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Bagnasco F, Pesce P, Baldi D, Motta F, Pera F, De Angelis N, Menini M. Dental Implants with External Hex Inclined Shoulder in Full-Arch Immediate Loading Rehabilitations of the Maxilla. Dent J (Basel) 2024; 12:131. [PMID: 38786529 PMCID: PMC11119815 DOI: 10.3390/dj12050131] [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: 01/28/2024] [Revised: 04/15/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Background: Coaxial implants with an inclined neck might overcome some problems related to angulation of the implant axis when using tilted implants. Therefore, the aim of the present work was to conduct a narrative review of the current literature and to present a case series comparing traditional and coaxial external hex implants in full-arch immediate loading rehabilitations of the maxilla. Methods: A total of 13 external hex tapered implants (Southern Implants) was inserted in the upper jaw of 3 patients. Each patient received two tilted implants in distal sites. In one randomly selected quadrant, the tilted implant was a standard implant, while a Co-Axis® implant with a 24° inclination of the implant shoulder was inserted on the other hemi-arch. Straight conical abutments were screwed on coaxial implants while multiunit abutments of appropriate inclination were screwed as needed on the other implants to correct their axes. Peri-implant bone level was recorded radiographically at T0 (delivery of the immediate loading prosthesis), and at 3, 6, 12, and 24 months of healing and then annually. Plaque index, probing depth, and bleeding on probing were also evaluated. Cumulative implant survival rate (CSR) was calculated, and biological or technical complications were recorded as well as the operator satisfaction towards the use of coaxial implants. Results: The preliminary data collected did not show significant differences in peri-implant tissues health and maintenance over time between the two implant types. No implants failed, and both implant types proved to be favorable for full-arch rehabilitation using tilted implants. Coaxial implants facilitated the prosthodontic procedures. However, a learning curve is required in order to optimize their insertion. Conclusions: Both implants proved to be reliable and suitable for achieving clinical success in full-arch immediate loading rehabilitations, but further research with longer follow-up and larger sample size is needed to confirm these preliminary outcomes.
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Affiliation(s)
- Francesco Bagnasco
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
| | - Domenico Baldi
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
| | | | - Francesco Pera
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
| | - Nicola De Angelis
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
| | - Maria Menini
- Department of Surgical Sciences (DISC), Dental School, University of Genoa, 16126 Genova, Italy; (F.B.); (P.P.); (D.B.); (F.P.); (M.M.)
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Jacob RGM, Ervolino da Silva AC, Chaushu L, Lang NP, Borges Duailibe de Deus C, Botticelli D, Rangel Garcia Júnior I. Evaluation of Two Configurations of Hydroxyapatite and Beta-Tricalcium Phosphate in Sinus Grafts with Simultaneous Implant Installation: An Experimental Study in Rabbits. Dent J (Basel) 2023; 11:121. [PMID: 37232771 PMCID: PMC10217008 DOI: 10.3390/dj11050121] [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: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND This study aimed to evaluate peri-implant bone formation in rabbits after sinus grafting mediated by hydroxyapatite and beta-tricalcium phosphate (HA + β-TCP) in granule or paste configurations, concomitant with immediate implant installation. MATERIAL & METHODS Thirty-four rabbit maxillary sinuses were grafted with HA + β-TCP, half of which were applied in a granule and half in a paste composition. Implant placement was performed simultaneously. At 7 and 40 days postoperatively, the animals were euthanized, and samples were prepared for tomographic, microtomographic, histological, histometric (hematoxylin and eosin staining, HE), and immunohistochemical (labeling of transcription factor Runx-2 [RUNX2], vascular endothelial growth factor [VEGF], osteocalcin [OCN], and tartrate-resistant acid phosphatase [TRAP]) analysis. Implant removal torque was also measured. RESULTS On tomography, maintenance of sinus membrane integrity was observed in both the groups. Higher values of morphometric parameters evaluated by micro-CT were found in the "paste group" after seven days. At 40 days, there were no significant differences between the groups in most of the microtomographic parameters evaluated. In histological sections stained with HE, a higher percentage of newly formed bone was observed in the "granule group" after 40 days. Similar positive immunolabeling was observed for both RUNX2 and OCN in both the experimental groups. TRAP immunolabeling was similar in both groups as well. VEGF labeling increased in the "granule group", indicating a higher osteoconductive potential in this biomaterial. Similar removal torque values were observed in both groups. Thus, the two HA + β-TCP configurations showed similar healing patterns of simultaneously installed implants adjacent to sinus floor elevation. However, significantly higher bone values were observed for the "granule configuration". CONCLUSIONS The HA + β-TCP granules and paste presentations showed favorable long-term healing results, with bone formation in similar quantities and quality adjacent to the implants.
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Affiliation(s)
- Ricardo Garcia Mureb Jacob
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | - Ana Cláudia Ervolino da Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
| | - Liat Chaushu
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dentistry, Tel Aviv University, Tel Aviv 69978, Israel;
| | - Niklaus Peter Lang
- School of Dental Medicine, University of Berne, CH-3010 Berne, Switzerland
| | - Ciro Borges Duailibe de Deus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil
| | | | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba 16015-050, SP, Brazil; (R.G.M.J.); (A.C.E.d.S.); (C.B.D.d.D.); (I.R.G.J.)
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