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Ickroth A, Christiaens V, Pitman J, Cosyn J. A Systematic Review on Immediate Implant Placement in Intact Versus Non-Intact Alveolar Sockets. J Clin Med 2025; 14:2462. [PMID: 40217911 PMCID: PMC11989472 DOI: 10.3390/jcm14072462] [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: 03/05/2025] [Revised: 03/19/2025] [Accepted: 03/30/2025] [Indexed: 04/14/2025] Open
Abstract
Objectives: The primary objective of this systematic review was to compare IIP in intact versus non-intact sockets in terms of buccal bone thickness. Methods: Two independent reviewers carried out an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to June 2024. Randomized controlled trials (RCTs), cohort studies, and case series on intact and/or non-intact sockets were included for analysis. The primary outcome was buccal bone thickness (BBT). Secondary outcomes were vertical midfacial soft tissue level change, pink esthetic score (PES), implant survival and complications. This systematic review was conducted in accordance with the PRISMA guidelines. Results: After screening 1001 unique titles and conducting manual searches, 20 articles reporting on 525 implants (intact: 265; non-intact: 260) in the anterior maxilla with a follow-up of up to 120 months were selected. The overall study quality was low, especially for non-intact sockets since only two RCTs could be found, and none demonstrated a low risk of bias. Meta-analyses were not feasible due to a lack of direct comparisons, and heterogeneity in terms of surgical approach, soft tissue handling, and restorative approach. BBT ranged between 1.10 and 3.18 mm (intact) and 1.18 and 3 mm (non-intact). Vertical midfacial soft tissue level change ranged between -0.13 and -0.58 mm (intact) and -0.03 and -0.59 mm (non-intact). Pink esthetic scores ranged between 10.48 and 12.80 (intact) and 9.25 and 12.43 (non-intact). Implant survival exceeded 90% in all studies and was 100% in the vast majority of the studies. Conclusions: This systematic review suggests a similar outcome of IIP in intact and non-intact sockets. However, the overall low study quality, a lack of direct comparisons, and heterogeneity rendered the comparison highly biased. Future studies should be conducted to establish an evidence-based treatment approach for IIP in non-intact sockets.
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Affiliation(s)
- Axelle Ickroth
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium
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Dong S, Lv J, Wang L, Chen W, Wang L, Wang L, Xia X, Gao S, Tang C. Analysis of Risk Factors for Early Implant Failure in the Anterior Region: A Retrospective Study of 2620 Implants. Clin Implant Dent Relat Res 2025; 27:e70027. [PMID: 40183220 DOI: 10.1111/cid.70027] [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: 11/23/2024] [Revised: 02/08/2025] [Accepted: 03/12/2025] [Indexed: 04/05/2025]
Abstract
OBJECTIVES This study aimed to identify risk factors associated with early implant failure in the anterior maxillary and mandibular regions. MATERIALS AND METHODS A total of 2023 patients with 2620 implants placed in the maxillary and mandibular anterior regions between January 2020 and June 2023 were included in this study. Clinical and radiographic data were extracted from medical records and imaging software. In organizing the information, 19 variables were categorized into patient-related factors (gender, age, periodontitis, reasons for tooth loss, bone quality, and penicillin allergy), implant-related factors (implant system, bone level/soft tissue level, diameter, and length), and surgical factors (jaw position, placement timing, bone grafting, bone compression/splitting surgery, concentrated growth factors (CGFs), bone graft materials, barrier membrane, torque, and healing style). Univariate and multivariate Cox proportional hazards regression models were used to identify significant risk factors for early failure. RESULTS The cumulative survival rate (CSR) of all implants after a 0- to 43-month observation period was 95.6% (95% confidence interval [CI]: 94.8%-96.4%). Independent risk factors for early implant failure included non-submerged healing (hazard ratio [HR] = 3.000, 95% CI = 1.712-5.256), torque < 30 N/cm (HR = 13.193, 95% CI = 8.439-20.626), and Type I bone quality (HR = 3.220, 95% CI = 1.413-7.342) (all p < 0.05). Conversely, bone compression or splitting surgery was identified as a protective factor (HR = 0.344, 95% CI = 0.186-0.634). No significant associations were observed for age, reasons for tooth loss, penicillin allergy, use of CGF, or implant characteristics (location, type, length, and diameter). CONCLUSION After 0-43 months of observation, the CSR for 2620 implants placed in 2023 patients was 95.6% (95% CI = 94.8%-96.4%). Torque < 30 N/cm, non-submerged healing, and Type I bone quality were considered independent risk factors for early implant failure in the anterior region.
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Affiliation(s)
- Shuo Dong
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jiaxin Lv
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Liang Wang
- Department of Stomatology, Ningbo No. 2 Hospital, Ningbo, China
| | - Wei Chen
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Long Wang
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Lingxu Wang
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiangcheng Xia
- School of Stomatology, Nanjing Medical University, Nanjing, China
| | - Shan Gao
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Chunbo Tang
- Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
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Qian X, Vánkos B, Kelemen K, Gede N, Varga G, Hegyi P, Gerber G, Hermann P, Joób-Fancsaly Á, Mikulás K. Comparison of implant placement and loading protocols for single anterior maxillary implants: A systematic review and network meta-analysis. J Prosthet Dent 2025; 133:677-688. [PMID: 39054170 DOI: 10.1016/j.prosdent.2024.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024]
Abstract
STATEMENT OF PROBLEM With increasing esthetic needs, patients prefer missing anterior teeth to be restored as soon as possible, but how the timing of implantation and prosthetic loading influences peri-implant tissue and the esthetic results remains unclear. PURPOSE The purpose of this systematic review and network meta-analysis of randomized controlled trials was to investigate and rank the hard-tissue and soft-tissue outcomes, esthetics, and patient satisfaction of single maxillary implant placement and loading protocols. MATERIAL AND METHODS A systematic search was conducted to identify studies with at least a 1-year follow-up that compared different implant placement and loading protocols and reported on survival, marginal bone loss (MBL), soft tissue, and esthetics. A random effects model and a Bayesian approach were applied to compare protocols by using mean differences (MD) with 95% credible intervals (CrI) and surface under the cumulative ranking curve (SUCRA) values. RESULTS A total of 43 articles were included, with a follow-up of 1 to 5 years. All protocols had high survival rates and no significant differences for 1-year or 2-year MBL. Immediate placement with immediate loading ranked first in pink and white esthetic scores and satisfaction and was statistically significantly better than immediate placement with delayed loading or late placement protocols in pink esthetic scores, where its advantage over late placement with late loading was also clinically relevant [MD: -1.74, CrI: -2.34 to -1.15]. CONCLUSIONS Immediate implantation with immediate loading showed a considerable esthetic advantage over later rehabilitation, whereas only a slight difference in MBL resulted from different protocols.
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Affiliation(s)
- Xinyi Qian
- PhD Student, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Resident, Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Boldizsár Vánkos
- PhD Student, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Resident, Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Kata Kelemen
- PhD Student, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Assistant Lecturer, Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Noémi Gede
- Biostatistician, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Biostatistician, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Varga
- Vice-director, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Professor, Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Director, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Director, Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; and Director, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Gerber
- Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Dean, Faculty of Dentistry, Semmelweis University, Budapest, Hungary; and Associate Professor, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Vice-rector, Semmelweis University, Budapest, Hungary; and Director, Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Árpád Joób-Fancsaly
- Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Vice-director, Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary
| | - Krisztina Mikulás
- Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; and Associate Professor, Department of Prosthodontics, Semmelweis University, Budapest, Hungary.
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Wu Z, Su G, Yu X, Ye L, Wang F, Xu C. Evaluation of the Pink Esthetic Score for Single Implants in the Esthetic Zone Using Intraoral Scanning Data: A Proof-of-Concept Study. J ESTHET RESTOR DENT 2025. [PMID: 39985401 DOI: 10.1111/jerd.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/10/2025] [Accepted: 02/11/2025] [Indexed: 02/24/2025]
Abstract
OBJECTIVES To evaluate the feasibility of esthetic assessments based on intraoral scanning data using pink and white esthetic scores (PES/WES). MATERIALS AND METHODS Thirty samples with both intraoral photographs and scanning data were collected and rated by two observers with excellent consistency independently. PES includes seven variables, and WES includes five. The maximum scores were 14 and 10, respectively. RESULTS The mean PES/WES was 10.60 ± 1.69 and 8.50 ± 1.28 for photographs and 10.97 ± 1.69 and 8.40 ± 1.25 for scanning data. No significant difference was observed between the two sample types. The alveolar process variable had significantly higher scores, while the soft-tissue color variable had significantly lower scores based on intraoral photographs compared to scanning. CONCLUSIONS Intraoral scanning could be a method for the esthetic evaluation of single implant-supported restorations using PES/WES. The use of three-dimensional imaging enables the precise assessment of esthetic outcomes, paving the way for improvements in the digital workflow of implant dentistry. However, the limitations of color and texture reproducibility should be noted. CLINICAL SIGNIFICANCE Intraoral scanning data can be used for esthetic evaluation, and reliable results could be achieved with the application of scanning.
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Affiliation(s)
- Ziang Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Guanyu Su
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinbo Yu
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijuan Ye
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
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Samal A, Majzoub J, Rodriguez Betancourt A, Webber L, Mazzocco J, Wang HL, Castilho R, Fenno JC, Chan HL, Kripfgans OD. High-Frequency Ultrasound for Detecting Periodontal Inflammation: A Preclinical Diagnostic Accuracy Study. J Periodontal Res 2025. [PMID: 39799460 DOI: 10.1111/jre.13376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 11/27/2024] [Accepted: 12/02/2024] [Indexed: 01/15/2025]
Abstract
AIM Ultrasonography (US) has shown accuracy in imaging healthy periodontium. This study aims to evaluate the feasibility and accuracy of US for estimating dimensions of inflamed periodontium induced by ligature and bacteria. METHODS Periodontal tissues of maxillary as well as mandibular premolars and molars in six female mini pigs were treated with ligature and three strains of bacteria for 4-10 weeks. Before euthanization, the periodontium was imaged with US. After euthanization, cone-beam computed tomography (CBCT) scans and histology were performed. Soft and hard tissue measurements by calibrated and masked examiners from US, CBCT, and histology were statistically compared. RESULTS Seventy-one histological samples with corresponding CBCT and US scans were available for analysis. Overall, there was a good to excellent agreement between histology and US (ICC: 0.77-0.96) for parameters such as Soft Tissue Thickness (STT), Gingival Recession, Crestal Bone Thickness (CBT), and the bone-to-cemento-enamel junction (B-CEJ) distance. However, discrepancies were observed for STT at 3 mm below the CEJ and Soft Tissue Height (STH) (ICC: 0.44 and 0.54, respectively). CBCT showed lower agreement with histology, particularly for thin CBT (< 1 mm), with an ICC of 0.20, compared to 0.90 for US vs. histology. CBCT failed to identify crestal bone in 14 cases when the crestal bone was thin. Notably, CBCT results differed more from histological measurements than US in assessing B-CEJ and thin CBT. CONCLUSION US demonstrated substantial potential as a transformative tool for periodontal diagnostics, exhibiting high agreement with histology in determining critical parameters. Compared to CBCT, US offered advantages, particularly in cases with thin crestal bone.
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Affiliation(s)
- Ankita Samal
- Department of Periodontology, University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Jad Majzoub
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | | | - Liana Webber
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - John Mazzocco
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rogerio Castilho
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - J Christopher Fenno
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hsun-Liang Chan
- Division of Periodontology, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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Ruhstorfer M, Güth JF, Stimmelmayr M, Waltenberger L, Schubert O, Graf T. Systematic review of peri-implant conditions and aesthetic outcomes of customized versus conventional healing abutments. Int J Implant Dent 2024; 10:61. [PMID: 39661263 PMCID: PMC11635071 DOI: 10.1186/s40729-024-00581-8] [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: 11/01/2024] [Accepted: 11/25/2024] [Indexed: 12/12/2024] Open
Abstract
PURPOSE Customized healing abutments are utilized to enhance aesthetics and peri-implant soft and hard tissue health, and play a crucial role in the implant-prosthetic workflow. This systematic review was performed to assess and compare the clinical outcomes of customized healing abutments with conventional ones. METHODS The review was registered with PROSPERO (ID: CRD42024532449) and followed the PRISMA-guidelines. The PICO-question addressed was: "In patients with dental implants, do customized healing abutments result in beneficial peri-implant conditions compared with conventional healing abutments?" Clinical trials involving immediate and late implant placement that compared different healing abutments based on quantifiable outcomes were included. The "PubMed", "PubMed Central", "Cochrane Library", and "Web of Science databases" were screened for eligible studies until 4/20/2024. RESULTS Of 1,396 titles retrieved, 5 studies met the inclusion criteria and were analyzed. The included studies showed a low risk of bias as assessed by the RoB2 tool and Joanna Briggs Institute Critical Assessment questionnaire. Compared to conventional healing abutments, customized abutments were associated with a trend toward better clinical outcomes in peri-implant soft and hard tissue, as well as aesthetics. Several results within the cohorts using customized healing abutments showed significantly improved values in soft and hard tissue results as well as aesthetic parameters. Importantly, none of the included studies reported biological or aesthetic disadvantages associated with the use of customized healing abutments. CONCLUSIONS Customized healing abutments maintain stability of peri-implant hard and soft tissue. However, further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.
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Affiliation(s)
- Miriam Ruhstorfer
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt Am Main, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt Am Main, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Lukas Waltenberger
- Department of Prosthodontics and Biomaterials, Center for Implantology, Uniklinik RWTH Aachen, Aachen, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University, Frankfurt Am Main, Germany.
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Guzman-Perez G, Jurado CA, Alresayes S, Floriani F, Rojas-Rueda S, Tsujimoto A. Navigating Esthetic Challenges: Immediate Implant Placement and Comprehensive Restorative Solutions-A Clinical Case With 2-Year Follow-Up Study. Case Rep Dent 2024; 2024:1186299. [PMID: 39544695 PMCID: PMC11563714 DOI: 10.1155/2024/1186299] [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: 05/05/2024] [Revised: 09/29/2024] [Accepted: 10/21/2024] [Indexed: 11/17/2024] Open
Abstract
Introduction: The esthetics of immediate implant dentistry can be challenging. Clinical considerations for immediate implant placement have demonstrated long-term success rates comparable to traditional delayed implant protocols. However, it is a sensitive technique that requires proper treatment planning as well as meticulous execution to be predictable and successful in the long term. Methods: This clinical situation demands extensive knowledge of soft and hard tissue management for atraumatic tooth extraction followed by implant therapy, along with an understanding of the available materials to meet esthetic needs. This case report features a female patient with the chief complaint of needing to replace an anterior crown due to loss of retention. After a comprehensive oral assessment and cone beam computed tomography (CBCT) radiographic examination, it was determined that the crown on Tooth #9 was fractured at the subgingival level. Furthermore, gingival zenith positions displayed differences at the keratinized mucosa level in Teeth #7, #8, and #9, and the metal marginal areas of the porcelain-fused-to-metal (PFM) crowns in the anterior area of Teeth #5, #7, #8, #9, and #10 were apparent. The procedure involved atraumatic extraction of Tooth #9, followed by immediate implant placement. Crowns on Teeth #5, #7, #8, and #10 were replaced, and veneers on Teeth #6 and #11 were fabricated using press lithium disilicate-reinforced ceramic. Connective tissue graft (CTG) was contoured before final implant restorations. Results: The final implant crown was restored using a prefabricated abutment with a titanium base and lithium disilicate ceramic dental material. A well-planned combined treatment, including atraumatic tooth extractions for immediate implants and ideal contouring of soft tissues, can significantly impact the outcome of esthetic restorations. Conclusions: Single immediate implant-supported crowns in the esthetic zone were able to fulfill the patient's esthetic expectations.
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Affiliation(s)
| | - Carlos A. Jurado
- Department of General Dentistry, Division of Operative Dentistry, The University of Tennessee Health Science Center, Tennesse, USA
| | - Saad Alresayes
- Department of Prosthetic Dental Sciences, King Saud University College of Dentistry, Riyadh, Saudi Arabia
| | - Franciele Floriani
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Silvia Rojas-Rueda
- Division of Dental Biomaterials, University of Alabama at Birmingham School of Dentistry, Birmingham, Alabama 35233, USA
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, School of Dentistry, Aichi Gakuin University, Nagoya 464-8651, Japan
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City IA 52242, USA
- Department of General Dentistry, School of Dentistry, Creighton University, Omaha NE 68102, USA
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Yang Y, Geng N. Clinical study of immediate implant placement in posterior maxillary region assisted by dynamic real-time navigation: A randomized controlled trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101976. [PMID: 39043292 DOI: 10.1016/j.jormas.2024.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/30/2024] [Accepted: 07/20/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE To evaluate the accuracy of the implant accuracy and clinical effect of navigation-assisted immediate implant placement (IIP) in the posterior maxillary tooth region. METHODS This study included 60 patients with 96 implants undergoing IIP in the posterior maxillary region from January 2021 to December 2022, stratified into dynamic navigation and freehand implant groups. All clinical indicators, including initial stability, implant deviation (entry point deviation, end point deviation, depth deviation and angle deviation), marginal bone resorption and implant success rate, were systematically recorded. RESULTS All implants were successfully placed with an average torque of (24.38 ± 1.84)N.cm. The mean entry point deviation, apex point deviation and angular deviation in the navigation group were significantly smaller than that of the freehand group (P < 0.05). Marginal bone resorption was significantly less in the navigated group than in the freehand group (P < 0.05). All dental implants were considered an operational success and the mean follow-up time was (27.8 ± 8.4) months. CONCLUSION The application of dynamic navigation-assisted immediate implant placement in the maxillary posterior region can achieve good implant accuracy and satisfactory clinical results.
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Affiliation(s)
- Yun Yang
- Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guang dong, China
| | - Ningbo Geng
- Department of Oral Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guang dong, China.
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Li J, Dai M, Wang S, Zhang X, Fan Q, Chen L. Accuracy of immediate anterior implantation using static and robotic computer-assisted implant surgery: A retrospective study. J Dent 2024; 148:105218. [PMID: 38955260 DOI: 10.1016/j.jdent.2024.105218] [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: 04/11/2024] [Revised: 06/15/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVES To investigate the accuracy of immediate anterior implantation using static computer-assisted implant surgery (s-CAIS) and robotic computer-assisted implant surgery (r-CAIS). MATERIALS AND METHODS One hundred and six implants were immediately inserted in the anterior zone of 69 patients using a freehand technique, s-CAIS or r-CAIS. Postoperative cone-beam computed tomography scans were matched with preoperative plans to evaluate the deviations between the planned and placed implant positions. RESULTS The global coronal deviations in the freehand, s-CAIS, and r-CAIS groups were 1.29 ± 0.52 mm, 1.01 ± 0.41 mm, and 0.62 ± 0.28 mm, respectively. Significant differences were observed in the r-CAIS group compared to both the s-CAIS group and the freehand group (p < 0.05). However, no significant differences were found between the s-CAIS group and the freehand group (p > 0.05). The global apical deviations in the freehand, s-CAIS and r-CAIS groups were 1.78 ± 0.59 mm, 1.24 ± 0.52 mm and 0.65 ± 0.27 mm, respectively, while the angular deviations in the freehand, s-CAIS and r-CAIS groups were 6.46 ± 2.21°, 2.94 ± 1.71° and 1.46 ± 0.57°, respectively. Significant differences were observed in both the global apical deviations and angular deviations among the three groups (p < 0.05). CONCLUSIONS The accuracy of immediate anterior implantation with r-CAIS was better than that with s-CAIS. This difference is attributed to better control of the coronal, vertical and axial errors during r-CAIS. CLINICAL SIGNIFICANCE This study provides significant evidence to support the use of r-CAIS as a potential alternative in immediate anterior implantation.
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Affiliation(s)
- Jun Li
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Meng Dai
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Siwei Wang
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xitao Zhang
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
| | - Qin Fan
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China.
| | - Lin Chen
- Hospital of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China.
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Hicklin SP, Sailer I, Todorovic A, Mojon P, Worni A, Strasding M. Immediately versus early placed bone-level-tapered implants supporting all-ceramic crowns on titanium base abutments: 1-year radiographic and pink esthetic outcomes of a multicenter pilot RCT. J ESTHET RESTOR DENT 2024; 36:1109-1121. [PMID: 38334315 DOI: 10.1111/jerd.13206] [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: 12/19/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Aim of this study was to assess survival rates, radiographic, and pink esthetic outcomes of a bone-level-tapered (BLT) implant following immediate or early implant placement. MATERIALS AND METHODS Patients in need of tooth extraction and one implant in the anterior or premolar area were recruited in five centers. Patients were randomly assigned to the immediate or early placement protocol. Implants were restored with all-ceramic crowns cemented to titanium-base-abutments. Radiographic bone levels, implant stability quotient (ISQ), and pink esthetic outcomes were assessed. Data were analyzed descriptively. Level of significance was set at 0.05. Differences between groups were tested using Wilcoxon-signed-rank and Mann-Whitney-U test as nonparametric tests. RESULTS A total of 60 patients received 60 BLT implants (Institut Straumann). At 12-months, 59 implants (98.3%) were osseointegrated. The mean distance from implant shoulder to first bone-to-implant contact was 0.15 ± 0.59 mm without significant differences between the groups. Median ISQ values increased from 75.5 to 78.5. A mean buccal recession of 0.1 ± 0.70 mm occurred with no difference between groups. The mean papilla height gain in both groups was 0.5 ± 1.47 mm mesially and 0.4 ± 1.36 mm distally. CONCLUSIONS After 1 year, immediately and early placed BLT implants exhibit similar bone level changes, ISQ values, and pink esthetic outcomes. CLINICAL SIGNIFICANCE The present research contributes to the knowledge on clinical outcomes of immediately and early placed BLT implants restored with buccally microveneered ceramic single crowns out of two different ceramic materials. The research shows that similar esthetic and radiographic outcomes can be reached by means of immediate implant placement compared to the conventional early placement protocol. The improvement of esthetic soft-tissue parameters over time was shown for both implant placement protocols.
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Affiliation(s)
- Stefan P Hicklin
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Ana Todorovic
- Division of Prosthodontics, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Philippe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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11
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da Silva AMP, Horta Dos Santos FA, Mota RF, Teixeira MKS, Telles DM, Lourenço EJV. Clinical and radiographic outcomes of a two-piece ceramic implant: one year results from a prospective clinical trial. Clin Oral Investig 2024; 28:380. [PMID: 38886209 DOI: 10.1007/s00784-024-05783-3] [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: 12/28/2023] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. MATERIALS AND METHODS Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. RESULTS The survival rate was 98.5%. The average MBLM was 0.24 mm (± 0.53) and the MBLD was 0.27 mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). CONCLUSION The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. CLINICAL RELEVANCE These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.
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Affiliation(s)
- Alexandre Marques Paes da Silva
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | | | - Rodrigo Franco Mota
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | - Mayla Kezy Silva Teixeira
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
| | - Daniel Moraes Telles
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
| | - Eduardo José Veras Lourenço
- Department of Prosthodontics, Faculty of Odontology, Rio de Janeiro State University, Boulevard 28 de Setembro 157, 2o Andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil
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12
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Torra-Moneny M, Mauri-Obradors E, Egido-Moreno S, Valls-Roca-Umbert J, Marí-Roig A, López-López J. Association of Connective Tissue Grafts in Immediate Implants: Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:183. [PMID: 38920885 PMCID: PMC11202705 DOI: 10.3390/dj12060183] [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: 05/03/2024] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. METHODS A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. RESULTS Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total "n" of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: -0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. CONCLUSIONS The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned.
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Affiliation(s)
- Marta Torra-Moneny
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Elisabet Mauri-Obradors
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Sonia Egido-Moreno
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Joan Valls-Roca-Umbert
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
| | - Antonio Marí-Roig
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
- Maxillofacial Surgery Service, Bellvitge University Hospital, 08907 Barcelona, Spain
- Oral Health and Masticatory System Group, Institut d’Investigació Biomédica de Bellvitge IDIBELL (Bellvitge Institute of Biomedical Research), 08907 Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain; (M.T.-M.); (E.M.-O.); (J.V.-R.-U.); (A.M.-R.)
- Maxillofacial Surgery Service, Bellvitge University Hospital, 08907 Barcelona, Spain
- Oral Health and Masticatory System Group, Institut d’Investigació Biomédica de Bellvitge IDIBELL (Bellvitge Institute of Biomedical Research), 08907 Barcelona, Spain
- Medical Surgical Area of the Dental Hospital, University of Barcelona (HOUB), 08907 Barcelona, Spain
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13
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Ickroth A, Seyssens L, Christiaens V, Pitman J, Cosyn J. Immediate versus early implant placement for single tooth replacement in the aesthetic area: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:585-597. [PMID: 38558205 DOI: 10.1111/clr.14261] [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: 04/18/2023] [Revised: 02/23/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To compare immediate implant placement (IIP) with early implant placement (EIP) for single tooth replacement in the aesthetic area in terms of aesthetic, clinical, and patient-reported outcomes. MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in PubMed, Web of Science, Embase, and Cochrane databases as well as a manual search to identify eligible clinical studies up to February 2023. Randomized Controlled Trials (RCTs) comparing IIP with EIP were included for a qualitative and quantitative analysis. The primary outcome was vertical midfacial soft tissue change. Secondary outcomes were horizontal midfacial soft tissue change, vertical papillary change, pink esthetic score (PES), implant survival, buccal bone thickness, marginal bone level change, patient discomfort, chair time, and patient satisfaction. RESULTS Out of 1185 records, 6 RCTs were selected, reporting on 222 patients who received 222 single implants (IIP: 112 implants in 112 patients; EIP: 110 implants in 110 patients) in the anterior maxilla or mandible. Patients had a mean age ranging from 35.6 to 52.6 years and were followed between 8 and 24 months. Two RCTs showed some concerns, and four showed a high risk of bias. Four studies could be included in a meta-analysis on the primary outcome and three only considered cases with an intact buccal bone wall. Meta-analysis failed to demonstrate a significant difference in terms of vertical midfacial soft tissue change between IIP and EIP (mean difference: 0.31 mm, 95% CI [-0.23; 0.86], p = .260; I2 = 83%, p < .001). No significant differences were found for PES (standardized mean difference: 0.92, 95% CI [-0.23; 2.07], p = .120; I2 = 89%, p < .001), implant survival (RR: 0.98, 95% CI [0.93, 1.03], p = .480; I2 = 0%, p = .980), and marginal bone level change (mean difference: 0.03 mm, 95% CI [-0.12, 0.17], p = .700; I2 = 0%, p = .470). Insufficient data were available for meta-analyses of other secondary outcomes. CONCLUSION In low-risk patients with an intact buccal bone wall, there seems to be no difference between IIP and EIP in terms of aesthetic and clinical outcomes. The strength of this conclusion is rated as low since studies showed an unclear or high risk of bias. In addition, state-of-the-art therapy was only delivered in a minority of studies. Future RCTs should also provide data on patient-reported outcomes since these have been underreported.
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Affiliation(s)
- Axelle Ickroth
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jeremy Pitman
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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14
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Lai K, Yu Q, Huang T, Dai W, Yu Z, Wang Y, Xi Y, Chen Y, Yang G. Bone alteration and esthetics associated with implant-supported prostheses in the anterior maxilla under different implant placement timing: A retrospective clinical study of 1 to 3 years. J Prosthet Dent 2024:S0022-3913(24)00353-6. [PMID: 38806340 DOI: 10.1016/j.prosdent.2024.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/30/2024]
Abstract
STATEMENT OF PROBLEM Different factors influence alterations in facial bone thickness and esthetic outcomes after implant placement. Whether the timing of implant placement influences alterations in the bone dimensional and esthetic outcomes is unclear. PURPOSE The purpose of this retrospective clinical study was to assess the influence of the timing of implant placement on alveolar bone alterations and esthetic outcome. MATERIAL AND METHODS Data were collected from 40 patients who had received guided bone regeneration (GBR) performed simultaneously with immediate, early, or delayed single-tooth implant placement in the anterior maxilla. Facial and palatal horizontal bone thicknesses (FHBT, PHBT) and vertical bone level (FVBL, PVBL) immediately after surgery (T0), at 6 months after implant placement (T1), and at 1 to 3 years follow-up (T2) were measured, and the changes calculated. The pink esthetic score (PES) and white esthetic score (WES) were evaluated at the 1- to 3-year follow-up. The Kruskal-Wallis followed by the Dunn t test was applied to evaluate bone alteration among groups, and the Bonferroni method was used for adjusting multiple comparisons. The 1-way ANOVA test was used to determine any significance in the esthetic outcome in the 3 groups (α=.05). RESULTS The reduction in the FHBT0 of the immediate, early, and delayed implant placement group (T2-T0) was -1.17 (-1.70, -0.61) mm, -1.53 (-1.69, -0.49) mm, and -1.47 (-2.30, -0.20) mm, respectively. The FHBT around the implant apices remained basically stable. No obvious changes in the PHBT around the implants of the immediate and delayed implant placement group were noted. The FVBL significantly decreased in each group during the follow-up period (-1.34 (01.88, -0.56) mm, immediate; -2.88 (-3.79, -1.07) mm, early; -1.26 (-2.52, -0.48) mm, delayed). The PVBL change in the early implant placement group (-2.18 (-3.26, -0.86) mm) was more significant than that in the immediate (-0.55 (-2.10, -0.17) mm) and delayed (-0.51 (-1.29, 0.02) mm) implantation groups (P =.013). The mean ±standard deviation PES/WES score of the immediate (15.6 ±1.84) and early (15.00 ±1.13) implant placement groups was higher than that of the delayed implant placement group (13.92 ±2.10) without significant difference. CONCLUSIONS Similar bone changes and esthetic outcomes were found around implants of the immediate, early, and delayed implant placement groups.
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Affiliation(s)
- Kaichen Lai
- Attending Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Qiong Yu
- Resident Physician, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Tingben Huang
- Attending Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Wei Dai
- Graduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Zhou Yu
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yuchen Wang
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yue Xi
- Resident Physician, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Yitong Chen
- Postgraduate student, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Guoli Yang
- Professor, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China.
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15
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AlHelal AA, Alzaid AA, Almujel SH, Alsaloum M, Alanazi KK, Althubaitiy RO, Al-Aali KA. Clinical Peri-Implant Parameters and Marginal Bone Loss for Early Mandibular Implant Overdentures: A Follow-Up of 60 Months. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:588. [PMID: 38674234 PMCID: PMC11052130 DOI: 10.3390/medicina60040588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Despite the identified benefits of early implant loading, studies have questioned its advantages compared to delayed loading in edentulous patients. This study aimed to evaluate clinical peri-implant parameters and marginal bone loss around early placed and loaded mandibular implant overdentures with a 60-month follow-up. Materials and Methods: In this prospective cohort study, 43 patients were enrolled to receive 86 early loading sub-crestal dental implants through prosthetic guides. Implant overdentures were supported by two isolated implant locator attachments between two mental foramens. Clinical peri-implant parameters, including plaque index (PI), bleeding index (BI), peri-implant pocket depth (PIPD), and marginal bone loss (MBL) were evaluated using standardized techniques at 1, 12, 24, 36, 48, and 60 months follow-up. At 60 months, complications associated with implant overdentures (IOD's) were noted. The mean comparison of peri-implant clinical parameters was performed through ANOVA test. A p-value of ≤0.05 was taken as significant. Results: Out of the total 43 enrolled patients, 8 patients were lost during follow-up; as a result, 35 patients completed the 5 years follow-up. The mean values of PI, BI, and PIPD increased with no statistical difference (p > 0.05). For marginal bone loss, an increase in the mean values was noted at different time intervals with statistical differences (p < 0.001). The most common complications noted were loosening of the abutment, occlusal adjustment, retentive locator loosening and replacement, and relining of the denture. Conclusions: Early placement of IODs failed to prevent bone loss over time and was associated with complications, predominantly consisting of abutment loosening, occlusal adjustments, broken retentive locator components, relining, and rebasing.
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Affiliation(s)
- Abdulaziz A. AlHelal
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, P.O. Box 21069, Riyadh 11475, Saudi Arabia;
| | - Abdulaziz A. Alzaid
- Restorative and Prosthetic Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia; (A.A.A.); (M.A.)
- King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia
| | - Saad H. Almujel
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, P.O. Box 21069, Riyadh 11475, Saudi Arabia;
| | - Mohammed Alsaloum
- Restorative and Prosthetic Dental Science Department, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia; (A.A.A.); (M.A.)
- King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia
| | - Khalid K. Alanazi
- Conservative Dental Science Department, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia;
| | - Ramzi O. Althubaitiy
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia;
| | - Khulud A. Al-Aali
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
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16
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Yu W, Luo D, Yang J, Yuan M, Yang Y, Gao Y. Immediate implant placement for chronic peri-apical periodontitis in the molar region: a randomised controlled trial. Int J Oral Maxillofac Surg 2024; 53:223-230. [PMID: 37673734 DOI: 10.1016/j.ijom.2023.08.005] [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: 03/21/2022] [Revised: 03/03/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023]
Abstract
The aim of this study was to evaluate the feasibility of immediate implantation for chronic peri-apical periodontitis in the molar region. Seventy-four molars were selected and allocated randomly to two groups. The experimental group (n = 38) received immediate implantation by flap surgery and the control group (n = 36) received delayed implantation. CBCT was performed immediately after surgery (T1) and 12 months after the permanent repair (T3). The implant survival rate at T3 was 100% in both groups. There was no significant difference in buccal or lingual vertical marginal bone loss between the groups (P = 0.515, P = 0.736). However, the buccal horizontal margin bone loss was significantly greater in the experimental group: 0.98 ± 0.34 mm vs 0.77 ± 0.27 mm in the control group (P = 0.003). In the experimental group, the highest point of buccal and lingual implant-bone contact increased at T3. The buccal and lingual jump gap widths were 3.21 ± 1.10 mm and 2.92 ± 1.01 mm at T1, and CBCT showed no jump gap around the implants at T3. The clinical outcomes showed immediate implantation to be feasible for chronic peri-apical periodontitis in the molar region.
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Affiliation(s)
- W Yu
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - D Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - J Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China.
| | - M Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Y Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
| | - Y Gao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, PR China; School of Stomatology of Qingdao University, Qingdao, Shandong, PR China
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17
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Rijal AH, Dhami B, Ghimire P, Humagain M, Lamichhane S. Early Implant Placement with Immediate Loading in the Mandibular Anterior Region: A Rapid Solution to Edentulism. Case Rep Dent 2023; 2023:8487094. [PMID: 38146421 PMCID: PMC10749726 DOI: 10.1155/2023/8487094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 12/27/2023] Open
Abstract
The aim of this article is to present the case of an early implant placement with immediate loading in the mandibular anterior region as a rapid solution to edentulism. A 40-year-old healthy male patient reported with a chief complaint of loosening of tooth in the lower front region of the jaw. On intraoral examination, there was a mobile tooth with respect to 41. The mobile tooth was extracted, and early implant placement was done along with Bio-Oss bone grafts to fill the jumping distance with no barrier membrane. Immediate provisionalisation was done on early-placed dental implants. After 5 months of the healing period, the final implant-level impressions were made, and the provisional crown was replaced with the final zirconia crown. This case report demonstrates satisfactory esthetic and functional outcomes along with various other advantages.
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Affiliation(s)
- Arjun Hari Rijal
- Department of Periodontology and Oral Implantology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Bhageshwar Dhami
- Department of Periodontology and Oral Implantology, Kantipur Dental College and Hospital, Basundhara, Kathmandu, Nepal
| | | | - Manoj Humagain
- Department of Periodontology and Oral Implantology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
| | - Simant Lamichhane
- Department of Periodontology and Oral Implantology, Kathmandu University School of Medical Sciences, Dhulikhel, Kavrepalanchok, Nepal
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Lin X, Yu X, Wang F, Wu Y. Marginal bone level change of immediately restored implants with simultaneous guided bone regeneration: A systematic review. Clin Implant Dent Relat Res 2023; 25:1112-1137. [PMID: 37555385 DOI: 10.1111/cid.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
AIM To assess marginal bone level change (MBLc), clinical outcomes for soft tissue, and survival rates for immediately restored implants with simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS Electronic and manual searches were conducted in PubMed/MEDLINE, EMBASE, and CENTRAL for studies that investigated immediately restored implants in simultaneously grafted sites with a mean follow-up of over 12 months. MBLc was the primary outcome. Soft tissue clinical parameters and implant survival rate (ISR) were the secondary outcomes. RESULTS Twenty-five studies (5 randomized controlled trials, 6 prospective studies, 2 retrospective studies, and 12 case series) were included, from which 692 immediately restored implants were analyzed. For studies that investigated bone grafts in the gap between the implant and the peripheral bone wall, the weighted mean MBLc was -0.73 ± 1.52 mm (range: -1.50 to 0.26 mm) for 475 implants. Pink esthetic score (PES) was improved in eight studies and the weighted cumulative ISR was 98.99% (Median: 100%) in 622 implants. Mean MBLc was -1.19 ± 0.26 mm for 30 implants in studies that reported gap with dehiscence and/or fenestration augmentation. Weighted cumulative ISR was 97.25% in 70 implants. A meta-analysis was not possible due to the lack of studies with an eligible control group. Therefore, the data should be interpreted with caution. CONCLUSION Less marginal bone loss and more predictable soft tissue parameters can be achieved for immediately restored implants with simultaneous peri-implant gap filling compared with gap with dehiscence/fenestration grafting. Increased ISR for implants with gap filling was observed. However, more evidence is needed to confirm whether immediate provisional prostheses should be utilized when bone defects are simultaneously augmented around the implants.
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Affiliation(s)
- Xinyan Lin
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinbo Yu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Wang
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yiqun Wu
- Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
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Wittneben JG, Molinero-Mourelle P, Hamilton A, Alnasser M, Obermaier B, Morton D, Gallucci GO, Wismeijer D. Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:266-303. [PMID: 37750531 DOI: 10.1111/clr.14172] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 08/07/2023] [Accepted: 08/13/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15-25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. MATERIAL AND METHODS An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). RESULTS Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6-99.5) % at 1 year, 97.5 (95.9-98.4) % after 3 years, and 95.8 (93.3-97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8-99.5) % after 1 year, 96.8 (93.6-98.4) % after 2 years, and 94.8 (89.6-97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of -0.71 (-1.25, -0.1) mm, midfacial recession change of -0.15 (-0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. CONCLUSIONS Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.
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Affiliation(s)
- Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Hamilton A, Gonzaga L, Amorim K, Wittneben JG, Martig L, Morton D, Martin W, Gallucci GO, Wismeijer D. Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:304-348. [PMID: 37750515 DOI: 10.1111/clr.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. MATERIALS AND METHODS An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. RESULTS A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of -1.9 percentage points [PP], 95% CI: [-0.3, -4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). CONCLUSIONS Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia
- Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Luiz Gonzaga
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Karina Amorim
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | | | | | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - William Martin
- Center for Implant Dentistry, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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21
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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [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: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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22
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What Does Bone Corticalization around Dental Implants Mean in Light of Ten Years of Follow-Up? J Clin Med 2022; 11:jcm11123545. [PMID: 35743625 PMCID: PMC9225429 DOI: 10.3390/jcm11123545] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/06/2023] Open
Abstract
The phenomenon of peri-implant bone corticalization after functional loading does not yet have a definite clinical significance and impact on prognosis. An attempt was made to assess the clinical significance of this phenomenon. This prospective study included 554 patients. Standardized intraoral radiographs documenting the jawbone environment of 1556 implants were collected. The follow-up period was 10 years of functional loading. Marginal alveolar bone loss (MBL) and radiographic bone structure (bone index, BI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. After five years, bone structure abnormalities expressed by a reduction of BI to 0.47 ± 0.21 and MBL = 0.88 ± 1.27 mm were observed. Both values had an inverse relationship with each other (p < 0.0001). Reference cancellous bone showed BI = 0.85 ± 0.18. The same relationship was observed after ten years of functional loading: BI = 0.48 ± 0.21, MBL = 1.49 ± 1.94 mm, and again an inverse relationship (p < 0.0001). Increasing corticalization (lower BI) is strongly associated with increasing marginal bone loss and increasing corticalization precedes future marginal bone loss. Marginal bone loss will increase as corticalization progresses.
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