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Guljé FL, Raghoebar GM, Gareb B, Vissink A, Meijer HJA. Single crown restorations supported by 6-mm implants in the resorbed posterior mandible: A 10-year prospective case series. Clin Implant Dent Relat Res 2024. [PMID: 38534097 DOI: 10.1111/cid.13326] [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: 12/27/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE To assess marginal bone level changes, implant and restoration survival, condition of the peri-implant mucosa, and the patient's satisfaction with the single restoration supported by a 6-mm long implant in the posterior mandible after 10 years in function. MATERIALS AND METHODS Twenty-one consecutive patients missing premolars or molars in the posterior mandible, with a bone volume consisting of a width of at least 6 mm and an estimated height of 8 mm between the top of the ridge and alveolar nerve, were included. Each patient received one or more 6-mm implants. After 3 months, the implants were restored with custom-made titanium abutments and cemented zirconia-based porcelain crowns. The clinical examination and radiograph data were assessed at restoration placement and after 12, 60, and 120 months. The patients answered a questionnaire to score their satisfaction before treatment and after 12, 60, and 120 months with the restoration in function. RESULTS A total of 31 implants were placed. Implant survival was 100%. The 10-year mean marginal bone loss was 0.18 mm (SE: 0.08). The plaque, calculus, gingiva, and bleeding indices scores were low as was the mean pocket probing depth. The patients' satisfaction was high. CONCLUSION The 10-year follow-up data of this limited case series study reveal that 6-mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restorations.
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Affiliation(s)
- Felix L Guljé
- Referral practice for implant dentistry, Center for Dental Implants De Mondhoek, Apeldoorn, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Naseri R, Asadollahi S, Shirani M, Pouremadi N. Clinical outcomes of dental implants placed in fresh sockets: A five-year retrospective study. Saudi Dent J 2024; 36:146-150. [PMID: 38375396 PMCID: PMC10874783 DOI: 10.1016/j.sdentj.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/08/2023] [Accepted: 10/31/2023] [Indexed: 02/21/2024] Open
Abstract
Purpose This retrospective clinical study aimed to evaluate the implants placed in fresh sockets and investigate the effect of varied oral health conditions and treatment plan details on the clinical and radiographic outcomes. Materials and methods Fifty-nine participants (102 implants) were included in this study. Four variables, including mean probing depth (PD), mean marginal bone loss (MBL), pink esthetic score (PES), and patient satisfaction, were significant dependent variables, and the effects of independent variables on these four items were studied. The data were analyzed by the analysis of covariance (ANCOVA) using a statistical software. Results The mean follow-up period was 4.75 ± 1.74 years, and the mean MBL was 1.21 ± 0.81 mm. The survival rate was 97 %. There were significant effects of the finish line site, keratinized gingival width, and attached gingival width on PD after adjusting the factors. Also, the implant brand, plaque index, and uncemented prosthesis affected MBL significantly. In addition, significant effects of the surgeon, implant brand, and proximal contact on PES were found. Conclusion More PD was found around restorations with a finish line site > 1.5 mm subgingival. Sufficient attached gingiva was a more effective factor on PD than keratinized gingiva. Implants with more plaque scores showed more MBL.
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Affiliation(s)
- Roohollah Naseri
- Dental Research Center, Department of Periodontics, Dental Research Institute, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
| | - Sepideh Asadollahi
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Narges Pouremadi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Yuan X, Liu Y, Yang Y, Ren M, Luo L, Zheng L, Liu Y. Effect of short implant crown-to-implant ratio on stress distribution in anisotropic bone with different osseointegration rates. BMC Oral Health 2023; 23:683. [PMID: 37730562 PMCID: PMC10512631 DOI: 10.1186/s12903-023-03379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/31/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE This study aimed to provide evidence for the clinical application of single short implants by establishing an anisotropic, three-dimensional (3D) finite element mandible model and simulating the effect of crown-to-implant ratio (CIR) on biomechanics around short implants with different osseointegration rates. METHODS Assuming that the bone is transversely isotropic by finite element method, we created four distinct models of implants for the mandibular first molar. Subsequently, axial and oblique forces were applied to the occlusal surface of these models. Ultimately, the Abaqus 2020 software was employed to compute various mechanical parameters, including the maximum von Mises stress, tensile stress, compressive stress, shear stress, displacement, and strains in the peri-implant bone tissue. RESULTS Upon establishing consistent osseointegration rates, the distribution of stress exhibited similarities across models with varying CIRs when subjected to vertical loads. However, when exposed to inclined loads, the maximum von Mises stress within the cortical bone escalated as the CIR heightened. Among both loading scenarios, notable escalation in the maximum von Mises stress occurred in the model featuring a CIR of 2.5 and an osseointegration rate of 25%. Conversely, other models displayed comparable strength. Notably, stress and strain values uniformly increased with augmented osseointegration across all models. Furthermore, an increase in osseointegration rate correlated with reduced maximum displacement for both cortical bone and implants. CONCLUSIONS After fixing osseointegration rates, the stress around shorter implants increased as the CIR increased under inclined loads. Thus, the effect of lateral forces should be considered when selecting shorter implants. Moreover, an implant failure risk was present in cases with a CIR ≥ 2.5 and low osseointegration rates. Additionally, the higher the osseointegration rate, the more readily the implant can achieve robust stability.
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Affiliation(s)
- Xi Yuan
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, 712000, China
| | - Yuchen Liu
- Dalian University of Technology, Dalian, 116000, China
| | - Yunhe Yang
- Dalian Stomatological Hospital, Dalian, 116000, China
| | - Mingfa Ren
- Dalian University of Technology, Dalian, 116000, China
| | - Lailong Luo
- Dalian University of Technology, Dalian, 116000, China
| | - Lang Zheng
- Dalian University, Dalian, 116000, China
| | - Yang Liu
- Department of Prosthodontics, Dalian Stomatological Hospital, 935 Changjiang Road, Shahekou District, Dalian, 116000, China.
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Anitua E, Eguia A, Alkhraisat MH. Extra-short implants (≤ 6.5 mm in length) in atrophic and non-atrophic sites to support screw-retained full-arch restoration: a retrospective clinical study. Int J Implant Dent 2023; 9:29. [PMID: 37702800 PMCID: PMC10499764 DOI: 10.1186/s40729-023-00499-7] [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: 05/26/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Increasing scientific evidence support extending the application of short dental implants to non-atrophic dental arches. The purpose of this study has been the evaluation of extra-short implants (≤ 6.5 mm in length) that were placed in atrophic and non-atrophic anatomical sites to support the same prosthesis. METHODS For that, a retrospective study was conducted by including complete dentures that were solely supported by extra-short implants in the maxilla and/or the mandible. Clinical data about patients, implants, anatomy, and prosthesis were obtained. Statistical analysis was performed to assess implant- and prosthesis-survival, changes in the marginal bone level and prosthetic complications. RESULTS A total of 87 implants in 15 screw-retained complete dentures were assessed. None of the prostheses nor the extra-short implant failed during the follow-up of 27.2 ± 15.4 months. The changes in the mesial and distal marginal bone level were + 0.15 ± 0.51 mm and + 0.11 ± 0.50 mm, respectively. Comparing the implants according to the availability of sufficient bone to place longer implants, indicated the absence of significant differences in the changes of the mesial marginal bone level. However, the changes in the distal marginal bone level showed a statistically significant difference in favor of implants that were placed in non-atrophic sites. Two events of screw loosening were reported that were resolved by retightening the screws. CONCLUSIONS Implant- and prosthesis-related outcomes support the use of extra-short implants in atrophic and non-atrophic site to support complete prosthesis.
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Affiliation(s)
- Eduardo Anitua
- Private Practice in Oral Implantology, Clínica Eduardo Anitua Foundation, C/ Jose Maria Cagigal 19, 01007, Vitoria, Spain.
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain.
- BTI Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- University of the Basque Country UPV/EHU, Leioa (Bizkaia), Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- BTI Biotechnology Institute, Vitoria, Spain
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Chen Z, Li W, Li P. Effects of crown-to-implant ratio on marginal bone level and bone density in non-splinted single implants: a cross-sectional study. BMC Oral Health 2023; 23:298. [PMID: 37194034 DOI: 10.1186/s12903-023-03014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Few studies have evaluated the effects of the crown-to-implant (C/I) ratio on the marginal bone level (MBL) and bone density in non-splinted single implants. The aim of this study was to assess the effect of C/I ratio on MBL and density of peri-implant bone in non-splinted posterior implants. METHODS The C/I ratio, MBL, and grayscale values (GSVs) for bone density were measured from X-rays. Four areas of interest (two at the apical area and two at the middle of the peri-implant area) and two control areas were selected for evaluation. Follow-up radiographs were calibrated according to the control areas. RESULTS In all, 117 non-splinted posterior implants in 73 patients followed up for a mean duration of 36.23 ± 10.40 (range 24-72) months were considered. The mean anatomical C/I ratio was 1.78 ± 0.43 (range 0.93 to 3.06). The mean change in MBL was 0.28 ± 0.97 mm. There were no significant associations between the C/I ratio and MBL changes (r = -0.028, p = 0.766). Pearson correlation showed a significant correlation between changes in GSV and the C/I ratio in the middle peri-implant area (r = 0.301, p = 0.001) and apical area (r = 0.247, p = 0.009). CONCLUSIONS A higher C/I ratio of single non-splinted posterior implants is associated with increased peri-implant bone density, but not correlated with changes in MBL.
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Affiliation(s)
- Ziyuan Chen
- Second Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Weiting Li
- Second Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Peng Li
- Second Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
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Menini M, Pesce P, Delucchi F, Ambrogio G, Canepa C, Carossa M, Pera F. One-stage versus two-stage technique using two splinted extra-short implants: A multicentric split-mouth study with a one-year follow-up. Clin Implant Dent Relat Res 2022; 24:602-610. [PMID: 35700161 PMCID: PMC9796435 DOI: 10.1111/cid.13113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/05/2022] [Accepted: 05/21/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To compare the clinical outcomes of extra-short implants (≤6.5 mm) inserted with one-stage versus two-stage technique in adjacent sites of the upper or lower jaw. MATERIALS AND METHODS In this split-mouth multicenter study, implants were randomly divided into two groups according to the healing phase: two-stage and one-stage technique. Primary outcome measures were implant survival, implant success, and prosthodontic complications. Secondary outcome measurements were: implant stability quotient (ISQ) collected at surgery time (T0), and after 3 (T3) and 12 (T12) months, marginal bone level (MBL) evaluated at T0, T3, T6, and T12, marginal bone loss evaluated at T6 and T12, plaque index (PI), probing depth (PD), bleeding on probing (BoP) evaluated at T3, T6, and T12. Significances of differences between groups were tested by linear mixed model with random intercept. RESULTS Nineteen patients (8 males and 11 females) were included. A total of 38 implants were inserted. At T12 implant cumulative survival and implant success rate were 100% in both groups. No statistically significant differences were recorded for any of the analyzed parameters between the two groups at any time point. ISQ values were similar at T0 (two-stage: mean 67.53 ± SD 19.47; one-stage: mean 66.53 ± 19.07 p = 0.8738) and increased in both groups at the 12-month follow-up appointment (two-stage: 81.1 ± 7.04; one-stage: 81.39 ± 0.9266). MBL values were similar in the two groups at any time point. At T12 marginal bone loss was 0.46 ± 0.41 (two-stage) and 0.45 ± 0.38 (one-stage) mm (p = 0.9417), while mean PD was 2.7 ± 0.85 (two-stage) and 2.69 ± 0.89 (one-stage) mm. CONCLUSIONS Within the limits of the present short-term report, extra-short implants demonstrated optimal clinical outcomes using the one-stage technique, without statistically significant differences compared with the traditional two-stage approach.
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Affiliation(s)
- Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences and Integrated Diagnostics (DISC)University of GenoaGenoaItaly
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC)University of GenoaGenoaItaly
| | - Francesca Delucchi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences and Integrated Diagnostics (DISC)University of GenoaGenoaItaly
| | - Giulia Ambrogio
- CIR Dental School Department of Surgical SciencesUniversity of TurinTorinoItaly
| | - Camilla Canepa
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences and Integrated Diagnostics (DISC)University of GenoaGenoaItaly
| | - Massimo Carossa
- CIR Dental School Department of Surgical SciencesUniversity of TurinTorinoItaly
| | - Francesco Pera
- CIR Dental School Department of Surgical SciencesUniversity of TurinTorinoItaly
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Shi J, Sun Y, Han Y, Chai M, Liu H, Wang J. A finite element analysis on the biomechanical performance of implant-retained finger prostheses designed for Asians. J Plast Reconstr Aesthet Surg 2022; 75:4048-4053. [DOI: 10.1016/j.bjps.2022.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/19/2022] [Accepted: 08/16/2022] [Indexed: 11/26/2022]
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Prognosis of Implants with Implant-Supported Fixed Dental Prostheses in the Elderly Population: A Retrospective Study with a 5- to 10-Year Follow-Up. Healthcare (Basel) 2022; 10:healthcare10071250. [PMID: 35885775 PMCID: PMC9317632 DOI: 10.3390/healthcare10071250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/11/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
This retrospective study aimed to investigate the survival rate of implants from 5 to 10 years after the placement of implant-supported fixed dental prostheses (ISFDPs) and the management of implant loss in the elderly population. Elderly patients (≥65 years old) who had been treated with ISFDPs and followed up with for at least 5 years between October 2009 and March 2020 were enrolled. Patient profiles and implant-related data were extracted. The survival rate of implants up to 5 years as well as the 10-year cumulative survival rate were evaluated. The management of implant loss and prosthetic interventions were also investigated. In total, 195 patients (mean age: 70.1 ± 4.5 years old) and 687 implants (287 ISFDPs) were assessed. The 5-year survival rate was 99.0% and the 10-year cumulative survival rate was 98.1%. Seven of the eleven implants lost were lost due to peri-implantitis. Only three implants in two patients were placed after the loss of the implants; most were restored using non-invasive procedures. Two patients underwent a conversion from ISFDPs to removable prostheses. This study showed that high survival rates were observed in an elderly population with ISFDPs and that non-invasive procedures were often applied after the loss of an implant.
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Barausse C, Pistilli R, Canullo L, Bonifazi L, Ferri A, Felice P. A 5-year randomized controlled clinical trial comparing 4-mm ultrashort to longer implants placed in regenerated bone in the posterior atrophic jaw. Clin Implant Dent Relat Res 2022; 24:4-12. [PMID: 35019219 DOI: 10.1111/cid.13061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/27/2021] [Accepted: 12/10/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Short implants (up to 5-mm long) have shown good results when compared to longer implants placed in augmented bone. PURPOSE To evaluate if 4-mm ultrashort implants could also be an alternative to bone augmentation in the severely atrophic posterior jaws. The primary aim of the study was to compare implant survival rates between study groups. MATERIALS AND METHODS Eighty partially edentulous patients with posterior atrophic jaws (5-6 mm of bone above the mandibular canal and 4-5 mm below the maxillary sinus) were included: 40 patients in the maxilla and 40 in mandible. The patients were randomized to receive one to three 4-mm ultrashort implants or one to three implants at least 10-mm long in augmented bone. Results are reported 5 years after loading with the following outcome measures: implant and prosthetic failures, complications and peri-implant marginal bone level changes. RESULTS Thirty-two complications were reported for the control group in 18 patients versus 13 complications in 10 patients in the test group, the difference being not statistically significant (p = 0.103). In the augmented group, 12 implants failed in 6 patients versus 7 short implants in 6 cases, and 9 prostheses failed in the control group while 4 in the test one, without statistically significant differences (p = 1.000 and 0.363, respectively). At 5 years after loading, short implants lost on average 0.58 ± 0.40 mm of peri-implant marginal bone and long implants 0.99 ± 0.58 mm, the difference was statistically significant (p = 0.006). CONCLUSION Four-millimeter ultrashort implants showed similar if not better results when compared to longer implants placed in augmented jaws 5 years after loading. For this reason, their use could be in specific cases preferable to bone augmentation since the treatment is less invasive, faster, cheaper and associated with less morbidity. However, longer follow-ups and larger trials are needed.
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Affiliation(s)
- Carlo Barausse
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy.,Postgraduate School of Oral Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Luigi Canullo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Bonifazi
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
| | - Agnese Ferri
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
| | - Pietro Felice
- Department of Biomedical and Neuromotor Sciences, Unit of Oral Surgery, University of Bologna, Bologna, Italy
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Donker VJJ, Raghoebar GM, Jensen‐Louwerse C, Vissink A, Meijer HJA. Monolithic zirconia single tooth implant‐supported restorations with
CAD
/
CAM
titanium abutments in the posterior region: A 1‐year prospective case series study. Clin Implant Dent Relat Res 2022; 24:125-132. [PMID: 35075756 PMCID: PMC9303442 DOI: 10.1111/cid.13069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/26/2021] [Indexed: 11/29/2022]
Abstract
Purpose To assess the clinical, radiographic, and patient‐reported outcome measures, including the success of screw‐retained monolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments in the posterior region during a 1‐year follow‐up. Methods In a prospective case series, 50 molar sites in the posterior region of 46 patients with a minimum age of 18 years and sufficient bone volume and anatomical conditions for placing an implant (≥8 mm) and an anatomical restoration were included. Parallel‐walled implants with a conical connection were inserted in a two‐stage surgical procedure. Implant uncovering and healing abutment placement occurred 12 weeks after insertion. Two weeks after mucosa healing, a screw‐retained monolithic zirconia restoration with a CAD/CAM titanium abutment was placed. Clinical, radiographic, and patient‐reported outcome measures were collected at baseline before implant placement and then during the 1 month and 1 year follow‐ups. Results At the 1 year follow‐up, 49 restorations could be evaluated. The plaque accumulation, presence of calculus, bleeding tendency and peri‐implant inflammation indices were low, representing healthy peri‐implant conditions. The mean marginal bone level change between the 1 month and the 1 year follow‐up was −0.17 ± 0.46 mm. The mean patient satisfaction was high. The restoration success was, according to the modified USPHS criteria, 95.9%. Conclusion Monolithic zirconia implant‐supported restorations with CAD/CAM titanium abutments have very good clinical, radiographic and patient‐reported outcomes after 1 year in function.
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Affiliation(s)
- Vincent J. J. Donker
- Department of Oral and Maxillofacial Surgery University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Gerry M. Raghoebar
- Department of Oral and Maxillofacial Surgery University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Charlotte Jensen‐Louwerse
- Department of Implant Dentistry University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery University of Groningen, University Medical Center Groningen Groningen The Netherlands
| | - Henny J. A. Meijer
- Department of Oral and Maxillofacial Surgery University of Groningen, University Medical Center Groningen Groningen The Netherlands
- Department of Implant Dentistry University of Groningen, University Medical Center Groningen Groningen The Netherlands
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Tay JRH, Ng E, Lu XJ, Lai WMC. Healing complications and their detrimental effects on bone gain in vertical-guided bone regeneration: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:43-71. [PMID: 35048503 DOI: 10.1111/cid.13057] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Guided bone regeneration (GBR) utilizes a barrier membrane to allow osteogenic cells to populate a space by excluding epithelial and connective tissue cells. The purpose of this systematic review was to investigate the ratio of means (RoM) of vertical bone gained (Outcome) in vertical GBR procedures with healing complications (Intervention) and in vertical GBR procedures without healing complications (Comparison) in patients with vertically resorbed edentulous ridges that require dental implant placement (Population). A further aim was to investigate the incidence of complications after vertical GBR, and the influence of the timing of implant placement and regenerative devices on complications. MATERIALS AND METHODS MEDLINE (through PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched in duplicate up to, and including, November 2020 for randomized and controlled clinical trials and prospective and retrospective case series. Outcomes included patient-level and site-level RoM of vertical bone gain between healing complications and uneventful healing, and incidences of complications that occurred after vertical GBR. Random-effects and fixed-effects meta-analyses were performed where appropriate. This study was registered on PROSPERO (CRD42021226432). RESULTS A total of 31 publications were selected for the qualitative and quantitative analyses. The RoM of vertical bone gained was 0.65 [95% CI = 0.47, 0.91] and 0.62 [95% CI = 0.45, 0.85] when membrane exposure without suppuration and abscess formation without membrane exposure occurred respectively, in comparison to uneventful healing. The overall incidence proportion of healing complications occurring at the augmented site at a site- and patient-level was 11.0% [95% CI = 7.0, 15.6] and 10.8% [95% CI = 6.6, 15.7]. At a patient-level, there were no significant differences between a simultaneous or staged approach, or with the regenerative device used. The site-level incidence proportion of membrane exposure without suppuration, membrane exposure with suppuration, and with abscess formation without membrane exposure was 8.7% [95% CI = 4.2, 14.2], 0.7% [95% CI = 0.0, 2.9], and 0.5% [95% CI = 0.0, 1.7], respectively. The site-level weighted mean incidence proportion of neurologic complications occurring at the donor site was 0.8% [95% CI = 0.0, 5.3]. CONCLUSIONS There is a significant reduction in bone gain when healing complications occur. However, healing complications are relatively uncommon surgical complications after vertical GBR.
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Affiliation(s)
- John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
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Matsumoto T, Matsunaga S, Kasahara M, Kasahara N, Nakano T, Ishimoto T, Nishii Y. Evaluation of the Microstructural Characteristics of Bone Surrounding Anchor Screws Placed under a Horizontal Load by Exploring the Orientation of Biological Apatite Crystals and Collagen Fiber Anisotropy. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Norio Kasahara
- Department of Histology and Developmental Biology, Tokyo Dental College
| | - Takayoshi Nakano
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
| | - Takuya Ishimoto
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
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The influence of crown-to-implant ratio in single crowns on clinical outcomes: A systematic review and meta-analysis. J Prosthet Dent 2021; 126:497-502. [DOI: 10.1016/j.prosdent.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/23/2023]
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14
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Wolfart S, Rittich A, Groß K, Hartkamp O, von der Stück A, Raith S, Reich S. Cemented versus screw-retained posterior implant-supported single crowns: A 24-month randomized controlled clinical trial. Clin Oral Implants Res 2021; 32:1484-1495. [PMID: 34547824 DOI: 10.1111/clr.13849] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/02/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the incidence of biological and technical complications of cemented and screw-retained monolithic lithium-disilicate implant-supported posterior single crowns. MATERIAL AND METHODS Forty-one subjects with a total of 56 implants received randomly allocated 28 cemented and 28 screw-retained crowns. In the screw-retained group, monolithic lithium-disilicate restorations were luted to titanium bases extraorally. In the cemented group, monolithic lithium-disilicate crowns were cemented on individualized titanium abutments intraorally. All restorations were examined according to modified FDI criteria within 2 weeks of inserting the crowns (baseline) and after 12 (n = 46) and 24 (n = 43) months. Bone loss was evaluated by standardized radiographs at baseline and 12 months. RESULTS After 12 months, the incidence of mucositis (positive bleeding on probing) was 14.2% (screw-retained) and 17.9% (cement-retained). The gingival and plaque index and a mean marginal bone loss between 0.03-0.15 mm showed no significant difference between the groups. In the cemented group, cement residues were detected at baseline at two restorations (6.9%) by radiographic examination. A complete digital workflow was realized in most cases (85.7%). At 24 months, no restoration had failed, and no chipping of the ceramic had occurred. In the screw-retained group, screw loosening occurred in one implant. In both groups, there was obvious deterioration in the quality of 32% of the occlusal and of 18% of the proximal contact points. CONCLUSIONS The type of retention mode of monolithic implant-retained lithium-disilicate posterior crowns had no influence on the biological and technical complication rate.
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Affiliation(s)
- Stefan Wolfart
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany
| | - Karin Groß
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany
| | - Oliver Hartkamp
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany
| | | | - Stefan Raith
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany.,Clinic for Oral and Maxillofacial Surgery, Aachen, Germany
| | - Sven Reich
- Department of Prosthodontics and Biomaterials, RWTH University Hospital, Aachen, Germany
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15
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Influence of Dental Implant Diameter and Bone Quality on the Biomechanics of Single-Crown Restoration. A Finite Element Analysis. Dent J (Basel) 2021; 9:dj9090103. [PMID: 34562977 PMCID: PMC8464909 DOI: 10.3390/dj9090103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Success of an implant-supported prosthesis is highly dependent on implant diameter and bone quality. The objective of this study is to assess these two variables under axial or 30° angulated loading. Methods: The study was conducted using finite element model simulations of dental implants with an unchanging length of 6.5 mm and varying diameters of Ø3.3; Ø3.5; Ø3.75; Ø4, Ø4.25 and Ø4.75 mm. The implants were placed in an axial position and a 2 mm high straight transepithelial (intermediate abutment) was used to perform a single tooth restoration. Four bone quality scenarios, Type IV, III, II or 0-I bone, were simulated from a simplified model of the mandible. A 200N load was applied both axially and at a 30° angle to the occlusal surface of the prosthesis, which was 11 mm above the implant platform, and the equivalent Von Mises stress in the bone was analyzed. Results: The maximum stress value was obtained for the Ø3.3 implant in Type IV bone (235 MPa), while the lowest value was obtained for the Ø4.75 implant and in Type 0-I bone (41 MPa). Regardless of the implant diameter, an improvement in bone quality produced a reduction in bone stress. The same effect was observed as the implant diameter was increased, being this effect even more pronounced. Conclusions: Implant diameter has an important effect on bone stress, with a reduction in stress as the implant diameter increases.
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16
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Single-crown restorations supported by short implants (6 mm) compared with standard-length implants (13 mm) in conjunction with maxillary sinus floor augmentation: a randomized, controlled clinical trial. Int J Implant Dent 2021; 7:66. [PMID: 34268630 PMCID: PMC8282885 DOI: 10.1186/s40729-021-00348-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications. Results Both treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA. Conclusion Within the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities. Trial registration Clinicaltrials.Gov ID: NCT04518020. Date of registration: August 14, 2020, retrospectively registered.
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Affiliation(s)
- Helle Baungaard Nielsen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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17
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Haeberle CB, Abreu A, Metzler K, Robles-Moreno M. Complications Associated with Rehabilitation of a Unilateral Partially Edentulous Mandible with Inferior Alveolar Nerve Transposition and Implant Placement: A Clinical Report. J Prosthodont 2021; 30:285-289. [PMID: 33434366 DOI: 10.1111/jopr.13324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 12/16/2022] Open
Abstract
Rehabilitation of an edentulous posterior mandible to restore function and arch stability can be accomplished with a removable partial denture or an implant supported fixed partial denture. If the alveolus is severely resorbed, implant placement becomes challenging due to inadequate bone and the position of the inferior alveolar nerve. This report details a situation where a mandibular fracture occurred soon after inferior alveolar nerve (IAN) transposition and simultaneous implant placement. The prosthodontic reconstruction was completed using a fixed-dental prosthesis.
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18
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Murakami H, Igarashi K, Fuse M, Kitagawa T, Igarashi M, Uchibori S, Komine C, Gotouda H, Okada H, Kawai Y. Risk factors for abutment and implant fracture after loading. J Oral Sci 2020; 63:92-97. [PMID: 33311012 DOI: 10.2334/josnusd.20-0443] [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] [Indexed: 11/01/2022]
Abstract
PURPOSE Implant component fractures are one of the most serious complications in implant treatment. With a better understanding of the risk factors for fracture in the preoperative, surgery, superstructure, and post-loading phases of implant treatment, low-risk treatment could reduce implant component fractures, leading to a better prognosis. The aim of this study was to clarify the risk factors for abutment and implant fractures that occur after loading, and to perform a retrospective, approximately 10-year follow-up study to explore the risk factors in each treatment phase. METHODS Subjects were fitted with an implant prosthesis between January 2008 and December 2009. In total, 1,126 Ankylos implants in 430 patients were included for analysis. Binary logistic regression analysis was performed to extract factors related to non-fracture and fracture of the abutment or implant as a dependent variable. RESULTS Gender (OR = 3.466, 95% CI 1.296-9.268, P = 0.013), gonial angle (OR = 3.420, 95% CI 1.308-8.945, P = 0.012), and splinting status of the superstructure (OR = 4.456, 95% CI 1.861-10.669, P = 0.001) were identified as significant risk factors. CONCLUSION The risk of fracture is increased in males, especially those with a mandibular angle of less than 120° on panoramic radiographs, and those with a non-splinted superstructure.
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Affiliation(s)
- Hiroshi Murakami
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Kentaro Igarashi
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo
| | - Megumi Fuse
- Liberal Arts (Chemistry), Nihon University School of Dentistry at Matsudo
| | - Tsuyoshi Kitagawa
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Mitsuhiko Igarashi
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Satoshi Uchibori
- Department of Fixed Prosthodontics and Oral Implantology, Nihon University School of Dentistry at Matsudo
| | - Chiaki Komine
- Department of Oral Health Science, Division of Laboratory Medicine for Dentistry, Nihon University School of Dentistry at Matsudo
| | - Hiroya Gotouda
- Department of Community Oral Health, Nihon University School of Dentistry at Matsudo
| | - Hiroyuki Okada
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Yasuhiko Kawai
- Department of Removable Prosthodontics, Nihon University School of Dentistry at Matsudo
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19
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Caramês J, Pinto AC, Caramês G, Francisco H, Fialho J, Marques D. Survival Rate of 1008 Short Dental Implants with 21 Months of Average Follow-Up: A Retrospective Study. J Clin Med 2020; 9:jcm9123943. [PMID: 33291369 PMCID: PMC7761997 DOI: 10.3390/jcm9123943] [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: 11/15/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 01/26/2023] Open
Abstract
This retrospective study evaluated the survival rate of short, sandblasted acid-etched surfaced implants with 6 and 8 mm lengths with at least 120 days of follow-up. Data concerning patient, implant and surgery characteristics were retrieved from clinical records. Sandblasted and acid-etched (SLA)-surfaced tissue-level 6 mm (TL6) or 8 mm (TL8) implants or bone-level tapered 8 mm (BLT8) implants were used. Absolute and relative frequency distributions were calculated for qualitative variables and mean values and standard deviations for quantitative variables. A Cox regression model was performed to verify whether type, length and/or width influence the implant survival. The cumulative implant survival rate was assessed by time-to-event analyses (Kaplan–Meier estimator). In all, 513 patients with a mean age of 58.00 ± 12.44 years received 1008 dental implants with a mean follow-up of 21.57 ± 10.77 months. Most implants (78.17%) presented a 4.1 mm diameter, and the most frequent indication was a partially edentulous arch (44.15%). The most frequent locations were the posterior mandible (53.97%) and the posterior maxilla (31.55%). No significant differences were found in survival rates between groups of type, length and width of implant with the cumulative rate being 97.7% ± 0.5%. Within the limitations of this study, the evaluated short implants are a predictable option with high survival rates during the follow-up without statistical differences between the appraised types, lengths and widths.
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Affiliation(s)
- João Caramês
- Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal; (J.C.); (H.F.)
- Instituto de Implantologia, 1070-064 Lisbon, Portugal; (A.C.P.); (G.C.)
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
| | | | - Gonçalo Caramês
- Instituto de Implantologia, 1070-064 Lisbon, Portugal; (A.C.P.); (G.C.)
| | - Helena Francisco
- Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal; (J.C.); (H.F.)
- Instituto de Implantologia, 1070-064 Lisbon, Portugal; (A.C.P.); (G.C.)
| | - Joana Fialho
- Escola Superior de Tecnologia e Gestão de Viseu, Centro de Estudos em Educação, Tecnologias e Saúde, 3504-510 Viseu, Portugal;
| | - Duarte Marques
- Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal; (J.C.); (H.F.)
- Instituto de Implantologia, 1070-064 Lisbon, Portugal; (A.C.P.); (G.C.)
- LIBPhys-FCT UID/FIS/04559/2013, Faculty of Dental Medicine, University of Lisbon, 1600-277 Lisbon, Portugal
- Correspondence: ; Tel.: +35-19-6648-6375
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20
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Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
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Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
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21
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Vetromilla BM, Mazzetti T, Pereira-Cenci T. Short versus standard implants associated with sinus floor elevation: An umbrella review of meta-analyses of multiple outcomes. J Prosthet Dent 2020; 126:503-511. [PMID: 32951871 DOI: 10.1016/j.prosdent.2020.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM Bone loss in the edentulous posterior maxilla complicates dental implant placement. In spite of the evidence available, there is continued uncertainty about the benefit of short implants for different outcomes. PURPOSE The purpose of this review was to evaluate the existing evidence for short and standard implants in association with sinus floor elevation regarding implant survival, marginal bone loss, and complications by using an umbrella review of the evidence across meta-analysis of interventional studies. MATERIAL AND METHODS Medline, Scopus, and Cochrane Library were searched to identify systematic reviews and meta-analyses comparing short implants and standard implants associated with sinus floor elevation. Data extraction and methodological quality (AMSTAR-2) was assessed by 2 authors independently. Outcomes were categorized and tabulated to assess effectiveness. Qualitative data were analyzed using thematic synthesis. The certainty of the evidence was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS From 2011 studies, 7 systematic reviews (66 studies) were included as per the eligibility criteria. There was no statistically significant difference between groups for implant survival (risk ratio=1.08; P=.79), and the qualitative analysis did not show differences for prosthetic outcomes. Standard implants were associated with fewer prosthetic complications in the quantitative analysis (risk ratio=3.27; P<.01), but no difference was found between the treatments in the qualitative analysis. Short implants showed reduced marginal bone loss (0.98 ±0.12 mm; mean difference=-0.22; P<.01) and better biologic outcomes (risk ratio=0.16; P<.01). Patient satisfaction was similar for both groups, whereas costs and time for the procedure favored short implants. The quality of the evidence was graded as "critically low" (57.1% of the reviews) and "low." There was a high certainty of evidence for implant survival, whereas marginal bone loss and complications had moderate certainty. CONCLUSIONS Short implants had a better or equal performance compared with standard implants for all outcomes assessed. However, assumptions were based on reviews with low or critically low quality of the evidence, suggesting the development of high-quality systematic reviews in this field.
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Affiliation(s)
- Bruna M Vetromilla
- Graduate student, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Thais Mazzetti
- Graduate student, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Tatiana Pereira-Cenci
- Associate Professor, Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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22
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Al-Sawaf O, Tuna T, Rittich A, Kern T, Wolfart S. Randomized clinical trial evaluating the effect of splinting crowns on short implants in the mandible 3 years after loading. Clin Oral Implants Res 2020; 31:1061-1071. [PMID: 33463774 DOI: 10.1111/clr.13652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To compare the radiographic marginal bone loss and clinical parameters of splinted and non-splinted fixed dental prostheses on short implants in the posterior region of the lower jaw 3 years after loading. MATERIAL AND METHODS Twenty patients, 15 female and five males, with uni- or bilateral free-end situations in the mandible participated in the study. Two short implants (7 mm) in the posterior mandible were placed and patients were randomized to receive splinted (n = 11) or non-splinted (n = 13) cemented crowns. Marginal bone loss (MBL) was assessed on radiographs taken with customized positioning jigs at baseline, 1 and 3 years after loading. Plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were measured. (ClinicalTrials.gov; identifier: NCT03558347). RESULTS After 3-year survival rate of altogether 48 implants was 100% for both groups. Success rate (according to Papaspyridakos, Chen, Singh, Weber, & Gallucci, 2012) was 84.6% for non-splinted and 86.4% for splinted implants. At restoration level survival rate was 100% for both groups. Marginal bone level changes showed mean gain of 0.3 ± 0.8 mm for non-splinted and 0.1 ± 0.5 mm for splinted implants 3 years after loading. Statistical analysis showed no significant difference in PI, GI, PD, BOP, and marginal bone loss between both groups (p > .05). CONCLUSION Within the limitations of this study it can be concluded that splinting crowns on short implants neither seems to affect the amount of marginal bone loss nor peri-implant health 3 years after loading.
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Affiliation(s)
- Omar Al-Sawaf
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Taskin Tuna
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Anne Rittich
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Thomas Kern
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Center of Implantology, RWTH Aachen University, Aachen, Germany
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23
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Rameh S, Menhall A, Younes R. Key factors influencing short implant success. Oral Maxillofac Surg 2020; 24:263-275. [PMID: 32323043 DOI: 10.1007/s10006-020-00841-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
AIM This systematic article reviews the literature on the confounding parameters that affect short implant survival in order to establish specific surgical and prosthetic protocols that create an optimal biomechanical scenario and ensure implant longevity. MATERIALS AND METHODS The available literature was screened for randomized clinical trials and prospective cohort and retrospective studies, published up to February 20, 2020, on the prognosis of short-length implants placed in posterior jaws. Studies evaluating the 5-year clinical performance of short dental implants (5 mm or 6 mm) in fixed rehabilitations of partially edentulous posterior jaws were included. RESULTS Eleven studies were selected after assessment of inclusion and exclusion criteria, of which 8 were RCTs, 2 were prospective studies, and 1 was a retrospective study. After 5 years in function, 22 short (12 in maxilla and 10 in mandible) and 10 standard (2 in maxilla and 8 in mandible) implants were lost, resulting in high survival rates independent of implant length or location. More biological complications were found in standard implants especially those placed in augmented posterior mandibles (135 complications compared to 48 in short mandibular implants). Splinted prostheses were associated with less technical complications (15 out of 53 complications affecting short implants). CONCLUSION The findings of this review showed that, when used correctly, short implants achieve predictable and promising long-term outcomes, provided they are placed following a comprehensive surgical and prosthetic protocol, based on the different biomechanical parameters essential to optimize long-term prognosis. CLINICAL SIGNIFICANCE The use of short implants in clinical practice has considerably increased in a wide variety of cases, given that they offer several advantages for both patient and practitioner. Recent literature shows that, when specific criteria are respected, new generations of short implants present high, long-term survival rates. This review is designed to provide a thorough understanding of the surgical and prosthetic protocols that create an optimal biomechanical scenario for short implants and improve their prognosis.
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Affiliation(s)
- Stephanie Rameh
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Cranio-Facial Research Laboratory, Unit of Oral Biology, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Abdallah Menhall
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
- Cranio-Facial Research Laboratory, Unit of Oral Biology, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
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24
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Pamato S, Honório HM, da Costa JA, Traebert JL, Bonfante EA, Pereira JR. The influence of titanium base abutments on peri-implant soft tissue inflammatory parameters and marginal bone loss: A randomized clinical trial. Clin Implant Dent Relat Res 2020; 22:542-548. [PMID: 32441407 DOI: 10.1111/cid.12900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/18/2020] [Accepted: 03/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Some techniques in implant dentistry have been suggested that may potentially alter peri-implant soft and hard tissue parameters. PURPOSE To evaluate the peri-implant soft tissue inflammatory parameters and crestal bone loss around titanium base abutments. MATERIALS AND METHODS Fifty two implants were placed in 21 patients and restored by single crowns. Subjects were randomly allocated into two groups: cement-retained abutment (n = 24) and titanium base (n = 28). Peri-implant probing depth, and mesial and distal marginal bone loss (MBL) were evaluated at implant loading (T1), 6 and 12 months (T2 and T3, respectively). Peri-implant bleeding-on-probing was evaluated at T2 and T3. Two-way repeated measures analysis of variance, Tukey test, Man Whitney, and Pearson correlation were performed for statistical analysis at P < .05. RESULTS The mean difference of peri-implant MBL from implant installation to 12 months in function was 1.15 ± 0.82 mm for the cement-retained group, and 1.23 ± 0.79 mm for the titanium base group. No statistically significant difference was found between the two groups for clinical and radiographic peri-implant evaluation. CONCLUSIONS Titanium base abutments present no negative effect on peri-implant soft tissue and MBL. When used to support single crowns, both approaches performed likewise regarding clinical and radiographic parameters.
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Affiliation(s)
- Saulo Pamato
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Heitor Marques Honório
- Department of Pediatrics Dentistry, Orthodontics, and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru Campus, São Paulo, Brazil
| | - Jorge Alexandre da Costa
- Department of Prosthodontics, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Jefferson Luiz Traebert
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Estevam Augusto Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru Campus, São Paulo, Brazil
| | - Jefferson Ricardo Pereira
- Post-Graduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
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25
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Abstract
The purpose of this article is not to discuss the success of short dental implants versus standard/long dental implants, but to compare short dental implants with standard/long dental implants in areas that necessitated adjunctive bone grafting or augmentation procedures and as a way to avoid the need for advanced surgical procedures and their associated risks. It can be concluded that short dental implants are a viable alternative in sites that would have required additional complex and costly augmentation procedures. Short dental implants resulted in comparable survival and success rates with faster, less expensive treatment with fewer surgical complications and morbidity.
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Affiliation(s)
- Steven R Schwartz
- Private Practice: NY Oral & Maxillofacial Surgeon, PC, 2844 Ocean Parkway, Brooklyn, NY 11235, USA; Department of Oral & Maxillofacial Surgery, Woodhull Medical Center, 760 Broadway 2c320, Brooklyn, NY 11206, USA.
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Zheng Z, Ao X, Xie P, Jiang F, Chen W. Proposal and In-Depth Analysis of Emergency Treatment Procedures for Removing Fractured Abutments in Implants With Tapped-In Connections: Case Report. J ORAL IMPLANTOL 2020; 46:51-56. [PMID: 31603379 DOI: 10.1563/aaid-joi-d-19-00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In implant-supported prostheses, the most frequently reported mechanical complications after implant restoration are loosening or fracture of abutments or screws. Such complications have serious consequences, and removal of fractured abutments or screws is difficult. There are various methods to remove fractured abutment screws in implants with screwed-in connections. However, no approach has been reported to retrieve solid abutments in implants with a locking-taper implant-abutment connection, which are rarely observed in clinical settings. This study presents the case of a 62-year-old male patient with a fractured abutment in an upper-right second premolar implant. Abutment fracture is a common mechanical complication after dental implantation. Parafunctional habits and occlusal overloading may generate excessive occlusal forces, which increase the risk of mechanical complications. This report presents a series of emergency procedures for removing a fractured solid abutment and fabricating a new prosthesis to restore the edentulous area. In this retrospective analysis, the authors deeply consider the whole treatment, through which the deficiencies of the treatment are noted, and corresponding future directions are discussed. This case report presents a convenient approach to removing a solid abutment in a sudden emergency, discusses possible reasons for solid abutment fractures, designs a new rescue kit for easy retrieval of such abutments and summarizes a valid solution for removing fractured solid abutments.
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Affiliation(s)
- Zheng Zheng
- Graduate Prosthodontics, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China; Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaogang Ao
- Graduate Prosthodontics, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China; Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Peng Xie
- Graduate Prosthodontics, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China; Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Fan Jiang
- Department of Stomatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China; Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Prospective, Clinical Pilot Study with Eleven 4-Mm Extra-Short Implants Splinted to Longer Implants for Posterior Maxilla Rehabilitation. J Clin Med 2020; 9:jcm9020357. [PMID: 32012979 PMCID: PMC7074081 DOI: 10.3390/jcm9020357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/17/2020] [Accepted: 01/26/2020] [Indexed: 01/01/2023] Open
Abstract
In many clinical situations, rehabilitation with implants in the posterior maxillary region is complicated by limited bone availability. In this context, the use of 4 mm long implants (known as extra-short implants) may be used thanks to the concept of osseointegration enhancement. It has been demonstrated that short implants offer an alternative to the regeneration procedures involved in placing longer implants in areas where bone height is compromised. This prospective pilot study tested a treatment protocol in which 11 extra-short (4 mm) implants were splinted to 11 mesially placed longer (8 mm) implants in the posterior maxillary regions of partially edentulous patients, without using supplementary bone regeneration procedures. Eleven patients were included in this single cohort study. The clinical performance of the extra-short implants was assessed during a two-year follow-up period, obtaining a 100% survival rate and mean bone loss of 0.3 mm. Implant stability measured by resonance frequency analysis (RFA) at the time of placement was 54.9 ± 4.9, increasing to 77.0 ± 2.6 at 24 months. The study demonstrated the gradual consolidation of osseointegration in bone of less-than-ideal quality in the posterior maxillary region. The results obtained show that a partially edentulous maxilla with reduced bone height may be rehabilitated by using an extra-short implant splinted to a mesial implant of 8mm length or longer. Despite the small sample size, this pilot study observed that extra-short implants achieved adequate bone stability and clinical performance after a 24-month follow-up.
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de Siqueira RAC, Savaget Gonçalves Junior R, Dos Santos PGF, de Mattias Sartori IA, Wang HL, Fontão FNGK. Effect of different implant placement depths on crestal bone levels and soft tissue behavior: A 5-year randomized clinical trial. Clin Oral Implants Res 2020; 31:282-293. [PMID: 31886592 DOI: 10.1111/clr.13569] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES This randomized clinical trial analyzed the long-term (5-year) crestal bone changes and soft tissue dimensions surrounding implants with an internal tapered connection placed in the anterior mandibular region at different depths (equi- and subcrestal). MATERIALS AND METHODS Eleven edentulous patients were randomly divided in a split-mouth design: 28 equicrestal implants (G1) and 27 subcrestal (1-3 mm) implants (G2). Five implants were placed per patient. All implants were immediately loaded. Standardized intraoral radiographs were used to evaluate crestal bone (CB) changes. Patients were assessed immediately, 4, 8, and 60 months after implant placement. The correlation between vertical mucosal thickness (VMT) and soft tissue recession was analyzed. Sub-group analysis was also performed to evaluate the correlation between VMT and CB loss. Rank-based ANOVA was used for comparison between groups (α = .05). RESULTS Fifty-five implants (G1 = 28 and G2 = 27) were assessed. Implant and prosthetic survival rate were 100%. Subcrestal positioning resulted in less CB loss (-0.80 mm) when compared to equicrestal position (-0.99 mm), although the difference was not statistically significant (p > .05). Significant CB loss was found within the G1 and G2 groups at two different measurement times (T4 and T60) (p < .05). Implant placement depths and VMT had no effect on soft tissue recession (p > .05). CONCLUSIONS There was no statistically significant difference in CB changes between subcrestal and equicrestal implant positioning; however, subcrestal position resulted in higher bone levels. Neither mucosal recession nor vertical mucosa thickness was influenced by different implant placement depths.
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Affiliation(s)
| | | | | | | | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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29
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Tang Y, Yu H, Wang J, Gao M, Qiu L. Influence of crown-to-implant ratio and different prosthetic designs on the clinical conditions of short implants in posterior regions: A 4-year retrospective clinical and radiographic study. Clin Implant Dent Relat Res 2020; 22:119-127. [PMID: 31908138 DOI: 10.1111/cid.12881] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 11/15/2019] [Accepted: 12/09/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Short implants (intra-bony length ≤ 8 mm) are generally considered as an alternative to bone augmentation in challenging situations; however, clinical evidence from large-scale studies with long follow-up regarding the application of short implants remains deficient. PURPOSE The present study aimed to assess the mid-term clinical outcomes of short implants supporting fixed prostheses in the posterior region, and to investigate the effects of the crown-to-implant ratio (C/I), and other patient-, implant-, prosthesis-relevant factors on the clinical conditions around short implants. MATERIALS AND METHODS 180 Thommen short implants in 130 partially edentulous patients were enrolled in the study after 3 to 7 (mean 4.2) years of follow-up. Potential risk factors (patient sex and age, implant diameter and location, splinted vs single-tooth restorations, retention mode, anatomical and clinical C/I ratios) were evaluated according to the following outcomes: Implant survival, marginal bone loss (MBL), and mechanical and biological complications. RESULTS In total, four implants in four patients failed as a result of peri-implantitis. The cumulative survival rate was 97.8% for implant-based analysis. The peri-implant MBL around 180 short implants was 0.90 ± 0.78 mm. The mean clinical C/I ratio was 1.16 ± 0.36. Correlation analysis revealed that the influence of the clinical C/I ratio and patient age were significant for MBL (P < .05), whereas other potential risk factors showed no significant association with the outcome. Among 180 short implants, 24 cases (13.3%) had biological complications and 32 cases (17.8%) had mechanical complications, respectively. Peri-implant MBL and complication rates around splinted and non-splinted implants were not statistically different. CONCLUSION Within the limitations of this study, short implants supporting fixed prostheses in the posterior region achieved predictable clinical outcomes over a 3 to 7 year period. Within the range of 0.47 to 3.01, the higher the C/I ratio, the less the peri-implant MBL.
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Affiliation(s)
- Yiman Tang
- 4th Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huajie Yu
- 4th Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Juan Wang
- 4th Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ming Gao
- 4th Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Lixin Qiu
- 4th Division, Peking University School and Hospital of Stomatology, Beijing, China
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30
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Pelissier E, Desoutter A, Chaux-Bodard AG. Peri implant bone resorption on microvascular free fibula flap: a radiographic retrospective study. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: As the vascularization of the microvascular free fibula flap enables to maintain an osteogenic potential, osseointegrated implants have a 86% to 99% success rate. Thus, only few studies consider peri-implant bone resorption (PIBR). The aim of the study was to radiologically evaluate PIBR on fibula flaps. Materials and methods: Data were retrospectively collected. Gender, age, reason for interruptive mandibulectomy, previous radiotherapy, number of implants placed on the reconstruction, length and number of segments of the reconstruction, height of resorption were collected for each patient. Measurements were made on panoramic radiograph. Results: 85 clinical reports were reviewed for 39 retained. Peri-implant bone resorption was observed in 21 (53.9%) patients. The average age of the resorption group was 55.4 . All of the 5 patients with 4 or 5 implants on their reconstruction did not developed PIBR. 59.1% of patients with 1 segment reconstruction developed PIBR, 54.6% with 2 segments and 33.3% with 3 segments. Discussion: Age and poor oral hygiene appeared to be clearly more related to PIBR. An important number of implant (4 or 5) and a reconstruction with more than 1 segment seemed to decrease PIBR. Further studies are required to confirm these hypotheses.
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Manea A, Bran S, Dinu C, Rotaru H, Barbur I, Crisan B, Armencea G, Onisor F, Lazar M, Ostas D, Baciut M, Vacaras S, Mitre I, Crisan L, Muresan O, Roman R, Baciut G. Principles of biomechanics in oral implantology. Med Pharm Rep 2019; 92:S14-S19. [PMID: 31989104 PMCID: PMC6978931 DOI: 10.15386/mpr-1512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/02/2019] [Indexed: 01/04/2023] Open
Abstract
Background and aims The principles of biomechanics comprise all the interactions between the body (tissues) and the forces acting upon it (directly or via different medical devices). Besides the mechanical aspects, the tissues response is also studied. Understanding and applying these principles is vital for the researchers in the field of oral implantology, but they must be equally known by the practitioners. From the planning stages to the final prosthetic restoration, they are involved in each and every aspect. Ignoring them inevitably leads to failure. Methods The first part of this paper includes a review of our current research in oral implantology (mechanical, digital and biological testing), while the second part includes a review of the available literature on certain biomechanical aspects and their implications in everyday practice. Results Our research opens new study directions and provides increased chances of success for dental implant therapy. The practical aspects of our findings, combined with the available literature (from the basic principles described more than 40 years ago to the most recent studies and technologies) can serve as a guide to practitioners for increasing their success rate. Conclusion While no therapy is without failure risk, a good understanding of the biomechanics involved in oral implantology can lead to higher success rates in implant supported prosthetic restorations.
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Affiliation(s)
- Avram Manea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Dinu
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horatiu Rotaru
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Barbur
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Bogdan Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriel Armencea
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Madalina Lazar
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Ostas
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sergiu Vacaras
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ileana Mitre
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liana Crisan
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ovidiu Muresan
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rares Roman
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Maxillo-Facial Surgery and Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Sadowsky SJ. Occlusal overload with dental implants: a review. Int J Implant Dent 2019; 5:29. [PMID: 31332553 PMCID: PMC6646429 DOI: 10.1186/s40729-019-0180-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Controversy persists as to the role of occlusal overload in peri-implantitis. Animal studies have not revealed the biological threshold for fatigue failure in the peri-implant bone. On the other hand, clinical studies have demonstrated a link between parafunction and implant failure, although variables such as intensity and frequency of loads, as well as bone density, have led to different outcomes. The absence of specific engineering “building codes” for the clinician has relegated prosthetic design planning to intuitive guidelines for all patients. For example, higher crown to implant ratios (2–3:1), implant cantilever prostheses and non-splinted restorative designs have been avoided because of the concern for overload. However, evidence has not supported this general approach. A call for preclinical research to establish specific patient load thresholds is in order to establish a customized treatment plan.
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Affiliation(s)
- Steven J Sadowsky
- Preventive and Restorative Department, University of Pacific Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
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33
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Meijer HJA, Boven C, Delli K, Raghoebar GM. Is there an effect of crown-to-implant ratio on implant treatment outcomes? A systematic review. Clin Oral Implants Res 2019; 29 Suppl 18:243-252. [PMID: 30306696 PMCID: PMC6221159 DOI: 10.1111/clr.13338] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES High crown-to-implant ratios may lead to complications due to unfavorable occlusal forces, including nonaxial forces, on the bone surrounding the neck of the implant and within the connection of the crown and implant itself. The aim of this study was to perform a systematic review on the influence of crown-to-implant ratio of single-tooth, nonsplinted, implants on biological and technical complications. MATERIALS AND METHODS MEDLINE (1950-January 2018), EMBASE (1966-January 2018), and Cochrane Central Register of Controlled Trials database (1800-January 2018) were searched to identify eligible studies. Inclusion criteria were as follows: crown-to-implant ratio of single-tooth, nonsplinted, implant-supported restorations in the posterior maxilla or mandible and follow-up of at least 1 year. Main outcome measures were as follows: implant survival rate, marginal bone level changes, biological complications, and technical complications. Two reviewers independently assessed the articles. A meta-analysis was carried out for implant survival rate and peri-implant bone changes. RESULTS Of 154 primarily selected articles, eight studies fulfilled the inclusion criteria. Study groups presented a mean crown-to-implant ratio varying from 0.86 (with 10-mm implants) to 2.14 (with 6-mm implants). The meta-analysis showed an implant survival of more than 99% per year and mean peri-implant bone changes of <0.1 mm per year. Limited biological and technical complications were reported. CONCLUSION Data reviewed in the current manuscript on crown-to-implant ratio, ranging from 0.86 to 2.14, of single-tooth, nonsplinted, implants did not demonstrate a high occurrence of biological or technical complications.
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Affiliation(s)
- Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Implant Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Carina Boven
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Konstantina Delli
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Hämmerle CHF, Cordaro L, Alccayhuaman KAA, Botticelli D, Esposito M, Colomina LE, Gil A, Gulje FL, Ioannidis A, Meijer H, Papageorgiou SN, Raghoebar G, Romeo E, Renouard F, Storelli S, Torsello F, Wachtel H. Biomechanical aspects: Summary and consensus statements of group 4. The 5th
EAO Consensus Conference 2018. Clin Oral Implants Res 2018; 29 Suppl 18:326-331. [DOI: 10.1111/clr.13284] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/03/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Luca Cordaro
- Department of Periodontics and Prosthodontics; Policlinico Umberto I; Eastman Dental Hospital; Roma Italy
| | | | | | - Marco Esposito
- Department of Biomaterials; University of Gothenburg; Gothenburg Sweden
| | - Lino E. Colomina
- Private Practice; Alicante Spain
- Department of Anatomy and Histology; University Miguel Hernández; Alicante Spain
| | - Alfonso Gil
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Felix L. Gulje
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry; University Medical Center Groningen, Dental School; University of Groningen; Groningen The Netherlands
| | - Alexis Ioannidis
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Henny Meijer
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry; University Medical Center Groningen, Dental School; University of Groningen; Groningen The Netherlands
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Gerry Raghoebar
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry; University Medical Center Groningen, Dental School; University of Groningen; Groningen The Netherlands
| | - Eugenio Romeo
- Department of Biomedical; Surgical and Dental Sciences; University of Milan; Milan Italy
| | | | - Stefano Storelli
- Department of Biomedical; Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Ferruccio Torsello
- Department of Periodontics and Prosthodontics; George Eastman Dental Hospital; Rome Italy
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