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Kermanshah H, Keshtkar A, Hassani A, Bitaraf T. Comparing short implants to standard dental implants: a systematic review and meta-analysis of randomized controlled trials with extended follow-up. Evid Based Dent 2023; 24:192-193. [PMID: 37568011 DOI: 10.1038/s41432-023-00924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To compare the difference of marginal level changes (MBL), implant failure (IF), biological and prosthetic complications (BC and PC), and prosthetic failure (PF) of short implants (SH) and standard implants (ST). MATERIALS AND METHODS Electronic searches (PubMed, Web of Science, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov) and manual searches were performed to identify all randomized controlled trials (RCTs) evaluating SH to ST. Applying Stata, a meta-analysis was conducted on the weighted mean difference (WMD) and standardized mean difference (SMD) of MBL and the risk difference (RD) of the secondary outcome. RESULTS Twenty-four articles were involved in the present study. There were statistically significant differences in MBLs, preferring short implants in the maxilla (WMD: -0.147 (CI: -0.224, -0.070), I2: 76.6%; SMD: -0.757 (CI: -1.226, -0.289), I2: 89.2%) and in the mandible (WMD: -0.377 (CI: -0.656, -0.098), I2: 85.8%; SMD: -0.811 (CI: -1.418, -0.204), I2: 78.8%). There were no significant differences in IF (RD: 0.011 (-0.002, 0.023), I2: 0.0%), PF (RD:0.003 (-0.007, 0.014), I2: 0.0%), and PC (RD:0.001 (-0.008, 0.010), I2: 0.0%). There were significantly higher biological complications (RD: -0.071 (-0.106, -0.036), I2: 0.82.9%) for ST compared to SH in both jaws up to a 10-year follow-up. CONCLUSION SH and ST had comparable overall outcomes, but short implants had less marginal bone loss and lower biological complications. However, more research is needed to confirm these findings.
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Affiliation(s)
- Hamid Kermanshah
- Department of Restorative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Hassani
- Department of Oral and Maxillofacial Surgery, Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Tahereh Bitaraf
- Dental Implant Research Center, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, 19585/175, Tehran, Iran.
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El Haron AM, Askar OMR, Said Ahmed W, Elsyad MA. Rehabilitation of distal extension maxillary ridges with fixed and removable implant-supported prostheses: Preliminary 12-month randomized clinical trial. Clin Implant Dent Relat Res 2023; 25:795-806. [PMID: 37154012 DOI: 10.1111/cid.13212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
PURPOSE This trial evaluated clinical outcomes of fixed and removable implant-supported prostheses for rehabilitation of atrophied distal extension maxillary ridges. MATERIALS AND METHODS A total of 54 participants with atrophied distal extension maxillary ridges were randomly assigned into three groups (n = 18/group). Group I (SLF); participants treated with fixed restoration supported by three long implants after sinus augmentation, Group II (SF); participants treated with fixed restoration supported by one long and two short implants, and Group III (OD): participants treated with removable partial denture assisted by one long implant that was placed mesial to maxillary sinus (IARPD). Modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and crestal bone loss (CBL) were measured after prosthesis insertion (T0), 6 (T6), and 12 months (T12) after insertion. Patient satisfaction was measured at T12 using a visual analog scale (VAS). RESULTS The implant survival rates were 96.8%, 92.4%, and 84.6% for SLF, SF, and OD groups respectively. The SLF recorded the highest MPI, MGI, PD, and IS values, followed by the SF, and the OD showed the lowest values. The OD recorded the highest CBL followed by the SF and the SLF showed the lowest CBL. With exception of satisfaction with surgery and cleaning, SLF and SF groups recorded significantly higher patient satisfaction than the OD for all VAS questions. CONCLUSION Fixed restorations supported with either long or short implants were associated with improved implant stability, reduced bone loss, and increased patient satisfaction compared to implant-assisted RPDs. However, implant-assisted RPDs were associated with more favorable peri-implant soft tissue health and increased satisfaction with surgery, healing, and cleaning.
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Affiliation(s)
- Ahmed Mahmoud El Haron
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Removable Prosthodontics, Faculty of Dentistry, Delta University, Belqas, Egypt
| | - Osama Mohammed Raouf Askar
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Wael Said Ahmed
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
| | - Moustafa Abdou Elsyad
- Faculty of Dentistry, University of Mansoura, Mansoura, Egypt
- Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Short Implants versus Standard Implants and Sinus Floor Elevation in Atrophic Posterior Maxilla: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with ≥5 Years' Follow-Up. J Pers Med 2023; 13:jpm13020169. [PMID: 36836403 PMCID: PMC9960634 DOI: 10.3390/jpm13020169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background and objectives: The aim of this systematic review with meta-analysis was to assess the performance of short implants in comparison with standard implants and sinus floor elevation in atrophic posterior maxilla. Materials and methods: The protocol of the study was registered in the PROSPERO database (CRD42022375320). An electronic search on three databases (PubMed, Scopus, Web of Science) was performed to find randomized clinical trials (RCTs) with ≥5 years' follow-up, published until December 2022. Risk of bias (ROB) was calculated using Cochrane ROB. A meta-analysis was performed for primary (implant survival rate, ISR) and secondary outcomes (marginal bone loss, MBL; biological and prosthetic complications). Results: Of 1619 articles, 5 RCTs met the inclusion criteria. The ISR showed a risk ratio (RR) of 0.97 [0.94, 1.00] (CI 95%), p = 0.07. The MBL indicated a WMD of -0.29 [-0.49, -0.09] (CI 95%), p = 0.005. Biological complications showed a RR of 0.46 [0.23, 0.91] (CI 95%), p = 0.03. Prosthetic complications showed a RR of 1.51 [0.64, 3.55] (CI 95%), p = 0.34. Conclusions: The available evidence suggests that short implants might be used as an alternative to standard implants and sinus floor elevation. After 5 years, in terms of ISR, standard implants and sinus floor elevation showed a higher survival rate comparted to short implants, although statistical significance was not achieved. Future RCTs with long-term follow-up are needed to draw a clear conclusion on the advantages of one method over another.
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Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D’Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227995. [PMID: 36431480 PMCID: PMC9695726 DOI: 10.3390/ma15227995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/31/2023]
Abstract
Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.
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Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Mauro Marincola
- Dental Implant Unit, Research Department, Faculty of Dentistry, University of Cartagena, Cartagena 130001, Colombia
| | - Pietro Liboni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Paolo Faccioni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio D’Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
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Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6681-6698. [PMID: 36070150 DOI: 10.1007/s00784-022-04628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Short implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL). METHODS Screening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration's tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed. RESULTS Fourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01-0.20) mm (p = 0.03) and 0.23 (0.07-0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants. DISCUSSION Within the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs. CLINICAL CLINICAL RELEVANCE The low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.
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Yang DW, Xiao JY, Zhang P, Lu BY, Liang X. Retrospective study on the merits of bone grafts and the influence of implant protrusion length after osteotome sinus elevation surgery. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:570-575. [PMID: 34636206 DOI: 10.7518/hxkq.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aims to evaluate the endo-sinus bone remodeling of dental implants placed via osteotome sinus floor elevation (OSFE) after 6 months and using different implant protrusion lengths and bone grafts through cone beam computed tomography (CBCT). METHODS Ninety-six patients with 124 implants were included and assigned into four groups. Group 1: implant protrusion length<4 mm with bone graft; group 2: implant protrusion length>4 mm with bone graft; group 3: implant protrusion length<4 mm without bone graft; group 4: implant protrusion length>4 mm without bone graft. Apical bone gain (ABG), cortical bone gain (CBG), bone density gain (BDG), and marginal bone loss (MBL) were observed and analyzed at baseline and 6 months after implant surgery. RESULTS The CBG in grafted groups 1 and 2 was higher than that in non-grafted groups. The ABG and BDG were higher in non-grafted groups 3 and 4 than in grafted groups, and the levels in group 3 were higher than those in group 4. The CBG in grafted group 2 was higher than that in group 1. No significant difference was observed in MBL analysis. CONCLUSIONS The BDG of IPL<4 mm implants was higher than IPL>4 mm implant when bone grafts were not applied. No relevance was observed between IPL and CBG. Bone grafts can accelerate endo-sinus bone remodeling by increasing CBG and dissipating the influence of IPL on BDG.
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Affiliation(s)
- Da-Wei Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing-Yi Xiao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Peng Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bo-Yao Lu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xing Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Kitchen elbow sign predicts surgical outcomes in adults with spinal deformity: a retrospective cohort study. Sci Rep 2021; 11:12859. [PMID: 34145338 PMCID: PMC8213796 DOI: 10.1038/s41598-021-92520-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/11/2021] [Indexed: 11/09/2022] Open
Abstract
Kitchen elbow sign (KE-Sign) is a skin abnormality on the extensor side of the elbow and forearm that is often observed in patients with adult spinal deformity (ASD). The significance of KE-Sign in surgical cases was investigated. Overall, 114 patients with ASD treated with long spinal fusion were reviewed and divided into KE-Sign positive and negative groups. The preoperative and 1-year follow-up evaluations included radiographic parameters [C7 sagittal vertical axis (SVA), pelvic incidence (PI) and lumbar lordosis (LL)], the Oswestry Disability Index (ODI), visual analogue scales (VASs) for low back pain, leg pain, and satisfaction, and Short Form 36 questionnaire (SF-36). Multi-regression analysis was performed to identify patient satisfaction predictors and improvement in the ODI as dependent variables and preoperative background factors as independent variables. Preoperative characteristics showed no significant difference between both groups. Improvement in the ODI and VAS for satisfaction were significantly superior in the KE-Sign positive group. In multiple regression analysis, KE-Sign and preoperative ODI were significantly associated with improvement in the ODI; age, KE-Sign, preoperative low back pain VAS, and leg pain VAS were significantly associated with satisfaction. KE-Sign can be a predictor of better surgical outcomes in ASD patients.
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Carosi P, Lorenzi C, Lio F, Laureti M, Ferrigno N, Arcuri C. Short implants (≤6mm) as an alternative treatment option to maxillary sinus lift. Int J Oral Maxillofac Surg 2021; 50:1502-1510. [PMID: 33637392 DOI: 10.1016/j.ijom.2021.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/15/2020] [Accepted: 02/06/2021] [Indexed: 02/03/2023]
Abstract
The aim of this systematic review was to evaluate survival rate of short dental implants placed in the posterior area of the maxilla. The electronic literature search of studies published between January 1, 2010 and February 29, 2020 was performed using specific word combinations. The outcome was to meta-analyse the implant survival rate (ISR). The search generated 238 potential studies. After screening procedures, only nine randomized controlled trials fulfilled the inclusion criteria and were selected for qualitative and quantitative analysis. ISR of short implants ranged from 91.9% to 100%, while standard-length implants ISR ranged from 82.9% to 100% with a follow-up from 1 to 5 years in function. The risk ratio difference was 1.24 (95% confidence interval: 0.63-2.45, P=0.52) for short dental implants failure when compared with standard dental implants, and was not statistically significant. Based on the evidence of the included studies, short implants (≤6mm) reported high survival rates over short to medium follow-up in posterior maxilla, but the long-term success is as yet not demonstrated.
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Affiliation(s)
- P Carosi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy.
| | - C Lorenzi
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - F Lio
- Department of Chemical Science and Technologies, University of Rome 'Tor Vergata', Rome, Italy
| | - M Laureti
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - N Ferrigno
- Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - C Arcuri
- Department of Clinical Sciences and Translational Medicine, School of Dentistry, University of Rome 'Tor Vergata', Rome, Italy
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Yue Z, Liu Q, Zhang H, Yang J, Hou J. Histological, radiological, and clinical outcomes of sinus floor elevation using a lateral approach for pre-/post-extraction of the severely compromised maxillary molars: a study protocol for a randomized controlled trial. Trials 2021; 22:101. [PMID: 33509257 PMCID: PMC7844904 DOI: 10.1186/s13063-021-05047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 01/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The volume of residual alveolar bone is critical to the survival of dental implants. When the volume of alveolar bone in the posterior maxillary region is less than 4 mm, maxillary sinus floor elevation (MSFE) with the lateral approach is an effective option. Traditionally, this standard approach is usually conducted at 4-6 months after tooth extraction (standard MSFE). However, defective dentition due to extraction can impair mastication during the period of bone remodeling, especially if the molars on both sides are severely compromised and must be extracted. MSFE before extraction (modified MSFE) can take full advantage of residual tooth strength. However, the effectiveness and practicability of the modified MSFE procedure remain unknown. Therefore, the aim of this study was to compare the clinical outcomes of modified vs. standard MSFE, in order to provide references to periodontists. METHODS/DESIGN The study cohort included 25 adult patients (50 surgery sites) recruited from Peking University Hospital and School of Stomatology who met the inclusion criteria. The two sides of each patient will be randomly divided into two groups: a test group-modified MSFE or a control group-standard MSFE. The surgical duration and patient-reported outcomes (visual analog scale for discomfort) will be documented. Clinical indicators, including implant survival rates, mucosal conditions, and complications, will be recorded every 6 months during the 5-year follow-up period. The volume of the alveolar bone and marginal bone level will be assessed radiographically (cone-beam CT and periapical films) every 6 months. Histological analysis of biopsy samples retrieved from both sides will be performed to evaluate the biological features of the bone. DISCUSSION The current study will explore the implant survival rates, safety, reliability, effectiveness, and practicability of the modified MSFE procedure. Moreover, the extent of osteogenesis on the sinus floor will also be assessed. The results of this trial will provide strategies for the modified MSFE procedure to achieve ideal clinical outcomes. TRIAL REGISTRATION International Clinical Trials Registry Platform ChiCTR1900020648 . Registered on 1 January 2019.
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Affiliation(s)
- Zhaoguo Yue
- Department of Periodontology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Qi Liu
- BYBO Dental Hospital, Qinian Street, Dongcheng District, Beijing, 100062, China
| | - Haidong Zhang
- Department of Periodontology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- National Clinical Research Center for Oral Diseases, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Jingwen Yang
- National Clinical Research Center for Oral Diseases, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Department of Prosthetics, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Jianxia Hou
- Department of Periodontology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
- National Clinical Research Center for Oral Diseases, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University Hospital and School of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
- Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
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Andrés-García R, Ríos-Santos JV, Herrero-Climent M, Bullón P, Fernández-Farhall J, Gómez-Menchero A, Fernández-Palacín A, Ríos-Carrasco B. Sinus Floor Elevation via an Osteotome Technique without Biomaterials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031103. [PMID: 33513756 PMCID: PMC7908564 DOI: 10.3390/ijerph18031103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 11/16/2022]
Abstract
According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.
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Affiliation(s)
- Rodrigo Andrés-García
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - José Vicente Ríos-Santos
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
- Correspondence: ; Tel.: +34-954-481-121; Fax: +34-954-481-157
| | | | - Pedro Bullón
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | | | - Alberto Gómez-Menchero
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
| | - Ana Fernández-Palacín
- Department of Social and Health Sciences, Universidad de Sevilla, 41009 Sevilla, Spain;
| | - Blanca Ríos-Carrasco
- Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain; (P.B.); (A.G.-M.); (B.R.-C.)
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11
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Chaware SH, Thakare V, Chaudhary R, Jankar A, Thakkar S, Borse S. The rehabilitation of posterior atrophic maxilla by using the graftless option of short implant versus conventional long implant with sinus graft: A systematic review and meta-analysis of randomized controlled clinical trial. J Indian Prosthodont Soc 2021; 21:28-44. [PMID: 33835066 PMCID: PMC8061432 DOI: 10.4103/jips.jips_400_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/08/2020] [Accepted: 10/03/2020] [Indexed: 01/23/2023] Open
Abstract
Aim The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. Setting and Design Systematic review and meta analysis. Materials and Methods Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972). Statistical Analysis Used Random-effect model, fixed-effect model, A funnel plot and the Egger's test. Results Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I2 = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I2 = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I2 = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I2 = 0%). Conclusion There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.
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Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Vrushali Thakare
- Department of Public Health Dentistry, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Ritu Chaudhary
- Department of Prosthodontics, Royal College of Surgeons England, Britannia Dental Surgery, Newport, UK
| | - Ajit Jankar
- Department of Prosthodontics, MIDSR Dental College, Latur, Maharashtra, India
| | - Smruti Thakkar
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Sidesh Borse
- Department of Prosthodontics, MGVs KBH Dental College and Hospital, Nashik, Maharashtra, India
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12
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Corsalini M, D’Agostino S, Favia G, Dolci M, Tempesta A, Di Venere D, Limongelli L, Capodiferro S. A Minimally Invasive Technique for Short Spiral Implant Insertion with Contextual Crestal Sinus Lifting in the Atrophic Maxilla: A Preliminary Report. Healthcare (Basel) 2020; 9:healthcare9010011. [PMID: 33374157 PMCID: PMC7823647 DOI: 10.3390/healthcare9010011] [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: 12/06/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022] Open
Abstract
The most recently reported techniques for the rehabilitation of the atrophic posterior maxilla are increasingly less invasive, as they are generally oriented to avoid sinus floor elevation with lateral access. The authors describe a mini-invasive surgical technique for short spiral implant insertion for the prosthetic rehabilitation of the atrophic posterior maxilla, which could be considered a combination of several previously described techniques based on the under-preparation of the implant site to improve fixture primary stability and crestal approach to the sinus floor elevation without heterologous bone graft. Eighty short spiral implants were inserted in the molar area of the maxilla in patients with 4.5–6 mm of alveolar bone, measured on pre-operative computed tomography. The surgical technique involved careful drilling for the preparation of implant sites at differentiated depths, allowing bone dislocation in the apical direction, traumatic crestal sinus membrane elevation, and insertion of an implant (with spiral morphology) longer than pre-operative measurements. Prostheses were all single crowns. In all cases, a spiral implant 2–4 mm longer than the residual bone was placed. Only two implants were lost due to peri-implantitis but subsequently replaced and followed-up. Bone loss values around the implants after three months (at the re-opening) ranged from 0 to 0.6 mm, (median value: 0.1 mm), while after two years, the same values ranged from 0.4 to 1.3 mm (median value: 0.7 mm). Clinical post-operative complications did not occur. After ten years, no implant has been lost. Overall, the described protocol seems to show good results in terms of predictability and patient compliance.
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Affiliation(s)
- Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
| | - Silvia D’Agostino
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (S.D.); (M.D.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
| | - Marco Dolci
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (S.D.); (M.D.)
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70023 Bari, Italy; (M.C.); (G.F.); (A.T.); (D.D.V.); (L.L.)
- Correspondence: ; Tel.: +39-080-5478621
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13
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Afrashtehfar KI, Katsoulis J, Koka S, Igarashi K. Single versus splinted short implants at sinus augmented sites: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:303-310. [PMID: 33002610 DOI: 10.1016/j.jormas.2020.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/08/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This review primarily evaluated the success, survival and failure rates of implants shorter than 10 mm restored with single-unit or splinted fixed dental prostheses in maxillary sinus augmented sites. MATERIAL AND METHODS Two reviewers independently performed the systematic search of electronic databases, including MEDLINE, EMBASE and CENTRAL, up to September 2019 with no language restriction. A supplemental hand search consisted of screening 13 journals. The inclusion criteria were: primary studies reporting implant, prosthetic and patient-reported outcome measures (PROMs) of extra-short and short implants placed in conjunction with sinus floor elevation in partially dentate patients, restored with single- and splinted-crowns for direct comparison, with a minimal 1-year follow-up. Weighted arithmetic mean (WAM) of the implant survival was performed according to the type of prosthesis. This was confirmed by using Review Manager software to perform meta-analysis. RESULTS Two observational studies reporting on 106 tapered, press-fit, sintered porous-surfaced implants with a length ranging from 5 mm to 9 mm were included in this systematic review. Of these, 20 and 86 implants were restored with single and splinted prostheses, respectively. The risk ratio (RR) was 1.16 (95% CI: .31-4.30, p = .58, I² = 0%) for individually restored implants failure when compared to splinted implants, indicating that short dental implants restored with single crowns could have a 16% higher possibility of failure if compared to implants with splinted crowns. The heterogeneity value was not statistically significative (p = .58). No statistical difference in the implant survival rate of the two types of analysed prostheses was observed after WAM (p= .923). The level of evidence for the included studies ranged from low (4) to fair (2B). CONCLUSION Similar clinical outcomes up to a 9-year follow-up were observed in single and splinted porous-surfaced implants shorter than 10 mm located in sites with sinus lift. However, the conclusion shall be interpreted with caution due to the level of evidence and limited number of included studies included in this systematic review.
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Affiliation(s)
- Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Oral Surgery and Stomatology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Division of Restorative Dental Sciences, College of Dentistry, Ajman University, 346 Ajman City, UAE; Department of Restorative Dentistry, Edinburgh Dental Institute, University of Edinburgh, College of Medicine and Veterinary, Lauriston Place, Edinburgh, EH3 9HA, UK; Department of Oral Health Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Joannis Katsoulis
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Preventive & Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104, USA
| | - Sreenivas Koka
- Division of Advanced Prosthodontics, School of Dentistry, Loma Linda University, Loma Linda, CA 92350, US; Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095, USA; MIT Sloan School of Management, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Kensuke Igarashi
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Bern, Switzerland; Department of Life Science Dentistry, The Nippon Dental University, Niigata 951-8580, Japan
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14
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Lozano-Carrascal N, Anglada-Bosqued A, Salomó-Coll O, Hernández-Alfaro F, Wang HL, Gargallo-Albiol J. Short implants (<8mm) versus longer implants (≥8mm) with lateral sinus floor augmentation in posterior atrophic maxilla: A meta-analysis of RCT`s in humans. Med Oral Patol Oral Cir Bucal 2020; 25:e168-e179. [PMID: 32040465 PMCID: PMC7103450 DOI: 10.4317/medoral.23248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 01/20/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Despite the high survival rate of implants placed next to sinus elevation, this technique presents complications that can be avoided by placing short implants, an option that also presents high survival rates. For this reason, the aim of this study is to compare the survival rate, marginal bone loss and complications associated with short implants (<8 mm) versus longer implants (≥8mm) placed with lateral sinus floor elevation in posterior atrophic maxillae. MATERIAL AND METHODS A literature search was conducted by two independent reviewers in the PubMed/Medline (National Library of Medicine, Washington, DC) electronic database for articles published from January 2007 to July 2018. Seven qualified articles were selected for the meta-analysis. RESULTS The test for overall effect did not find statistical significance in the survival rates, overall complications, intra-operative complications, post-operative complications and prosthetic complications. However, the test showed statistically significant differences in biological complications in favor of standard implants, and marginal bone loss between control and test groups in favor of short implants (<8mm) was found. CONCLUSIONS Within the limitations of the present study, prosthetic rehabilitations with short implants (<8mm) in posterior maxilla is a reliable treatment option as an alternative to lateral wall sinus floor augmentation.
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Affiliation(s)
- N Lozano-Carrascal
- Surgery Department. International University of Catalonia Josep trueta s/n, Sant Cugat del Valles, Barcelona, Spain
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15
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Vazouras K, Souza AB, Gholami H, Papaspyridakos P, Pagni S, Weber H. Effect of time in function on the predictability of short dental implants (≤6 mm): A meta‐analysis. J Oral Rehabil 2020; 47:403-415. [DOI: 10.1111/joor.12925] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/01/2019] [Accepted: 12/09/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Konstantinos Vazouras
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Andre Barbisan Souza
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Hadi Gholami
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Sarah Pagni
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston MA USA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
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16
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Shi J, Li Y, Qiao S, Gu Y, Xiong Y, Lai H. Short versus longer implants with osteotome sinus floor elevation for moderately atrophic posterior maxillae: A 1‐year randomized clinical trial. J Clin Periodontol 2019; 46:855-862. [PMID: 31124147 DOI: 10.1111/jcpe.13147] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 04/08/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Jun‐Yu Shi
- Department of Oral and Maxillo‐facial Implantology, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
| | - Yuan Li
- Department of Oral and Maxillo‐facial Implantology, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
| | - Shi‐Chong Qiao
- Department of Oral and Maxillo‐facial Implantology, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
| | - Ying‐Xin Gu
- Department of Oral and Maxillo‐facial Implantology, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
| | - Yao‐Yang Xiong
- Department of Prosthodontics, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
| | - Hong‐Chang Lai
- Department of Oral and Maxillo‐facial Implantology, Shanghai Key Laboratory of Stomatology, School of Medicine, Shanghai Ninth People's Hospital Shanghai Jiaotong University Shanghai China
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17
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Bitaraf T, Keshtkar A, Rokn AR, Monzavi A, Geramy A, Hashemi K. Comparing short dental implant and standard dental implant in terms of marginal bone level changes: A systematic review and meta‐analysis of randomized controlled trials. Clin Implant Dent Relat Res 2019; 21:796-812. [DOI: 10.1111/cid.12774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Tahereh Bitaraf
- Dental Implant Research Center, Dental FacultyTehran Medical Sciences, Islamic Azad University Tehran Iran
| | - Abbasali Keshtkar
- Department of Health Sciences Education DevelopmentSchool of Public Health, Tehran University of Medical Sciences Tehran Iran
| | - Amir Reza Rokn
- Dental Implant Research Center, Dental Research Institute, Department of Periodontics of Dental SchoolTehran University of Medical Sciences Tehran Iran
| | - Abbas Monzavi
- Dental Research Institute, Department of ProsthodonticsTehran University of Medical Sciences Tehran Iran
| | - Allahyar Geramy
- Dental Research Center, Department of Orthodontics, Faculty of DentistryTehran University of Medical Sciences Tehran Iran
| | - Kazem Hashemi
- Dental Implant Research CenterDental Research Institute, Tehran University of Medical Sciences Tehran Iran
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18
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Mokcheh A, Jegham H, Turki S. Short implants as an alternative to sinus lift for the rehabilitation of posterior maxillary atrophies: Systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:28-37. [DOI: 10.1016/j.jormas.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 10/14/2018] [Accepted: 11/11/2018] [Indexed: 11/25/2022]
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19
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Papaspyridakos P, Souza A, Vazouras K, Gholami H, Pagni S, Weber H. Survival rates of short dental implants (≤6 mm) compared with implants longer than 6 mm in posterior jaw areas: A meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:8-20. [DOI: 10.1111/clr.13289] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Andre Souza
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Konstantinos Vazouras
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Hadi Gholami
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
| | - Sarah Pagni
- Department of Public Health and Community ServiceTufts University School of Dental Medicine Boston MA USA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA USA
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20
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Cruz RS, Lemos CADA, Batista VEDS, Oliveira HFFE, Gomes JMDL, Pellizzer EP, Verri FR. Short implants versus longer implants with maxillary sinus lift. A systematic review and meta-analysis. Braz Oral Res 2018; 32:e86. [PMID: 30231176 DOI: 10.1590/1807-3107bor-2018.vol32.0086] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/17/2018] [Indexed: 11/22/2022] Open
Abstract
This study compared the survival rate of dental implants, amount of marginal bone loss, and rates of complications (biological and prosthetic) between short implants and long implants placed after maxillary sinus augmentation. This systematic review has been registered at PROSPERO under the number (CRD42017073929). Two reviewers searched the PubMed/MEDLINE, Embase, LILACS, and Cochrane Library databases. Eligibility criteria included randomized controlled trials, comparisons between short implants and long implants placed after maxillary sinus augmentation in the same study, and follow-up for >6 months. The Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used to assess the quality and risk of bias of the included studies. The search identified 1366 references. After applying the inclusion criteria, 11 trials including 420 patients who received 911 dental implants were considered eligible. No significant difference was observed in the survival rate [p = 0.86; risk ratio (RR): 1.08; 95% confidence interval (CI): 0.46-2.52] or in the amount of marginal bone loss (p = 0.08; RR: -0.05; 95%CI: -0.10 to 0.01). However, higher rates of biological complications for long implants associated with maxillary sinus augmentation were observed (p < 0.00001; RR: 0.21; 95%CI: 0.10-0.41), whereas a higher prosthetic complication rate for short implants was noted (p = 0.010; RR: 3.15; 95%CI: 1.32-7.51). Short implant placement is an effective alternative because of fewer biological complications and similar survival and marginal bone loss than long implant placement with maxillary sinus augmentation. However, the risk of mechanical complications associated with the prostheses fitted on short implants should be considered.
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Affiliation(s)
- Ronaldo Silva Cruz
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | | | - Victor Eduardo de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | | | - Jéssica Marcela de Luna Gomes
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
| | - Fellippo Ramos Verri
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Universidade de São Paulo, Araçatuba, SP, Brazil
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21
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Al-Moraissi E, Elsharkawy A, Abotaleb B, Alkebsi K, Al-Motwakel H. Does intraoperative perforation of Schneiderian membrane during sinus lift surgery causes an increased the risk of implants failure?: A systematic review and meta regression analysis. Clin Implant Dent Relat Res 2018; 20:882-889. [PMID: 30168884 DOI: 10.1111/cid.12660] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 06/25/2018] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE There is still debate whether intraoperative Schneiderian membrane (SM) perforation in the maxillary sinus lift causes an increase the risk of implants failure. The aim of this study was to assess an association between SM perforation and implants loss following the maxillary sinus lift. MATERIALS AND METHODS A systematic review and meta-analysis of clinical studies assessing association between SM perforation and implants failure based on PRISMA was conducted. Three major databases were used to gather research dating from their respective inception up until March 2018. All clinical studies expressly reported the number of the SM perforation and implants loss that installed in the perforated and nonperforated sinuses were included. The statistical analyses used were Pearson's correlation, simple linear regression, and meta regression. The risk ratio (RR) of implant loss between perforated and nonperforated sites was estimated. RESULTS A total of 2947 patients with 3884 maxillary sinuses augmentations who received 7358 implants, enrolled in 58 studies were included in this study. There was a significant relationship between the implants' failure and SM perforation according to simple linear regression (P < .001) and meta regression analysis (P = .06). There was a significant decrease (moderate quality evidence) in implant loss in the nonperforated sinuses compared to perforated sunrises (RR = 2.17, CI: 1.52-3.10, P = .001). There was also no significant association between implant loss in the perforated sinuses and the surgical devices used (piezosurgical or rotary), surgical approach applied (lateral or crestal sinus lift), barrier membrane used and type of bone grafting materials. CONCLUSION The results of this study showed that an intraoperative SM perforation could increase the risk of implant failure after the sinus lift surgery.
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Affiliation(s)
- Essam Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - Ahmed Elsharkawy
- Department of Oral and Maxillofacial Surgery, Cairo University, Cairo, Egypt
| | - Bassam Abotaleb
- Department of Oral and Maxillofacial Surgery, Ibb University, Ibb, Yemen
| | - Khaled Alkebsi
- Department of Oral and Maxillofacial Surgery, Ibb University, Ibb, Yemen
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What Is the Most Effective Rehabilitation Method for Posterior Maxillas With 4 to 8 mm of Residual Alveolar Bone Height Below the Maxillary Sinus With Implant-Supported Prostheses? A Frequentist Network Meta-Analysis. J Oral Maxillofac Surg 2018; 77:70.e1-70.e33. [PMID: 30243705 DOI: 10.1016/j.joms.2018.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/20/2018] [Accepted: 08/08/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The most effective rehabilitation method for patients with edentulous posterior maxillas with an intermediate (4 to 8 mm) residual bone height (RBH) below the maxillary sinus is unclear. Evidence derived from conventional meta-analysis is limited because of the lack of head-to-head studies. This network meta-analysis (NMA) was performed to identify the most effective method to treat patients with intermediate posterior RBH. MATERIALS AND METHODS An NMA of randomized controlled clinical trials (RCTs) was conducted to assess various rehabilitation methods using implant-supported prostheses for patients with intermediate posterior maxillary RBH (4 to 8 mm). Publications from 1970 through March 2018 in 3 major databases were searched. Parallel and split-mouth RCTs that reported the outcomes of interest with follow-up of at least 6 months from initial loading were included. Predictor variables were short implants (SIs; ≤8 mm) alone, SIs in conjunction with osteotome sinus floor elevation (OSFE) with or without bone grafting, long implants (LIs) in conjunction with OSFE with and without bone grafting, and LIs combined with lateral sinus floor elevation (LSFE) with bone grafting. Outcome variables were implant and prosthesis failure rates, marginal bone loss, and complications. Frequentist NMA was performed using STATA software. RESULTS Twenty RCTs involving 770 patients with intermediate posterior maxillary RBH and 837 concerned maxillary sinuses who received 1,486 implants using any of the 4 rehabilitation methods were included. There were no statistically significant differences among the 4 groups for implant and prosthesis failure rates and marginal bone loss at follow-up (range, 6 months to 5 years after loading). There was a marked decrease in complications for SIs alone compared with LIs combined with LSFE. For implant and prosthesis survival rates, SIs in conjunction with OSFE with or without bone grafting ranked first as the most effective option (77.1%) followed by LIs plus OSFE with or without bone grafting (62%), LIs plus LSFE with bone grafting (43.9%), and SIs alone (24.8%). CONCLUSION There is moderate-quality evidence derived from this NMA showing that OSFE combined with SI or LI placement with or without bone grafting or SI placement alone is superior to LI placement combined with LSFE and bone grafting when used for patients with intermediate maxillary RBH (4 to 8 mm). Furthermore, the results of this study show that LSFE for patients with intermediate RBH is not a suitable treatment option because of unjustified high cost and rate of complications.
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Tolentino da Rosa de Souza P, Binhame Albini Martini M, Reis Azevedo-Alanis L. Do short implants have similar survival rates compared to standard implants in posterior single crown?: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018; 20:890-901. [PMID: 30051949 DOI: 10.1111/cid.12634] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Short implants have been presented as an option for posterior rehabilitation in cases of poor bone height. PURPOSE To compare the survival rate of short implants and standard implants when used in posterior single crowns, in addition to reporting marginal bone loss, prosthetic failures, and surgical complications. MATERIALS AND METHODS Electronic search (PubMed, LILACS, Cochrane Library, Scopus, and Web of Science) and hand search were performed to identify all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated both short and standard implants in posterior single crowns. RESULTS Out of 345 articles identified by both electronic and hand search, four studies were selected (one CCT and three RCTs). The meta-analysis for the survival rate showed that there was no significant difference between the short implants and the standard ones (P = 1.00; RR:1.00; CI:0.97-1.03) performed with three RCTs for a one-year follow-up. The mean marginal bone loss ranged from 0.1 mm to 0.54 mm. Only one study reported the presence of prosthetic failures and surgical complications. CONCLUSIONS The survival rate of short implants was similar to the standard ones in posterior single crowns, for the one-year follow-up period. They also presented low surgical complications, prosthetic failures and marginal bone loss, being a predictable treatment for single rehabilitation in posterior tooth loss.
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Affiliation(s)
| | - Milena Binhame Albini Martini
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Luciana Reis Azevedo-Alanis
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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