 90.1 ± 6.5 on a visual analog scale. No complications occurred. CONCLUSION It can be concluded from a 1-year followup that treatment with the bone level tapered implant system resulted in good implant stability, healthy peri-implant soft and hard tissues, satisfying esthetics, and good patient-reported outcomes.
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol air polishing in the surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 33:184-196. [PMID: 34808006 PMCID: PMC9299917 DOI: 10.1111/clr.13881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 01/14/2023]
Abstract
Objectives To compare erythritol air polishing with implant surface cleansing using saline during the surgical treatment of peri‐implantitis. Material and Methods During a resective surgical intervention, implant surfaces were randomly treated with either air polishing (test group n = 26 patients/53 implants) or saline‐soaked cotton gauzes (control group n = 31 patients/ 40 implants). Primary outcome was change in mean bleeding on probing (BoP) from baseline to 12 months follow‐up. Secondary outcomes were changes in mean suppuration on probing (SoP), plaque score (Plq), probing pocket depth (PPD), marginal bone loss (MBL), periodontal full‐mouth scores (PFMS), and levels of 8 classical periodontal pathogens. Clinical and radiographical parameters were analyzed using multilevel regression analyses. Microbiological outcomes were analyzed using the Mann–Whitney U test. Results No differences between the test and control group were found for BoP over 12 months of follow‐up, nor for the secondary parameters Plq, PPD, and MBL. Between both groups, a significant difference was found for the levels of SoP (p = 0.035). No significant effect on microbiological levels was found. A total number of 6 implants were lost in the test group and 10 in the control group. At 1‐year follow‐up, a successful treatment outcome (PPD<5 mm, max 1 out of 6 sites BoP, no suppuration and no progressive bone loss >0.5 mm) was achieved for a total of 18 implants (19.2%). Conclusions Erythritol air polishing as implant surface cleansing method was not more effective than saline during resective surgical treatment of peri‐implantitis in terms of clinical, radiographical, and microbiological parameters. Both therapies resulted in low treatment success. Trial registry: https://www.trialregister.nl/ Identifier: NL8621.
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Raghoebar GM, Korfage A, Meijer HJA, Gareb B, Vissink A, Delli K. Linear and profilometric changes of the mucosa following soft tissue augmentation in the zone of aesthetic priority: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32 Suppl 21:138-156. [PMID: 34642988 DOI: 10.1111/clr.13759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/02/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the outcomes of soft tissue augmentation, in terms of change in level and thickness of mid-buccal mucosa, at implants sites in the zone of the aesthetic priority. MATERIAL AND METHODS MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases were searched (last search on 1 June 2020). Inclusion criteria were studies reporting outcomes of different materials and timing of grafting in patients undergoing soft tissue augmentation at implant sites in the aesthetic zone with a follow-up of ≥1 year after implant placement. Outcome measures assessed included changes in level and thickness of mid-buccal mucosa, implant survival, peri-implant health and patients' satisfaction. RESULTS Eighteen out of 2,185 articles fulfilled the inclusion criteria. Meta-analysis revealed a significant difference in vertical mid-buccal soft tissue change (0.34 mm, 95% CI: 0.13-0.56, p = .002) and mid-buccal mucosa thickness (0.66 mm, 95% CI: 0.35-0.97, p < .001) following immediate implant placement in favour of the use of a graft versus no graft. Mean difference in mid-buccal mucosa level following delayed implant placement (0.17 mm, 95% CI: 0.01-0.34, p = .042) was also in favour of the use of a graft versus no graft. With regard to mucosa thickness, the use of a graft was not in favour compared with no graft following delayed implant placement (0.22 mm, 95% CI: -0.04-0.47, p = .095). Observed changes remained stable in the medium term. CONCLUSION Soft tissue augmentation in the zone of the aesthetic priority results in less recession and a thicker mid-buccal mucosa following immediate implant placement and less recession in mid-buccal mucosa following delayed implant placement compared with no graft.
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Bakker MH, Vissink A, Raghoebar GM, Peters LL, Visser A. General health, healthcare costs and dental care use of elderly with a natural dentition, implant-retained overdenture or conventional denture: an 8-year cohort of Dutch elderly (aged 75 and over). BMC Geriatr 2021; 21:477. [PMID: 34481474 PMCID: PMC8418734 DOI: 10.1186/s12877-021-02427-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/22/2021] [Indexed: 11/16/2022] Open
Abstract
Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02427-z.
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Meijndert CM, Raghoebar GM, Vissink A, Delli K, Meijer HJA. The effect of implant-abutment connections on peri-implant bone levels around single implants in the aesthetic zone: A systematic review and a meta-analysis. Clin Exp Dent Res 2021; 7:1025-1036. [PMID: 34418324 PMCID: PMC8638280 DOI: 10.1002/cre2.471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/04/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To systematically review literature about the effect of different implant‐abutment interface designs on peri‐implant bone level changes, implant loss and mid‐buccal mucosa changes around single implants in the anterior maxilla. Reviewing three connection configurations: Platform switched conical (PS‐conical); Platform switched parallel (PS‐parallel); Platform matched parallel (PM‐parallel). Methods A detailed search was carried out in Pubmed, EMBASE, Cochrane, Scopus, Open Gray and African journals Online (until December 1, 2020) and was restricted to clinical prospective studies of at least 1 year and with at least 10 human participants. A meta regression analysis was carried out primarily on the pooled peri‐implant bone level changes followed by implant loss and mid‐buccal mucosa level change. Risk of bias was assessed with RoB 2.0 and ROBINS‐I. The manuscript complied with the PRISMA guidelines and was registered in the PROSPERO database (ID: 225092). Results A total of 5513 hits gave 44 eligible articles for the analyses. Bone level change did not differ significantly between the two platform switched connections; their bone loss scores were significantly lower than PM‐connection. The PS‐conical connections have significantly lower implant losses than the PM connection. Mid‐buccal mucosa level change was comparable between the three connection configurations. Moderate to high risk of bias was detected in the included studies. Conclusions The performance of PS‐conical and PS‐parallel connection configurations both favored bone loss scores compared to the PM‐parallel connection configuration. All three demonstrated mid‐buccal mucosa changes that were small and did not differ significantly amongst the groups.
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Abdoel SF, Haagedoorn SS, Raghoebar GM, Meijer HJA. Implant-supported mandibular overdentures: a retrospective case series study in a daily dental practice. Int J Implant Dent 2021; 7:64. [PMID: 34235585 PMCID: PMC8263826 DOI: 10.1186/s40729-021-00345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background Evaluation of dental implant treatment is mostly based on studies with well-controlled study groups treated within a university-based setting. There are no long-term observational practice-based studies known on implant-supported overdentures. The present retrospective study deals with implant survival, peri-implant hard and soft tissue health, surgical and prosthetic aftercare, and satisfaction of patients treated with an implant-supported mandibular overdenture in a daily dental practice. Materials and methods Within the years 2006 till 2015, 295 patients were treated with two, three, or four implants for mandibular overdenture treatment in a daily dental practice in Zaandam, The Netherlands. Outcome parameters were scored at a routine yearly inspection including implant loss, plaque index, gingival index, bleeding index, presence of calculus, probing depth, and satisfaction with implant-supported overdenture. Radiographic analysis was performed to assess peri-implant bone changes. Surgical and prosthetic aftercare was obtained from the medical record. Results A total of 133 patients were seen for an evaluation visit (mean follow-up 51.2 months). Cumulative implant survival rate in the 2-implant group, 3-implant group, and 4-implant group was 100%, 99.1%, and 97.8% respectively, with a mean peri-implant bone loss of 0.53 mm, 0.61 mm, and 0.40 mm. Patients’ satisfaction was high in all groups. Conclusion It was demonstrated, within the limitations of this study, that patients, who were treated with an implant-supported mandibular overdenture in a daily dental practice, experienced a high cumulative implant survival rate and a good peri-implant health, and were very satisfied. Trial registration Netherlands Trial Register, NL8867. Registered 15 September 2020—retrospectively registered.
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Thoma DS, Cosyn J, Fickl S, Jensen SS, Jung RE, Raghoebar GM, Rocchietta I, Roccuzzo M, Sanz M, Sanz-Sánchez I, Scarlat P, Schou S, Stefanini M, Strasding M, Bertl K. WITHDRAWN: Consensus Report of Working Group 2: Soft Tissue Management. Clin Oral Implants Res 2021; 32 Suppl 21:174-180. [PMID: 34145925 PMCID: PMC8596754 DOI: 10.1111/clr.13798] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
Objectives The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient‐reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment. Materials and methods Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions. Results The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs.
Conclusions Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited.
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Vosselman N, Glas HH, de Visscher SAHJ, Kraeima J, Merema BJ, Reintsema H, Raghoebar GM, Witjes MJH. Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study. Int J Implant Dent 2021; 7:54. [PMID: 34121148 PMCID: PMC8200332 DOI: 10.1186/s40729-021-00335-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/30/2021] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this study was to introduce a complete 3D workflow for immediate implant retained prosthetic rehabilitation following maxillectomy in cancer surgery. The workflow consists of a 3D virtual surgical planning for tumor resection, zygomatic implant placement, and for an implant-retained prosthetic-obturator to fit the planned outcome situation for immediate loading. Materials and methods In this study, 3D virtual surgical planning and resection of the maxilla, followed by guided placement of 10 zygomatic implants, using custom cutting and drill/placement-guides, was performed on 5 fresh frozen human cadavers. A preoperatively digitally designed and printed obturator prosthesis was placed and connected to the zygomatic implants. The accuracy of the implant positioning was obtained using 3D deviation analysis by merging the pre- and post-operative CT scan datasets. Results The preoperatively designed and manufactured obturator prostheses matched accurately the per-operative implant positions. All five obturators could be placed and fixated for immediate loading. The mean prosthetic point deviation on the cadavers was 1.03 ± 0.85 mm; the mean entry point deviation was 1.20 ± 0.62 mm; and the 3D angle deviation was 2.97 ± 1.44°. Conclusions It is possible to 3D plan and accurately execute the ablative surgery, placement of zygomatic implants, and immediate placement of an implant-retained obturator prosthesis with 3D virtual surgical planning.The next step is to apply the workflow in the operating room in patients planned for maxillectomy.
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Wortmann DE, Klein-Nulend J, van Ruijven LJ, Schortinghuis J, Vissink A, Raghoebar GM. Incorporation of anterior iliac crest or calvarial bone grafts in reconstructed atrophied maxillae: A randomized clinical trial with histomorphometric and micro-CT analyses. Clin Implant Dent Relat Res 2021; 23:492-502. [PMID: 34056848 PMCID: PMC8362136 DOI: 10.1111/cid.13012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/15/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
Background Autologous bone grafts have been applied successfully to severely atrophied maxilla via a preimplant procedure. Differences in graft incorporation at the microscopic level can be the decisive factor in the choice between anterior iliac crest and calvarial bone. Purpose To compare conversion of anterior iliac crest bone and calvarial bone 4 months after grafting of the edentulous maxilla. Materials and methods Twenty consecutive patients were randomly assigned to either anterior iliac crest (n = 10) or calvarial (n = 10) bone harvesting to reconstruct their atrophied maxillae. Biopsies were taken from both fresh bone grafts and reconstructed maxillae after 4 months healing, at time of implant placement. Micro‐CT, histomorphometric and histological analyses were performed. Results Micro‐CT analysis revealed that both the anterior iliac crest and calvarial bone grafts retained their volume and bone mass after being incorporated in the maxilla, but with a favor for calvarial bone grafts: calvarial bone grafts had a higher mineral density before and after incorporation. Both bone grafts types were well incorporated after 4 months of healing with preservation of bone volume and mineral density. Although the fresh bone biopsies were similar histomorphometrically, after 4 months of graft incorporation, the osteoid percentage and osteocyte count remained higher in the anterior iliac crest bone whereas the percentage of bone was higher in the calvarial bone grafts compared to the anterior iliac crest bone grafts. Conclusions Both donor sites, that is, anterior iliac crest and calvarial bone, are well suited to provide a reliable and stable basis for implant placement 4 months after grafting with mineral density, porosity, and resorption rate in favor of calvarial bone grafts.
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Slagter KW, Raghoebar GM, Hamming I, Meijer J, Vissink A. Reply to the editor concerning: Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study. Clin Oral Investig 2021; 25:5115-5116. [PMID: 33988762 DOI: 10.1007/s00784-021-03974-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
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Hentenaar DFM, De Waal YCM, Stewart RE, Van Winkelhoff AJ, Meijer HJA, Raghoebar GM. Erythritol airpolishing in the non-surgical treatment of peri-implantitis: A randomized controlled trial. Clin Oral Implants Res 2021; 32:840-852. [PMID: 33844373 PMCID: PMC8360148 DOI: 10.1111/clr.13757] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/13/2021] [Accepted: 03/31/2021] [Indexed: 12/14/2022]
Abstract
Objectives To compare erythritol air polishing with piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis. Material and methods Eighty patients (n = 139 implants) with peri‐implantitis (probing pocket depth (PPD) ≥5 mm, marginal bone loss (MBL) ≥2 mm as compared to bone level at implant placement, bleeding, and/or suppuration on probing (BoP/SoP)) were randomly allocated to air polishing or ultrasonic treatment. The primary outcome was mean BoP (%) at 3 months after therapy (T3). Secondary outcomes were mean SoP (%), plaque score (Plq) (%), PPD (mm), MBL (mm), full mouth periodontal scores (FMPS) (%), levels of 8 classical periodontal pathogens, and treatment pain/discomfort (Visual Analog Scale, VAS). Patients who were considered successful at T3 were additionally assessed at 6, 9, and 12 months. Differences between both groups were analyzed using multilevel statistics. Results Three months after therapy, no significant difference in mean BoP (%) between the air polishing and ultrasonic therapy was found (crude analysis β (95% CI) −0.037 (−0.147; 0.073), p = .380). Neither secondary outcomes SoP (%), Plq (%), PPD (mm), MBL (mm), FMPS (%), and periodontal pathogens showed significant differences. Treatment pain/discomfort was low in both groups (VAS score airpolishing group 2.1 (±1.9), ultrasonic 2.6 (±1.9); p = .222). All successfully treated patients at T3 (18.4%) were still considered successful at 12‐month follow‐up. Conclusions Erythritol air polishing seems as effective as piezoelectric ultrasonic scaling in the non‐surgical treatment of peri‐implantitis, in terms of clinical, radiographical, and microbiological parameters. However, neither of the proposed therapies effectively resolved peri‐implantitis. Hence, the majority of patients required further surgical treatment.
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Slagter KW, Meijer HJA, Hentenaar DFM, Vissink A, Raghoebar GM. Immediate single-tooth implant placement with simultaneous bone augmentation versus delayed implant placement after alveolar ridge preservation in bony defect sites in the esthetic region: A 5-year randomized controlled trial. J Periodontol 2021; 92:1738-1748. [PMID: 33724473 DOI: 10.1002/jper.20-0845] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND It is unclear if an intact buccal bony plate is a prerequisite for immediate implant placement in post-extraction sockets. The aim of this 5-year randomized controlled trial was therefore comparison of peri-implant soft and hard tissue parameters, esthetic ratings, and patient-reported satisfaction of immediate implant placement in post-extraction sockets with buccal bony defects of ≥ 5 mm in the esthetic zone, with delayed implant placement after ridge preservation. METHODS Patients presenting a failing tooth in the esthetic region and a buccal bony defect of ≥ 5 mm after extraction were randomly assigned to immediate (Immediate group, n = 20) or delayed (Delayed group, n = 20) implant placement. Second-stage surgery and placement of a provisional restoration occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. The follow-up was 5 years. Marginal bone level (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. RESULTS Mean marginal bone level change was -0.71 ± 0.35 mm and -0.54 ± 0.41 mm in respectively the Immediate group and the Delayed group after 5 years (P = 0.202). This difference, and in other variables, was not significant. CONCLUSIONS Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in post-extraction sockets with buccal bony defects of ≥ 5 mm, were comparable to those following delayed implant placement after ridge preservation in the esthetic zone.
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Meijndert CM, Raghoebar GM, Vissink A, Meijer HJA. Alveolar ridge preservation in defect sockets in the maxillary aesthetic zone followed by single-tooth bone level tapered implants with immediate provisionalization: a 1-year prospective case series. Int J Implant Dent 2021; 7:18. [PMID: 33604747 PMCID: PMC7892651 DOI: 10.1186/s40729-021-00292-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 11/15/2022] Open
Abstract
Background Clinical studies of single-tooth replacement in compromised bone using bone level tapered implants in the aesthetic zone are scarce. Aim To assess clinically, radiographically and aesthetically over 1 year the performance of a bone level tapered implant in the maxillary aesthetic zone in sites after alveolar ridge preservation. Material and methods Thirty patients (16 male, 14 female) with a failing tooth and large bone defect after removal received alveolar ridge preservation. After 3 months, implants were placed with immediate provisionalization. Definitive restorations were placed after 3 months. The treatment was evaluated 1 year following the definitive restoration. Results All the patients attended the 1-year follow-up. One implant was lost (96.7% implant survival rate). The mean implant stability quotient value was 68.9 ± 8.74 at implant placement. The mean marginal bone level change was minor (− 0.07 ± 0.12 mm). The mean mid-buccal mucosa changed with + 0.01 ± 0.45 mm. The median Pink Esthetic Score and White Esthetic Score after 1 year were 6 [4; 7] and 8 [7; 9], respectively. The patients’ mean overall satisfaction (0–100 VAS scale) was 86.6 ± 10.3. Conclusion Bone level tapered implants with immediate provisionalization perform well after alveolar ridge preservation in the maxillary aesthetic zone, according to implant stability, clinical, radiographic, aesthetic and patient-centred outcomes. Trial registration NTR, NL8755. Registered on 1 January 2016
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Hentenaar DFM, De Waal YCM, Vissink A, Van Winkelhoff AJ, Meijer HJA, Liefers SC, Kroese FGM, Raghoebar GM. Biomarker levels in peri-implant crevicular fluid of healthy implants, untreated and non-surgically treated implants with peri-implantitis. J Clin Periodontol 2021; 48:590-601. [PMID: 33454996 DOI: 10.1111/jcpe.13423] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 12/26/2020] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
AIM To compare biomarker levels in peri-implant crevicular fluid (PICF) of healthy implants with levels in PICF of implants with peri-implantitis (before and after non-surgical treatment). MATERIALS AND METHODS Samples were taken from 20 healthy implants (n = 17 patients) and from 20 implants with peri-implantitis (n = 19 patients) before and 3 months after non-surgical treatment using the Airflow Master Piezon® (EMS). A Luminex™ assay was used to evaluate pro-inflammatory and anti-inflammatory cytokines IL-1β, TNF-α, IL-6 and G-CSF, collagen degradation enzyme MMP-8, chemokines MCP-1 & MIP-1α/CCL3, bone markers OPG and sRANKL and interferon-γ. Clinical and radiographical characteristics were assessed. A Mann-Whitney U and Wilcoxon signed-rank test analysed between- and within-group differences. RESULTS IL-1β and MMP-8 levels were found significantly elevated in implants with peri-implantitis (p = .007; p = <.001, respectively). No difference in levels of TNF-α, IL-6, MCP-1 and MIP-1α/CCL3, OPG and G-CSF between healthy and diseased implants was found. Levels of sRANKL and INF-γ were under the level of detection. None of the biomarker levels improved after non-surgical therapy, and levels of IL-1β and MMP-8 remained high. CONCLUSION Implants diagnosed with peri-implantitis have higher levels of IL-1β and MMP-8 in PICF compared to healthy implants. Non-surgical therapy did not influence the inflammatory immune response.
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Terheyden H, Meijer GJ, Raghoebar GM. Vertical bone augmentation and regular implants versus short implants in the vertically deficient posterior mandible: a systematic review and meta-analysis of randomized studies. Int J Oral Maxillofac Surg 2021; 50:1249-1258. [PMID: 33589294 DOI: 10.1016/j.ijom.2021.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/29/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the outcomes of short dental implants (≤7mm) versus vertical bone augmentation followed by regular dental implants (>7mm) in the deficient posterior mandible. In total, eight RCTs (six using interpositional sandwich grafting and two using a guided bone regeneration technique) were reported in 17 articles at different time points. In the meta-analysis of the sandwich group, the relative risk (RR) for implant loss at 1year was in favour of short implants (RR 0.41, P=0.02), while no significant difference was found at 3 years (RR 0.65, P=0.43), 5 years (RR 1.08, P=0.86), or 8 years (RR 1.53, P=0.52). The risk of complications was in favour of short implants (RR 0.34, P=0.0002), as was the mean difference in marginal bone resorption after 1 year (-0.09mm, P=0.17), 3 years (-0.32mm, P<0.00001), 5 years (-0.65mm, P<0.00001), and 8 years (-0.88, P<0.00001). The mean residual osseointegration length of the implants was between 2.94mm and 4.44mm in the short implants group and between 7.97mm and 8.62mm in the regular implants group after 5 years. In conclusion, in the deficient atrophic posterior mandible, short implants and regular implants demonstrate comparable outcomes within the first 5 years. Patients who are fit for surgery should be informed about the risks and benefits of both options.
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Bakker MH, Vissink A, Raghoebar GM, Visser A. General health status of Dutch elderly receiving implant-retained overdentures: A 9-year big data cross-sectional study. Clin Implant Dent Relat Res 2021; 23:228-235. [PMID: 33554462 PMCID: PMC8248181 DOI: 10.1111/cid.12984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/18/2020] [Accepted: 01/11/2021] [Indexed: 12/28/2022]
Abstract
Background Very little information is available on the general health of elderly who are provided with an implant‐retained overdenture (IOD). Purpose The general health status of three groups of elderly (≥75 years) were compared: those with a natural dentition (ND), those treated with an implant‐retained overdenture (IOD), and those wearing a conventional denture (CD). Materials and methods Data on healthcare costs were obtained from records of Dutch health insurers that are collected by Vektis. Data on general health (chronic diseases, medication use, and polypharmacy) were acquired for elderly patients with a ND, an IOD, and a CD in 2009 and 2017. Data on the general health of elderly who received an IOD were also acquired from 2010 through 2016. Results On average, the general health of elderly who received an IOD was comparable to general health of elderly with a ND and was better than the general health of elderly with a CD (lower prevalence of diabetes, cardiac disease, and hypertension). The general health profile of elderly receiving an IOD was consistent during all years. Conclusions The general health of elderly with a ND or IODs is better than those with CDs.
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Slagter KW, Raghoebar GM, Hamming I, Meijer J, Vissink A. Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study. Clin Oral Investig 2020; 25:3431-3439. [PMID: 33315177 PMCID: PMC8137608 DOI: 10.1007/s00784-020-03665-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/28/2020] [Indexed: 11/25/2022]
Abstract
Objectives To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems. Materials and methods A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months’ post frenotomy. Results All 175 women completed the 1-month follow-up and 146 women the 6 months’ follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment. Conclusions Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems. Clinical relevance Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help. International trial register ISRCTN64428423 Supplementary Information The online version contains supplementary material available at 10.1007/s00784-020-03665-y.
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Pol CW, Raghoebar GM, Cune MS, Meijer HJ. Implant-Supported Three-Unit Fixed Dental Prosthesis Using Coded Healing Abutments and Fabricated Using a Digital Workflow: A 1-Year Prospective Case Series Study. INT J PROSTHODONT 2020; 33:609-619. [PMID: 33284902 DOI: 10.11607/ijp.6707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To test the applicability of coded healing abutments, intraoral scanners, and monolithic zirconia for the fabrication of three-unit fixed dental prostheses (FDPs) on two dental implants. MATERIALS AND METHODS Patients with three missing teeth in the posterior region of either the maxilla or mandible received two dental implants. After healing, coded healing abutments were placed. Full-arch intraoral scans were made to produce individual titanium abutments and a three-unit FDP. Peri-implant tissues were assessed 2 weeks after placement of the FDP and again after 1 year. Patient-reported outcome measures were registered prior to treatment and after 1 year. The quality of the FDPs was assessed using modified United States Public Health Service criteria after 1 year of service. RESULTS A total of 54 patients were treated with 60 restorations, and 51 patients with 56 restorations were available at the 1-year follow-up. Implant survival was 99.1%, and prosthesis survival was 100%. The peri-implant tissues remained healthy, and patient satisfaction was high. However, the USPHS evaluation showed that some prostheses exhibited fit or color issues that needed to be addressed, although most were rated as successful (80.4%). CONCLUSION The use of coded healing abutments and intraoral scanners to produce full-zirconia three-unit FDPs on two dental implants proved to be a feasible technique, with promising objective and subjective results. However, technical challenges still impacted the treatment results, resulting in a number of restorations having clinical or radiographic marginal gaps or reduced color match.
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