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Wang S, Duan S, Chen R, Wang Z, Tang Y. Immediate loading in partially edentulous patients with fixed implant-supported restorations cases report. FRONTIERS IN ORAL HEALTH 2024; 5:1369494. [PMID: 38774040 PMCID: PMC11106488 DOI: 10.3389/froh.2024.1369494] [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: 01/12/2024] [Accepted: 04/24/2024] [Indexed: 05/24/2024] Open
Abstract
Objectives This article reports on four rare cases involving multiple trauma-induced adjacent missing anterior teeth in the maxillary or mandibular region. These cases were successfully treated using a 4-axial implant-based alternative insert and an immediate loading protocol. Material and methods This series of cases was summarized by retrospective study that 4 patients who received a total of 20 immediately loaded implants. These patients had suffered from trauma-induced loss of 8-9 adjacent anterior teeth. The 4-axial-implants were inserted with the assistance of digital pioneer drill guides. The surgical procedure involved alveolar bone trimming or ultrasonic osteotomy, eliminating the need for traditional large-area bone augmentation. Pre- and post-operative CBCT was matched using DTX Studio Implant software, the deviation of implant between actual position and preoperative design was measured and compared using SPSS software package. Results The average follow-up duration 48 months after implant prostheses, the cumulative retention rate of the implants was 100%, the marginal bone loss averaged 0.53 mm (SD 0.15 mm), and buccal plate bone loss averaged 0.62 mm (SD 0.41 mm). Conclusions This retrospective clinical report demonstrates the successful treatment of several patients with multiple adjacent maxillary or mandibular anterior teeth using four implant-supported screws to fix the frame and employing immediate loading. The approach resulted in long-term stable clinical outcomes. Moreover, the method not only shortens the period of edentulism but also facilitates easy disassembly, maintenance, and cleaning. Consequently, it emerges as a highly favorable clinical option for patients suffering from extensive tooth loss.
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Affiliation(s)
- Shuang Wang
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Siyi Duan
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Rui Chen
- Graduate School, China Medical University, Shenyang, China
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Zijian Wang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
- Graduate School, Dalian Medical University, Dalia, China
| | - Yulong Tang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Acar G, Özer T. Impact of bone levels on stress distribution around all-on-four concept: A 3-D finite element analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101905. [PMID: 38702013 DOI: 10.1016/j.jormas.2024.101905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/03/2024] [Accepted: 04/27/2024] [Indexed: 05/06/2024]
Abstract
This study aimed to investigate the impact of implant placement levels within the bone on stress distribution in the context of the All-on-Four concept. In this Finite Element Analysis(FEA), two 4.1 mm x 10 mm implants were axially placed in the anterior region of the jawbone, while two 4.1 mm x 14 mm implants were tilted at 30 ° in the posterior region following the all-on-four concept. In the EC scenario, all implants were inserted at the equicrestal level. In other scenarios, implants were positioned at 1 mm and 2 mm subcrestal levels (SC1, SC2). In all groups, the prosthesis was designed to replicate a group-function occlusion. A total load of 450 N was applied to the prosthesis. Upon deeper implant placement below the crest level, a trend of decreasing Von Mises stresses was observed in both implants and implant fragments. The highest Pmax value in the bone was recorded in SC-2, characterized by the absence of cortical bone support, with values of 3.16 N/mm2 in the anterior region and 1.55 N/mm2 in the posterior region. Conversely, the lowest Pmax values were noted in SC-1 for the anterior implant (2.67 N/mm2) and the EC for the posterior implant (0.87 N/mm2). Implant placements devoid of cortical bone support result in stress transmission from the implant and its components to the peri-implant bone. Optimal stress minimization is achieved by placing anterior axial angle implants deeper than the crest level while retaining cortical bone support and positioning posterior tilted implants at the crest level.
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Affiliation(s)
- Gülin Acar
- Hacettepe University Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Ankara, Turkey.
| | - Taha Özer
- Hacettepe University Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Ankara, Turkey
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Martins J, Rangel J, de Araújo Nobre M, Ferro A, Nunes M, Almeida R, Moura Guedes C. A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:720. [PMID: 38792903 PMCID: PMC11123051 DOI: 10.3390/medicina60050720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.
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Affiliation(s)
- João Martins
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - João Rangel
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - Miguel de Araújo Nobre
- Research, Development and Education Department, Malo Clinic, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisbon, Portugal
| | - Ana Ferro
- Oral Surgery Department, Malo Clinic, Avenida dos Combatentes, 43, Level 9, 1600-042 Lisbon, Portugal; (A.F.); (M.N.)
| | - Mariana Nunes
- Oral Surgery Department, Malo Clinic, Avenida dos Combatentes, 43, Level 9, 1600-042 Lisbon, Portugal; (A.F.); (M.N.)
| | - Ricardo Almeida
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - Carlos Moura Guedes
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
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4
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Uesugi T, Shimoo Y, Munakata M, Kataoka Y, Sato D, Yamaguchi K, Sanda M, Fujimaki M, Nakayama K, Watanabe T, Malo P. A Study of the Associated Risk Factors for Early Failure and the Effect of Photofunctionalisation in Full-Arch Immediate Loading Treatment Based on the All-on-Four Concept. Bioengineering (Basel) 2024; 11:223. [PMID: 38534497 DOI: 10.3390/bioengineering11030223] [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: 01/05/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Early implant failure occurring within 1 year after implantation has been attributed to various factors. Particularly, early failure can lead to challenges in maintaining a full-arch prosthetic device, necessitating prompt intervention, including reoperation. This study aimed to retrospectively examine implant- and patient-related factors and the effects of photofunctionalisation associated with early failure in patients who underwent treatment using the all-on-four concept in both the maxilla and mandible. We conducted this retrospective study comprising 561 patients with 2364 implants who underwent implant-supported immediate loading with fixed full-arch rehabilitation using the all-on-four concept. We aimed to assess the survival rate within 1 year after implantation and determine the risk factors influencing early failure. The 1-year survival rates after implantation were 97.1% (patient level) and 98.9% (implant level) for the maxilla and 98.5% (patient level) and 99.6% (implant level) for the mandible. There was a significant difference in the implant-level survival rates between the maxilla and mandible, with a lower rate in the maxilla (p = 0.043). The risk factors associated with early implant failure according to the all-on-four concept included the maxilla (implant level) and smoking (patient level). We could not find a significant effect of photofunctionalisation on early failure (p = 0.25) following this treatment protocol.
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Affiliation(s)
- Takashi Uesugi
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Yoshiaki Shimoo
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Yu Kataoka
- Department of Oral Biomaterials and Technology, Showa University School of Dentistry, Tokyo 142-8555, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | - Minoru Sanda
- Department of Prosthodontics, Showa University School of Dentistry, Tokyo 145-8515, Japan
| | | | | | - Tae Watanabe
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
| | - Paulo Malo
- Malo Dental & Medical Tokyo, Tokyo 104-0061, Japan
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Munakata M, Kataoka Y, Yamaguchi K, Sanda M. Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review. Bioengineering (Basel) 2024; 11:192. [PMID: 38391678 PMCID: PMC10886188 DOI: 10.3390/bioengineering11020192] [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: 01/25/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.
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Affiliation(s)
- Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Yu Kataoka
- Department of Dental Education, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-8-5, Hatanodai, Shinagawa-ku, Tokyo 1428555, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
| | - Minoru Sanda
- Department of Prosthodontics, Showa University School of Dentistry, 2-1-1, Kita-senzoku, Ota-ku, Tokyo 1458515, Japan
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Hamadé L, El-Disoki S, Chrcanovic BR. Hypertension and Dental Implants: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:499. [PMID: 38256633 PMCID: PMC10816909 DOI: 10.3390/jcm13020499] [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: 12/24/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE The aim of the present systematic review was to investigate the influence of hypertension on the dental implant failure rate. METHODS An electronic search was undertaken in four databases, plus a manual search of journals. The I2 statistic was used to check heterogeneity and the inverse-variance method was used for the meta-analysis. The estimate of relative effect for dichotomous outcome was expressed as an odds ratio (OR). RESULTS The review included 24 publications. There were 4874 implants (257 failures) placed in hypertensive patients and 16,192 implants (809 failures) placed in normotensive patients. A pairwise meta-analysis showed that implants in hypertensive patients did not have a higher risk of failure than implants placed in normotensive patients (OR 1.100, p = 0.671). The log OR of implant failure between hypertensive and normotensive patients did not significantly change with the follow-up time (p = 0.824). CONCLUSIONS This review suggests that implants in hypertensive patients do not present higher odds of failure in comparison to normotensive patients. However, further research on this topic, with the use of more rigorous criteria to diagnose patients as being hypertensive, as well as clearer information about the pharmacological management of the condition in the patients, is recommended.
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Affiliation(s)
- Liljan Hamadé
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (L.H.); (S.E.-D.)
| | - Salma El-Disoki
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (L.H.); (S.E.-D.)
| | - Bruno Ramos Chrcanovic
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
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Gaikwad A, Rachh P, Raut K. Critical evaluation of YouTube videos regarding the all-on-4 dental implant treatment concept: A content-quality analysis. J Prosthet Dent 2024:S0022-3913(23)00821-1. [PMID: 38216377 DOI: 10.1016/j.prosdent.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/02/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
STATEMENT OF PROBLEM Rehabilitation of complete edentulous arches by using the all-on-4 dental implant treatment concept is a well-established procedure. Considering the popularity of YouTube as a source for health-related information, a thorough investigation of the content-quality and reliability of videos regarding the all-on-4 concept is lacking. PURPOSE The purpose of this cross-sectional analysis was to critically appraise the content-quality and reliability of YouTube videos regarding the all-on-4 dental implant treatment concept as a source of information for patients, students, and dentists. MATERIAL AND METHODS A comprehensive search was performed on the YouTube website using the specific keyword "All-on-4," which was identified as the most appropriate search term by the Google Trends website. Only English language videos regarding the all-on-4 dental implant treatment concept were included for systematic analyses. Following the eligibility criteria, the included videos were assessed for their demographic characteristics and quality-content. Based on the content score, the videos were categorized as low content (LC) and moderate + high content (MHC) groups. Further, qualitative analyses were performed by using the DISCERN tool and a global quality (GQ) scale. Statistical analyses were conducted by using the Mann-Whitney U test and the Spearman correlation analysis (α=.05). RESULTS Of 250 screened videos, only 73 were eligible for final analyses. The included videos presented an average 123 846 (range, 4 to 3 182 404) views with a mean duration of 528 (range, 12 to 1699) seconds. In addition, the average number of likes was 1122 (range, 0 to 3300), but, remarkably, none of the included videos received any dislikes. Overall, the mean content-quality score was 6.2 ±3.8, thus indicating low-quality content. The average DISCERN and GQ scores were 47.73 ±9.94 and 3.41 ±0.95, with the Spearman rank correlation test showing a strong positive correlation (r=.732; P<.001) among the total obtained scores. Moreover, statistically significant differences were reported between the LC and MHC groups for both DISCERN and GQ scores (P<.001). CONCLUSIONS The reliability of YouTube videos regarding the all-on-4 dental implant treatment concept is questionable, as they exhibit poor content-quality, thus making them an unreliable source for patients, students, and dentists seeking accurate information.
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Affiliation(s)
- Amit Gaikwad
- Associate Professor, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi-Mumbai, Maharashtra, India; Doctoral Researcher, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, Hanover, Germany; and Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany.
| | - Pranidhipurnima Rachh
- Graduate student, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Navi-Mumbai, Maharashtra, India
| | - Kaustubh Raut
- Graduate student, Department of Prosthodontics and Crown & Bridge, MGM Dental College and Hospital, Kamothe, Navi-Mumbai, Maharashtra, India
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Häggman-Henrikson B, Ali D, Aljamal M, Chrcanovic BR. Bruxism and dental implants: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:202-217. [PMID: 37589382 DOI: 10.1111/joor.13567] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/24/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Overload from bruxism may affect survival of dental implants. OBJECTIVES To evaluate implant failure and marginal bone loss (MBL) in patients presenting with probable bruxism compared to non-bruxers. The study was registered in PROSPERO (CRD42021238397). METHODS An electronic search September 2022 in PubMed/Medline, Web of Science and Science Direct was combined with a hand search. Two independent reviewers carried out abstract screening, full-text assessment, quality assessment (National Institutes of Health tool) and data extraction. Only studies that provided information on self-report and clinical examination needed for the diagnosis of at least 'probable' bruxism were included. A pairwise random-effect meta-analysis was carried out. RESULTS In total 1338 studies were identified, and after screening and full-text assessment 27 studies that presented data on 2105 implants in probable bruxers and 10 264 implants in non-bruxers were included, with 138 and 352 implant failures in respective groups. the meta-analysis showed that implants placed in probable bruxers had a higher risk of failure than in non-bruxers (OR 2.189; 95% CI 1.337, 3.583, p = .002). A meta-regression showed that follow-up time did not affect this OR. Eighteen studies provided general data on MBL but did not report results separated between bruxers and non-bruxers. Therefore, an analysis of MBL was not possible. CONCLUSION The results of the present systematic review show that implants placed in probable bruxers present a significantly higher risk of failure than implants placed in non-bruxers. This should be considered in treatment planning and management of implant patients.
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Affiliation(s)
| | - David Ali
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Krennmair S, Malek M, Stehrer R, Stähler P, Otto S, Postl L. The effect of frontal trauma on the edentulous mandible with four different interforaminal implant-prosthodontic anchoring configurations. A 3D finite element analysis. Eur J Med Res 2023; 28:608. [PMID: 38115128 PMCID: PMC10729383 DOI: 10.1186/s40001-023-01580-y] [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: 02/06/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Abstract
PURPOSE The present three-dimensional (3D) finite element analysis (FEA) was aimed to assess the biomechanical effects and fracture risks of four different interforaminal implant-prosthodontic anchoring configurations exposed to frontal trauma. MATERIAL AND METHODS A symphyseal frontal trauma of 1 MPa was applied to four dental implant models with different configurations (two unsplinted interforaminal implants [2IF-U], two splinted interforaminal implants [2IF-S], four unsplinted interforaminal implants[ 4IF-U], four splinted interforaminal implants [4IF-S]. By using a 3D-FEA analysis the effective cortical bone stress values were evaluated in four defined regions of interest (ROI) (ROI 1: symphyseal area; ROI 2: preforaminal area; ROI 3: mental foraminal area; and ROI 4: condylar neck) followed by a subsequent intermodel comparison. RESULTS In all models the frontal traumatic force application revealed the highest stress values in the condylar neck region. In both models with a four-implant configuration (4IF-U, 4IF-S), the stress values in the median mandibular body (ROI 1) and in the condylar neck region (ROI 4) were significantly reduced (P <0.01) compared with the two-implant models (2IF-U, 2IF-S). However, in ROI 1, the model with four splinted implants (4IF-S) showed significantly (P < 0.01) reduced stress values compared to the unsplinted model (4IF-U). In addition, all models showed increased stress patterns in the area adjacent to the posterior implants, which is represented by increased stress values for both 2IF-U and 2IF-S in the preforaminal area (ROI 3) and for the four implant-based models (4IF-U, 4IF-S) in the mental foraminal area. CONCLUSION The configuration of four splinted interforaminal implants showed the most beneficial distribution of stress pattern representing reduced stress distribution and associated reduced fracture risk in anterior symphysis, condylar neck and preforaminal region.
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Affiliation(s)
- Stefan Krennmair
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
- NumBioLab, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
| | - Raphael Stehrer
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria
| | - Philip Stähler
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany
| | - Lukas Postl
- Medical Faculty, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria.
- Department of Oral and Maxillofacial Surgery, Kepler University Hospital, Johannes Kepler University, Krankenhausstrasse 7a, Linz, Austria.
- Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians-University Munich, Lindwurmstrasse 2a, 80337, Munich, Germany.
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de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N. The All-on-4 Concept Using Polyetheretherketone (PEEK)-Acrylic Resin Prostheses: Follow-Up Results of the Development Group at 5 Years and the Routine Group at One Year. Biomedicines 2023; 11:3013. [PMID: 38002014 PMCID: PMC10669282 DOI: 10.3390/biomedicines11113013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND It is necessary to investigate the application of polymer materials in implant dentistry. The aim of this study was to examine the outcome of full-arch polyetheretherketone (PEEK)-acrylic resin implant-supported prostheses. METHODS Seventy-six patients were rehabilitated consecutively with 100 full-arch implant-supported prostheses of PEEK-acrylic resin (a development group (DG): 37 patients with 5 years of follow-up; a routine group (RG): 39 patients with 1 year of follow-up). The primary outcome measure was prosthetic survival. Secondary outcome measures were implant survival, marginal bone loss, biological complications, prosthetic complications, veneer adhesion, plaque levels, bleeding levels, and a patient subjective evaluation (including the Oral Health Impact Profile for the RG). RESULTS In both groups, prosthetic (DG: 93.6%; RG: 100%) and implant survival (DG: 98.9%; RG: 99.5%) were high, and marginal bone loss was low (DG: 0.54 mm; RG: 0.28 mm). The veneer adhesion rate was 28.6% of prostheses in DG (RG = 0%). Mechanical complications occurred in 49% and 11.8% of prostheses in DG and RG, respectively. Biological complications, plaque, and bleeding levels were low in both groups. The subjective patient evaluation was excellent in both groups (8.6 < DG < 8.8; 9.3 < RG < 9.5; OHIP = 1.38). CONCLUSIONS Within the limitations of this study, PEEK can be considered a viable prosthetic alternative.
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Affiliation(s)
- Miguel de Araújo Nobre
- Research, Development and Education Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisboa, Portugal
| | - Carlos Moura Guedes
- Research, Prosthodontic Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisboa, Portugal; (C.M.G.); (R.A.)
| | - Ricardo Almeida
- Research, Prosthodontic Department, MALO CLINIC, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisboa, Portugal; (C.M.G.); (R.A.)
| | - António Silva
- MALO CLINIC Ceramics, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisboa, Portugal;
| | - Nuno Sereno
- Invibio Biomaterial Solutions & JUVORA, Global Technology Center, Hillhouse International, Thornton, Cleveleys FY5 4QD, UK;
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11
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Uesugi T, Shimoo Y, Munakata M, Sato D, Yamaguchi K, Fujimaki M, Nakayama K, Watanabe T, Malo P. The All-on-four concept for fixed full-arch rehabilitation of the edentulous maxilla and mandible: a longitudinal study in Japanese patients with 3-17-year follow-up and analysis of risk factors for survival rate. Int J Implant Dent 2023; 9:43. [PMID: 37938479 PMCID: PMC10632321 DOI: 10.1186/s40729-023-00511-0] [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: 07/10/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE Implant-supported immediately loaded fixed full-arch rehabilitation via All-on-four treatment yields good long-term results for both the maxilla and the mandible. However, the risk factors affecting long-term implant survival are unknown, and the long-term prognosis of All-on-four concept procedures in Japanese individuals has not been elucidated. We aimed to determine the cumulative implant survival rate after 3-17-year follow-up and identify the associated risk factors. METHODS We analysed 561 cases (307 maxillae, 254 mandibles) with 2364 implants (1324 maxillae, 1040 mandibles) that received All-on-four treatment. We investigated the cumulative implant- and patient-level survival rates and various risk factors for implant failure. Statistical analysis was performed using the log-rank test for differences in Kaplan-Meier curves, univariate analysis using the Chi-square test, and multivariate analysis for risk factors affecting the survival rate. RESULTS The cumulative survival rate was 94.4% by patient level and 97.4% by implant level for the maxilla, and 96.7% by patient level and 98.9% by implant for the mandible, with up to 17 years of follow-up. The maxillary survival rate at the implant level was significantly lower (p < 0.05). Furthermore, the maxillary survival rate within 24 months was significantly lower at the implant level (p < 0.01). Multivariate analysis revealed that the maxilla was the most significant risk factor (p < 0.01). CONCLUSIONS All-on-four treatment yielded high long-term survival rates in Japanese patients. However, the maxilla showed a significantly lower cumulative survival rate than the mandible, while early failure was significantly higher. Furthermore, the maxilla was a significant risk factor influencing the survival rate.
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Affiliation(s)
- Takashi Uesugi
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan.
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan.
| | - Yoshiaki Shimoo
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Motohiro Munakata
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Kikue Yamaguchi
- Department of Implant Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Michiya Fujimaki
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Kazuhisa Nakayama
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Tae Watanabe
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
| | - Paulo Malo
- Malo Dental and Medical Tokyo, Fukuhara Ginza 8F, 7-8-10 Ginza, Chuo-Ku, Tokyo, 104-0061, Japan
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Szabó ÁL, Matusovits D, Slyteen H, Lakatos ÉI, Baráth Z. Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA). Dent J (Basel) 2023; 11:261. [PMID: 37999025 PMCID: PMC10670282 DOI: 10.3390/dj11110261] [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: 09/13/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1-LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1-where masticatory forces covered the entire mesio-distal surface of the denture, including the cantilever-was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97-15.87% and 87.96-94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.
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Affiliation(s)
- Árpád László Szabó
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Danica Matusovits
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Haydar Slyteen
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Éva Ilona Lakatos
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
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Clozza E. Intraoral scanning and dental photogrammetry for full-arch implant-supported prosthesis: A technique. Clin Adv Periodontics 2023. [PMID: 37921978 DOI: 10.1002/cap.10269] [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: 08/22/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To introduce a novel digital workflow to replace a terminal or a complete edentulous arch with a complete-arch implant-supported fixed prosthesis. CLINICAL CONSIDERATIONS A novel fully digital protocol provides an interim and definitive prosthesis by integrating extraoral dental photogrammetry with intraoral scanners. CONCLUSIONS The described technique has great potential to deliver a complete-arch implant-supported fixed interim and definitive prosthesis in edentulous patients in an efficient way. CLINICAL SIGNIFICANCE In the era of digital dentistry, using a fully digital workflow in full arch implant rehabilitations might be beneficial to replace multistep conventional methods. KEY POINTS Why is this case new information? To the author's knowledge, this article illustrates the first step-by-step technique that combines intraoral scanning with dental photogrammetry to provide a full-arch implant-supported interim and definitive prosthesis. What are the keys to successful management of this case? Well-defined presurgical planning and adequate primary stability of the dental implants. Accurate digital impressions of the scan bodies. A dental laboratory that is familiar with digital workflow for complete-arch rehabilitations. What are the primary limitations to success in this case? The learning curve of the scanning procedure. The cost barriers to acquire intraoral and photogrammetry scanners. Limited clinical studies that investigated the accuracy of intraoral scanning and dental photogrammetry for complete-arch digital implant impression.
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Wang PS, Tsai MH, Wu YL, Chen HS, Lei YN, Wu AYJ. Biomechanical Analysis of Titanium Dental Implants in the All-on-4 Treatment with Different Implant-Abutment Connections: A Three-Dimensional Finite Element Study. J Funct Biomater 2023; 14:515. [PMID: 37888180 PMCID: PMC10606984 DOI: 10.3390/jfb14100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
The type of implant-abutment connection is one of the factors influencing the distribution of occlusal forces. This study aims to investigate the biomechanical performance of the mandibular all-on-4 treatment with different implant-abutment connections. Two connection types with 30° abutments and 18-mm implant fixtures were chosen for the posterior implants of the all-on-4 assembly. For the external hexagon connection (EHC) group, the implants with 4 mm in diameter were used. For the internal hexagon connection (IHC) group, we selected implants with 4.3 mm in diameter. A vertical force of 190 N was applied to the cantilever region. The FEA results indicated that the most stressed region in the two groups was prosthetic screws, followed by multi-unit abutments (MUAs). The lowest values of von Mises stress were both observed on the bone. The peak stress value of the implant screw and implant fixture in the EHC group were 37.75% and 33.03% lower than the IHC group, respectively. For stress distribution patterns, the load force tended to be concentrated at locations where components were interconnected. The EHC and IHC are clinically durable under the tested loading conditions, but the prosthetic screws and MUAs can be the weak point on the posterior implant within the mandibular all-on-four assembly. The peak stress values of implant screw and implant fixture in the EHC groups were lower than the IHC group.
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Affiliation(s)
- Pei-Shuang Wang
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Ming-Hsu Tsai
- Department of Mechanical Engineering, Cheng Shiu University, Kaohsiung 833, Taiwan
| | - Yu-Ling Wu
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Hung-Shyong Chen
- Department of Mechanical Engineering, Cheng Shiu University, Kaohsiung 833, Taiwan
- Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833, Taiwan
| | - Yao-Ning Lei
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
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Gong Z, Lin Y, Di P. Plaque accumulation on the fitting surface of full-arch implant-supported fixed prostheses with contact or noncontact pontics: A split mouth randomized controlled trial. J ESTHET RESTOR DENT 2023; 35:1077-1084. [PMID: 37171039 DOI: 10.1111/jerd.13062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/04/2023] [Accepted: 04/21/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To explore the differences in plaque accumulation on the fitting surface of full-arch implant-supported fixed prostheses with contact or noncontact pontics. MATERIALS AND METHODS Nineteen patients (20 prostheses, 7 in the maxilla, and 13 in the mandible) intending to undergo full-arch implant-supported immediate function prostheses were recruited. During immediate restoration and using the midline as the boundary, one side was restored as a pontic and mucosa noncontact type (the test group), and the opposite side was restored as a pontic and mucosa contact type (the control group). In a follow-up 6 months after the surgery, the cleanliness of the fitting surface of the immediate prosthesis was evaluated by plaque staining and debris index determination. Patient satisfaction was investigated by questionnaire. RESULTS Twenty prostheses from 19 patients included in the randomized controlled trial were followed up. Among the 20 prostheses, the percentage of area covered with plaque was significantly lower in the test group compared with that in the control group (31.5 ± 15.8% vs. 43.7 ± 15.3%; p < 0.001). The debris index in the test group was lower than that in the control group, although the difference was not statistically significant (2.77 ± 0.73 vs. 3.15 ± 0.90; p > 0.05). In the patient satisfaction survey, most of the patients were satisfied with most aspects of the prostheses, however, nearly half of the patients were not satisfied with the cleaning. CONCLUSIONS The pontic and mucosa noncontact prosthetic design reduces plaque accumulation on the fitting surface, which is beneficial for maintaining oral cleanliness. However, the majority of study samples were mandible and conclusions may not be fully applicable to maxilla. TRIAL REGISTRATION www.chictr.org.cn (ChiCTR1900028576). CLINICAL SIGNIFICANCE The noncontact design in full-arch implant-supported fixed prostheses may be an effective measure of improving oral hygiene promotion. There is need for more research that can further improve oral hygiene of patients with full-arch implant-supported prostheses.
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Affiliation(s)
- Zhenjiang Gong
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
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Sun X, Cheng K, Liu Y, Ke S, Zhang W, Wang L, Yang F. Biomechanical comparison of all-on-4 and all-on-5 implant-supported prostheses with alteration of anterior-posterior spread: a three-dimensional finite element analysis. Front Bioeng Biotechnol 2023; 11:1187504. [PMID: 37397958 PMCID: PMC10313229 DOI: 10.3389/fbioe.2023.1187504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/08/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction: The all-on-4 concept is widely used in clinical practice. However, the biomechanical changes following the alteration of anterior-posterior (AP) spread in all-on-4 implant-supported prostheses have not been extensively studied. Methods: Three-dimensional finite element analysis was used to compare the biomechanical behavior of all-on-4 and all-on-5 implant-supported prostheses with a change in anterior-posterior (AP) spread. A three-dimensional finite element analysis was performed on a geometrical mandible model containing 4 or 5 implants. Four different implant configurations were modeled by varying the angle of inclination of the distal implants (0°and 30°), including all-on-4a, all-on-4b, all-on-5a, and all-on-5b, and a 100 N force was successively applied to the anterior and unilateral posterior teeth to observe and analyze the differences in the biomechanical behavior of each model under the static influence at different position. Results: Adding an anterior implant to the dental arch according to the all-on-4 concept with a distal 30° tilt angle implant exhibited the best biomechanical behavior. However, when the distal implant was implanted axially, there was no significant difference between the all-on-4 and all-on-5 groups. Discussion: In the all-on-5 group, increasing the AP spread with tilted terminal implants showed better biomechanical behavior. It can be concluded that placing an additional implant in the midline of the atrophic edentulous mandible and increasing the AP spread might be beneficial in improving the biomechanical behavior of tilted distal implants.
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Affiliation(s)
- Xin Sun
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Kangjie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, China
- National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, China
| | - Yunfeng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
- Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, China
- National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, China
| | - Sipeng Ke
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Wentao Zhang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Linhong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Fan Yang
- Department of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
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Agliardi EL, Pozzi A, Romeo D, Del Fabbro M. Clinical outcomes of full-arch immediate fixed prostheses supported by two axial and two tilted implants: A retrospective cohort study with 12-15 years of follow-up. Clin Oral Implants Res 2023; 34:351-366. [PMID: 36760035 DOI: 10.1111/clr.14047] [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: 06/30/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To retrospectively assess clinical and radiographic outcomes of immediately loaded full-arch fixed prostheses supported by axial and tilted implants up to 15 years of function. MATERIALS AND METHODS Patients with one completely edentulous arch received an immediate full-arch fixed prosthesis supported by two anterior axial and two posterior tilted implants. Definitive prosthesis consisting of a CAD-CAM titanium framework and acrylic teeth was delivered 6 months later. Patients were regularly followed to assess clinical parameters and marginal bone level (MBL) change. Multilevel regression analysis was performed to investigate factors affecting implant failure and MBL. RESULTS Six hundred ninety-two implants were placed in 72 maxillae and 101 mandibles. Seven maxillary implants (5 axial and 2 tilted) in 6 patients and 12 mandibular implants (6 axial and 6 tilted) in 5 patients failed. 15-year cumulative implant survival was 97.51% and 96.91% in maxilla and mandible, respectively (p = .64). After 10 years, the difference in MBL between axial and tilted implants was not significant in the maxilla (p = .47, 65 patients), while it was in the mandible (p < .001, 80 patients). Significant higher bone loss was reported in the mandible at both 5- and 10-year follow-up (p < .001 and p = .004, respectively). Mixed-effect multilevel linear regression evidenced a correlation between arch and bone loss at 5- and 10-year follow-up, while no correlation was found with age, gender, smoking, diabetes, and history of periodontal disease. CONCLUSION This long-term study suggests that the present technique can be considered a viable treatment modality for the immediate rehabilitation of both maxilla and mandible.
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Affiliation(s)
- Enrico Luigi Agliardi
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Alessandro Pozzi
- Dental College of Georgia, Augusta, USA.,Private Practice in Rome, Rome, Italy
| | - Davide Romeo
- Advanced Oral Surgery Unit, Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,UOC Maxillofacial Surgery and Dentistry, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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La Monaca G, Pranno N, Annibali S, Di Carlo S, Pompa G, Cristalli MP. Immediate flapless full-arch rehabilitation of edentulous jaws on 4 or 6 implants according to the prosthetic-driven planning and guided implant surgery: A retrospective study on clinical and radiographic outcomes up to 10 years of follow-up. Clin Implant Dent Relat Res 2022; 24:831-844. [PMID: 36197040 PMCID: PMC10092257 DOI: 10.1111/cid.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full-arch prostheses, supported by 4/6 implants according to prosthetic-driven planning and guided surgery. MATERIALS AND METHODS The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all-on-4/15 all-on-6) and 164 implants. The Implants survival, prostheses success/survival, peri-implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss. RESULTS Cumulative implant survival rate was 89.7% for all-on-four (seven failures) and 99.0% for all-on-six (one failure) after a mean follow-up of 6.46 ± 2.236 years (range 1-10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all-on-four/ 43.8% for all-on-six). Prosthesis survival rate was 88.2% for all-on-four. No failure was registered in all-on-six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5-year and 2.09 ± 0.56 mm at 10-year follow-up. No difference was found in the mean value of marginal bone resorption between all-on-four (1.56 ± 1.61 mm) and all-on-six (1.20 ± 0.85 mm) (p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) (p = 0.385) after 5-year follow-up. The incidence of biological complications was 1.0% in all-on-six (one mucositis) and 10.3% in all-on-four (two peri-implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears. CONCLUSIONS Based on the results and within the limitations of the present study, the implant-supported hybrid prosthesis according to prosthetic-driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza, University of Rome, Rome, Italy
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Chen C, Lai H, Zhu H, Gu X. Digitally prefabricated versus conventionally fabricated implant-supported full-arch provisional prosthesis: a retrospective cohort study. BMC Oral Health 2022; 22:335. [PMID: 35945572 PMCID: PMC9361685 DOI: 10.1186/s12903-022-02376-y] [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: 04/23/2022] [Accepted: 08/03/2022] [Indexed: 12/05/2022] Open
Abstract
Background To evaluate and compare the clinical outcomes of digitally prefabricated and conventionally fabricated implant-supported full-arch provisional prostheses. Methods In this retrospective study, a total of 39 patients (22 males and 17 females) who underwent implant-supported full-arch rehabilitation using the All-on-4 concept with an immediate loading protocol were included: 20 patients treated with digitally prefabricated provisional prostheses were assigned into Group A, and 19 patients treated with conventionally fabricated provisional prostheses were assigned into Group B. Implant/provisional prosthesis survival rates and complications were reviewed. Marginal bone loss (MBL) was investigated by CBCT. Surgical time, restorative time, and total operative time were analyzed. Postoperative pain and swelling were evaluated with the visual analog scale (VAS). The oral health impact profile (OHIP) questionnaire was administered before and after surgery. Results The implant/provisional prosthesis survival rate was 100%, and complications appeared with low frequency in both groups, while the mean MBL was 0.30 ± 0.29 mm in Group A and 0.31 ± 0.41 mm in Group B after 3~ 6 months (P > 0.05). The average restorative time in Group A (116.16 ± 16.61 min) was significantly shorter than that in Group B (242.11 ± 30.14 min) (P < 0.05). Patients in Group A showed lower pain/swelling VAS scores after surgery than Group B (P < 0.05). Low OHIP scores with high satisfaction with the overall effects were shown in both groups. Conclusion Prefabricated prostheses reduced the prosthetic time and postoperative discomfort in patients whose immediate rehabilitation was based on the All-on-4 concept. This prefabrication technology may be a predictable alternative to improve the short-term clinical outcome of implant-supported full-arch provisional rehabilitation.
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Affiliation(s)
- Chaoqun Chen
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Haiyan Lai
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Huiyong Zhu
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
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Bone quality effect on short implants in the edentulous mandible: a finite element study. BMC Oral Health 2022; 22:139. [PMID: 35473637 PMCID: PMC9044581 DOI: 10.1186/s12903-022-02164-8] [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: 01/24/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The aim of this study was to verify whether the use of short implants could optimize stress distribution of bone surrounding implants in atrophic mandibles with different bone qualities. Methods A three-dimensional model of the atrophic mandible with three levels of bone quality was made using computer software. Short implants (6 mm) and standard implants (10 mm) were used in four designs: Design 1 "All-On four", Design 2 "All-On-four" with two short implants, Design 3 four vertical implants with two short implants, and Design 4 six short implants. The distal short implants were placed at the first molar position. All twelve models were imported into finite element analysis software, and 110 N oblique force was loaded on the left second premolar. Maximum principal stress values of peri-implant bone and the volumes of bone with over 3000 microstrians (overload)were analyzed. Result Stress values and volumes of overload bone increased in all four groups with the decline of bone quality. The highest stress values were found in the cortical bone surrounding the Design 1 inclined implant in two lower bone quality mandibles, and the lowest in Design 3. However, Design 1 had less overload bone tissue than all three designs with short implants. Conclusion Short implants placed posteriorly helped decrease stress values in peri-implant bone, while bone surrounding short implants had a high resorption risk in low bone quality mandible.
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Ebeid K, Nouh I, Ashraf Y, Cesar PF. Accuracy of different laboratory scanners for scanning of implant-supported full arch fixed prosthesis. J ESTHET RESTOR DENT 2022; 34:843-848. [PMID: 35441805 DOI: 10.1111/jerd.12918] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study evaluated the accuracy of different laboratory scanners (LS) for scanning of implant-supported full arch fixed prosthesis with different implant angulations. MATERIALS AND METHODS Two maxillary models that are designed to receive an all-on-four implant retained prosthesis were fabricated then scanned using five different LS. The models were divided into two groups according to the angulation of the posterior implant (Group 1; 30° and group 2; 45°). Each group was then subdivided into five subgroups according to the type of LS, subgroup T; Medit T710, subgroup I; IneosX5, subgroup E; 3ShapeE4, subgroup A; Autoscan DS-Mix, and subgroup M; Ceramill Map600. An industrial 3D scanner was used as reference scanner, then each model was scanned with 5 LS 10 times. Trueness and precision were analyzed using Geomagic 3D analysis software. RESULTS Both scanner type and implant angle had a significant effect on the trueness (p < 0.001). Significant interaction was found between the scanner type and implant angle (p < 0.001). For scanner type tukeys post hoc test revealed highest trueness with the 3Shape E4 (21.3 ± 2.1) and the medit T710 (22.6 ± 2.1) and least trueness with the shining 3D autoscan ds-mix (33.8 ± 3.0). Significantly better trueness was observed with the 30° than the 45° angle. Regarding precision, two-way ANOVA revealed significant effect of the scanner type only (p < 0.001). There were no significant differences between the 3Shape E4, medit T710, Ineos X5, and the Ceramill map600. However, all showed significantly higher precision values when compared to shining 3D autoscan ds-mix. CONCLUSIONS All tested scanners showed results within the clinically acceptable range with 3ShapeE4 and Medit T710 showing the highest accuracy. CLINICAL SIGNIFICANCE Tested scanners can be used for scanning of All-on-four implant supported prosthesis.
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Affiliation(s)
- Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ingy Nouh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Yasmine Ashraf
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Paulo F Cesar
- Department of Biomaterials and Oral Biology, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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de Araújo Nobre M, Lopes A, Antunes E. The 10 Year Outcomes of Implants Inserted with Dehiscence or Fenestrations in the Rehabilitation of Completely Edentulous Jaws with the All-on-4 Concept. J Clin Med 2022; 11:jcm11071939. [PMID: 35407547 PMCID: PMC8999632 DOI: 10.3390/jcm11071939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 12/10/2022] Open
Abstract
Background: There is a need for a long-term evidence of implants placed in challenging conditions. The aim of this study was to investigate the outcome of full-arch rehabilitations with the All-on-4 concept for implants inserted with dehiscence or fenestrations. Methods: This retrospective cohort study included 123 patients (dehiscence, n = 87 patients; fenestrations, n = 28 patients; both conditions, n = 8 patients), with a total of 192 implants in immediate function presenting dehiscence (n = 150), fenestrations (n = 40), or both conditions (n = 2). Primary outcome measures were cumulative implant survival (CSurR) and success (CSucR) rates. Secondary outcome measures were prosthetic survival, marginal bone loss, and incidence of biological complications. Results: CSurRs were 94.1% (overall), 95.6% (dehiscence), and 88.1% (fenestrations) at 10 years using the patient as the unit of analysis. Smoking affected implant failure significantly (p = 0.019). Implant-level CSurRs and CSucRs at 10 years were 96.2% and 93.5% (overall), 97.2% and 94.6% (dehiscence), and 90.0% and 87.6% (fenestrations), respectively. Average bone resorption at 5 and 10 years was 1.22 mm and 1.53 mm, respectively. Biological complications occurred in 18 patients (n = 18 implants). Conclusions: Implants inserted with dehiscence or fenestrations demonstrate good long-term outcomes with overall high success and survival rates and low average marginal bone resorption, despite an inferior outcome in implants with fenestrations and smoking’s negative effect.
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Affiliation(s)
- Miguel de Araújo Nobre
- Research, Development and Education Department, Maló Clinic, 1600-042 Lisboa, Portugal
- Correspondence: ; Tel.: +351-21-7228-100
| | - Armando Lopes
- Oral Surgery Department, Maló Clinic, 1600-042 Lisboa, Portugal;
| | - Elsa Antunes
- Dental Hygiene Department, Maló Clinic, 1600-042 Lisboa, Portugal;
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Rehabilitation of the Completely Edentulous Mandible by All-on-Four Treatment Concept: A Retrospective Cohort Study with Up to 10 Years Follow-Up. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010010. [PMID: 35056317 PMCID: PMC8779431 DOI: 10.3390/medicina58010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 02/01/2023]
Abstract
(1) Background and Objectives. Currently, there are no definitive long-term data about clinically significant difference in the failure of prosthesis and implant or marginal bone loss related to the rehabilitation of the completely edentulous mandible by all-on-four treatment concept. The main aim of present investigation was to report the long-term outcomes (10-years follow-up) of complete-arch mandibular rehabilitations based on the all-on-four concept. (2) Materials and Methods. Patients in need of extractions of teeth due to the occurrence of caries and/or severe periodontal disease and patients presented with edentulous mandibles were enrolled to the study. A total of 96 participants (mean follow-up period after intervention of 3185.2 days) were enrolled in the study. Participants were evaluated at the first visit, 10 days after intervention and every year after the intervention. Implant and prosthesis survival, bone loss and both local biological and mechanical complications were evaluated during the follow-up period. (3) Results. An implants’ survival rate of 97.9% was observed at the end of the follow-up period. Biological complications were reported in 19.8% of patients, whereas mechanical complications were reported in 27.1% of cases. The average marginal bone level at baseline was −0.03 mm. A significant marginal bone loss was observed after 10-years follow-up (2.5 mm). Binary logistic regression analysis showed significant association between smoke and both marginal bone loss and local biological complications. Lastly, a significant association was observed between bruxism and mechanical complications. (4) Conclusions. The high implant and prosthesis survival rate and the moderate incidence of biological and mechanical complications observed in present investigation can be associated to several factors such as high implant primary stability, prosthetic design, and control of the occlusal forces.
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Krennmair S, Malek M, Forstner T, Krennmair G, Stimmelmayr M, Hunger S. Immediately loaded implants simultaneously placed in fresh extraction and healed sites supporting four-implant-supported fixed mandibular prostheses using the all-on-4 concept: A 5-year prospective study. Clin Oral Implants Res 2021; 33:158-171. [PMID: 34800325 DOI: 10.1111/clr.13879] [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: 02/26/2020] [Revised: 10/18/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the peri-implant marginal bone level for immediately loaded implants placed simultaneously in both fresh extraction sites (FES) and healed sites (HS) supporting a 4-implant supported mandibular fixed prosthesis (4-ISFMP) using the all-on-4 concept. MATERIAL AND METHODS A 5-year prospective study was conducted in 24 patients (96 implants) treated with 4-ISFMP including 55 implants inserted in FES and 41 implants in HS. At implant placement (baseline) and at the 1st -, 3rd - and 5th -year follow-up examinations, peri-implant marginal bone level was evaluated radiographically and compared between placement in FES and HS. Marginal bone loss was calculated as the difference in the marginal bone level evaluated at the follow-up periods. Additionally, implant and prosthesis survival rates as well as the presence of peri-implant mucositis (bleeding on probing+[BOP]) and peri-implantitis (BOP+ >2 mm MBL) were evaluated. RESULTS 22/24 patients with 88/96 implants (dropout rate: 8.3%) were continually followed for 5 years (survival rate: 100%). Radiographically measured marginal bone level differed significantly between FES and HS at implant placement (1.46 ± 0.80 mm vs. 0.60 ± 0.70 mm; p < .001), at the 1-year (-0.04 ± 0.14 mm vs. -0.18 ± 0.20 mm; p = .002) and 3-year (-0.26 ± 0.49 mm vs. -0.58 ± 0.48 mm, p = .049), but not at the 5-year evaluation (-0.90 ± 0.66 mm vs. -1.00 ± 0.59 mm, p = .361). The marginal bone loss differed significantly (p < .001) between FES and HS between implant placement and the 1-year evaluation but not for the 1- to 3-year (p > .99) and the 3- to 5-year period (p = .082). At the 5-year follow-up evaluation, no implant/prosthesis failed (100% survival) and peri-implant mucositis and peri-implantitis were noted in 41.2% and 11.7% at patient level and in 17.6% and 4.5% at implant level respectively. CONCLUSION Implants placed in FES showed a prolonged peri-implant remodelling process but provided for similar peri-implant marginal bone levels as implants placed in HS at the 5-year evaluation for immediately loaded 4-ISFMP.
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Affiliation(s)
- Stefan Krennmair
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
| | - Michael Malek
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
| | - Thomas Forstner
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria.,Department of Applied Systems Research Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Gerald Krennmair
- Dental School, Sigmund Freud Private Medical University Vienna, Austria
| | | | - Stefan Hunger
- Department of Oral & Maxillofacial Surgery, Johannes Kepler University Linz, Linz, Austria
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Clinical Effect and Aesthetic Observation of All-on-4 Immediate Loading Implant Denture in Severe Periodontitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3120260. [PMID: 34462640 PMCID: PMC8403045 DOI: 10.1155/2021/3120260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/12/2021] [Indexed: 12/17/2022]
Abstract
Objective To explore the clinical effect and aesthetics of All-on-4 immediate loading implant denture in severe periodontitis. Methods Totally, 60 patients with dentition loss caused by severe periodontitis who were admitted to our hospital from February 2017 to February 2019 were selected. The patients were randomly divided into the observation group (n = 30) and the control group (n = 30) according to different restoration methods. The control group was used in traditional implant restoration treatment, and the observation group was used in All-on-4 immediate loading implant denture restoration. The clinical effect, periodontal index, aesthetic effect, and complications of the two groups were compared, and the levels of serum leptin (LEP), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6) were measured. Results The total effective rate of the observation group (83.33%) was higher than that of the control group (60.00%) (P < 0.05). After treatment, the plaque index, gingival sulcus bleeding index, and depth of exploration of the two groups were lower than those before treatment (P < 0.05), and there was no significant difference between the two groups (P > 0.05). After treatment, the serum LEP, TNF-α, CRP, and IL-6 in both groups were lower than before treatment, and the serum LEP, TNF-α, CRP, and IL-6 in the observation group were lower than that in the control group (P < 0.05). The aesthetic rate of teeth in the observation group (90.00%) was higher than that in the control group (66.67%) (P < 0.05). There was no significant difference in the total incidence of complications between the two groups (P > 0.05). Conclusion All-on-4 immediate loading implant denture has a good effect in the treatment of severe periodontitis, which is conducive to maintaining periodontal health, reducing the level of inflammation, improving aesthetics, and has high safety.
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Casula L, Poli A, Clemente T, Artuso G, Capparé P, Gherlone EF. Prevalence of peri-implantitis in a sample of HIV-positive patients. Clin Exp Dent Res 2021; 7:1002-1013. [PMID: 34288560 PMCID: PMC8638315 DOI: 10.1002/cre2.469] [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: 04/24/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence of peri-implantitis in human immunodeficiency virus (HIV)-positive patients and the presence of a possible correlation between the immunological profile and serological values, of peri-implantitis, and of possible differences between all-on-4 and single crown/bridge prostheses. SUBJECTS AND METHODS This retrospective study included 58 adult HIV-positive patients (222 implants) with either all-in-4 prostheses or single crowns/bridges on at least one dental implant loaded for more than a year who were followed for 3 year (mean follow-up). Data pertaining to the probing pocket depth (PPD), bleeding on probing, and immunological and systemic profile were collected. RESULTS Patients with single crown/bridge implant rehabilitation showed higher prevalence of peri-implantitis (34%) than patients with all-on-4 rehabilitation (0%) (p = 0.012). Patients with all-on-4 rehabilitation were significantly older than those with single crowns/bridges (p = 0.004). Patients with peri-implantitis had implants for a significantly longer duration than those without (p = 0.001), implying that the probability of peri-implantitis increases as the age of implant increases. CONCLUSIONS The prevalence of peri-implantitis was 26% in the HIV-positive patients population. No correlation was found between patients' immunological and serological factors and peri-implantitis. The most important risk factor for peri-implantitis and mucositis was implant age.
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Affiliation(s)
- Luca Casula
- Oral Surgery Resident, Department of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Poli
- BioEngineering, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tommaso Clemente
- Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Paolo Capparé
- Dental School, Vita-Salute San Raffaele University, Milan, Italy
| | - Enrico F Gherlone
- Department of Dentistry, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
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Korsch M, Walther W, Hannig M, Bartols A. Evaluation of the surgical and prosthetic success of All-on-4 restorations: a retrospective cohort study of provisional vs. definitive immediate restorations. Int J Implant Dent 2021; 7:48. [PMID: 34056669 PMCID: PMC8165050 DOI: 10.1186/s40729-021-00330-1] [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: 12/13/2020] [Accepted: 03/19/2021] [Indexed: 01/10/2023] Open
Abstract
Background All-on-4 concept allows an immediate restoration, which is frequently a provisional restoration (PR), and will be replaced by a definitive restoration (DR) a few months later. However, this approach involves much higher treatment efforts and costs, compared to a DR immediately after implantation. PRs were mostly incorporated in the introductory phase of the All-on-4 concept in our respective clinics. Today, PRs are only used for referred patients and bimaxillary restorations. The aim of the study was to investigate whether PRs and DRs have comparable success rates. Methods A total of 126 patients with 136 All-on-4 restorations supported by 544 implants were included in this retrospective cohort study. The observation period was 1 year. In 42 cases, a PR was placed initially and replaced by a DR 3 months later. In 94 cases, a DR was placed immediately. Biological, technical, and severe (loss of an implant or PR/DR) complications associated with PRs and DRs were compared. The absence of a serious complication was considered a success. Results A total of 27 patients were affected by 33 complications, 19 biological (2 PR and 17 DR) and 14 technical (6 in PR and 8 in DR) in the first 3 months. Eight patients had ten severe complications (1 PR and 9 DR). Severe complications were all implant losses. Implant survival rate was 98.2% (99.4% PR and 97.6 DR), and restoration survival rate was 94.4% (97.6% PR and 92.6% DR). Six out of the ten implant losses occurred in the posterior maxillae of male patients. After 3 months, ten complications occurred in six patients within 1 year. One of these complications was an implant loss in the posterior maxillae of a male patient. Conclusion PRs and DRs showed comparable complication rates during the observation period. Only in male patients did implant losses occur more frequently in the posterior maxilla. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00330-1.
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Affiliation(s)
- Michael Korsch
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany. .,Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Germany. .,Center for Implantology and Oral Surgery, 69120, Heidelberg, Germany.
| | - Winfried Walther
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Germany
| | - Andreas Bartols
- Dental Academy for Continuing Professional Development, Lorenzstrasse 7, 76135, Karlsruhe, Germany.,Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University, Kiel, Germany
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de Carvalho LP, de Carvalho AM, Francischone CE, do Amaral FLB, Sotto-Maior BS. Biomechanical behavior of atrophic maxillary restorations using the all-on-four concept and long trans-sinus implants: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2021; 15:106-110. [PMID: 34386181 PMCID: PMC8346716 DOI: 10.34172/joddd.2021.018] [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: 06/14/2020] [Accepted: 01/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background. Maxillary bone atrophy with a considerable amount of pneumatization and anterior expansion of the maxillary sinus might be a situation limiting oral rehabilitation with osseointegrated implants. Therefore, the present study aimed to biomechanically evaluate two rehabilitation techniques for maxillary bone atrophy: all-on-four and long trans-sinus implants. Methods. Two three-dimensional models consisting of atrophic maxilla with four implants were simulated. In the M1 model, two axially inserted anterior implants and two tilted implants, 15 mm in length, placed tangential to the maxillary sinus’s anterior wall were used. In the M2 model, two axially inserted anterior implants and two trans-sinus tilted implants, 24 mm in length, were used. For the finite element analysis (FEA), an axial load of 100 N was applied on the entire extension of the prosthesis, simulating a rehabilitation with immediate loading. The peri-implant bone and the infrastructure were analyzed according to the Mohr-Coulomb and Rankine criteria, respectively. Results. The results were similar when the stresses on peri-implant bone were compared: 0.139 and 0.149 for models 1 and 2, respectively. The tension values were lower in the model with trans-sinus implants (27.99 MPa). Conclusion. It was concluded that the two techniques exhibited similar biomechanical behavior, suggesting that the use of long trans-sinus implants could be a new option for atrophic maxilla rehabilitation.
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Affiliation(s)
| | | | | | | | - Bruno Salles Sotto-Maior
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Juiz de Fora, Brazil
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ÖZDAL ZİNCİR Ö. Sosyal medya kullanıcılarına sağlanan All-on-4 dental implant sistemi hakkındaki bilgilerin yararlılığı. ACTA ODONTOLOGICA TURCICA 2021. [DOI: 10.17214/gaziaot.784657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Nunes de Sousa BL, Leitão de Almeida B. Pterygoid implants for the immediate rehabilitation of the atrophic maxilla: A case report of a full arch on 4 implants. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ben Yehuda D, Weber H, Finkelman M, Sicilia E, Muftu A, Chochlidakis K, Papaspyridakos P. Accuracy of Guided Implant Surgery in 25 Edentulous Arches: A Laboratory Observational Study. J Prosthodont 2020; 29:718-724. [DOI: 10.1111/jopr.13224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daniel Ben Yehuda
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Matthew Finkelman
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston MA
| | - Elena Sicilia
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Ali Muftu
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | | | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
- Department of Prosthodontics University of Rochester Eastman Institute for Oral Health Rochester NY
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Krennmair S, Hunger S, Postl L, Winterhalder P, Holberg S, Malek M, Rudzki I, Holberg C. Edentulous mandible with four splinted interforaminal implants exposed to three different situations of trauma: A preliminary three‐dimensional finite element analysis. Dent Traumatol 2020; 36:607-617. [DOI: 10.1111/edt.12575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Stefan Krennmair
- NumBioLab Department of Orthodontics Ludwig‐Maximilians University of Munich Munich Germany
| | - Stefan Hunger
- Department of Oral and Maxillofacial Surgery Johannes Kepler University Linz Linz Austria
| | - Lukas Postl
- NumBioLab Department of Orthodontics Ludwig‐Maximilians University of Munich Munich Germany
- Department of Oral and Maxillofacial Surgery Johannes Kepler University Linz Linz Austria
| | - Philipp Winterhalder
- Department of Oral and Maxillofacial Surgery RWTH Aachen University Aachen Germany
| | - Svenia Holberg
- NumBioLab Department of Orthodontics Ludwig‐Maximilians University of Munich Munich Germany
| | - Michael Malek
- Department of Oral and Maxillofacial Surgery Johannes Kepler University Linz Linz Austria
| | - Ingrid Rudzki
- NumBioLab Department of Orthodontics Ludwig‐Maximilians University of Munich Munich Germany
| | - Christof Holberg
- NumBioLab Department of Orthodontics Ludwig‐Maximilians University of Munich Munich Germany
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de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N. Hybrid Polyetheretherketone (PEEK)-Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up. J Clin Med 2020; 9:jcm9072187. [PMID: 32664393 PMCID: PMC7408851 DOI: 10.3390/jcm9072187] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.
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Affiliation(s)
- Miguel de Araújo Nobre
- MALO CLINIC, Research and Development Department, Av. Combatentes, 43, 11, 1600-042 Lisbon, Portugal
- Correspondence:
| | - Carlos Moura Guedes
- MALO CLINIC, Prosthodontics Department, Av. Combatentes, 43, 10, 1600-042 Lisbon, Portugal; (C.M.G.); (R.A.)
| | - Ricardo Almeida
- MALO CLINIC, Prosthodontics Department, Av. Combatentes, 43, 10, 1600-042 Lisbon, Portugal; (C.M.G.); (R.A.)
| | - António Silva
- MALO CLINIC, Ceramics, Av. Combatentes, 43, 11, 1600-042 Lisbon, Portugal;
| | - Nuno Sereno
- Invibio Biomaterial Solutions & JUVORA, Global Technology Center, Hillhouse International, Thornton, Cleveleys FY5 4QD, UK;
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Open-Healing Socket Preservation with a Novel Dense Polytetrafluoroethylene (dPTFE) Membrane: A Retrospective Clinical Study. ACTA ACUST UNITED AC 2020; 56:medicina56050216. [PMID: 32354120 PMCID: PMC7279177 DOI: 10.3390/medicina56050216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/22/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: Non-resorbable dense polytetrafluoroethylene (dPTFE) membranes are widely used for regeneration procedures, alone or in combination with particulate materials. The aim of this work was to examine the efficacy of a newly developed dPTFE membrane in the management of extraction socket healing. Materials and Methods: The extraction premolar sockets of 44 patients (20 men and 24 women) were preserved. One group received prosthetic rehabilitation with a fixed partial denture (FPD) (PROS group, N = 19) and a second group received immediate implant placement (IMPL group, N = 25). The PROS group sockets were augmented with a bovine derived xenograft and covered with a newly developed dPTFE membrane prior to FPD rehabilitation. Results: In the IMPL group, socket preservation was combined with immediate implant placement. Before (T0) and 6 months after surgery (T1), horizontal and vertical dimensions were measured with customized stents. No significant differences in alveolar bone loss from T0 to T1 were observed between the PROS and IMPL groups in the horizontal dimension for any tooth type. There was a significant difference in alveolar bone loss from T0 to T1 between the two groups for only single-rooted maxillary premolars in the vertical dimension. Conclusions: The use of the examined new dPTFE membrane consistently led to the preservation of hard tissue in the extraction sites.
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Lopes A, de Araújo Nobre M, Santos D. The Workflow of a New Dynamic Navigation System for the Insertion of Dental Implants in the Rehabilitation of Edentulous Jaws: Report of Two Cases. J Clin Med 2020; 9:jcm9020421. [PMID: 32033089 PMCID: PMC7073768 DOI: 10.3390/jcm9020421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/16/2020] [Accepted: 02/01/2020] [Indexed: 12/19/2022] Open
Abstract
Background: This case series describes the surgical workflow during maxillary full-arch rehabilitations in two patients through the All-on-4 concept (standard and hybrid) assisted by DTX Studio Implant Software planning and X-Guide Navigation. Results: The X-Guide Navigation enabled the drills and implants to be positioned and oriented precisely, allowing the implants to be positioned favorably under the surgical and prosthetic points of view through the avoidance of damage to the maxillary sinus and nasal cavity. Dynamic navigation-assisted surgery provided advantages, including the possibility to modify the implants’ system, length, or location perioperatively. However, it must be underlined that to achieve proficiency with this technology it is necessary to consider a necessary learning curve. Conclusion: The insertion of dental implants assisted by dynamic navigation for maxillary full-arch rehabilitations was considered a safe and predictable procedure. Nevertheless, it can be improved (such as with a simpler fiducial markers protocol), aiming to simplify the procedure.
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Affiliation(s)
- Armando Lopes
- Implantology Department, Maló Clinic, 1600-042 Lisbon, Portugal; (A.L.); (D.S.)
| | - Miguel de Araújo Nobre
- Research and Development Department, Maló Clinic, 1600-042 Lisbon, Portugal
- Correspondence: ; Tel.: +351-217-228-100
| | - Diogo Santos
- Implantology Department, Maló Clinic, 1600-042 Lisbon, Portugal; (A.L.); (D.S.)
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Papaspyridakos P, Bordin TB, Kim YJ, El-Rafie K, Pagni SE, Natto ZS, Teixeira ER, Chochlidakis K, Weber HP. Technical Complications and Prosthesis Survival Rates with Implant-Supported Fixed Complete Dental Prostheses: A Retrospective Study with 1- to 12-Year Follow-Up. J Prosthodont 2019; 29:3-11. [PMID: 31650669 DOI: 10.1111/jopr.13119] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. MATERIALS AND METHODS The single-visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Kaplan-Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. RESULTS Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1-12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal-resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement-retained IFCDPs (2.9%), and loss of the screw access filing material of the screw-retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal-resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). CONCLUSIONS After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5-year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5-year dental unit-based rate of 9.5%. The cumulative rates for "prosthesis free of minor complications" at 5- and 10-years were 60.5% (95% CI: 47.2-71.3%) and 8.9% (95% CI: 2.9-18.0%), respectively. The cumulative rates for "prosthesis free of major technical complications" at 5- and 10-years were 85.5% (95% CI: 73.0-92.5%) and 30.1% (95% CI: 12.0-50.6%), respectively. Presence of bruxism, and absence of a nightguard were associated with increased risk for chipping of the prosthetic material of the IFCDPs.
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Affiliation(s)
- Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Thaisa Barizan Bordin
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Yong-Jeong Kim
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Khaled El-Rafie
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Sarah E Pagni
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Zuhair S Natto
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Eduardo Rolim Teixeira
- Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
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