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Suzuki A, Nakano T, Inoue M, Isigaki S. Multivariate analysis of the effect of keratinized mucosa on peri-implant tissues with platform switching: A retrospective study. Clin Implant Dent Relat Res 2024; 26:592-603. [PMID: 38500194 DOI: 10.1111/cid.13318] [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: 08/23/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND In recent years, platform switching implant treatment has been increasing, which is believed to minimize bone loss around the implant after placement. However, there have been no reports on the relationship between keratinized mucosa width (KMW) and bone loss and soft tissue recession in platform switching implants. OBJECTIVE We evaluated the effect of the KMW on the amount of bone loss and soft tissue recession around a platform switching implant retrospectively using multivariate analysis. MATERIALS AND METHODS This one-year retrospective study included 91 implants in 48 patients. Age, sex, a history of periodontitis, implant location, oral hygiene status, and the KMW were included as explanatory variables to evaluate bone loss (BL) and buccal gingival height (GH). Generalized estimating equations (GEEs) were used to evaluate the effect of the KMW on platform switching peri-implant tissues. RESULTS The mean bone loss on the mesial (ΔBLm), distal (ΔBLd), and buccal (ΔBLb) sides of the implant were 0.16 ± 0.27 mm, 0.19 ± 0.34 mm, and 0.24 ± 0.50 mm, respectively, at 1 year after superstructure placement. The mean amount of change of GH (ΔGH) on the buccal side was 0.30 ± 0.47 mm. After correcting for confounders using GEEs, the results suggested that KMW <1.5 mm was a significant factor (P < 0.001) for bone loss over time in ΔBLm, ΔBLd, and ΔBLb. In addition, for soft tissues on the buccal side, KMW <1.5 mm was a significant factor for ΔGH reduction over time (P < 0.001). CONCLUSIONS Keratinized mucosa width ≥1.5 mm was associated with a higher probability less hard and soft tissue recession around the platform switching implant after 1 year from superstructure placement.
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Affiliation(s)
- Azusa Suzuki
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tamaki Nakano
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaki Inoue
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shoichi Isigaki
- Department of Fixed Prosthodontics and Orofacial Function, Division of Oral Reconstruction and Comprehensive Dentistry, Osaka University Graduate School of Dentistry, Suita, Japan
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Cruz RS, Fernandes E Oliveira HF, Lemos CAA, de Souza Batista VE, Capalbo da Silva R, Verri FR. Biomechanical influence of narrow-diameter implants placed at the crestal and subcrestal level in the maxillary anterior region. A 3D finite element analysis. J Prosthodont 2024; 33:180-187. [PMID: 36799260 DOI: 10.1111/jopr.13667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 02/18/2023] Open
Abstract
PURPOSE To evaluate the tendency of movement, stress distribution, and microstrain of single-unit crowns in simulated cortical and trabecular bone, implants, and prosthetic components of narrow-diameter implants with different lengths placed at the crestal and subcrestal levels in the maxillary anterior region using 3D finite element analysis (FEA). MATERIALS AND METHODS Six 3D models were simulated using Invesalius 3.0, Rhinoceros 4.0, and SolidWorks software. Each model simulated the right anterior maxillary region including a Morse taper implant of Ø2.9 mm with different lengths (7, 10, and 13 mm) placed at the crestal and subcrestal level and supporting a cement-retained monolithic single crown in the area of tooth 12. The FEA was performed using ANSYS 19.2. The simulated applied force was 178 N at 0°, 30°, and 60°. The results were analyzed using maps of displacement, von Mises (vM) stress, maximum principal stress, and microstrain. RESULTS Models with implants at the subcrestal level showed greater displacement. vM stress increased in the implant and prosthetic components when implants were placed at the subcrestal level compared with the crestal level; the length of the implants had a low influence on the stress distribution. Higher stress and strain concentrations were observed in the cortical bone of the subcrestal placement, independent of implant length. Non-axial loading influenced the increased stress and strain in all the evaluated structures. CONCLUSIONS Narrow-diameter implants positioned at the crestal level showed a more favorable biomechanical behavior for simulated cortical bone, implants, and prosthetic components. Implant length had a smaller influence on stress or strain distribution than the other variables.
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Affiliation(s)
- Ronaldo S Cruz
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | | | - Cleidiel Aparecido Araújo Lemos
- Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora (UFJF)-Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Victor Eduardo de Souza Batista
- Department Prosthodontics, Presidente Prudente Dental School, The University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Rodrigo Capalbo da Silva
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo R Verri
- Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
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Kim JE, Yoon Y, Pae A, Kwon YD. Clinical outcome of narrow diameter dental implants: a 3-year retrospective study. Maxillofac Plast Reconstr Surg 2023; 45:26. [PMID: 37526800 PMCID: PMC10393933 DOI: 10.1186/s40902-023-00394-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND This study aimed to analyze the clinical outcome and complications of narrow-diameter dental implants (NDIs) (diameter ≤3.5 mm). METHODS The 274 NDIs that met the selection criteria from 2013 to 2018 were included in the retrospective study, and the survival rates (SVR) were compared. Mechanical complications included screw loosening and fractures of the implant components, such as the implant fixture, abutment, and prosthesis. In addition, marginal bone loss (MBL) was measured immediately after surgery and 1 year after loading. RESULTS The 3-year cumulative SVR was 92.4%. Nineteen fixtures failed during the follow-up. The failure rate was significantly higher (OR=4.573, p<0.05) in smokers and was significantly higher in osteoporosis patients (OR=3.420, p<0.05). The vertical and horizontal values of MBL were 0.33±0.32 mm and 0.18±0.17 mm, respectively. Mechanical complications included screw loosening (5.5%) and porcelain fracture (2.2%), but no fractures of the fixture or components were observed. The choice of titanium and zirconium (TiZr) alloy implant was significantly more frequent in the posterior region. Bone graft was significantly more frequently done in the anterior region. CONCLUSIONS According to the high SVR and stability of NDIs, the findings of the study suggest that NDIs may be a replacement for regular diameter dental implants (RDIs) and the use of TiZr alloy could extend the indication of NDIs. In the esthetic area, contour augmentation may be a reason for increasing the frequency of bone grafts.
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Affiliation(s)
- Jae-Eun Kim
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Youngjae Yoon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Ahran Pae
- Department of Prosthodontics, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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de Morais RC, Simionato AA, Moris ICM, Leoni GB, Faria ACL, Rodrigues RCS, Ribeiro RF. Influence of Torque on Platform Deformity of the Tri-Channel Implant: Two- and Three-Dimensional Analysis Using Micro-Computed Tomography. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1311. [PMID: 37512122 PMCID: PMC10386693 DOI: 10.3390/medicina59071311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The insertion of the dental implant in the bone is an essential step in prosthetic rehabilitation. The insertion torque has the potential to distort the prosthetic platform, which can cause future biomechanical problems with the continuous action of occlusal forces. The aim of this study is to evaluate different insertion torques in the deformation of tri-channel platform connections through two- and three-dimensional measurements with micro-CT. Materials and Methods: A total of 164 implants were divided into groups (platform diameter and type): 3.5, 3.75, and 4.3 mm NP (narrow platform), and 4.3 mm RP (regular platform). Each implant-platform group was then divided into four subgroups (n = 10) with different torques: T45 (45 Ncm), T80 (80 Ncm), T120 (120 Ncm), and T150 (150 Ncm). The implant-abutment-screw assemblies were scanned and the images obtained were analyzed. Results: A significant difference was observed for the linear and volume measures between the different platforms (p < 0.01) and the different implant insertion torques (p < 0.01). Qualitative analysis suggested a higher deformation resistance for the 3.75 NP compared to the 3.5 NP, and RP was more resistant compared to the NP. Conclusions: The 0.25 mm increment in the implant platform did not increase the resistance to the applied insertion torques; the 4.3 mm implant was significantly stronger compared to the 3.5 mm implant; and the proposed micro-CT analysis was considered valid for both the 2D and 3D analyses of micro-gaps, qualitatively and quantitatively.
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Affiliation(s)
- Renata Costa de Morais
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Anselmo Agostinho Simionato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | | | - Graziela Bianchi Leoni
- Department of Dentistry, Ribeirão Preto University-UNAERP, Ribeirão Preto 14096-900, Brazil
| | - Adriana Cláudia Lapria Faria
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Renata Cristina Silveira Rodrigues
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Ricardo Faria Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
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Abd El Rahim NS, Ashour AA. Impact of Platform Switched Implants on Marginal Bone Level in Mandibular Overdentures: A Six-Year Follow-Up Longitudinal Study. Clin Cosmet Investig Dent 2022; 14:307-319. [PMID: 36285194 PMCID: PMC9588294 DOI: 10.2147/ccide.s378636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the impact of the platform-switched implant on marginal bone loss (MBL) and the probing pocket depth (PPD) in patients wearing mandibular overdenture. PATIENTS AND METHODS This longitudinal study included 40 completely edentulous patients aged 51-64 years. All patients received complete dentures and were distributed into two groups randomly; 20 patients each. The first group GI received two platform switched implants; however, the 2nd group GII received two platform matched implants (3.6 × 11.5 mm) in the canine region of the mandible. The radiographic evaluations were carried out every year for six years, whereas probing pocket depth was evaluated every six months for 72 months for both groups. The data were analyzed by repeated ANOVA, Friedman's, and Student's t-test. RESULTS This study included 36 patients; 56 ± 3.6 years was the mean age; 17 females (47%) and 19 males (53%) completed the study. Statistically significant differences were observed in MBL and PPD in each of GI and GII after 6 years, p ≤ 0.05. Between GI and GII after 6 years, a statistically insignificant difference was detected in MBL or PPD, p ≥ 0.05, except in PPD at loading, 2 and 6 years, p ≤ 0.05. CONCLUSION Time positively affected MBL and PPD in platform switched and matched implants retained mandibular overdentures. Platform switching influences probing pocket depth in implants retained mandibular overdentures.
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Affiliation(s)
- Neveen S Abd El Rahim
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt,Department of Removable Prosthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - Asmaa A Ashour
- Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt,Correspondence: Asmaa A Ashour, Department of Removable Prosthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Nasr, Cairo, Egypt, Tel +20 1284048535, Email
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Zhang WT, Cheng KJ, Liu YF, Wang R, Chen YF, Ding YD, Yang F, Wang LH. Effect of the prosthetic index on stress distribution in Morse taper connection implant system and peri-implant bone: a 3D finite element analysis. BMC Oral Health 2022; 22:431. [PMID: 36180871 PMCID: PMC9523891 DOI: 10.1186/s12903-022-02465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background The combination of a prosthetic index with Morse taper connection was developed, with the purpose of making prosthetic procedures more precise. However, the presence of the index may compromise the mechanical performance of the abutment. The aim of this study is to evaluate the effect of prosthetic index on stress distribution in implant–abutment-screw system and peri-implant bone by using the 3D finite element methodology. Methods Two commercial dental implant systems with different implant–abutment connections were used: the Morse taper connection with platform switching (MT-PS) implant system and the internal hex connection with platform matching (IH-PM) implant system. Meanwhile, there are two different designs of Morse taper connection abutment, namely, abutments with or without index. Consequently, three different models were developed and evaluated: (1) MT-PS indexed, (2) MT-PS non-indexed, and (3) IH-PM. These models were inserted into a bone block. Vertical and oblique forces of 100 N were applied to each abutment to simulate occlusal loadings. Results For the MT-PS implant system, the maximum stress was always concentrated in the abutment neck under both vertical and oblique loading. Moreover, the maximum von Mises stress in the neck of the MT-PS abutment with index even exceed the yield strength of titanium alloy under the oblique loading. For the IH-PM implant system, however, the maximum stress was always located at the implant. Additionally, the MT-PS implant system has a significantly higher stress level in the abutment neck and a lower stress level around the peri-implant bone compared to the IH-PM implant system. The combined average maximum stress from vertical and oblique loads is 2.04 times higher in the MT-PS indexed model, and 1.82 times for the MT-PS non-indexed model than that of the IH-PM model. Conclusions MT-PS with index will cause higher stress concentration on the abutment neck than that of without index, which is more prone to mechanical complications. Nevertheless, MT-PS decreases stress within cancellous bone and may contribute to limiting crestal bone resorption.
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Affiliation(s)
- Wen-Tao Zhang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Kang-Jie Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.,Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China.,National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Yun-Feng Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, 310023, China.,Key Laboratory of Special Purpose Equipment and Advanced Processing Technology, Ministry of Education and Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310023, China.,National International Joint Research Center of Special Purpose Equipment and Advanced Processing Technology, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Russell Wang
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, OH, 44106-4905, USA
| | - Yun-Fang Chen
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Yu-de Ding
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China
| | - Fan Yang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China.
| | - Lin-Hong Wang
- Center for Plastic and Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), No. 158 Shangtang Rd., Hangzhou, 310014, China.
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Lin HT, Lin JCY, Salamanca E, Dorj O, Pan YH, Wu YF, Hsu YS, Fang CY, Chang WJ. Marginal Bone Level Evaluation of Fixed Partial Dental Prostheses Using Preformed Stock versus CAD/CAM Customized Abutments. J Pers Med 2022; 12:jpm12071051. [PMID: 35887548 PMCID: PMC9317139 DOI: 10.3390/jpm12071051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/01/2022] Open
Abstract
Background: The maintenance of marginal bone levels around dental implants is an important criterion for evaluating the success of implants. Although computer-aided design/computer-aided manufacturing (CAD/CAM) customized abutments (CAs) provide more flexible solutions, compared with the original preformed stock abutments (PAs), there are dimensional tolerances and underlying drawbacks in the production of CAD/CAM CAs, which may change the tightness and seamless connection between fixtures and abutments set by the manufacturer and then affect the long-term stability of the abutments. This study aimed to examine the change in both mesial and distal bone levels using digital periapical radiographs to evaluate the difference between CAD/CAM CAs and original PAs.Material and methods: Radiographs were taken before delivery; after functional loading for 1 month; and after 3, 6, and 12 months; and the vertical marginal bone levels (vMBLs) of both the mesial and distal surrounding implant bones were measured. All data are presented as means ± standard errors and were analyzed using Student’s t-test. A p-value < 0.05 was judged to represent a significant difference. Results: A total of 57 implants in 50 patients were divided into 22 CAD/CAM CAs and 35 original stock abutments. The PAs appeared to have a more stable bone level. By contrast, the amount of bone level change in the CAs was higher than that in the PAs. The change in the vMBL of the CAs was significantly more than that of the PAs after functional loading for 1 month (p = 0.006), 3 months (p = 0.013), 6 months (p = 0.014), and 12 months (p = 0.002). In contrast, the distal marginal bone level was lower than the mesial marginal bone level in any period. Nevertheless, the bone levels of the CAs and PAs in any period were comparable with no significant difference. Conclusions: Significant differences were found between the mesial and distal bone levels in the PAs. The CAD/CAM CAs showed a significantly greater bone level change than the original stock abutments after functional loading.
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Affiliation(s)
- Hui-Ting Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
| | - Jerry Chin-Yi Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA 01238, USA
| | - Eisner Salamanca
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
| | - Odontuya Dorj
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Department of Dental technology and Dental Hygiene, School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Yu-Hwa Pan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan
- School of Dentistry, College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Yi-Fan Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
| | - Yung-Szu Hsu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Dental Department, Taipei Medical University, Shuang Ho Hospital, New Taipei City 235, Taiwan
| | - Chih-Yuan Fang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Department of Dentistry, Taipei Municipal Wan Fang Hospital, Taipei 110, Taiwan
- Correspondence: (C.-Y.F.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (W.-J.C.)
| | - Wei-Jen Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan; (H.-T.L.); (J.C.-Y.L.); (E.S.); (O.D.); (Y.-H.P.); (Y.-F.W.); (Y.-S.H.)
- Dental Department, Taipei Medical University, Shuang Ho Hospital, New Taipei City 235, Taiwan
- Correspondence: (C.-Y.F.); (W.-J.C.); Tel.: +886-2-2736-1661 (ext. 5148) (W.-J.C.)
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Al-Ahmari MM. Estimation of Soft and Hard Tissue Revolutionization Surrounding Dental Implant: A 2-Year Retrospective Study. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1540668. [PMID: 35295180 PMCID: PMC8920654 DOI: 10.1155/2022/1540668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/09/2022] [Indexed: 11/18/2022]
Abstract
A dental implant is an idyllic mode of operandi for oral rehabilitation for complete and partially edentulous patients. The success of an implant is based on the health of its surrounding tissues. Therefore, the biological and clinical aspects of implant prosthesis and their surrounding tissues must persist to be investigated. A two-year retrospective clinical-radiological study was conducted to estimate peri-implant soft and hard tissue revolutionization after the placement of implants. A clinical-radiological investigation was carried out to determine the amount of soft and hard tissue revolutionization that occurred following the implantation of 200 implants. From October 2020 to March 2021, the research was carried out in the College of Dentistry at King Khalid University in Saudi Arabia. It was decided to conduct this study using a retrospective clinical record, which involved gathering information about patients who had previously received dental implants within the previous two years. Plaque index (PI), gingival index (GI), bleeding index (BI), peri-implant probing depth (PD), and peri-implant crestal bone level were measured at baseline and three months after implant placement in adult patients ranging in age from 20 to 50 years. The results were compared to the full-mouth index (FMI). Ethical clearance and written informed consent were obtained from all the study participants. The statistical analysis was done by using Statistical Package for Social Sciences (SPSS-23.0 version) (IBM; Chicago). The present study concluded that plaque accumulation, gingival bleeding, and probing depth were increased around implants during the follow-up, but it would not affect crestal bone loss. Still, it is essential to conduct a similar study with a larger sample size and a long follow-up period to give more precise results.
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Affiliation(s)
- Manea Musa Al-Ahmari
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Dinc MM, Turkoglu P, Selvi F. Biomechanical evaluation of stress distributions at the implant-abutment complex and peri-implant bone around mandibular dental implants with different neck geometries and inclinations. Proc Inst Mech Eng H 2021; 235:1035-1045. [PMID: 34098780 DOI: 10.1177/09544119211022985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the effects of the different dental implant neck designs, diameters, and inclinations, on the stress distributions at the mandibular crestal bone and implant-abutment complex, using three-dimensional (3D) finite element stress analysis (FEA) method. Finite element models of three-unit fixed partial dentures supported with two same length implants (10 mm), placed on the second premolar and second molar regions, were designed. Eight different models were designed according to the implants' neck designs (platform switching/traditional), diameters (4.1 mm/4.8 mm) and the tilting angles of the posterior implants (0°/15°). The anterior implants' widths were 4.1 mm and the neck design of the anterior implants matched the posterior implants. Two types of 100-N loads in vertical and 30° oblique directions were applied separately onto each central fossae and functional cusps of the fixed partial dentures crowns. Algor Fempro Software was used for the simulation and evaluation of the stress levels at the implant-abutment complex and the crestal bone. Stress levels measured at the crestal bone were found to be lower for the platform switching models. However, the platform switching design generated higher stress magnitudes within the implant-abutment complex. Inclined placement of posterior implants increased the amount of stress at the crestal bone around both implants. Biomechanically, selection of the largest diameter possible when using tilted platform switched implants may be recommended at the posterior mandible.
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Affiliation(s)
| | | | - Firat Selvi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Istanbul University, Istanbul, Turkey
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One-Piece Titanium Implants: Retrospective Case Series. Case Rep Dent 2021; 2021:6688355. [PMID: 33898069 PMCID: PMC8052180 DOI: 10.1155/2021/6688355] [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: 12/15/2020] [Revised: 03/17/2021] [Accepted: 03/30/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose One-piece titanium implants are not routinely used for reconstruction after tooth loss. Several limitations seemed to be apparent although the concept provides a straightforward approach for different clinical situations. A clinical documentation of five prosthetic restorations with one-piece titanium implants serving as a relevant treatment option in dental surgery is pursued. We demonstrate the feasibility and benefits of one-piece titanium implants for fixed dental prosthesis. Detailed descriptions of the technical features and the surgical approach by means of clinical cases are given. The prosthetic workflow when working with one-piece titanium implants is depicted in detail as well as examples for implant-supported tooth replacement in the posterior region and the esthetic zone. Conditions of applications regarding different timing of implant placement using the system and its limitations are discussed. Results Clinical cases with a follow-up period of up to 10 years are presented to prove the long-term success of one-piece titanium implants in terms of bone and soft-tissue stability respecting the biological criteria for periodontal health. Conclusions One-piece titanium implants represent a reliable treatment method for single-tooth replacements. Clinical success with long-time bone stability around the implantation site can be achieved. Taken into account the requirements for periodontal tissue stability, uneventful healing without extensive tissue loss is demonstrated by means of clinical cases presenting patients with periodontitis.
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11
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Cruz RS, Lemos CAA, de Luna Gomes JM, Fernandes E Oliveira HF, Pellizzer EP, Verri FR. Clinical comparison between crestal and subcrestal dental implants: A systematic review and meta-analysis. J Prosthet Dent 2020; 127:408-417. [PMID: 33358610 DOI: 10.1016/j.prosdent.2020.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM How the performance of dental implants is related to their occlusogingival placement, crestal or subcrestal, is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate marginal bone loss, implant survival rate, and peri-implant soft tissue parameters between implants placed at the crestal and subcrestal bone level. MATERIAL AND METHODS Two independent reviewers searched the PubMed/MEDLINE, Embase, and Cochrane Library databases for randomized clinical trials published up to September 2020. The meta-analysis was based on the Mantel-Haenszel and the inverse variance methods (α=.05). RESULTS The search identified 928 references, and 10 studies met the eligibility criteria. A total of 393 participants received 709 implants, 351 at crestal bone levels and 358 at subcrestal bone levels. Meta-analysis indicated that crestal bone level implants showed similar marginal bone loss to that seen with subcrestal bone level implants (mm) (P=.79), independent of the subcrestal level (P=.05) and healing protocol (P=.24). The bone level implant placement did not affect the implant survival rate (P=.76), keratinized tissue (mm) (P=.91), probing depth (mm) (P=.70), or plaque index (%) (P=.92). CONCLUSIONS The evidence suggests that both approaches of implant placement are clinically acceptable in terms of peri-implant tissue parameters and implant-supported restoration survival.
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Affiliation(s)
- Ronaldo Silva Cruz
- Researcher, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil.
| | - Cleidiel Aparecido Araújo Lemos
- Adjunct Professor, Department of Dentistry (Division of Prosthodontics), Federal University of Juiz de Fora, Campus Avançado Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil
| | - Jéssica Marcela de Luna Gomes
- PhD student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Hiskell Francine Fernandes E Oliveira
- PhD student, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil; PhD candidate, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Eduardo Piza Pellizzer
- Titular Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
| | - Fellippo Ramos Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Araçatuba Dental School (UNESP), Univ Estadual Paulista, Araçatuba, Brazil
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12
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Montemezzi P, Ferrini F, Pantaleo G, Gherlone E, Capparè P. Dental Implants with Different Neck Design: A Prospective Clinical Comparative Study with 2-Year Follow-Up. MATERIALS 2020; 13:ma13051029. [PMID: 32106401 PMCID: PMC7084739 DOI: 10.3390/ma13051029] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Abstract
The present study was conducted to investigate whether a different implant neck design could affect survival rate and peri-implant tissue health in a cohort of disease-free partially edentulous patients in the molar–premolar region. The investigation was conducted on 122 dental implants inserted in 97 patients divided into two groups: Group A (rough wide-neck implants) vs. Group B (rough reduced-neck implants). All patients were monitored through clinical and radiological checkups. Survival rate, probing depth, and marginal bone loss were assessed at 12- and 24-month follow-ups. Patients assigned to Group A received 59 implants, while patients assigned to Group B 63. Dental implants were placed by following a delayed loading protocol, and cemented metal–ceramic crowns were delivered to the patients. The survival rates for both Group A and B were acceptable and similar at the two-year follow-up (96.61% vs. 95.82%). Probing depth and marginal bone loss tended to increase over time (follow-up: t1 = 12 vs. t2 = 24 months) in both groups of patients. Probing depth (p = 0.015) and bone loss (p = 0.001) were significantly lower in Group A (3.01 vs. 3.23 mm and 0.92 vs. 1.06 mm; Group A vs. Group B). Within the limitations of the present study, patients with rough wide-neck implants showed less marginal bone loss and minor probing depth, as compared to rough reduced-neck implants placed in the molar–premolar region. These results might be further replicated through longer-term trials, as well as comparisons between more collar configurations (e.g., straight vs. reduced vs. wide collars).
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Affiliation(s)
- Pietro Montemezzi
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.F.); (E.G.); (P.C.)
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Correspondence:
| | - Francesco Ferrini
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.F.); (E.G.); (P.C.)
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Giuseppe Pantaleo
- UniSR-Social.Lab (Research Methods), Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Enrico Gherlone
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.F.); (E.G.); (P.C.)
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Paolo Capparè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.F.); (E.G.); (P.C.)
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
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13
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The Effect of One-Abutment at One-Time on Marginal Bone Loss Around Implants Placed in Healed Bone: A Systematic Review of Human Studies. IMPLANT DENT 2019; 28:603-612. [PMID: 31373902 DOI: 10.1097/id.0000000000000931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The primary aim of the present article was to review the effect and the clinical significance of abutment dis- and reconnection on the peri-implant marginal bone levels. MATERIALS AND METHODS English articles published from 2009 to April 2019 were identified on the MEDLINE, Cochrane Library, and PubMed databases, according to the PRISMA guidelines. Comparative in vivo studies on humans were included. RESULTS A total of 4 studies with different levels of bias were included in this review. A significant heterogeneity of the reported data was observed, which limited the comparison of the findings. The only parameter that was homogenous throughout all 4 studies was the marginal bone level measurement. CONCLUSION Within the limitations of the present review, it can be suggested that minimizing the number of abutment dis- and reconnections would be beneficial to ensure minimal disruption to the peri-implant tissue and marginal bone level. However, the clinical significance of the marginal bone level changes is still inconclusive.
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Dávila E, Ortiz-Hernández M, Perez RA, Herrero-Climent M, Cerrolaza M, Gil FJ. Crestal module design optimization of dental implants: finite element analysis and in vivo studies. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:90. [PMID: 31346767 DOI: 10.1007/s10856-019-6291-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/14/2019] [Indexed: 06/10/2023]
Abstract
The aim of this study was to evaluate the biomechanical behavior of Bone Level dental implants with four different neck designs in contact with cortical bone. Numerical simulations were performed using a Finite Element Method (FEM) based-model. In order to verify the FEM model, the in silico results were compared with the results obtained from histological analysis performed in an in vivo study with New Zealand rabbits. FEM was performed using a computerized 3D model of Bone Level dental implants inserted in the lower jaw bone with an applied axial load of 100 N. The analysis was performed using four different implant neck designs: even surfaced, screwed, three-ring design and four-ring design. Interface are of bone growth was evaluated by analyzing the Bone-Implant-Contact (BIC) parameter obtained from in vivo histological process and analyzed by Scanning Electron Microscopy (SEM). Bone Level implants were inserted in the rabbit tibia, placing two implants per tibia. The BIC was evaluated after three and six weeks of implantation. FEM studies showed that the three-ring design presented lower values of stress distribution compared to the other studied designs. The lower levels of mechanical stress were then correlated with the in vivo studies, showing that the three-ring design presented the highest BIC value after 3 and 6 weeks of implantation. In silico and in vivo results both concluded that the implants with three-ring neck design presented the best biomechanical and histological behavior in terms of new bone formation, enhanced mechanical stability and optimum osseointegration.
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Affiliation(s)
- E Dávila
- National Institute of Bioengineering (INABIO), Universidad Central de Venezuela, c/ Miguel Otero Silva s/n, Caracas, Venezuela
| | - M Ortiz-Hernández
- Department of Materials Science and Metallurgy, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10-14, 08019, Barcelona, Spain
| | - R A Perez
- Bioengineering Institute of Technology, School of Dentistry, Universitat Internacional de Catalunya, Inmaculada 22, 08017, Barcelona, Spain
| | | | - M Cerrolaza
- CIMNE, Universitat Politècnica de Catalunya, c/Gran Capita s/n, 08034, Barcelona, Spain
| | - F J Gil
- Bioengineering Institute of Technology, School of Dentistry, Universitat Internacional de Catalunya, Inmaculada 22, 08017, Barcelona, Spain.
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Durkan R, Oyar P, DESTE G. The Impact of Platform-Switched Implants on the Marginal Bone Level and Soft Tissue Dimensions. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.505807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Makowiecki A, Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. An evaluation of superhydrophilic surfaces of dental implants - a systematic review and meta-analysis. BMC Oral Health 2019; 19:79. [PMID: 31077190 PMCID: PMC6509828 DOI: 10.1186/s12903-019-0767-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/15/2019] [Indexed: 01/07/2023] Open
Abstract
Background The characteristics of a dental implant surface have a decisive influence on the process of osseointegration. According to the current state of knowledge, surface modification can not only affect the morphology of cells, and in this way have a positive impact on osseointegration. Methods The objective of this study was to compare survival rates and marginal bone loss as well as assess the degree of stability of Straumann SLAactive® and Thomenn Incell® implants with a superhydrophilic surface. Authors present review of data published between 01.01.2008 and 12.31.2016 that was found in PubMed/MEDLINE internet database, An Internet search of databases produced a total of 1230 studies, 20 publications were finally selected for the present study based on the established selection and exclusion criteria. Results The statistical analysis was performed. A Cumulative Implant Survival Rate (CSR%) was 98.5%, Marginal bone loss (MBL) after 6 months was M = 0.60 mm and 0.6 5 mm after 12 months and secondary stability in a group Thommen implants M = 71.3 ISQ and M = 75.2 ISQ in group of Straumann. Conclusion Despite certain differences in the values of the studied parameters, both of the systems, i.e. Thommen Inicell and Straumann SLActive, demonstrated a high survival rate, a high level of implant stability and low marginal bone loss.
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Affiliation(s)
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland. .,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland.
| | - Artur Błaszczyszyn
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Tomasz Gedrange
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Orthodontics, Carl Gustav Carus Campus, Technische Universität Dresden, Germany, Fetscherstr. 74, 01307, Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
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17
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Kofron MD, Carstens M, Fu C, Wen HB. In vitro assessment of connection strength and stability of internal implant-abutment connections. Clin Biomech (Bristol, Avon) 2019; 65:92-99. [PMID: 31005695 DOI: 10.1016/j.clinbiomech.2019.03.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/01/2019] [Accepted: 03/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Various connections have been machined to improve the fit between the dental abutment and implant. In vivo, the instability created by imprecisely fitting components can cause soft tissue irritation and bacterial colonization of the implant system. The aim of this study was to quantify abutment stability under in vitro force applications. METHODS Abutment stability and fit were quantitatively measured after application of rotational, vertical, and horizontal forces. FINDINGS The abutment connection held by friction (Friction-Fit) was the only group to have 0° angular rotation. A significantly greater vertical force was required to pull the abutment from the implant for the Friction-Fit connection as compared to all other experimental groups. The abutment connection held by a mechanically locking friction-fit with four grooves (CrossFit) and Friction-Fit demonstrated significantly lower lateral movement as compared to all other connections. The remaining connections evaluated included two hexagon connections that rely on screw placement for abutment fit (Conical + Hex #1 and Conical + Hex #2), one connection with protruding slots to align with recessed channels inside the implant (Conical + 6 Indexing Slots), and an internal connection that allows for abutment indexing every 120° (Internal Tri-Channel). INTERPRETATION Internal connection geometry influenced the degree of abutment movement. Friction-Fit and CrossFit connections exhibited the lowest rotational and horizontal motions. Significant differences were found between Friction-Fit and CrossFit following the application of a vertical force, with the Friction-Fit requiring a significantly greater pull force to separate the abutment from the implant.
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Affiliation(s)
- Michelle D Kofron
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States.
| | - Matthew Carstens
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
| | - Cong Fu
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
| | - Hai Bo Wen
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
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18
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Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: A systematic review. Ann Afr Med 2019; 18:1-6. [PMID: 30729925 PMCID: PMC6380118 DOI: 10.4103/aam.aam_15_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss around the implants determines the success rate of treatment. Platform switching (PLS) concept preserves the crestal bone loss, and this approach should be applied clinically for the overall success of dental implants. Purpose: The purpose of this study is to discuss the literature dealing with the concept of PLS concept and preservation of marginal bone, the mechanism by which it contributes to maintenance of marginal bone, its clinical applications, advantages, and disadvantages, to assess its survival rates. Materials and Methods: PubMed and Google Scholar search was done to find out the studies involving PLS concept from 2005 to 2017. Data were analyzed using SPSS statistical software. Results: Literature search revealed studies involving concepts of PLS, comparison of platform-switched and nonplatform-switched implants, case reports on PLS, and studies with histological and finite element analyses regarding PLS. Conclusion: PLS helps preserve crestal bone around the implants, and this concept should be followed when clinical situations in implant placement permit.
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Affiliation(s)
- Shivangi Gupta
- Department of Periodontology and Implantology, MMCDSR, Mullana, Ambala, Haryana, India
| | - Robin Sabharwal
- Department of Oral Pathology and Microbiology, MMCDSR, Mullana, Ambala, Haryana, India
| | - Jazib Nazeer
- Department of Oral Pathology and Microbiology, Patna Dental college and Hospital, Patna, India
| | - Lavina Taneja
- Department of Oral Medicine and Radiology, SGT Dental College and Research Institute, Gurugram, Haryana, India
| | | | - Sudipta Sahu
- Department of Public Health Dentistry, IDS, Sum hospital, Bhubaneswar, India
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