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Moreno-Pérez J, Rubio Flores D, Fernández Villares C, Nagendrababu V, Abella Sans F. Guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine implant. AUST ENDOD J 2024; 50:369-376. [PMID: 38509785 DOI: 10.1111/aej.12840] [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: 11/05/2023] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/22/2024]
Abstract
The aim of this report is to demonstrate the guided tooth autotransplantation of a palatally impacted maxillary canine into the site of a failed maxillary canine dental implant. A 47-year-old woman visited a dental clinic complaining of loose dental implant in the left maxillary canine site, tooth #11, as well as pain and swelling of the gum around the implant. The clinical examination revealed a mobile implant along with swollen soft tissues with bleeding on probing. A periapical radiograph demonstrated peri-implant marginal bone loss. Cone beam computed tomography sections revealed that tooth #11 was impacted palatally. The implant was removed and replaced with the impacted canine via guided autotransplantation and posterior orthodontic alignment. The patient was recalled at 1, 3, 6, 9, 12, 24 and 48 months after the procedure. During this period, the patient was symptom-free and radiographic examination at 2 years revealed no periapical pathosis or root resorption.
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Affiliation(s)
| | - David Rubio Flores
- Department of Conservative Dentistry and Prosthetics, Universidad Complutense de Madrid, School of Dentistry, Madrid, Spain
| | | | | | - Francesc Abella Sans
- Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
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Golob Deeb J, Ha M, Carrico CK, Waldrop T, Lee PK. Effect of Implant Maintenance on Incidence of Peri-implantitis and Early Implant Failure: Retrospective Cohort Study. J ORAL IMPLANTOL 2024; 50:328-334. [PMID: 38916039 DOI: 10.1563/aaid-joi-d-24-00003] [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] [Indexed: 06/26/2024]
Abstract
Maintaining dental implants and managing peri-implant tissues has become integral to dental practice. Owing to the larger number of implants placed, the number of peri-implant lesions is increasing. Periodontal implant maintenance therapy (PIMT) provides a conservative long-term treatment modality to monitor and maintain implants. This study aims to investigate periodontal maintenance effects on peri-implant tissue health to add to existing evidence. A retrospective analysis included implant patients with 1-7 years of follow-up, assessing peri-implantitis and early implant failure as outcome variables. The frequency of PIMT, implant characteristics, and demographics served as predictors, and associations between peri-implantitis, implant failure, and PIMT frequency were analyzed using Fisher exact tests with the significance level set at .05. Data were collected on 501 implants from 185 patients. Twenty-nine (6%) demonstrated peri-implantitis, whereas 22 (5%) experienced early implant failure. A significant association between PIMT and peri-implantitis was observed (p-value = .0169) with the rate of peri-implantitis at 9% (n = 20) for patients without PIMT and only 4% (n = 10) for those with PIMT. Whereas PIMT was not significantly associated with early implant failure (p-value = .4372), peri-implantitis was: 25% of implants with peri-implantitis experienced early failure compared with 4% without (p-value = .0062). Considering the limitations of the present study, the absence of PIMT was found to be associated with peri-implantitis, which was itself associated with early implant failure. Implant maintenance at 6-month intervals is important in maintaining peri-implant health.
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Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Michael Ha
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Caroline K Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia
| | - Thomas Waldrop
- Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia
| | - Pandora K Lee
- Department of General Practice, Virginia Commonwealth University, Richmond, Virginia
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Ramanauskaite A, Padhye N, Kallab S, Dahmer I, Begic A, Tiede S, Schwarz F. Progressive bone loss and bleeding on probing: A cohort study. Clin Implant Dent Relat Res 2024; 26:809-818. [PMID: 38923709 DOI: 10.1111/cid.13356] [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: 03/20/2024] [Revised: 05/23/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
AIM To investigate whether a progressive marginal bone loss (PMBL) occurring beyond the initial bone remodeling (IBR) is linked with bleeding on probing. MATERIALS AND METHODS A total of 70 partially edentulous patients exhibiting 112 two-piece bone-level implants were included in this retrospective study. Panoramic radiographs were obtained after implant insertion (T0), after delivery of a final prosthetic restoration (T1) and subsequently during the 1-(T2), 5-(T3), 10-(T4), and 15-years (T5) follow-up visits. At each time point, radiographic marginal bone levels were assessed from the implant shoulder to the first bone-to-implant contact at mesial and distal aspects. The IBR was defined as a bone loss occurring up to prosthesis delivery, that is, from T0 to T1. The PMBL was defined as bone loss occurring after T1. At T2, T3, T4, and T5, the presence or absence of bleeding on probing (BOP) was recorded at four sites. A median regression with mixed models was performed to assess the difference of PMBL in PMBL + BOP+ and PBML + BOP- groups. RESULTS Over the mean implant functioning time of 4.44 ± 4.91 years, 38 (34%) implants showed no PBML, whereas 74 (66%) implants featured PMBL. Of these, 35 (47%) and 39 (53%) implants were assigned to the PMBL + BOP- and PMBL + BOP+ groups, respectively. The mean PMBL after 1, 5, 10, and 15 years were comparable between implants featuring PMBL with or without BOP. At 1 year, BOP intensity significantly correlated PMBL, with each increase in one BOP-positive site being associated with increase in PMBL by 0.55 mm (p = 0.038), whereas this association was not found at 5, 10, and 15 years. The IBR values in the no PBML, PMBL + BOP+, and PBML + BOP- groups were -0.24 ± 0.31, -0.41 ± 0.59, and -0.24 ± 0.33 mm, respectively, with no significant differences found among the groups. CONCLUSION Progressive bone loss at implant sites is not always linked with bleeding on probing.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ninad Padhye
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
| | - Sandra Kallab
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
| | - Iulia Dahmer
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
- Faculty of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany
| | - Amira Begic
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
| | - Stefanie Tiede
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt, Germany
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Volp Junior LC, Matarazzo F, Dias DR, de Oliveira RP, Sábio S, Araújo MG. The effect of the interproximal contour of single external hexagon implant restorations on the prevalence of peri-implantitis: A retrospective study. J Prosthodont 2024; 33:655-662. [PMID: 38487989 DOI: 10.1111/jopr.13835] [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: 08/29/2023] [Accepted: 02/11/2024] [Indexed: 08/10/2024] Open
Abstract
PURPOSE The objective of this retrospective study was to evaluate the effect of the interproximal contour of single external hexagon implant restorations on the prevalence of peri-implantitis. MATERIAL AND METHODS Records of 96 patients and 148 external hexagon (EH) implants with time in function ranging from 1 to 17 years were included in the study. The most recent clinical and radiographic data were collected from records and the prevalence of peri-implantitis was defined according to the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. Marginal bone level (MBL), emergence angle (EA), emergence profile (EP), and crown/implant platform horizontal ratio (CIHR) were obtained from periapical radiographs. Dichotomous variables at the patient- and implant level were compared with association tests. Mann-Whitney U-Test was performed to compare continuous quantitative values between the studied groups. Binomial logistic regression was conducted to identify risk indicators associated with the peri-implantitis event at the patient- and implant level, with the significance level set at 5% for all tests. RESULTS Nineteen patients (19.2%) and 24 implants (16.2%) with a mean time in function of 5.0 ± 4.7 years were classified as having peri-implantitis. No statistically significant differences concerning gender, mean age, implant location in the jaw, or time in function were observed between patients with or without peri-implantitis (p > 0.05). Of 24 implants with peri-implantitis 10 (41.7%) displayed EA ≤ 30° (16.4%) while 14 (58.3%) presented EA > 30° with no statistical difference between the groups (p > 0.05). No statistically significant associations were identified between EA, EP, or CIHR and the prevalence of peri-implantitis. CONCLUSION The findings seem to indicate that the EA, EP, and CIHR of single restorations over external hexagon implants are not associated with the presence of peri-implantitis. However, prospective studies with larger samples are required to better ascertain such an association in the long term.
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Affiliation(s)
| | - Flávia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Debora Reis Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | | | - Sérgio Sábio
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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Chen Z, Li J, Wei CX, Mendonca G, Wang HL. Accuracy of open-sleeved vs. closed-sleeved static computer-assisted implant systems in immediate maxillary molar implant placement: An in vitro study. Clin Oral Implants Res 2024; 35:694-705. [PMID: 38587183 DOI: 10.1111/clr.14265] [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: 09/17/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The objective of this study is (1) to compare the accuracy of an open-sleeved static computer-assisted implant system (sCAIS) with a closed-sleeve sCAIS and free-hand approach in immediate implant placement (IIP) of maxillary molar sites and (2) to investigate the influence of socket morphology on these approaches. MATERIALS AND METHODS Ninety partially edentulous duplicated maxillary models simulating three different molar sockets (type A, B, and C based on Smith and Tarnow's classification) were investigated. Three modalities, including sCAIS with open-sleeves, sCAIS with closed-sleeves, and free-hand approach, were applied separately to 30 models with 120 sockets. A customized Python script automatically measured the deviations between the virtual and actual implant positions for all 360 implants. RESULTS The 3D deviations of sCAIS were significantly influenced by the socket and sleeve types. Both guided groups exhibited significantly less deviation than the free-hand approach. Type A and C sockets resulted in better implant positions than type B socket sites. In type B sockets, the open-sleeve group achieved significantly less deviation compared to the closed-sleeve group, with respect to apical global (1.34 ± 0.53 vs. 1.84 ± 0.59 mm), coronal horizontal (0.68 ± 0.36 vs. 0.93 ± 0.34 mm), apical horizontal (1.21 ± 0.59 vs. 1.74 ± 0.63 mm), and angular (3.30 ± 1.41 vs. 4.41 ± 1.96°) deviations. CONCLUSIONS Guided implant surgery significantly reduces deviations during molar IIP compared to free-hand procedures. Furthermore, the use of open-sleeve sCAIS appears to be more effective in minimizing deviations in type B sockets when compared with the closed-sleeve guided system.
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Affiliation(s)
- Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Junying Li
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Chen Xuan Wei
- Department of Biologic and Materials Sciences, Division of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonca
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Lafuente-Ibáñez-de-Mendoza I, Marichalar-Mendia X, Setién-Olarra A, García-de-la-Fuente AM, Martínez-Conde-Llamosas R, Aguirre-Urizar JM. Genetic polymorphisms of inflammatory and bone metabolism related proteins in a population with dental implants of the Basque Country. A case-control study. BMC Oral Health 2024; 24:659. [PMID: 38840172 PMCID: PMC11155173 DOI: 10.1186/s12903-024-04319-1] [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: 01/03/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Peri-implantitis (PI) is a frequent inflammatory disorder characterised by progressive loss of the supporting bone. Not all patients with recognised risk factors develop PI. The aim of this study is to evaluate the presence of single nucleotide polymorphisms (SNP) of inflammatory and bone metabolism related proteins in a population treated with dental implants from the Basque Country (Spain). METHODS We included 80 patients with diagnosis of PI and 81 patients without PI, 91 women and 70 men, with a mean age of 60.90 years. SNPs of BMP-4, BRINP3, CD14, FGF-3, FGF-10, GBP-1, IL-1α, IL-1β, IL-10, LTF, OPG and RANKL proteins were selected. We performed a univariate and bivariate analysis using IBM SPSS® v.28 statistical software. RESULTS Presence of SNPs GBP1 rs7911 (p = 0.041) and BRINP3 rs1935881 (p = 0.012) was significantly more common in patients with PI. Patients with PI who smoked (> 10 cig/day) showed a higher presence of OPG rs2073617 SNP (p = 0.034). Also, BMP-4 rs17563 (p = 0.018) and FGF-3 rs1893047 (p = 0.014) SNPs were more frequent in patients with PI and Type II diabetes mellitus. CONCLUSIONS Our findings suggest that PI could be favoured by an alteration in the osseointegration of dental implants, based on an abnormal immunological response to peri-implant infection in patients from the Basque Country (Spain).
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Affiliation(s)
- Irene Lafuente-Ibáñez-de-Mendoza
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
| | - Xabier Marichalar-Mendia
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain.
- Department of Nursery I, Barrio Sarriena s/n, Leioa, 48940, Bizkaia, Spain.
- Biobizkaia Health Research Institute, Barakaldo, Spain.
| | - Amaia Setién-Olarra
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Nursery I, Barrio Sarriena s/n, Leioa, 48940, Bizkaia, Spain
| | - Ana María García-de-la-Fuente
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
| | | | - José Manuel Aguirre-Urizar
- Research Group: GIU21/042, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Stomatology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, Leioa, 48940, Spain
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Orishko A, Imber JC, Roccuzzo A, Stähli A, Salvi GE. Tooth- and implant-related prognostic factors in treatment planning. Periodontol 2000 2024; 95:102-128. [PMID: 39234949 DOI: 10.1111/prd.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/21/2024] [Accepted: 07/03/2024] [Indexed: 09/06/2024]
Abstract
Following a comprehensive patient examination, including the assessment of periodontal and peri-implant diseases as well as considering the patient's needs, a pretherapeutic prognosis for each tooth and implant is given. Teeth and implants with a secure pretherapeutic prognosis require simple procedures and may be regarded as secure abutments for function and with a doubtful pretherapeutic prognosis usually need a comprehensive therapy. Such teeth and implants must be brought into the category with a secure prognosis by means of additional therapy such as endodontic, restorative, and surgical procedures. Teeth and implants with a hopeless pretherapeutic prognosis should be extracted/explanted during the initial phase of cause-related therapy (i.e., infection control). For example, teeth with vertical root fracture or unrestorable caries and implants with mobility or unrestorable malposition fall into the category of hopeless units. The primary goal of periodontal and peri-implant therapy should be to arrest disease progression. The latest consensus statement highlights that periodontitis can be successfully controlled and treated teeth can be retained for life. Nevertheless, for patients with uncontrolled contributing factors, the endpoints might not always be achievable, and low disease activity may be an acceptable therapeutic goal. Similarly, the management of peri-implantitis frequently requires surgical intervention following nonsurgical therapy due to incomplete treatment outcomes. Different surgical modalities can be effective and lead to significant improvement; however, achieving complete resolution of peri-implantitis is challenging, not always predictable, and can depend on multiple baseline factors. Therefore, this review aims at summarising available evidence on the rationale for incorporating systemic, lifestyle-related, clinical, and radiographic prognostic factors into treatment planning of patients diagnosed with periodontal and peri-implant diseases.
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Affiliation(s)
- Anastasiya Orishko
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Periodontology Unit, University College London, Eastman Dental Institute, London, UK
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Al-Bakri SMR, Magan-Fernandez A, Galindo-Moreno P, O'Valle F, Martin-Morales N, Padial-Molina M, Mesa F. Detection and comparison of neutrophil extracellular traps in tissue samples of peri-implantitis, periodontitis, and healthy patients: A pilot study. Clin Implant Dent Relat Res 2024; 26:631-641. [PMID: 38556724 DOI: 10.1111/cid.13325] [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: 07/10/2023] [Revised: 02/07/2024] [Accepted: 03/18/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE The aim of this study was to detect and compare the tissular expression of neutrophil extracellular traps (NETs) in peri-implant and periodontal samples of patients with peri-implantitis, periodontitis, and controls. MATERIALS AND METHODS An observational study was performed on patients with peri-implantitis, periodontitis, and controls. Peri-implant and/or periodontal clinical examinations were performed on each participant. Tissue samples were collected during tooth/implant extraction for clinical reasons. Electron microscopy analysis, Picro-Sirius red staining, immunohistochemical (CD15), and immunofluorescence (citrullinated H3 and myeloperoxidase) techniques were performed to detect NET-related structures and the degree of connective tissue destruction, between the study groups. RESULTS Sixty-four patients were included in the study: 28 peri-implantitis, 26 periodontitis, and 10 controls, with a total of 51 implants, 26 periodontal teeth, and 10 control teeth. Neutrophil release of nuclear content was observed in transmission electron microscopy. Immunohistochemical analysis showed a greater CD15 expression in both peri-implantitis and periodontitis compared to controls (p < 0.001), and peri-implantitis presented lower levels of connective tissue and collagen compared to both periodontitis (p = 0.044; p < 0.001) and controls (p < 0.001). Immunofluorescence showed greater citH3 expression in peri-implantitis than the one found in both periodontitis (p = 0.003) and controls (p = 0.048). CONCLUSIONS A greater presence and involvement of neutrophils, as well as a greater connective tissue destruction were observed in cases of peri-implantitis. A higher expression of NET-related markers was found in mucosal samples of peri-implantitis compared to periodontitis and controls.
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Affiliation(s)
- Sarmad Muayad Rasheed Al-Bakri
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
- PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | | | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
| | - Francisco O'Valle
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
- Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
| | - Natividad Martin-Morales
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
- Department of Pathology, School of Medicine and IBIMER, University of Granada, Granada, Spain
- PhD Program in Biomedicine, University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- ibs.GRANADA - Instituto de Investigación Biosanitaria, Granada, Spain
| | - Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, Granada, Spain
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [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: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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10
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Zhu Y, Lu H, Yang S, Liu Y, Zhu P, Li P, Waal YCMD, Visser A, Tjakkes GHE, Li A, Xu S. Predictive factors for the treatment success of peri-implantitis: a protocol for a prospective cohort study. BMJ Open 2024; 14:e072443. [PMID: 38199627 PMCID: PMC10806708 DOI: 10.1136/bmjopen-2023-072443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 11/30/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Peri-implantitis, a common biological complication of dental implant, has attracted considerable attention due to its increasing prevalence and limited treatment efficacy. Previous studies have reported several risk factors associated with the onset of peri-implantitis (eg, history of periodontitis, poor plaque control and smoking). However, inadequate data are available on the association between these risk factors and successful outcome after peri-implantitis therapy. This prospective cohort study aims to identify the local and systemic predictive factors for the treatment success of peri-implantitis. METHODS AND ANALYSIS A single-centre cohort study will be conducted by recruiting 275 patients diagnosed with peri-implantitis. Sociodemographic variables, healthy lifestyles and systemic disorders will be obtained using questionnaires. In addition, clinical and radiographic examinations will be conducted at baseline and follow-up visits. Treatment success is defined as no bleeding on probing on more than one point, no suppuration, no further marginal bone loss (≥0.5 mm) and probing pocket depth ≤5 mm at the 12-month follow-up interval. After adjustment for age, sex and socioeconomic status, potential prognostic factors related to treatment success will be identified using multivariable logistic regression models. ETHICS AND DISSEMINATION This cohort study in its current version (2.0, 15 July 2022) is in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Stomatological Hospital, Southern Medical University (EC-CT-(2022)34). The publication will be on behalf of the study site. TRIAL REGISTRATION NUMBER ChiCTR2200066262.
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Affiliation(s)
- Yuanxi Zhu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Hongye Lu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Dental Biomaterials and Devices for Zhejiang Provincial Engineering Research Center, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang University, Hangzhou, China
| | - Shuo Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yang Liu
- Department of Oral Medicine, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Peijun Zhu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yvonne C M De Waal
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anita Visser
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Geerten-Has E Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - An Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
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11
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Rakic M, Tatic Z, Radovanovic S, Petkovic-Curcin A, Vojvodic D, Monje A. Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study. J Periodontol 2023. [PMID: 38041803 DOI: 10.1002/jper.23-0507] [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: 08/25/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors. METHODS Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms. RESULTS Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness. CONCLUSION AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.
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Affiliation(s)
- Mia Rakic
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
| | - Zoran Tatic
- Department of Oral Implantology, Military Medical Academy, Belgrade, Serbia
| | - Sandro Radovanovic
- Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia
| | | | - Danilo Vojvodic
- Institute for Medical Research, Military Medical Academy, Belgrade, Serbia
| | - Alberto Monje
- Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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12
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Corbella S, Morandi B, Calciolari E, Alberti A, Francetti L, Donos N. The influence of implant position and of prosthetic characteristics on the occurrence of peri-implantitis: a retrospective study on periapical radiographs. Clin Oral Investig 2023; 27:7261-7271. [PMID: 37910236 PMCID: PMC10713669 DOI: 10.1007/s00784-023-05303-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The present retrospective study aimed to investigate the influence of malposition on the occurrence of peri-implantitis. MATERIALS AND METHODS The study included clinical records of systemically healthy patients with single and partial implant-supported rehabilitations and at least 1-year post-loading follow-up. The parameters collected included implant-related factors, patient-related factors, site-related factors, and prosthesis-related factors. The radiographic measurements were taken by using a dedicated software and the diagnosis of peri-implantitis was made based on all the available clinical and radiographic data. Descriptive statistics were provided for all variables. Following an exploratory approach, an implant-level analysis of factors influencing the occurrence of peri-implantitis was done through a multilevel multivariate logistic regression (mixed). RESULTS A total of 180 implants belonging to 90 subjects were randomly selected. Malposition showed no statistically significant association with the occurrence of peri-implantitis. According to the multi-level analysis, the parameters that were significantly associated with peri-implantitis included presence / history of periodontitis (OR = 5.945, 95% CI: 1.093 - 32.334, P = 0.039) and presence of an emergence profile angle ≥ 45° (OR = 9.094, 95% CI: 2.017 - 40.995, P = 0.005). CONCLUSIONS Implant malposition, as defined following Buser's criteria (2004), did not influence the occurrence of peri-implantitis in the selected cohort. Conversely, history of periodontitis and presence of a prosthetic emergence profile with an angle ≥ 45° were correlated to an increased risk of peri-implantitis.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy.
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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13
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Kuusisto N, Abushahba F, Syrjänen S, Huumonen S, Vallittu P, Närhi T. Zirconia implants interfere with the evaluation of peri-implant bone defects in cone beam computed tomography (CBCT) images even with artifact reduction, a pilot study. Dentomaxillofac Radiol 2023; 52:20230252. [PMID: 37641961 DOI: 10.1259/dmfr.20230252] [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] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Three-dimensional cone beam computed tomography (CBCT) imaging can be considered, especially in patients with complicated peri-implantitis (PI). Artifacts induced by dense materials are the drawback of CBCT imaging and the peri-implant bone condition may not be assessed reliably because the artifacts are present in the same area. This pilot study investigates the performance of the artifact reduction algorithm (ARA) of the Planmeca Viso G7 CBCT device (Planmeca, Helsinki, Finland) with three different implant materials and imaging parameters. METHODS Three pairs of dental implants consisting of titanium, zirconia, and fiber reinforced composite (FRC) were set into a pig mandible. A vertical defect simulating peri-implantitis bone loss was made on the buccal side of one of each implant. The defect was identified and measured by two observers and compared to the actual dimensions. In addition, the bone structure and the marginal cortex visibility between the implants were estimated visually. RESULTS The bone defect and its dimensions with the zirconia implant could not be identified in any image with or without the metal artifact reduction algorithm. The bone defect of titanium and FRC implants were identified with all three imaging parameters or even without ARA. The interobserver agreement between the two observers was almost perfect for all categories analyzed. CONCLUSION Peri-implantitis defect of the zirconia implant and the peri-implant bone structure of the zirconia implants cannot be recognized reliably with any ARA levels, or any imaging parameters used with the Planmeca Viso G7. The need for ARA when imaging the peri-implant bone condition of the titanium and FRC implants may be unnecessary.
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Affiliation(s)
- Niina Kuusisto
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Stina Syrjänen
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Sisko Huumonen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, City of Turku, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
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14
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Atieh MA, Shah M, Ameen M, Tawse-Smith A, Alsabeeha NHM. Influence of implant restorative emergence angle and contour on peri-implant marginal bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2023; 25:840-852. [PMID: 37183357 DOI: 10.1111/cid.13214] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Implant restorative emergence angle and profile may have a negative impact on peri-implant marginal bone level and may increase the risk of developing peri-implantitis. However, the role of these prosthetic features on peri-implant health is still unclear. The aim of this systematic review and meta-analyses was to evaluate the long-term outcomes of implant restorations with an emergence angle of >30° in comparison to those with ≤30° in terms of changes in peri-implant marginal bone level, periodontal parameters, and prevalence rate of peri-implantitis. METHODS Electronic databases were searched to identify observational studies that compared implant restorations with an emergence angle of >30° to those with ≤30°. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. RESULTS Four studies with 912 dental implants in 397 participants were included in the present review. Of these, 455 implants had restorations with an emergence angle of >30°, while the remaining implants had restorative emergence angle of ≤30°. The follow-up time varied between 3.8 and 10.9 years. Implant restorations with an emergence angle of ≤30° were associated with less changes in peri-implant marginal bone level compared to those with emergence angle of >30°. The difference, however, was not statistically significant (mean difference 0.80; 95% confidence interval (CI) -0.13 to 1.72; p = 0.09). In platform-matched implants, the difference between the two groups was statistically significant in favor of implant restorations with emergence angle of ≤30°. In terms of emergence profile, implant restorations with convex profile had significantly higher rate of peri-implantitis (57.8%) compared to implant restorations with concave or straight profile (21.3%) (risk ratio 2.32; 95% CI 1.12-4.82; p = 0.02). CONCLUSIONS Within the limitation of this review, implant restorations with an emergence angles of >30° or ≤30° seem to have no significant influence on peri-implant marginal bone level. Platform-matched implants with an emergence angle of ≤30° may have positive effects on the peri-implant marginal bone level changes, but the evidence support is of low to moderate certainty.
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Affiliation(s)
- Momen A Atieh
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Maanas Shah
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Mohammed Ameen
- Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Andrew Tawse-Smith
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Nabeel H M Alsabeeha
- Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
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15
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Yazigi C, Chaar MS, Busch R, Kern M. The Effect of Sterilization on the Accuracy and Fit of 3D-Printed Surgical Guides. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5305. [PMID: 37570008 PMCID: PMC10419648 DOI: 10.3390/ma16155305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
This study was conducted to evaluate the accuracy of 3D-printed surgical guides before and after sterilization in a steam sterilizer. A test-model incorporating three implant replicas was customized. A total of forty guides were printed from five printable resins. A group made from a self-curing composite served as control group. The guides were checked for fit. Vertical discrepancies between the model and guides were measured at standardized points at a load of 500 g (P1). The guides were connected to implant replicas and scanned, and their angles were digitally measured. The specimens were sterilized in a steam sterilizer at 121 °C for 20 min at 2 bar pressure. Vertical discrepancies (P2) and angulations were remeasured. Additionally, the specimens were repositioned with an increased load, and measurements were repeated (P3). All specimens were repositionable after sterilization. The smallest variation in discrepancy at a 500 g load was 428 µm, whereas the greatest was 1487 µm. Under an increased force, the smallest change was 94 µm, while the greatest was 260 µm. The level of significance α = 0.05 (95% confidence interval) was set for all tests. The variation in the measured angles was not statistically significant (Kruskal-Wallis's test, p > 0.05). The accuracy was affected by the material and sterilization, but it was clinically acceptable when an increased load was applied during repositioning.
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Affiliation(s)
- Christine Yazigi
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, 24105 Kiel, Germany; (M.S.C.); (R.B.); (M.K.)
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16
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Bathija A, Papaspyridakos P, Finkelman M, Kim Y, Kang K, De Souza AB. Accuracy of static computer-aided implant surgery (S-CAIS) using CAD-CAM surgical templates fabricated from different additive manufacturing technologies. J Prosthet Dent 2023:S0022-3913(23)00191-9. [PMID: 37121851 DOI: 10.1016/j.prosdent.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023]
Abstract
STATEMENT OF PROBLEM Different 3D printers are available for guided implant surgery, but studies that evaluate their source of errors and their cost-effectiveness are lacking. PURPOSE The purpose of this in vitro study was to compare the accuracy of different 3-dimensional (3D) printed surgical templates made using different additive manufacturing technologies and to evaluate the effect of implant location on the accuracy of fully guided implant placement. MATERIAL AND METHODS Fifty partially edentulous maxillary typodonts with edentulous sites in the right second premolar (SP), right lateral incisor (LI), left central incisor (CI), and left first molar (FM) locations were scanned and printed from the standard tessellation language (STL) datasets. The study compared 5 groups for the fabrication of implant surgical templates: Varseo S-Bego (Bego), Polyjet-Stratasys (Poly), Low Force Stereolithography-FormLabs (LFS), P30+-Straumann (P30), and M2-Carbon (M2). After fully guided implant placement, the typodont was scanned, and the 3D implant positions were compared with the master model by superimposing the STL files. Descriptive statistics were calculated for groups and subgroups, and comparisons among the groups and subgroups were conducted via 2-way mixed analysis of variance, Tukey honest significant difference, and post hoc Bonferroni tests (α=.05). RESULTS The results were site specific and not consistent within each group. For angle deviation, the within-group analysis for P30 demonstrated significantly lower values for implants positioned at site SP (1.4 ±0.8 degrees) than for sites LI (2.3 ±0.7 degrees; P=.001) and CI (2.3 ±0.8 degrees; P=.007). For 3D offset at base for implant CI, LFS was significantly higher than Bego (P=.002), Poly (P=.035), or M2 (P=.001); P30 was also significantly higher than Bego (P=.014) and M2 (P=.006). LFS had a significantly higher 3D offset at the tip than Bego (P=.001) and M2 (P=.022) for implant CI. CONCLUSIONS The choice of 3D printer seemed to influence fully guided implant surgery in terms of the final implant position compared with initial implant planning. However, although statistically significant differences were present across groups, all additive manufacturing technologies were within clinically acceptable values.
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Affiliation(s)
- Anshu Bathija
- Assistant Professor, Department of Prosthodontics, University of New England, Portland, Maine
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass Adjunct Associate Professor, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Kiho Kang
- Professor, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Andre B De Souza
- Adjunct Professor, Department of Periodontology, Nova Southeastern University College of Dental Medicine, Davie, Fla.
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17
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Gelpi F, Modena N, Poscolere A, Bernardello F, Torroni L, De Santis D. Accuracy of Computer-Guided Implantology with Pilot Drill Surgical Guide: Retrospective 3D Radiologic Investigation in Partially Edentulous Patients. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040738. [PMID: 37109696 PMCID: PMC10142633 DOI: 10.3390/medicina59040738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/05/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Implant placement with static navigation enables the reaching of a correct position of implants from an anatomical and prosthetic point of view. Different approaches of static navigation are described in the scientific literature, and the pilot-guided approach is one of the least investigated. The aim of the present study is the evaluation of the accuracy of implant insertion using a pilot drill template. Materials and Methods: Fifteen partially edentulous patients, requiring an implant rehabilitation of at least one implant, were enrolled. Pre- and post-operative low-dose CTs were acquired to measure the differences between final positions of implants and virtually planned ones. Three linear discrepancies (coronal, apical, and depth), two angular ones (bucco-lingual and mesio-distal), and the imprecision area were evaluated. Correlations between accuracy and rehabilitated jaws, sectors, and implant length and diameters were also analyzed. Results: Forty implants were inserted in fifteen patients using pilot drill templates. Mean coronal deviation was 1.08 mm, mean apical deviation was 1.77 mm, mean depth deviation was -0.48 mm, mean bucco-lingual angular deviation was 4.75°, and mean mesio-distal one was 5.22°. The accuracy was statistically influenced only by the rehabilitated jaw for coronal discrepancy and sectors and implant diameter for bucco-lingual angular deviations. Conclusions: The pilot drill template could represent a predictable solution to obtain a correct implant placement. Nonetheless, a safety margin of at least 2 mm should be respected during implant planning to prevent damages to anatomical structures. Therefore, the tool is helpful in order to prosthetically drive the implants; still, great attention must be paid in fully relying on this procedure when approaching dangerous structures such as nerves and vessels.
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Affiliation(s)
- Federico Gelpi
- Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37124 Verona, Italy
| | | | | | | | - Lorena Torroni
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics & Public Health, University of Verona, 37129 Verona, Italy
| | - Daniele De Santis
- Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37124 Verona, Italy
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Mahardawi B, Jiaranuchart S, Damrongsirirat N, Arunjaroensuk S, Mattheos N, Somboonsavatdee A, Pimkhaokham A. The lack of keratinized mucosa as a risk factor for peri-implantitis: a systematic review and meta-analysis. Sci Rep 2023; 13:3778. [PMID: 36882495 PMCID: PMC9992510 DOI: 10.1038/s41598-023-30890-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
This study aimed to investigate the effect of the lack of keratinized mucosa on the risk of peri-implantitis, while also accounting for possible confounding factors. A literature search was conducted in PubMed and Scopus, including human studies that assessed the presence and width of keratinized mucosa in relation to the occurrence of peri-implantitis. Twenty-two articles were included, and 16 cross-sectional studies we meta-analyzed. The prevalence of peri-implantitis was 6.68-62.3% on patient-level and 4.5-58.1% on implant-level. The overall analysis indicated that the lack of keratinized mucosa was associated with a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Similar results were shown when subgroup analyses were performed, including studies with a similar case definition of peri-implantitis (Marginal Bone Loss, MBL ≥ 2 mm) (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001), fixed prostheses only (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001), patients under regular implant maintenance (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002), and studies adjusting for other variables (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Thus, the lack of keratinized mucosa is a risk factor that increases the prevalence of peri-implantitis and should be accounted for when placing dental implants.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Napat Damrongsirirat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirida Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anupap Somboonsavatdee
- Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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19
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Takashima M, Arai Y, Matsuzaki N, Yamazaki Y, Nishiyama H, Nohno K. Masseter muscle cross-sectional area and late implant failure: A case-control study. Clin Implant Dent Relat Res 2023; 25:313-320. [PMID: 36726209 DOI: 10.1111/cid.13189] [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: 10/18/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure. PURPOSE This case-control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure. METHODS This case-control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure. RESULTS The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82-10.79; p < 0.01). CONCLUSION Higher masseter muscle CSA increases the risk of late implant failure.
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Affiliation(s)
- Makiko Takashima
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoshiaki Arai
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Nanaka Matsuzaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yuta Yamazaki
- Oral Implant and Temporomandibular Joint Clinic, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaname Nohno
- Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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20
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Yamazaki M, Yamazaki K, Baba Y, Ito H, Loos BG, Takahashi K. The Stages and Grades of Periodontitis Are Risk Indicators for Peri-Implant Diseases-A Long-Term Retrospective Study. J Pers Med 2022; 12:jpm12101723. [PMID: 36294862 PMCID: PMC9604891 DOI: 10.3390/jpm12101723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
The aim of this study is to evaluate the factors of implant failure in patients with periodontitis and their impact on the prognosis of having a peri-implant disease and/or implant failure. Data regarding 325 implants among 84 patients with periodontitis were retrospectively examined. Patients were classified by Stage (I, II, III, IV) and Grade (A, B, C), implant failures for peri-implant disease and lack of osseointegration. Clinical data, including implant- and patient-related variables were evaluated by principal components analysis (PCA) and two-step cluster analysis (CA). Survival and success rates were 96.3% and 87.1%, respectively. Prevalence of peri-implant disease was significantly higher in Stage IV patients (p < 0.05), and incidence of lost implant due to peri-implantitis was significantly higher in patients with bone augmentation (BA) (p < 0.05). PCA and CA revealed five of eleven variables and four clusters at patient level, and six of fourteen variables and three clusters at implant level. Stage and Grade are useful indicators for the development of peri-implant diseases in which BA and the number of implants are involved.
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Affiliation(s)
- Mikiko Yamazaki
- Department of Endodontics and Periodontics, Graduate School of Dentistry, Ohu University, 31-1 Misumido Tomita-machi, Koriyama 963-8611, Japan
| | - Kosaku Yamazaki
- Division of Periodontics, Department of Conservative Dentistry, School of Dentistry, Ohu University, 31-1 Misumido Tomita-machi, Koriyama 963-8611, Japan
| | - Yuh Baba
- Ohu University Dental Hospital Otorhinolaryngology, School of Dentistry, Ohu University, 31-1 Misumido Tomita-machi, Koriyama 963-8611, Japan
| | - Hiroshi Ito
- Division of Oral Pathology, Department of Oral Medical Science, School of Dentistry, Ohu University, 31-1 Misumido Tomita-machi, Koriyama 963-8611, Japan
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Keiso Takahashi
- Division of Periodontics, Department of Conservative Dentistry, School of Dentistry, Ohu University, 31-1 Misumido Tomita-machi, Koriyama 963-8611, Japan
- Correspondence: ; Tel.: +81-24-932-9365
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21
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Takahashi K, Yamazaki K, Yamazaki M, Kato Y, Baba Y. Personalized Medicine Based on the Pathogenesis and Risk Assessment of Endodontic-Periodontal Lesions. J Pers Med 2022; 12:jpm12101688. [PMID: 36294826 PMCID: PMC9604566 DOI: 10.3390/jpm12101688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
Endodontic-periodontal lesions (EPLs) are chronic inflammatory lesions in the mouth caused by multiple factors. Both periapical and marginal periodontitis are characterized by infection and inflammation around the affected teeth, suggesting that the theory of complex systems might describe the progression of EPL. The diagnosis and treatment of EPLs are complicated by variations of this condition and difficulties distinguishing EPLs from other diseases. Technological advances in diagnostic and treatment methods, including cone beam computed tomography, microscopy, mineral trioxide aggregates, and periodontal regenerative treatment, have improved outcomes, even in untreatable teeth. However, treating EPLs with iatrogenic problems and/or severe periodontitis remains challenging. Assessing the risk of each EPL based on the possible pathogenesis of each EPL is essential for determining individualized treatment and optimizing personalized medicine for individual patients.
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Affiliation(s)
- Keiso Takahashi
- Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, 31-1, Misumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
- Correspondence: ; Tel.: +81-24-932-9365
| | - Kousaku Yamazaki
- Division of Periodontics, Department of Conservative Dentistry, Ohu University School of Dentistry, 31-1, Misumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
| | - Mikiko Yamazaki
- Division of Oral Pathology, Department of Oral Medical Science, Ohu University School of Dentistry, 31-1, Misumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
| | - Yasumasa Kato
- Department of Oral Function and Molecular Biology, Ohu University School of Dentistry, 31-1, Misumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
| | - Yuh Baba
- Department of General Clinical Medicine, Ohu University School of Dentistry, 31-1, Misumido, Tomita-machi, Koriyama City 963-8611, Fukushima, Japan
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22
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Learning Curve and Comparison of Dynamic Implant Placement Accuracy Using a Navigation System in Young Professionals. Dent J (Basel) 2022; 10:dj10100187. [PMID: 36285997 PMCID: PMC9600962 DOI: 10.3390/dj10100187] [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: 08/29/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of the current study was to evaluate the learning curve and accuracy of implant placement by young professionals using a dynamic computer-assisted surgical system for dental implant placement. Ten students tried to place eight implants with a dynamic surgical system in predefined positions on two consecutive weekends, resulting in 160 implant placements in total. Postoperatively, the positions of the implants were scanned with an intraoral scanner and compared for deviations at the entry point, the apex, as well as angular deviations to the master model. The mean values of all measurements improved; statistical significance was found for the changes in the angle as well as for the position of the implants to the apex (p < 0.001). Furthermore, the young professionals indicated subjective improvement in handling the dynamic surgery system. Navigated surgical dental implant placement can be learned quickly and can support young professionals in everyday clinical practice, especially in difficult anatomic situations.
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23
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Gehrke P, Riebe O, Fischer C, Weinhold O, Dhom G, Sader R, Weigl P. Microbiological cleaning and disinfection efficacy of a three-stage ultrasonic processing protocol for CAD-CAM implant abutments. J Adv Prosthodont 2022; 14:273-284. [PMID: 36452367 PMCID: PMC9672693 DOI: 10.4047/jap.2022.14.5.273] [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: 05/03/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 09/22/2023] Open
Abstract
PURPOSE Computer-aided design and manufacturing (CAD-CAM) of implant abutments has been shown to result in surface contamination from site-specific milling and fabrication processes. If not removed, these contaminants can have a potentially adverse effect and may trigger inflammatory responses of the peri-implant tissues. The aim of the present study was to evaluate the bacterial disinfection and cleaning efficacy of ultrasonic reprocessing in approved disinfectants to reduce the microbial load of CAD-CAM abutments. MATERIALS AND METHODS Four different types of custom implant abutments (total N = 32) with eight specimens in each test group (type I to IV) were CAD-CAM manufactured. In two separate contamination experiments, specimens were contaminated with heparinized sheep blood alone and with heparinized sheep blood and the test bacterium Enterococcus faecium. Abutments in the test group were processed according to a three-stage ultrasonic protocol and assessed qualitatively and quantitatively by determination of residual protein. Ultrasonicated specimens contaminated with sheep blood and E. faecium were additionally eluted and the dilutions were incubated on agar plates for seven days. The determined bacterial counts were expressed as colony-forming units (CFU). RESULTS Ultrasonic reprocessing resulted in a substantial decrease in residual bacterial protein to less than 80 µg and a reduction in microbiota of more than 7 log levels of CFU for all abutment types, exceeding the effect required for disinfection. CONCLUSION A three-stage ultrasonic cleaning and disinfection protocol results in effective bacterial decontamination. The procedure is reproducible and complies with the standardized reprocessing and disinfection specifications for one- or two-piece CAD-CAM implant abutments.
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Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany
- Private Practice for Oral Surgery and Implant Dentistry, Ludwigshafen, Germany
| | - Oliver Riebe
- HygCen Germany GmbH, Laboratory, Schwerin, Germany
| | | | - Octavio Weinhold
- Private Practice for Oral Surgery and Implant Dentistry, Ludwigshafen, Germany
| | - Günter Dhom
- Private Practice for Oral Surgery and Implant Dentistry, Ludwigshafen, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Germany
| | - Paul Weigl
- Department of Prosthodontics and Head of Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Frankfurt, Germany
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24
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Fürhauser R, Fürhauser L, Fürhauser N, Pohl V, Pommer B, Haas R. Bucco‐palatal implant position and its impact on soft tissue level in the maxillary esthetic zone. Clin Oral Implants Res 2022; 33:1125-1134. [DOI: 10.1111/clr.13995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/16/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - V. Pohl
- Academy of Oral Implantology Vienna/ Austria
| | - B. Pommer
- Academy of Oral Implantology Vienna/ Austria
| | - R. Haas
- Academy of Oral Implantology Vienna/ Austria
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25
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Di Fiore A, Montagner M, Sivolella S, Stellini E, Yilmaz B, Brunello G. Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods. J Clin Med 2022; 11:jcm11164812. [PMID: 36013048 PMCID: PMC9409652 DOI: 10.3390/jcm11164812] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | | | - Stefano Sivolella
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3012 Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH 43210, USA
| | - Giulia Brunello
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Department of Oral Surgery, University Hospital Düsseldorf, 40225 Düsseldorf, Germany
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26
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Soulami S, Slot DE, van der Weijden F. Implant‐abutment emergence angle and profile in relation to peri‐implantitis: A systematic review. Clin Exp Dent Res 2022; 8:795-806. [PMID: 35713938 PMCID: PMC9382038 DOI: 10.1002/cre2.594] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Statement The aim of this systematic review is to analyze literature regarding the relationship between the implant‐abutment emergence angle (EA) and implant emergence profile (EP) and the prevalence of peri‐implantitis. Methods PubMed and the Cochrane Library were searched for studies from initiation up to April 2022. Studies describing the EA and EP in association with peri‐implantitis were considered eligible for this review and selected for inclusion in this review if implant groups with wide and narrow EA and different EP types were described. Results Searches in PubMed and the Cochrane Library led to 1116 unique titles and the inclusion of three studies. These concerned 168–349 implants. Two studies presented the mean prevalence of peri‐implantitis which was 16.7% and 24.8% at the implant level. Both studies showed a significant relationship between peri‐implantitis in bone‐level implant groups with an EA above 30° compared to implants with an EA below 30°. A third study presented marginal bone loss which tended to be smaller when the EA was around 20°–40°. In one of the three included studies, the prevalence of peri‐implantitis was significantly higher if implants had a convex EP compared to a concave or straight EP. Another study showed a significantly higher prevalence of peri‐implantitis in implants with a convex EP compared to other EP types, if combined with an EA above 30°. Conclusions Three eligible studies were found. Reported associations should therefore be considered with caution. Synthesis suggests an association between a larger EA (>30°) and a higher prevalence of peri‐implantitis or marginal bone loss compared to a smaller EA (<30°). A convex EP may also be associated with a higher prevalence of peri‐implantitis. However, causality remains a question.
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Affiliation(s)
- Sara Soulami
- Master of Science Program of Dental Sciences Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Fridus van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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27
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Pieralli S, Beyer C, Wesemann C, Vach K, Russe MF, Kernen F, Nelson K, Spies BC. Impact of radiographic field-of-view volume on alignment accuracy during virtual implant planning: A noninterventional retrospective pilot study. Clin Oral Implants Res 2022; 33:1021-1029. [PMID: 35861131 DOI: 10.1111/clr.13983] [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: 12/08/2021] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the impact of reducing the radiographic field-of-view (FOV) on the trueness and precision of the alignment between cone beam computed tomography (CBCT) and intraoral scanning data for implant planning. MATERIALS AND METHODS Fifteen participants presenting with one of three clinical scenarios: single tooth loss (ST, n=5), multiple missing teeth (MT, n=5), and presence of radiographic artifacts (AR, n=5) were included. CBCT volumes covering the full arch (FA) were reduced to the quadrant (Q) or the adjacent tooth/teeth (A). Two operators, an expert (exp) in virtual implant planning and an inexperienced clinician, performed multiple superimpositions, with FA-exp serving as a reference. The deviations were calculated at the implant apex and shoulder levels. Thereafter, linear mixed models were adapted to investigate the influence of FOV on discrepancies. RESULTS Evaluation of trueness compared to FA-exp resulted in the largest mean (AR-A: 0.10 ± 0.33 mm) and single maximum discrepancy (AR-Q: 1.44 mm) in the presence of artifacts. Furthermore, for the ST group, the largest mean error (-0.06 ± 0.2 mm, shoulder) was calculated with the FA-FOV, while for MT, with the intermediate volume (-0.07 ± 0.24 mm, Q). In terms of precision, the mean SD intervals were ≤0.25 mm (A-exp). Precision was influenced by FOV volume (FA<Q<A) but not by operator expertise. CONCLUSIONS For single posterior missing teeth, an extended FOV does not improve registration accuracy. However, in the presence of artifacts or multiple missing posterior teeth, caution is recommended when reducing FOV.
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Affiliation(s)
- Stefano Pieralli
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Christoph Beyer
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany.,Medical Center - University of Freiburg, Center of Dental Medicine, Department of Oral and Maxillofacial Surgery, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Christian Wesemann
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Maximilian Frederik Russe
- Medical Center - University of Freiburg, Department of Diagnostic and Interventional Radiology, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Florian Kernen
- Medical Center - University of Freiburg, Center of Dental Medicine, Department of Oral and Maxillofacial Surgery, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Katja Nelson
- Medical Center - University of Freiburg, Center of Dental Medicine, Department of Oral and Maxillofacial Surgery, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany
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28
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Martins LRL, Grzech-Leśniak K, Castro dos Santos N, Suárez LJ, Giro G, Bastos MF, Shibli JA. Transcription Factor AhR, Cytokines IL-6 and IL-22 in Subjects with and without Peri-Implantitis: A Case Control-Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7434. [PMID: 35742682 PMCID: PMC9224299 DOI: 10.3390/ijerph19127434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/11/2022] [Accepted: 05/24/2022] [Indexed: 01/27/2023]
Abstract
Peri-implantitis is a plaque-associated condition characterized by mucosal inflammation and subsequent progressive loss of supporting bone; it is caused by bacterial biofilm, but the host response triggered by bacterial stimulation promotes the release of cells and mediators that culminate in tissue destruction. The Aryl-hydrocarbon Receptor (AhR) is associated with IL-22 production by Th22 and Th17 CD4+ Th cells. The presence of IL-6 may promote the Th22 phenotype. The present case-control study evaluated the gene expression of AhR, IL-22, and IL-6 in the peri-implant tissues of healthy and peri-implantitis patients. Tissue biopsies were collected from thirty-five volunteers (15 healthy and 20 with peri-implantitis). A real-time PCR reaction was utilized to assess the AhR, IL-22, and IL-6 gene expression levels relative to the reference gene (GAPDH). The results were analyzed using the Mann-Whitney test with a significance level of 5%. Higher levels of gene expression of AhR and IL-6 were detected in peri-implantitis tissues. The IL-22 gene expression levels did not differ between groups. In conclusion, higher gene expression levels for AhR and IL-6 were detected in the soft tissues of peri-implantitis patients. IL-22 did not vary between conditions, which may indicate the loss of the immunomodulatory role of IL-22 in periimplantitis.
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Affiliation(s)
- Luis Ricardo Linard Martins
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
| | - Kinga Grzech-Leśniak
- Laser Laboratory at Dental Surgery Department, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Nidia Castro dos Santos
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
- Center for Clinical and Translational Research, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Lina J. Suárez
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
- Departamento de Ciencias Básicas y Medicina Oral, Universidad Nacional de Colombia, Cra 45 # 26-85, Bogota 11001, Colombia
| | - Gabriela Giro
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
| | - Marta Ferreira Bastos
- Programa de Pós Graduação em Ciências do Envelhecimento, Universidade São Judas Tadeu, Rua Taquari, 546, Sao Paulo 03166-000, Brazil;
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (L.R.L.M.); (N.C.d.S.); (L.J.S.)
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29
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Chen Z, Li J, Ceolin Meneghetti P, Galli M, Mendonça G, Wang HL. Does guided level (fully or partially) influence implant placement accuracy at post-extraction sockets and healed sites? An in vitro study. Clin Oral Investig 2022; 26:5449-5458. [PMID: 35499656 DOI: 10.1007/s00784-022-04512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/25/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study is to evaluate the effect of guide level on the accuracy of static computer-aided implant surgery (sCAIS) at post-extraction sockets and healed sites. MATERIALS AND METHODS A total of 30 duplicate dental models, with 300 potential implant sites, were used. All the models were equally randomized into three groups: fully guided (FG, n = 100), partially guided (PG, n = 100), and free handed (FH, n = 100) surgeries. After implant placement, the mean global, horizontal, depth, and angular deviations between the virtually planned and actual implant positions were measured automatically by a Python script within software Blender. RESULTS Both FG and PG surgeries showed significantly higher accuracy than FH surgery at post-extraction sockets and healed sites. In both sCAIS groups, there were nearly 50% more deviations from implants placed at sockets than those from delayed placement. For the immediate implant placement, the accuracy of sCAIS was significantly affected by the level of guidance. The FG group exhibited lower deviations than the PG group, with a significant difference in coronal global and horizontal deviations (p < .05). For the healed sites, two guided groups exhibited similar outcomes (p > .05). CONCLUSIONS sCAISs provide more accuracy than the free-handed approach in position transferring from planning to a model simulation. Full guidance can significantly increase the accuracy, especially at post-extraction sites. CLINICAL RELEVANCE Guided protocols showed significantly higher accuracy than free-handed surgery regardless of implantation timing, but both had nearly 50% more deviations in immediate implant placement.
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Affiliation(s)
- Zhaozhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 North University Avenue, Ann Arbor, MI, 48109-1078, USA
| | - Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Priscila Ceolin Meneghetti
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,School of Dentistry, Pontific University Catholic of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Matthew Galli
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 North University Avenue, Ann Arbor, MI, 48109-1078, USA
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences & Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, 1011 North University Avenue, Ann Arbor, MI, 48109-1078, USA.
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30
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Guentsch A, An H, Dentino AR. Precision and trueness of computer-assisted implant placement using static surgical guides with open and closed sleeves: An in-vitro analysis. Clin Oral Implants Res 2022; 33:441-450. [PMID: 35148444 PMCID: PMC9302989 DOI: 10.1111/clr.13904] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/28/2021] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
Objectives The aim of this in vitro study was to determine accuracy defined by trueness and precision of computer‐assisted implant surgery comparing two guided surgery kits designed for either closed sleeves or open sleeves with a lateral window. Material and methods Each n=20 implants were placed fully guided (sleeve‐bone distance of 2 or 4 mm) in identical replicas using a surgical guide with both closed sleeve or an open sleeve, partially guided, or free hand. The achieved implant position was digitized and compared with the planned position. Trueness and precision were determined. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%‐confidence intervals were analyzed statistically with 1‐way ANOVA and the Scheffé procedure. Results The accuracy of guided implant placement using closed and open sleeves was comparable when the sleeve‐bone distance was 2 mm. Accuracy decreased when the sleeve‐bone distance increased in both fully guided groups, more so in the open than in the closed sleeve group. The least accurate method was the free‐hand group. Partially guided implant surgery was more accurate than free‐hand placement, but less accurate than the fully guided groups with 2‐mm sleeve‐bone distance. Conclusions The closer the sleeve to the bone, the more accurate and precise is computer‐assisted implant surgery using a closed system and a system using open sleeves. Partially guided implant surgery using only the static guide for the pilot drill is less accurate than both fully guided approaches, but more accurate than free‐hand surgery.
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Affiliation(s)
- Arndt Guentsch
- Professor of Periodontics and Department Chair, Department of Surgical Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Hongseok An
- Assistant Professor of Restorative Dentistry, Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, Portland, OR, 97201, USA
| | - Andrew R Dentino
- Professor of Periodontics and Associate Dean for Research and Graduate Studies, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
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31
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Tallarico M, Lumbau AMI, Meloni SM, Ieria I, Park CJ, Zadrożny L, Xhanari E, Pisano M. Five-Year Prospective Study on Implant Failure and Marginal Bone Remodeling Expected Using Bone Level Implants with Sandblasted/Acid-Etched Surface and Conical Connection. Eur J Dent 2022; 16:787-795. [PMID: 34991163 DOI: 10.1055/s-0041-1739439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE The purpose of the present prospective, case-series study was to report implant survival rate and marginal bone remodeling expected 5 years after loading using dental implants placed in daily practice. MATERIALS AND METHODS This research was designed as an open-cohort, prospective, case-series evaluation. Any partially or completely edentulous patient, scheduled to receive at least one bone level implant, was considered eligible for this study. Primary outcome measurements were: implant and prosthetic cumulative survival rate and any complications experienced up to the 5-year follow-up. Secondary outcome measures were: thickness of gingival biotype, implant insertion torque, implant stability quotient, and marginal bone loss (MBL). RESULTS Ninety consecutive patients (34 males and 56 females, aged between 24 and 81 years old [mean: 53.2 ± 15.4]) with 243 inserted implants were followed for at least 5 years after loading (mean: 65.4 ± 3.1 months; range from 60 to 72). At the 1-year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the 5-year examination. At the 5-year follow-up examination, six implants lost osseointegration (97.5%). In the same period, four prostheses failed (97.2%). Five complications were reported in five different patients (prosthetic success rate was 96.5%, at patient level). Five years after loading, the mean MBL was 0.41 ± 0.30 mm. The difference from the 1-year data was 0.04 ± 0.19 mm. A statistically significant higher MBL was found for smokers, and patients with thin gingival biotype. The mean implant insertion torque was 42.9 ± 4.8 Ncm (range from 15 to 45 Ncm). Two-hundred and three implants (83.5%) were inserted with an insertion torque ≥35 and ≤45 Ncm. CONCLUSIONS High implant survival and success rate could be expected with stable marginal bone remodeling up to 5 years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research studies are needed to confirm these results.
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Affiliation(s)
| | | | | | | | - Chang-Joo Park
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul, Korea
| | - Lukasz Zadrożny
- Department of Dental Propedeutics and Prophylaxis, Medical University of Warsaw, Warsaw, Poland
| | - Erta Xhanari
- Department of Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania
| | - Milena Pisano
- School of Dentistry, University of Sassari, Sassari, Italy
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Abstract
Implants fracture is a rare but possible complication that leads to implants failure after prostheses delivery. Mechanical properties play a key role in the failure of dental implant systems. The aim of this narrative review was to evaluate the existing evidence in identifying etiology risk factors for implants fracture. The focused question was to evaluate whether there was any possible factors influencing the fracture of dental implants. A literature search of papers written in English, published from 1967 to July 2021, and reporting incidence of implants fracture in human with at least 15 participants (and one year of follow-up) was conducted using PubMed database including MeSH and free text terms and filters. Selected manuscripts were analyzed and discussed. The outcomes were the incidence of implants failure due to a fracture and the associated risk factors. A total of 96 articles were initially selected, but only eight articles were included according to the search criteria (two systematic reviews and six retrospective evaluation). Incidence of implants fracture ranged from 0.2 to 2.3%, with a mean value of 0.52%. Poor implant planning, including implant design and diameter, and occlusal overloading, were the most common variables associated with implants fracture. Implant removal is the only possible treatment and hence prevention, including stability of the marginal bone loss, is mandatory.
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Guentsch A, Sukhtankar L, An H, Luepke PG. Precision and trueness of implant placement with and without static surgical guides: An in vitro study. J Prosthet Dent 2021; 126:398-404. [DOI: 10.1016/j.prosdent.2020.06.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
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Gehrke P, Burg S, Peters U, Beikler T, Fischer C, Rupp F, Schweizer E, Weigl P, Sader R, Smeets R, Schäfer S. Bacterial translocation and microgap formation at a novel conical indexed implant abutment system for single crowns. Clin Oral Investig 2021; 26:1375-1389. [PMID: 34401947 PMCID: PMC8816325 DOI: 10.1007/s00784-021-04112-2] [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: 06/14/2021] [Accepted: 07/27/2021] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A conometric concept was recently introduced in which conical implant abutments hold the matching crown copings by friction alone, eliminating the need for cement or screws. The aim of this in vitro study was to assess the presence of microgap formation and bacterial leakage at the Acuris conometric restorative interface of three different implant abutment systems. MATERIAL AND METHODS A total of 75 Acuris samples of three implant-abutment systems (Ankylos, Astra Tech EV, Xive) were subjected to microbiological (n = 60) and scanning electron microscopic (SEM) investigation (n = 15). Bacterial migration into and out of the conical coupling system were analyzed in an anaerobic workstation for 48, 96, 144, and 192 h. Bacterial DNA quantification using qrt-PCR was performed at each time point. The precision of the conometric coupling and internal fit of cemented CAD/CAM crowns on corresponding Acuris TiN copings were determined by means of SEM. RESULTS qrt-PCR results failed to demonstrate microbial leakage from or into the Acuris system. SEM analysis revealed minute punctate microgaps at the apical aspect of the conometric junction (2.04 to 2.64 µm), while mean cement gaps of 12 to 145 µm were observed at the crown-coping interface. CONCLUSIONS The prosthetic morse taper connection of all systems examined does not allow bacterial passage. Marginal integrity and internal luting gap between the ceramic crown and the coping remained within the clinically acceptable limits. CLINICAL RELEVANCE Conometrically seated single crowns provide sufficient sealing efficiency, relocating potential misfits from the crown-abutment interface to the crown-coping interface.
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Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany. .,Private Practice for Oral Surgery and Implant Dentistry, Bismarckstraße 27, 67059, Ludwigshafen, Germany.
| | - Simon Burg
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Carsten Fischer
- Dental Laboratory, Sirius Ceramics, 60528, Frankfurt am Main, Germany
| | - Frank Rupp
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Ernst Schweizer
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Paul Weigl
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center, University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Sogand Schäfer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
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Yu HY. The question about the numerical value and quantitative data transfer of implant prosthodontics-orom experience guidance to digital guidance. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2021; 39:386-397. [PMID: 34409793 DOI: 10.7518/hxkq.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The correct implant site design and placement are the basic clinical techniques that must be known for implant restoration. For a long time, most implants have been placed by free hands, and the choice of site is mostly dependent on the accumulation of long-term experience of the surgeon. The selection of implant site guided by this experience analogy logic is often based on the surgeon's level of experience,which often makes it very easy to produce complications related to the implant restoration of the incorrect site. In contrast, a clinical program using digital guidance and real-time measurable verification has emerged based on the restoration-oriented implantation concept, which marks the formation of an accurate, measurable and verifiable whole-process digital implant prototype. Furthermore, from the perspective of surveying, the numerical requirements that digital implant restoration relies on are actually incomplete to the four elements of measurement, which leading to the doubts about its authenticity. This article will question the numbers in implant restoration, and conduct a preliminary demonstration, and propose a new reliable actual measurement and verification method of the correct location and the numerical requirements of the restoration space and a new clinical program that relies on numbers from the perspective of the evolution of digital restoration, guided implantology and actual measurement technology. And this article further discusses the current mainstream implant restoration technology based on experience analogy which cannot effectively support the whole process of digital implant restoration and provides a new logical cognitive basis for the final realization of the entire process of digital implant restoration.
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Affiliation(s)
- Hai-Yang Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Søndergaard K, Hosseini M, Storgård Jensen S, Spin-Neto R, Gotfredsen K. Fully versus conventionally guided implant placement by dental students: A randomized controlled trial. Clin Oral Implants Res 2021; 32:1072-1084. [PMID: 34166539 DOI: 10.1111/clr.13802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To compare fully guided with conventionally guided implant surgery performed by dental students in terms of deviation of actual implant position from an ideal implant position. MATERIALS AND METHODS Twenty-five patients in need of 26 straightforward implant-supported single crowns were randomly allocated to a fully guided (FG, n = 14) or a conventionally guided (CG, n = 12) implant surgery. In the preoperative CBCTs, 3 experienced investigators placed a virtual implant in the ideal position, twice, allowing deviational analysis in the facio-lingual (coronal) and mesio-distal (sagittal) planes for 7 parameters. Facio-lingual crestal deviation, facio-lingual apical deviation, facio-lingual angular deviation, mesio-distal crestal deviation, mesio-distal apical deviation, mesio-distal angular deviation, and vertical deviation between the ideal, virtually placed position and actual implant position for the FG and CG groups were compared statistically (p < .05). RESULTS Statistically significant differences between ideal and actual implant position were only seen for the facio-lingual apical deviation (p = .047) and for the facio-lingual angular deviation (p = .019), where the CG group deviated more from the ideal position than the FG group. The 5 other examined variables did not show any significant differences, and none of the implants in the FG group and CG group were placed in conflict with the clinical guidelines. CONCLUSIONS The present study reported no difference in 5 out of 7 deviational parameters concerning actual implant position in relation to ideal implant position between a FG and CG implant placement protocol performed by dental students. Facio-lingual angular deviation and apical deviation were lower, when a FG protocol was followed. All implants were positioned according to clinical guidelines.
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Affiliation(s)
- Kasper Søndergaard
- Oral Rehabilitation, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mandana Hosseini
- Oral Rehabilitation, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon Storgård Jensen
- Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Oral and Maxillofacial Surgery, Centre of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section of Oral Radiology, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Klaus Gotfredsen
- Oral Rehabilitation, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences Sciences, University of Copenhagen, Copenhagen, Denmark
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Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography. Int J Implant Dent 2021; 7:34. [PMID: 33977359 PMCID: PMC8113432 DOI: 10.1186/s40729-021-00319-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/12/2021] [Indexed: 12/01/2022] Open
Abstract
Background The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender. Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge. Results The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less. Conclusions Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.
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Obreja K, Ramanauskaite A, Begic A, Galarraga-Vinueza ME, Parvini P, Sader R, Schwarz F. The prevalence of peri-implant diseases around subcrestally placed implants: A cross-sectional study. Clin Oral Implants Res 2021; 32:702-710. [PMID: 33714220 DOI: 10.1111/clr.13739] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the prevalence of peri-implant health, peri-implant mucositis or periimplantitis for subcrestally placed implants (1-3 mm) on the short-, medium- and long term. MATERIAL AND METHODS Two hundred patients were enrolled in this cross-sectional study that were treated and screened during regular maintenance visits at one university center. A total of 657 implants were evaluated. Peri-implant health and diseases were assessed according to predefined case definitions. Binary logistic regression was used to assess the correlation with local and systemic factors. RESULTS After a median function time of 9.36 ± 6.44 years (range: 1-26 years), the prevalence of peri-implant mucositis and peri-implantitis was 66.5% and 15.0%, at the patient level, corresponding to 62.6% and 7.5%, at the implant level, respectively. Peri-implantitis was significantly associated with patients' history of periodontitis (odds ratio, OR 5.33). CONCLUSION Peri-implant diseases were a common finding around subcrestally placed implants.
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Affiliation(s)
- Karina Obreja
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt am Main, Germany
| | - Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt am Main, Germany
| | - Amira Begic
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt am Main, Germany
| | - Maria Elisa Galarraga-Vinueza
- Post-Graduate Program in Implant Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.,School of Dentistry, Universidad de las Americas (UDLA), Quito, Ecuador
| | - Puria Parvini
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt am Main, Germany
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Spille J, Jin F, Behrens E, Açil Y, Lichtenstein J, Naujokat H, Gülses A, Flörke C, Wiltfang J. Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery. Int J Implant Dent 2021; 7:45. [PMID: 33928447 PMCID: PMC8085150 DOI: 10.1186/s40729-021-00322-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. Methods A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. Results The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. Conclusions The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.
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Affiliation(s)
- Johannes Spille
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Feilu Jin
- Department of oral and Maxillofacial Surgery, School of Medicine, 2nd Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Eleonore Behrens
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Yahya Açil
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jürgen Lichtenstein
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Hendrik Naujokat
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Aydin Gülses
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Christian Flörke
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Jörg Wiltfang
- Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
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Matsumura A, Nakano T, Ono S, Kaminaka A, Yatani H, Kabata D. Multivariate analysis of causal factors influencing accuracy of guided implant surgery for partial edentulism: a retrospective clinical study. Int J Implant Dent 2021; 7:28. [PMID: 33870473 PMCID: PMC8053739 DOI: 10.1186/s40729-021-00313-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/01/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract Background In dental implant treatment, the placement position of the implant body is important. The hypothesis is that there are factors that have a greater impact than the factors that have been studied so far. Material and Methods The deviation between planned and actually placed implants was measured three-dimensionally by modified treatment evaluation method in 110 patients who underwent implant placement with guided surgery for partial edentulism. Ten factors that seemed to affect errors in placement were selected: the type of tooth, type of edentulism, distance from the remaining teeth, the type of implant, implant length, number of implants, method of guidance, the number of teeth supporting the surgical guide, number of anchor pins, and presence or absence of a reinforcement structure. The effect of each factor that corrected each confounding was calculated using multivariate analysis. Results In this study, 188 implant bodies were set to target, and the errors measurement data of the implant position were as follows: average Angle, 2.5 ± 1.6° (95% CI 2.25–2.69); Base, 0.67 ± 0.37 mm (95% CI 0.62–0.72); and Apex, 0.92 ± 0.47 mm (95% CI 0.86–0.98). As the result of multivariate analysis, larger errors were present in the partially guided group than the fully guided group. The number of teeth supporting the surgical guide significantly influenced the error in placement position. The error caused by the number of anchor pins was significantly different for the Angle. Similarly, the presence of the reinforcement structure influenced the error significantly for the Angle. Conclusions It was suggested that the smaller errors could be present by performing guided surgery with full guidance and devising the design of the guide such as the number of teeth supporting the surgical guide, the setting of the anchor pin, and the reinforcement structure.
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Affiliation(s)
- Atsushi Matsumura
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Shinji Ono
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Akihiro Kaminaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3 Asahi, Abeno-ku, Osaka, 545-8585, Japan
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Montero J. A Review of the Major Prosthetic Factors Influencing the Prognosis of Implant Prosthodontics. J Clin Med 2021; 10:jcm10040816. [PMID: 33671394 PMCID: PMC7921991 DOI: 10.3390/jcm10040816] [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: 12/16/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The treatment plan of prosthetic restorations supported by dental implants requires comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A comprehensive review of the literature was conducted with a PICO (Patient Intervention Comparison Outcomes) question: “For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?”. A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS * OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%), or prospective evaluations of prosthesis with various kinds of events (18%). However, narrative reviews of literature (14%) and in vitro/animal studies (16%) were also found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.
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Affiliation(s)
- Javier Montero
- Department of Surgery, University of Salamanca, 37007 Salamanca, Spain
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A Possible Relationship between Peri-Implantitis, Titanium Hypersensitivity, and External Tooth Resorption: Metal-Free Alternative to Titanium Implants. Case Rep Dent 2021; 2021:8879988. [PMID: 33552604 PMCID: PMC7847357 DOI: 10.1155/2021/8879988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/09/2020] [Accepted: 01/09/2021] [Indexed: 11/17/2022] Open
Abstract
Titanium dental implant surface does not remain unaltered but may corrode and release ions or particles which trigger soft and hard tissue damage. Titanium may induce clinically relevant hypersensitivity in patients chronically exposed. A 56-year-old female patient presented peri-implantitis around a single titanium implant positioned three years earlier. Despite nonsurgical therapy, a rapid bone loss associated with pain and swelling occurred, and adjacent teeth presented external resorption. Compromised teeth were removed, and three titanium implants were inserted. Six months later, the patient complained about high mucosa sensitivity and implant exposure. At clinical and radiographic examinations, tissue inflammation and vertical bone loss involved the new implants and the process of external resorption affected the teeth. The blood test confirmed titanium hypersensitivity. Titanium implants were removed, and 5 zirconia implants were placed. No sign of bone loss or tooth resorption was recorded at clinical and radiographic control during 18 months of follow-up.
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Alaidrous M, Finkelman M, Kudara Y, Campos HC, Kim Y, De Souza AB. Influence of zirconia crown artifacts on cone beam computed tomography scans and image superimposition of tomographic image and tooth surface scan: An in vitro study. J Prosthet Dent 2021; 125:684.e1-684.e8. [PMID: 33549342 DOI: 10.1016/j.prosdent.2020.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM Zirconia restorations create significant artifacts on 3D cone beam computed tomography (CBCT) imaging. Static computer-assisted implant surgery (s-CAIS) relies on the accuracy of superimposition between an intraoral surface scan and CBCT imaging. However, how the artifacts from zirconia on the tomographic image might affect the predictability of s-CAIS is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of zirconia crown restorations on the superimposition process for s-CAIS. MATERIAL AND METHODS Four stone casts generated 4 groups: a control group (CG) with no crowns and 3 experimental groups with 4 (TG4), 7 (TG7), and 13 (TG13) zirconia crowns. A total of 40 CBCT scans were made for the 4 groups (n=10). All CBCTs were imported into a computer planning software program, and the casts from all 4 groups were scanned by using a high-resolution laboratory scanner. The standard tessellation language (STL) files were imported, segmented, and the 3 files superimposed for all groups. The accuracy of the superimposition was assessed, in millimeters, in 3 planes corresponding to anterior-posterior, horizontal, and vertical, as well as the overall measurement, and the results were analyzed statistically (α=.05). RESULTS The overall analysis demonstrated statistically significant differences between all groups (P<.001), except between CG and TG4. The anterior-posterior dimension demonstrated significant differences between CG and TG7 (P<.001), CG and TG13 (P<.001), TG4 and TG7 (P=.004), and TG4 and TG13 (P=.001). For the vertical dimension analysis, significant differences were found between CG and TG7 (P=.001), CG and TG13 (P<.001), and TG4 and TG13 (P<.001). For the horizontal variable, statistically significant differences were found between CG and TG7 (P=.049), CG and TG13 (P<.001), TG4 and TG13 (P<.001), and TG7 and TG13 (P=.003). CONCLUSIONS The accuracy of the superimposition of the images was influenced by the number of zirconia crowns, with an increased number reducing the superimposition accuracy.
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Affiliation(s)
- May Alaidrous
- Graduate Prosthodontics, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yukio Kudara
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Hugo C Campos
- Assistant Professor, Interim Division Director Oral and Maxillofacial Radiology Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Andre Barbisan De Souza
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
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Coli P, Jemt T. On marginal bone level changes around dental implants. Clin Implant Dent Relat Res 2021; 23:159-169. [PMID: 33463007 DOI: 10.1111/cid.12970] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/17/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Peri-implant bone level values have been used as the clinical standard of reference to describe the status of a dental implant, despite the fact that their significance for the long-term survival of the implant has never been properly assessed. PURPOSE To challenge the assumption that the natural course of peri-implant bone loss is the loss of the implant. MATERIALS AND METHODS This article is a narrative review on reasons and interpretations of marginal bone level changes around dental implants. RESULTS AND CONCLUSIONS Different views regarding the pattern and progression of marginal bone loss depending on dental specialties have been identified. However, the present finding of a negative correlation between an increasing cumulative marginal bone loss and a decreasing risk of implant failures over time indicates that peri-implant marginal bone loss does not necessarily represent a condition of disease. Reduction of marginal bone levels may be observed in a majority of patients during follow-up time, with only a minority of those patients losing implants and implant-supported prostheses in the long term. Bone level changes seem often to occur as a consequence of physiological processes and/or as an adaptation to altered external as well as host response factors. Periodical radiological assessments of implant-restorations remain a valid diagnostic tool for the detection of potential implant fractures, loss of osseointegration, screws working loose and for the detection of the few cases with advanced, continuously progressing marginal bone loss during time. The detection of peri-implant marginal bone loss at one time point should not be immediately considered as a sign of ongoing pathology and of an increased risk of future loss of the implant in question.
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Affiliation(s)
- Pierluigi Coli
- Edinburgh Dental Specialists, Edinburgh, UK.,Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden
| | - Torsten Jemt
- Department of Prosthetic Dentistry/Dental Material Science, The Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Brånemark Clinic, Public Dental Health Care Service, Gothenburg, Västra Götaland, Sweden
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Romandini M, Lima C, Pedrinaci I, Araoz A, Soldini MC, Sanz M. Prevalence and risk/protective indicators of peri-implant diseases: A university-representative cross-sectional study. Clin Oral Implants Res 2020; 32:112-122. [PMID: 33210772 DOI: 10.1111/clr.13684] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
AIM To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. MATERIALS AND METHODS Two hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. Peri-implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri-implant health category between peri-implant mucositis and peri-implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis. RESULTS Ninety-nine patients with a total of 458 dental implants were analyzed. The prevalences of pre-periimplantitis and of peri-implantitis were, respectively, 31.3% and 56.6% at patient-level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR = 3.59; 95% CI: 1.52-8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20-6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05-4.73), plaque (OR = 3.49; 95% CI: 1.13-10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17-6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76-11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19-5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11-0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01-0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01-0.56). CONCLUSIONS Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective- indicators of peri-implantitis.
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Affiliation(s)
- Mario Romandini
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Cristina Lima
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ignacio Pedrinaci
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - Ana Araoz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | | | - Mariano Sanz
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense, Madrid, Spain
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Inoue M, Nakano T, Shimomoto T, Kabata D, Shintani A, Yatani H. Multivariate analysis of the influence of prosthodontic factors on peri-implant bleeding index and marginal bone level in a molar site: A cross-sectional study. Clin Implant Dent Relat Res 2020; 22:713-722. [PMID: 33179401 DOI: 10.1111/cid.12953] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Peri-implant tissue condition can result from prosthodontic, surgical and bacteriological factors. PURPOSE This study investigated the effects of prosthodontic factors on peri-implant tissue. MATERIALS AND METHODS Subjects were 140 patients with 310 implants from Osaka University Dental Hospital. Prosthodontic factors examined were the connection type, the suprastructure retention type, the material of the abutment and the mesiodistal and buccolingual prosthetic form of the superstructure as emergence angle. The objective variables were the modified bleeding index (mBI) and marginal bone level (MBL). Statistical analysis was used as a generalized estimation equation. RESULTS The taper joint had a significantly smaller MBL than the butt joint (P < .001). There was no significant difference in mBI and MBL between cement and screw retaining. Zirconium and titanium resulted in a significantly smaller mBI than gold alloy (zirconium/gold alloy: P = .037, titanium / gold alloy: P = .021), but there was no significant difference in the MBL. Both mBI and MBL tended to be smaller when the emergence angle was around 20° to 40°, although this difference was not significant. CONCLUSION As a result of multivariate analysis, our findings suggest that to reduce MBL from the perspective of prosthodontic factors it is preferable to use an implant with a taper joint connection positioned with an emergence angle of 20° to 40°.
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Affiliation(s)
- Masaki Inoue
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takuya Shimomoto
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
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Sordi MB, Perrotti V, Iaculli F, Pereira KCR, Magini RS, Renvert S, Gattone SA, Piattelli A, Bianchini MA. Multivariate analysis of the influence of peri-implant clinical parameters and local factors on radiographic bone loss in the posterior maxilla: a retrospective study on 277 dental implants. Clin Oral Investig 2020; 25:3441-3451. [PMID: 33155065 PMCID: PMC8137597 DOI: 10.1007/s00784-020-03666-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. MATERIALS AND METHODS Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. RESULTS Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) CONCLUSIONS: ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. CLINICAL RELEVANCE Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.
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Affiliation(s)
- Mariane B Sordi
- Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.
| | - Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Keila C R Pereira
- Public Health Sciences, University of South of Santa Catarina, Tubarao, Brazil
| | - Ricardo S Magini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University School of Dentistry, Kristianstad, Sweden.,Dublin Dental Hospital, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Stefano Antonio Gattone
- Department of Philosophical, Pedagogical and Economic-Quantitative Sciences (DiSFPEQ), University of Chieti-Pescara, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences (DSMOB), University of Chieti-Pescara, Via dei vestini, 31, 66100, Chieti, Italy.,Biomaterials Engineering, Catholic University of Murcia (UCAM), Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (Pescara), Italy
| | - Marco A Bianchini
- Perio/Implantology, Department of Dentistry, Center for Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil
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Efficacy of Local Minocycline Agents in Treating Peri-Implantitis: An Experimental In Vivo Study in Beagle Dogs. Pharmaceutics 2020; 12:pharmaceutics12111016. [PMID: 33114168 PMCID: PMC7690844 DOI: 10.3390/pharmaceutics12111016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Local delivery agents (LDA) have the advantage of delivering the antibiotics at high concentrations to the targeted sites. However, the constant flow of gingival crevicular fluids and saliva may restrict their efficacy. Therefore, the drug sustainability and pharmacodynamic properties of any proposed LDA should be evaluated. METHODS Four dental implants were placed unilaterally in the edentulous mandible of six beagle dogs. Peri-implantitis were experimentally induced using silk-ligatures. Each implant was randomly allocated to receive one of the following four treatments: (i) MC (Chitosan-alginate (CA) minocycline), (ii) MP (CA-without minocycline), (iii) PG (Polyacrylate-glycerin minocycline), and (iv) Control (mechanical debridement only). Mechanical therapies and LDAs were administered into the gingival sulcus two times at a 4-week interval. Drug sustainability as well as clinical, radiographical, and immunohistochemical (IHC) analyses were conducted to evaluate the efficacies of treatments. RESULTS Reduced mean probing depth was observed in all of the test groups after the second delivery. A minimal marginal bone level change was observed during the treatment period (MP (-0.06 ± 0.53 mm) to PG (-0.25 ± 0.42 mm)). The distribution of IHC cell marker analysis of all targeted antibodies ranged from 6.34% to 11.33%. All treatment outcomes between the test groups were comparable. A prolonged retention of LDA was observed from CA microspheres (MC and MP) at both administrations (p < 0.017) and prolonged sustainability of bacteriostatic effect was observed from MC compared to PG after the second administration (p < 0.05). CONCLUSIONS Prolonged retention of CA microspheres was observed and the longer bacteriostatic effect was observed from the MC group. Mechanical debridement with adjunct LDA therapy may impede peri-implantitis progression, however, prolonged drug action did not lead to improved treatment outcome.
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Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
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Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
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50
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Tattan M, Chambrone L, González-Martín O, Avila-Ortiz G. Static computer-aided, partially guided, and free-handed implant placement: A systematic review and meta-analysis of randomized controlled trials. Clin Oral Implants Res 2020; 31:889-916. [PMID: 32654230 DOI: 10.1111/clr.13635] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To analyze the outcomes of static computer-aided implant placement (sCAIP) compared to partially guided (PGIP) and free-handed (FHIP) implant placement. MATERIAL AND METHODS This study was registered in PROSPERO (CRD42019131397). A comprehensive literature search was performed by two independent examiners. Only randomized controlled trials (RCTs) were selected. Treatment modalities included sCAIP, PGIP, and FHIP. Data pertaining to the outcomes of interest were extracted. Random-effects meta-analyses were feasible for a subset of outcomes. RESULTS From an initial list of 2,870 records, fourteen articles for a total of ten RCTs were selected. Data from 7 of these studies allowed for the conduction of three meta-analyses comparing accuracy of implant placement across modalities. Survival rate up to 12 months post-loading was high (>98%) and comparable between treatments (low-quality evidence). No tangible differences in terms of patient perception of intra- or postoperative discomfort were observed (low-quality evidence). Quantitative analyses revealed significantly lower angular (MD = 4.41°, 95% CI 3.99-4.83, p < .00001), coronal (MD = 0.65 mm, 95% CI 0.50-0.79, p < .00001), and apical (MD = 1.13 mm, 95% CI 0.92-1.34, p < .00001) deviation values for sCAIP as compared to FHIP (8 studies, 383 patients, 878 implants, high-quality evidence). A similar discrepancy, in favor of sCAIP, was observed for angular deviation only as compared to PGIP (MD = 2.11°, 95% CI 1.06-3.16, p < .00001). CONCLUSIONS sCAIP is associated with superior accuracy compared to PGIP and FHIP.
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Affiliation(s)
- Mustafa Tattan
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Leandro Chambrone
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Ibirapuera University School of Dentistry, São Paulo, Brazil.,School of Dentistry, Universidad El Bosque, Bogotá, Colombia
| | - Oscar González-Martín
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA.,Department of Periodontal Prosthesis, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.,Department of Periodontology, Complutense University of Madrid, Madrid, Spain
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, IA, USA
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