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Kern JS, Salin E, Elvers D, Rittich A, Tuna T, Hölzle F, Wolfart S. Maxillary and mandibular overdentures retained by two unsplinted narrow-diameter titanium-zirconium implants - A clinical pilot study. Clin Oral Implants Res 2024. [PMID: 38822688 DOI: 10.1111/clr.14303] [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: 02/07/2024] [Revised: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES To evaluate the survival rates and marginal bone loss of narrow-diameter titanium-zirconium implants supporting complete maxillary and mandibular overdentures up to 3 years after loading. MATERIALS AND METHODS Ten completely edentulous patients who were dissatisfied with their complete dentures were enrolled. Two narrow-diameter implants were placed in the canine region of the maxilla and mandible. After second-stage surgery, implant-supported overdentures (palatal-free) attached by parallel alignable stud-attachments were placed. Patients were followed periodically for up to 36 months. Standardized radiographs were taken at baseline, 12 and 36 months to analyze mean marginal bone level changes around the implants. RESULTS The Kaplan-Meier survival rates were 100% for mandibular and 68.0% (SE ± 10.9%) for maxillary implants at 36 months (p = .008). Six maxillary implants failed after loading; no mandibular implants were lost. Five implants failed due to loss of osseointegration. One implant fractured. The mean marginal bone level changes around the analyzed implants (n = 28, 9 patients) were -0.71 ± 0.82 mm in the mandible and -2.08 ± 1.52 mm in the maxilla at the 36-month follow-up. The difference in marginal bone level changes between the maxilla and mandible was significant (p = .019) at the 12- and 36-month follow-ups. CONCLUSION Two narrow-diameter titanium-zirconium implants with stud-attachments showed a highly satisfactory outcome in the mandible. The maxillary implants showed a high failure rate and significantly more bone loss over time than the mandibular implants. The minimal concept of two implants and an overdenture should be limited to the edentulous mandible.
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Affiliation(s)
- Jaana-Sophia Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Esra Salin
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Dirk Elvers
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Lin X, Yu X, Wang F, Wu Y. Marginal bone level change of immediately restored implants with simultaneous guided bone regeneration: A systematic review. Clin Implant Dent Relat Res 2023; 25:1112-1137. [PMID: 37555385 DOI: 10.1111/cid.13255] [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: 06/02/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
AIM To assess marginal bone level change (MBLc), clinical outcomes for soft tissue, and survival rates for immediately restored implants with simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS Electronic and manual searches were conducted in PubMed/MEDLINE, EMBASE, and CENTRAL for studies that investigated immediately restored implants in simultaneously grafted sites with a mean follow-up of over 12 months. MBLc was the primary outcome. Soft tissue clinical parameters and implant survival rate (ISR) were the secondary outcomes. RESULTS Twenty-five studies (5 randomized controlled trials, 6 prospective studies, 2 retrospective studies, and 12 case series) were included, from which 692 immediately restored implants were analyzed. For studies that investigated bone grafts in the gap between the implant and the peripheral bone wall, the weighted mean MBLc was -0.73 ± 1.52 mm (range: -1.50 to 0.26 mm) for 475 implants. Pink esthetic score (PES) was improved in eight studies and the weighted cumulative ISR was 98.99% (Median: 100%) in 622 implants. Mean MBLc was -1.19 ± 0.26 mm for 30 implants in studies that reported gap with dehiscence and/or fenestration augmentation. Weighted cumulative ISR was 97.25% in 70 implants. A meta-analysis was not possible due to the lack of studies with an eligible control group. Therefore, the data should be interpreted with caution. CONCLUSION Less marginal bone loss and more predictable soft tissue parameters can be achieved for immediately restored implants with simultaneous peri-implant gap filling compared with gap with dehiscence/fenestration grafting. Increased ISR for implants with gap filling was observed. However, more evidence is needed to confirm whether immediate provisional prostheses should be utilized when bone defects are simultaneously augmented around the implants.
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Affiliation(s)
- Xinyan Lin
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinbo Yu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Wang
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yiqun Wu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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3
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Koenig A, Rotenburg L, Fuchs F, Sander S, Lethaus B, Hahnel S. Influence of aging of PEEK attachment inserts on the pull-off force of implant-retained overdentures - A laboratory study. Clin Oral Implants Res 2023; 34:1363-1372. [PMID: 37694944 DOI: 10.1111/clr.14180] [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: 03/14/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The aim of the current study is to investigate the influence of mechanical stress as well as cleaning agents on the performance of various polyether ether ketone (PEEK) inserts for implant-retained overdentures (IOD). MATERIALS AND METHODS Three different standard PEEK inserts were subjected to rapid artificial aging through storage in chemical denture cleaning agents (acetic acid, sodium hypochlorite, or sparkling denture cleaner) as well as demineralized water. The pre-aged PEEK inserts were then placed in unilateral IOD and subjected to 200,000 chewing loads (5 kg ~ 50 N), with 5000 thermal cycles (5/55°C), and 1100 removal/insertion cycles (vertical movement 2 mm). RESULTS For all the PEEK inserts, the retention forces decreased significantly with an increasing number of mechanical load cycles and after exposure to all the cleaning agents. PEEK inserts aged by exposure to chemical cleaning agents showed a significantly higher decline in retention force than the inserts stored in water. Confocal laser scanning microscopy indicated that the decline in retention force might be caused by wear on the internal insert surface in contact with the patrix. CONCLUSIONS Within the limitations of this study, it can be concluded that the application of chemical cleaning agents accelerates the decline in the retention forces of PEEK retentive inserts in IODs.
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Affiliation(s)
- Andreas Koenig
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Laura Rotenburg
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Stephan Sander
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
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Jung SW, Fan YQ, Lee C. Digital Workflow for Edentulous Patients with Implant-Supported Fixed Prostheses: A Fully Digital Technique. Dent J (Basel) 2022; 10:dj10090174. [PMID: 36135169 PMCID: PMC9498228 DOI: 10.3390/dj10090174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/15/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Dentists have made prostheses using traditional methods, which are inconvenient and time-consuming. It includes functional impression taking, plaster model production, wax rim production, intermaxillary relationship and occlusal plane setting, artificial tooth arrangement, denture polymerization, polishing, etc. To make prostheses in this way, the patient has to visit the dentist several times, and it takes a long time for them to receive treatment. In addition, the potential for errors associated with the denture-manufacturing process and the use of denture materials has always existed. However, the recent use of digital technology in dentistry has made it possible to create digital prostheses. Several techniques for the immediate loading of implants with a fixed prostheses in edentulous patients have been developed. However, these techniques are partially digital techniques that include laboratory work for prosthesis fabrication. This article aimed to describe a fully digital technique for implant-supported fixed prostheses. It includes intra-oral scanning of edentulous patients, implant placement planning, and final prosthesis fabrication. This technique facilitates a simple and more efficient immediate restoration after implant placement without using stone casts.
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Affiliation(s)
| | | | - Chunui Lee
- Correspondence: ; Tel.: +82-33-741-1451; Fax: +82-33-741-1442
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5
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Flanagan D, Fisher A, Ciardiello C, Moreno V, Pierce D, Uvalic A, Winsor J, Rubano M, Howard E, Lykotrafitis G. A Theoretical Iteration for Predicting the Feasibility for Immediate Functional Dental Implant Loading. J ORAL IMPLANTOL 2021; 47:310-317. [PMID: 33031553 DOI: 10.1563/aaid-joi-d-20-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
When planning an implant-supported restoration, the dentist is faced with surgical and prosthetic technical issues as well as the patient's expectations. Many patients wish an immediate solution to an edentulous condition. This may be especially true in the esthetic zone, and that zone is determined by the patient. The dentist may consider when it is feasible to load the supporting implants with definitive or provisional prosthetics. In this work, many parameters were theoretically assessed for inclusion: bone density, cortical thickness, insertion torque, parafunction, bite load capacity, number of implants under load, implant/crown ratio, implant diameter, and length. After assessment, the most influential parameters were selected. An iteration, using patient age, implant diameter, bite load capacity, and cortical thickness, is now presented to aid the implant dentist in determining the feasibility for immediate functional loading of a just-placed dental implant in a healed site. Extensive testing is required to develop this concept. According to this iteration, most immediate functional loaded implants would fail. A future refined and definitive formula may enable the clinician to safely and immediately functionally load an implant with a definitive prosthesis. For access to the applet, please go to https://implantloading.shinyapps.io/shiny_app/.
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Affiliation(s)
- Dennis Flanagan
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Alessandro Fisher
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Carmen Ciardiello
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Vito Moreno
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - David Pierce
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Alen Uvalic
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Jyotsna Winsor
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Mark Rubano
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - Eric Howard
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
| | - George Lykotrafitis
- University of Connecticut, Department of Mechanical Engineering, Storrs, Conn
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6
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Yoo SY, Kim SK, Heo SJ, Koak JY, Jeon HR. Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism-A Retrospective Study. J Clin Med 2021; 10:jcm10102170. [PMID: 34069868 PMCID: PMC8157346 DOI: 10.3390/jcm10102170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/31/2022] Open
Abstract
The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.
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Affiliation(s)
- Soo-Yeon Yoo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Seong-Kyun Kim
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
- Correspondence: ; Tel.: +82-2-2072-3860
| | - Seong-Joo Heo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Jai-Young Koak
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Hye-Rin Jeon
- Department of Computer Science, Columbia University, New York, NY 10027, USA;
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Cervino G, Meto A, Fiorillo L, Odorici A, Meto A, D’Amico C, Oteri G, Cicciù M. Surface Treatment of the Dental Implant with Hyaluronic Acid: An Overview of Recent Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094670. [PMID: 33925742 PMCID: PMC8125310 DOI: 10.3390/ijerph18094670] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 12/17/2022]
Abstract
Recently, interest has grown by focusing on the evaluation of a molecule already produced in the human body such as hyaluronic acid (HA), as an application to the surface of the titanium implant. Its osteo-conductive characteristics and positive interaction with the progenitor cells responsible for bone formation, consequently, make it responsible for secondary stability. The aim of this work was to analyze the various surface treatments in titanium implants, demonstrating that the topography and surface chemistry of biomaterials can correlate with the host response; also focusing on the addition of HA to the implant surface and assessing the biological implications during early stages of recovery. Used as a coating, HA acts on the migration, adhesion, proliferation and differentiation of cell precursors on titanium implants by improving the connection between implant and bone. Furthermore, the improvement of the bioactivity of the implant surfaces through HA could therefore facilitate the positioning of the dental prosthesis precisely in the early loading phase, thus satisfying the patients’ requests. It is important to note that all the findings should be supported by further experimental studies in animals as well as humans to evaluate and confirm the use of HA in any field of dentistry.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Agron Meto
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1000 Tirana, Albania;
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
- Correspondence:
| | - Alessandra Odorici
- Laboratory of Microbiology and Virology, School of Doctorate in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Via G. Campi 287, 41125 Modena, Italy;
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, 1005 Tirana, Albania;
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy; (G.C.); (C.D.); (G.O.); (M.C.)
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8
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Yoo SY, Kim SK, Heo SJ, Koak JY, Jeon HR. New Rehabilitation Concept for Maxillary Edentulism: A Clinical Retrospective Study of Implant Crown Retained Removable Partial Dentures. J Clin Med 2021; 10:jcm10081773. [PMID: 33921768 PMCID: PMC8073221 DOI: 10.3390/jcm10081773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/05/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
There have been no studies of implant-crown-retained removable partial dentures (IC-RPD) for the treatment of maxillary edentulism. The purpose of this study was to perform clinical and radiographic evaluations of implants in IC-RPD compared to implant overdentures (IOD) in maxillary edentulous patients. Twenty IC-RPDs with 74 splinted implant crowns and 18 IODs with 71 implants retained with magnet attachments were observed in 38 patients. We statistically analyzed survival rates and marginal bone loss (MBL) of implants based on multiple variables including first year pathologic condition, location of placed implant, age, and sex in both treatments. Patient reported oral measurements (PROMs) regarding functional/esthetic improvement after IC-RPD or IOD treatments and prosthetic complications were also statistically analyzed. After a median observation period of 47.1 months (up to 147 months), we observed 97.3% implant survival rates for IC-RPD and 70.4% for IOD (p < 0.001). Among variables, first year pathologic condition (p < 0.001) and sex (p = 0.027) influenced implant survival rates. The MBL of implants for IC-RPD and IOD groups at the final check-up were 1.12 ± 1.19 mm and 3.31 ± 1.71 mm, respectively (p < 0.001). In both groups, patients with peri-implantitis (p < 0.001) and patients older than 65 years (p = 0.029) showed significantly higher implant MBL regardless of treatment modality. Functional and esthetic satisfaction were significantly improved (p < 0.001) after both treatments. The IOD group showed more frequent prosthetic complications compared to the IC-RPD group. Within the limitations of a retrospective study, we concluded that RPD with few splinted implant crowns is a feasible alternative treatment modality for maxillary edentulous patients with anatomical limitations.
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Affiliation(s)
- Soo-Yeon Yoo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Seong-Kyun Kim
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
- Correspondence: ; Tel.: +82-2-2072-3860
| | - Seong-Joo Heo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Jai-Young Koak
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Hye-Rin Jeon
- Department of Mathematics, Ewha Womans University, Seoul 03760, Korea;
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9
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Considerations for the Prosthetic Dental Treatment of Geriatric Patients in Germany. J Clin Med 2021; 10:jcm10020304. [PMID: 33467579 PMCID: PMC7830366 DOI: 10.3390/jcm10020304] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/06/2021] [Accepted: 01/13/2021] [Indexed: 12/14/2022] Open
Abstract
Demographic changes in the industrialized countries require that dentists adapt to the growing and heterogeneous group of elderly patients and develop concepts for the dental care of fit, frail, and dependent old and very old people. In general, dental care for old and very old people should be based on their individual everyday life. As a result of demographic changes, improved oral hygiene at home, and the establishment of professional teeth and denture cleaning, tooth loss occurs increasingly in higher ages, which implies that first extensive prosthetic rehabilitation with fixed or/and removable dental prostheses is shifting to a higher average age than ever before. This phenomenon requires that the individual diseases, potential multimorbidity and polypharmacy, and associated limitations are taken into consideration. Against this background, the current survey aims to summarize epidemiological trends associated with tooth loss, using Germany as a highly representative country for demographic changes as an example. Furthermore, the current narrative summary outlines general principles that should be followed in dental care, treatment of geriatric patients, and outlines current therapeutic options in prosthetic dentistry.
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10
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Differences in treatment outcomes of definitive fixed implant-supported restorations with or without an interim restoration: A systematic review. J Prosthet Dent 2020; 126:735-741. [PMID: 33148400 DOI: 10.1016/j.prosdent.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Guidance to determine whether providing an interim implant-supported restoration is beneficial is lacking. PURPOSE The purpose of this systematic review was to answer the following focused question: "Does the use of interim fixed implant prostheses before placement of a definitive fixed implant-supported prostheses impact esthetics, peri-implant health, and osseointegration in partially dentate adults?" MATERIAL AND METHODS A search of electronic databases (Medline and Embase) and the nonpeer-reviewed literature for randomized controlled trials, systematic reviews, and cohort studies in the English language was conducted. RESULTS Two studies met the eligibility criteria. Heterogeneity of the study methodologies and outcome measures did not allow for meta-analysis. Use of interim implant-supported restorations may improve the esthetic outcome. Occlusal loading of definitive implant-supported prosthesis without the use of an interim restoration may decrease chair time and the number of patient visits. CONCLUSIONS The systematic review has found insufficient evidence to support or refute the practice of providing an interim restoration before delivering an implant-supported prosthesis.
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11
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Schmidt MB, Rauch A, Schwarzer M, Lethaus B, Hahnel S. Combination of Digital and Conventional Workflows in the CAD/CAM-Fabrication of an Implant-Supported Overdenture. MATERIALS 2020; 13:ma13173688. [PMID: 32825488 PMCID: PMC7503874 DOI: 10.3390/ma13173688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/09/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication of implant-supported overdentures. The 53-year old patient was supplied with a digitally processed complete denture in the upper jaw and, simultaneously, with an overdenture supported by four interforaminal implants in the lower jaw. The overdenture included a completely digitally processed and manufactured alloy framework that had been fabricated by selective laser sintering. The case report indicates that digital manufacturing processes for extensive and complex removable restorations are possible. However, as it is currently not yet possible to digitally obtain functional impressions, future developments and innovations might focus on that issue.
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Affiliation(s)
- Michael Benno Schmidt
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
- Correspondence:
| | - Angelika Rauch
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
| | - Marcus Schwarzer
- Flemming Dental Tec GmbH, Dental Technology Center, 04317 Leipzig, Germany;
| | - Bernd Lethaus
- Clinic for Oral and Maxillofacial Surgery, University of Leipzig, 04103 Leipzig, Germany;
| | - Sebastian Hahnel
- Clinic for Prosthodontics and Dental Materials Science, University of Leipzig, 04103 Leipzig, Germany; (A.R.); (S.H.)
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12
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Glücker C, Rauch A, Hahnel S. Attitude and treatment options in implant-supported prosthetics: A survey among a cohort of German dentists. J Adv Prosthodont 2020; 12:15-21. [PMID: 32128082 PMCID: PMC7040449 DOI: 10.4047/jap.2020.12.1.15] [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: 08/23/2019] [Revised: 01/26/2020] [Accepted: 02/03/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.
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Affiliation(s)
- Carolin Glücker
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
| | - Angelika Rauch
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
| | - Sebastian Hahnel
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
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Carneiro-Campos LE, Freitas-Fernandes LB, Masterson D, Magno MB, Fernandes CP, Maia LC, Zanetta-Barbosa D. Does the natural maxillary dentition influence the survival rate of mandibular metal-resin implant-supported fixed complete dentures? A systematic review and meta-analysis. J Prosthet Dent 2019; 124:36-45. [PMID: 31753454 DOI: 10.1016/j.prosdent.2019.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 10/25/2022]
Abstract
STATEMENT OF PROBLEM Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD) with distal cantilevers. PURPOSE The purpose of this systematic review was to identify whether an opposing natural dentition influences the survival rate of mandibular MRISFCDs. MATERIAL AND METHODS A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, BBO/LILACS databases and also in the non-peer-reviewed literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses (RP), and complete fixed maxillary implant dentitions (ID) with at least a year of follow-up were included. The quality of the included studies was analyzed, and the risk of bias was reported. A meta-analysis comparing the survival rate of ND with RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity was tested by an I2 index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the evidence. RESULTS From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69; 95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP. No statistical differences were detected in the success rates between ND and RP (risk difference = 0.00 [-0.06, 0.06]; P=.93; I2=27%) or between ND and ID (risk difference=0.00 [-0.06, 0.07]; P=.97; I2=0%), both with moderate evidence. CONCLUSION With a moderate certainty of evidence, it is suggested that natural maxillary dentitions do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic designs.
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Affiliation(s)
- Luis Eduardo Carneiro-Campos
- Professor, Department of Oral and Maxillofacial Surgery and Implantology, Faculty of Dentistry, Federal University of Uberlandia (UFU), Uberlandia, Brazil.
| | - Liana B Freitas-Fernandes
- Researcher, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Daniele Masterson
- Librarian, Health Sciences Center Central Library, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Professor, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Claudio Pinheiro Fernandes
- Professor, Department of Prosthodontics, Faculty of Dentistry, Fluminense Federal University (UFF), Nova Friburgó, Brazil
| | - Lucianne Cople Maia
- Professor, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Darceny Zanetta-Barbosa
- Professor, Department of Oral and Maxillofacial Surgery and Implantology, Faculty of Dentistry, Federal University of Uberlandia (UFU), Uberlandia, Brazil
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14
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Chen J, Cai M, Yang J, Aldhohrah T, Wang Y. Immediate versus early or conventional loading dental implants with fixed prostheses: A systematic review and meta-analysis of randomized controlled clinical trials. J Prosthet Dent 2019; 122:516-536. [PMID: 31421892 DOI: 10.1016/j.prosdent.2019.05.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 01/23/2023]
Abstract
STATEMENT OF PROBLEM Immediate loading of dental implants has gained widespread popularity because of its advantages in shortening treatment duration and improving esthetics and patient acceptance. However, whether immediate loading can achieve clinical outcomes comparable with those of early or conventional delayed loading is still unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the efficacy of immediate loading versus early or conventional loading implants in patients rehabilitated with fixed prostheses. MATERIAL AND METHODS Electronic searches of CENTRAL, EMBASE, and MEDLINE were supplemented by manual searches up to October 2018. Only human randomized controlled trials (RCTs) comparing immediate with early or conventional loading dental implants were included. Quality assessment was performed by using the Cochrane Collaboration tool. For the meta-analysis, the dichotomous and continuous variables were pooled and analyzed by using risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (95% CIs). The outcomes assessed included survival rate, marginal bone level changes, peri-implant gingival level, probing depth, and implant stability. The subgroup analyses included healing methods, implant time, occlusal contact, number of missing teeth, and tooth position. RESULTS Thirty-nine trials (49 articles) were included from the initial 763 references evaluated. When compared with conventional loading, with implants regarded as a statistical unit, a statistically significant lower survival rate was observed in the immediate loading dental implant (RR=0.974; 95% CI, 0.954, 0.994; P=.012). Regarding other outcomes, including marginal bone level changes, peri-implant gingival level, probing depth, and implant stability, no statistically significant differences were observed when comparing immediate versus early or conventional loading (P>.05). CONCLUSIONS Compared with early loading, immediate loading could achieve comparable implant survival rates and marginal bone level changes. Compared with conventional loading, immediate loading was associated with a higher incidence of implant failure.
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Affiliation(s)
- Jie Chen
- Postgraduate student, Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, PR China
| | - Min Cai
- Predoctoral student, Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, PR China
| | - Jiajun Yang
- Postgraduate student, Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, PR China
| | - Taghrid Aldhohrah
- Postgraduate student, Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, PR China
| | - Yan Wang
- Professor, Department of Prosthodontics, Guanghua School of Stomatology & Hospital of Stomatology, Guangdong Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, PR China.
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15
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Altay MA, Sindel A, Tezerişener HA, Yıldırımyan N, Özarslan MM. Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes. Int J Implant Dent 2019; 5:2. [PMID: 30613918 PMCID: PMC6321832 DOI: 10.1186/s40729-018-0153-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/09/2018] [Indexed: 11/27/2022] Open
Abstract
Background This study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region. Methods Nineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the implant treatment using a subjective outcome questionnaire and a 10-cm visual analogue scale (VAS). Results The mean PES and WES were 10.7 (range 5–13, SD ± 2.24) and 8.6 (range 8–10, SD ± 0.60), respectively. The overall mean VAS was 8.54 ± 0.36 (range 3.8–9.8). No significant correlation was found between VAS and PES or WES (p = 0.475, p = 0.984, respectively). PES and WES scores for gingival biotypes failed to show any statistically significant difference (p = 0.701, p = 0.831). There was a significant negative correlation between the smile line and VAS; indicating that patients with lower smile lines expressed higher patient satisfaction (p = .001). Conclusions Professionally reported esthetic outcomes (PES and WES results) may not correlate with patient-reported outcomes. Smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey.
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Hüseyin Alican Tezerişener
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
| | - Nelli Yıldırımyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
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Abi-Aad HL, Daher FI, Baba NZ, Cordioli G, Majzoub ZAK. Insertion Torque of Variable-Thread Tapered Implants in the Posterior Maxilla: A Clinical Study. J Prosthodont 2018; 28:e788-e794. [PMID: 30178903 DOI: 10.1111/jopr.12965] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Primary stability is a key factor for successful implant osseointegration, especially in poor bone quality and early/immediate loading. In the immediate loading protocol, insertion torque values (ITVs) have been suggested to be the most valid prognostic factor for osseointegration of maxillary implants. The objectives of this study were to: (1) evaluate ITVs achieved by a variable-thread tapered implant in the posterior maxilla; and (2) assess the impact of bone quality, implant dimensions, bicortical anchorage, and implant location on ITVs. MATERIALS AND METHODS Twenty-six adult, systemically healthy patients received 173 variable-thread tapered implants in maxillary premolar and molar healed edentulous sites with a minimum subsinus height of 8 mm. Implant sites were prepared using the bone-quality adjusted drilling sequence according to manufacturer's recommendations. Bone quality was recorded subjectively during drilling based on Misch criteria (D1-D4), and ITVs were measured with a manual torque wrench. Univariate and multivariate analyses were performed at the 0.05 significance level. RESULTS First and second molar sites accounted for 46.8% of all implants. D4 bone was encountered in 61.3% of the sites. Most of the implants were 4.3 mm in diameter (59.5%), and lengths of 11.5 and 13 mm were most commonly used (75.2%). Approximately half of the implants were associated with apical cortical anchorage (51.4%). The overall mean ITV was 44.5 ± 23.0 Ncm, with 65.5 ± 15.6 Ncm, 55.5 ± 19.6 Ncm, and 36.6 ± 21.7 Ncm for D2, D3, and D4 bone, respectively. Bone quality and implant location significantly affected ITVs, while implant dimensions and apical cortical anchorage did not. CONCLUSIONS ITVs of variable-thread implants were significantly influenced by variations in bone quality and implant position in the posterior maxilla. Despite the influence of bone quality on primary stability, the mean ITVs attained with variable-thread tapered implants in poor bone quality were within the recommended range for immediate loading.
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Affiliation(s)
- Habib L Abi-Aad
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
| | - Fadi I Daher
- Department of Periodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
| | - Nadim Z Baba
- Advanced Specialty Education Program in Prosthodontics, School of Dentistry, Loma Linda University
| | | | - Zeina A K Majzoub
- Department of Periodontics, Faculty of Dental Medicine, Lebanese University, Hadath, Lebanon
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Jesch P, Jesch W, Bruckmoser E, Krebs M, Kladek T, Seemann R. An up to 17-year follow-up retrospective analysis of a minimally invasive, flapless approach: 18 945 implants in 7783 patients. Clin Implant Dent Relat Res 2018; 20:393-402. [PMID: 29446204 DOI: 10.1111/cid.12593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 01/13/2018] [Accepted: 01/17/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study investigates gender, age, jaw, implant position, loading protocol (immediate vs delayed), smoking, and type of surgery (punch vs flap) as influential factors of implant survival in a large patient collective. PURPOSE To evaluate the survival rates of implants in patients using a mucoperiosteal punch for flapless implantation in the majority of cases in order to evaluate its medical efficacy and safety. MATERIALS AND METHODS Between 1994 and 2015 all patients with complete data treated at the Wienerberg Dental Clinic, Vienna, Austria, were included and statistically analyzed in Cox proportional hazard (PH) models. As patients with multiple implants were included, a clustering term was added to the Cox PH model to respect pooled failures in patients. RESULTS Of the initial 24 282 ANKYLOS/Dentsply implants placed in 8137 patients a total of 7783 patients with 18 945 implants were finally included. The mean follow-up was 2.8 ± 3.2 up to 17.9 years. Cumulative survival rates (CSRs) after 1, 3, 5, and 10 years were 98.5%, 97.7%, 96.7%, and 93.0%, respectively. Of these, 17 517 (92.5%) implants were placed minimally invasive via a flapless approach by use of the ATP-Punch with comparable survival rates as observed for flap surgery. The Cox PH models proved smoking (hazard ratio [HR] = 2.2) and implant position as significant factors of implant survival. In the maxilla, canines and third molars were identified as low risk sites in comparison to the most frequently implanted first premolar site. In the mandible, the central incisor and second premolar were identified as high-risk sites, the canine as low risk site in comparison to the most frequently placed first molar site. CONCLUSION The analyzed data concludes the safety and medical efficacy of the ATP-Punch. The CSRs using this flapless technique are comparable to the classic surgical flap approach.
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Affiliation(s)
- Philip Jesch
- Dental Clinic Wienerberg City, Division of Oral Surgery, Vienna, Austria
| | - Wolfgang Jesch
- Dental Clinic Wienerberg City, Division of Oral Surgery, Vienna, Austria
| | - Emanuel Bruckmoser
- University Hospital for Craniomaxillofacial and Oral Surgery, Innsbruck, Austria
| | - Mischa Krebs
- Department of Oral Surgery and Implantology, School of Dentistry (Carolinum), Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Tibor Kladek
- Dental Clinic Wienerberg City, Division of Oral Surgery, Vienna, Austria
| | - Rudolf Seemann
- University Clinic of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria
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18
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Henningsen A, Smeets R, Köppen K, Sehner S, Kornmann F, Gröbe A, Heiland M, Gerlach T. Immediate loading of subcrestally placed dental implants in anterior and premolar sites. J Craniomaxillofac Surg 2017; 45:1898-1905. [DOI: 10.1016/j.jcms.2017.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/04/2017] [Accepted: 08/14/2017] [Indexed: 02/08/2023] Open
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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20
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Giannakopoulos NN, Ariaans K, Eberhard L, Klotz AL, Oh K, Kappel S. Immediate and delayed loading of two-piece reduced-diameter implants with locator-analog attachments in edentulous mandibles: One-year results from a randomized clinical trial examining clinical outcome and patient expectation. Clin Implant Dent Relat Res 2017; 19:643-653. [PMID: 28440024 DOI: 10.1111/cid.12489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/28/2017] [Accepted: 04/01/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prosthetic management of thin alveolar ridges in the edentulous mandibles of elderly patients, especially the time of loading, the number of implants needed, and patient expectations and perception, is a challenge in implant dentistry. PURPOSE Survival of conventionally and immediately loaded 2-piece reduced-diameter implants in the interforaminal region of the edentulous mandible supporting locator-analog attachments was evaluated. Prosthetic complications and peri-implant hygiene were also studied, and patient expectation and subjective evaluation of the treatment were documented. MATERIAL AND METHODS Twenty-five patients with adapted complete dentures received 4 reduced-diameter implants. All anterior implants were immediately loaded. Three months later, patients were allocated by randomization to 1 of 2 treatment groups: 2 locator-analog attachments on the anterior implants (Group A); or 4 locator-analog attachments (Group B). After another 3 months patient allocation was changed (crossover design) for the next 3 months. Questionnaires with Likert scales and numeric rating scales were used to assess patients' expectations and subjective overdenture-related variables, respectively. RESULTS One implant was lost in the immediate-loading group. Survival was 98% and 100% for immediate and delayed loading, respectively. During 12-month observation, 8 complications required aftercare. At the beginning of treatment, patients' expectations were highly positive. Subjective assessment of overdenture-related variables 3 months after immediate loading of 2 implants revealed a statistically significant improvement for most of the variables studied; this was maintained 1 year later. In the subjective assessments, there were no statistically significant differences between Groups A and B. CONCLUSION Immediate loading of reduced-diameter implants supporting locator-analog attachments resulted in high implant survival, few prosthetic complications, good oral hygiene, and improvement of subjective denture perception in the short-term. It might be a promising treatment option, especially for elderly patients with a narrow mandibular ridge.
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Affiliation(s)
| | - Kirsten Ariaans
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Lydia Eberhard
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Anna-Luisa Klotz
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Keunyoung Oh
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
| | - Stefanie Kappel
- Department of Prosthodontics, University of Heidelberg, INF 400, Heidelberg, 69120, Germany
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Schwarz F, Sanz-Martín I, Kern JS, Taylor T, Schaer A, Wolfart S, Sanz M. Loading protocols and implant supported restorations proposed for the rehabilitation of partially and fully edentulous jaws. Camlog Foundation Consensus Report. Clin Oral Implants Res 2016; 27:988-92. [PMID: 26748679 PMCID: PMC5064627 DOI: 10.1111/clr.12736] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this consensus meeting was to assess whether immediate loading protocols achieve comparable clinical outcomes when compared to conventional loading protocols depending on the type of prosthetic restoration. In addition post-loading implant loss for implant supported prostheses in edentulous jaws was analyzed regarding a potential impact of implant location (maxilla vs. mandible), implant number per patient, type of prosthesis (removable vs. fixed), and type of attachment system (screw-retained, ball vs. bar vs. telescopic crown). MATERIAL AND METHODS Two comprehensive systematic reviews were prepared in advance of the meeting. Consensus statements, practical recommendations, and implications for future research were based on within group as well as plenary scrutinization and discussions of these systematic reviews. RESULTS The survival rates are high for immediate loaded and conventional loaded implants, but immediate loading may impose a greater risk for implant failure. The estimated implant loss rate is influenced by the implant location, type of restoration, and implant number. CONCLUSIONS Consistent reporting of clinical studies is necessary and high-quality studies are needed to confirm the present results.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Germany
| | | | - Jaana-Sophia Kern
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Thomas Taylor
- Department of Reconstructive Sciences, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | | | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center for Implantology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Mariano Sanz
- Faculty of Odontology, Universidad Complutense of Madrid, Madrid, Spain
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