1
|
Naumann M, Scholz P, Krois J, Schwendicke F, Sterzenbach G, Happe A. Monolithic hybrid abutment crowns (screw-retained) versus monolithic hybrid abutments with adhesively cemented monolithic crowns. Clin Oral Implants Res 2023; 34:209-220. [PMID: 36692161 DOI: 10.1111/clr.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The objective of this study is to compare monolithic hybrid abutment crowns (screw-retained) versus monolithic hybrid abutments with adhesively cemented monolithic single-tooth crowns. MATERIALS AND METHODS Twenty subjects in need of an implant-borne restoration were randomly assigned to receive either a cement-retained (CRR) or a screw-retained (SRR) implant-supported monolithic lithium disilicate (LS2 ) reconstruction. Each patient received a titanium implant with in internal conic connection. After osseointegration and second-stage surgery, healing abutments were placed for about 10 days. The type of restoration (CRR vs. SRR) was randomly assigned, and the restorations were manufactured of monolithic LS2 . Both types of restorations, CRR and SRR, were based on a titanium component (Ti-base) that was bonded to the abutment (CRR) or the crown (SRR). The follow-up period for all restoration was 36 months. Clinical outcome was evaluated according to Functional Implant Prosthetic Score (FIPS). Quality of live (OHIP) and patient's satisfaction were assessed using patient-reported outcome measures (PROMs). Primary endpoint was loss of restoration for any reason. Kaplan-Meier curves were constructed and log-rank testing was performed (p < .05). RESULTS One restoration of group CRR failed after 6 months due to loss of adhesion between Ti-base and individual abutment. No further biological or technical failures occurred. Kaplan-Meier analysis showed no significant difference between both treatment options (p = .317). There was no statistically significant difference between both types of restoration, neither for FIPS, OHIP, treatment time nor patient satisfaction (p > .05). CONCLUSION Monolithic hybrid abutment crowns (screw-retained) and monolithic hybrid abutment with adhesively cemented monolithic crowns using lithium disilicate showed no statistically significant difference for implant-based reconstructions in this pilot RCT setting.
Collapse
Affiliation(s)
- Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Patricia Scholz
- Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Ulm, Ulm, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Arndt Happe
- Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Ulm, Ulm, Germany
| |
Collapse
|
2
|
Cicero E, El Rafie K, De Souza A, Kawabe Y, Kang K, Att W. Optimizing the esthetic outcome by using screw-retained implant abutment crowns: A 3-year clinical follow-up. J Prosthet Dent 2021; 126:608-15. [PMID: 33160619 DOI: 10.1016/j.prosdent.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/21/2022]
Abstract
This clinical report describes a ceramic complete-mouth rehabilitation with screw-retained implant abutment crowns, optimizing esthetics by combining the properties of ceramic materials. The abutments connected a titanium insert to a computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic zirconia framework, offering improved esthetics and biologic response without negatively affecting the implant abutment interface. Lithium disilicate crowns were cemented extraorally on the abutments, resulting in a screw-retained restoration.
Collapse
|
3
|
Serichetaphongse P, Chengprapakorn W, Thongmeearkom S, Pimkhaokham A. Immunohistochemical assessment of the peri-implant soft tissue around different abutment materials: A human study. Clin Implant Dent Relat Res 2020; 22:638-646. [PMID: 32902102 DOI: 10.1111/cid.12942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Soft tissue reaction to dental implant abutments influences the sustainability of restoration. Several abutment materials, such as titanium and gold alloy, have been introduced for strength and esthetic solutions. Zirconia and titanium-base abutments have also become popular in recent years due to high esthetic demands. PURPOSE To investigate the immune cell infiltration into the soft tissue in response to different abutment materials. MATERIALS AND METHODS Twenty dental implants were placed in the posterior regions of 17 patients. Titanium, zirconia, gold alloy, and titanium-base were randomly selected for each patient on the day of surgery. After 8 weeks of healing, the abutments were removed along with 1 mm of peri-implant soft tissue. Immunohistochemical assessment was performed using labeled streptavidin-biotin to identify T cells, B cells, macrophages, plasma cells, and microvascular infiltration. RESULTS Gold alloy demonstrated an overall higher inflammatory cell infiltration and highest number of CD3+ , CD20+ , and CD 68+ cells (P value <.05). The number of plasma cell and new microvascular infiltrations among abutment materials was not significantly different. CONCLUSION Titanium, titanium-base, and zirconia abutments showed comparable infiltration profiles; gold alloy abutments showed the highest B-cell, T cell, and macrophage infiltration. None of the abutment materials caused clinical inflammation; hence, they can be effectively used.
Collapse
Affiliation(s)
- Pravej Serichetaphongse
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wareeratn Chengprapakorn
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sirikarn Thongmeearkom
- Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Esthetics Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
4
|
Abt E, Carr AB, Worthington HV. WITHDRAWN: Interventions for replacing missing teeth: partially absent dentition. Cochrane Database Syst Rev 2019; 7:CD003814. [PMID: 31425605 PMCID: PMC6699666 DOI: 10.1002/14651858.cd003814.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients. OBJECTIVES To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review. DATA COLLECTION AND ANALYSIS Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data. MAIN RESULTS Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs. AUTHORS' CONCLUSIONS Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.
Collapse
Affiliation(s)
- Elliot Abt
- Illinois Masonic Medical CenterDepartment of Dentistry811 W WellingtonChicagoILUSA60657
| | - Alan B Carr
- Mayo ClinicDepartment of Dental Specialities200 First Street SWRochesterUSAMN 55905
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | | |
Collapse
|
5
|
Schoenbaum TR, Solnit GS, Alawie S, Sadowsky SJ. Treatment of peri-implant recession with a screw-retained, interim implant restoration: A clinical report. J Prosthet Dent 2019; 121:212-216. [DOI: 10.1016/j.prosdent.2018.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/23/2018] [Accepted: 03/26/2018] [Indexed: 10/28/2022]
|
6
|
Jain JK, Sethuraman R, Chauhan S, Javiya P, Srivastava S, Patel R, Bhalani B. Retention failures in cement- and screw-retained fixed restorations on dental implants in partially edentulous arches: A systematic review with meta-analysis. J Indian Prosthodont Soc 2018; 18:201-211. [PMID: 30111908 PMCID: PMC6070851 DOI: 10.4103/jips.jips_25_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 06/01/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE This systematic review aimed to evaluate retention failures in cement- and screw-retained fixed restorations on dental implants in partially edentulous arches. METHODS The relevant articles were retrieved from MEDLINE (PubMed), Cochrane Library, and EBSCO electronic databases for articles published from January 1995 to January 2016 and were restricted to randomized controlled trials and retrospective and prospective studies on human subjects that were reported in English. A further hand search was conducted on individual journals and reference list of the articles found. Reviewed studies which reported retention failures in fixed implant-supported prostheses using screw and cement retention mechanism. Information on the type and nature of restoration, as well as different luting cement, were also collected. RESULTS Thirty-three articles were finalized, 20 short-term clinical studies (up to 5 years) and 13 long-term studies (≥5 years). Out of 33 studies, 16 studies were included in meta-analysis, 8 in short-term and 8 in long-term studies. The results of the meta-analysis for short-term studies showed statistically significant difference between cement-retained and screw-retained prosthesis, with the forest plot favoring cement-retained prostheses (risk ratio [RR]: 0.26; confidence interval [CI]: 0.09-0.74; P < 0.0001; I2 = 79%). In long-term studies, the forest plot revealed statistically significant difference between both retention systems favoring cement-retained prostheses (RR: 0.31; CI: 0.13-0.76; P = 0.03; I2 = 56%). CONCLUSION Analysis of the short- and long-term studies shows lesser retention failures with cement-retained prostheses when compared to screw-retained prostheses. Further, multicentric, high-quality randomized controlled studies with long-term observations and modified cementation protocols can yield higher grades of recommendation to avoid retention failures.
Collapse
Affiliation(s)
- Jatin K. Jain
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Rajesh Sethuraman
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Sameer Chauhan
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Piyush Javiya
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Shreya Srivastava
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Rutvik Patel
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | | |
Collapse
|
7
|
Sanz-Sánchez I, Sanz-Martín I, Carrillo de Albornoz A, Figuero E, Sanz M. Biological effect of the abutment material on the stability of peri-implant marginal bone levels: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29 Suppl 18:124-144. [DOI: 10.1111/clr.13293] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | | | | | - Elena Figuero
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Mariano Sanz
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| |
Collapse
|
8
|
ElHoussiney AG, Zhang H, Song J, Ji P, Wang L, Yang S. Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis. Clin Cosmet Investig Dent 2018. [PMID: 29520162 PMCID: PMC5834166 DOI: 10.2147/ccide.s143910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication.
Collapse
Affiliation(s)
| | - He Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Lu Wang
- Department of Prosthodontics
| | | |
Collapse
|
9
|
Abstract
The integrity of the peri-implant soft-tissue seal is crucial for maintaining peri-implant tissue health. Whilst the transmucosal component of the restored implant shares some common features with teeth, namely the presence of a junctional epithelium and a connective tissue component, there are some important differences. A key difference is the nature of the relationship of the connective tissue with the implant surface, whereby there is 'adaptation' of collagen fibers in a parallel orientation in relation to the implant, but insertion of fiber attachment perpendicularly into cementum in the case of teeth. This, combined with reduced cellularity and vascularity in the peri-implant connective tissue, may make implants more susceptible to disease initiation and progression. Furthermore, the presence of a subgingival connection between the implant and the abutment/restoration poses some specific challenges, and maintaining the integrity of this connection is important in preserving peri-implant tissue health. Implant design features, such as the nature of the connection between the implant and the abutment, as well as the surface characteristics of the abutment and implants, may influence the maintenance of the integrity of soft tissue around implants. Iatrogenic factors, such as incorrect seating of the abutment and/or the restoration, and the presence of residual subgingival cement, will lead to loss of soft-tissue integrity and hence predispose to peri-implant disease.
Collapse
|
10
|
Sampatanukul T, Serichetaphongse P, Pimkhaokham A. Histological evaluations and inflammatory responses of different dental implant abutment materials: A human histology pilot study. Clin Implant Dent Relat Res 2017; 20:160-169. [PMID: 29181880 DOI: 10.1111/cid.12562] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Improvements of soft tissue to the abutment surface results in more stable peri-implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials. PURPOSE To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period. MATERIALS AND METHODS Fifteen edentulous sites were treated with implants. Eight weeks later, peri-implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups. RESULTS There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group. CONCLUSIONS The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments.
Collapse
Affiliation(s)
| | - Pravej Serichetaphongse
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
11
|
Van Weehaeghe M, De Bruyn H, Vandeweghe S. A prospective, split-mouth study comparing tilted implants with angulated connection versus conventional implants with angulated abutment. Clin Implant Dent Relat Res 2017; 19:989-996. [DOI: 10.1111/cid.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/06/2017] [Accepted: 08/21/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Manú Van Weehaeghe
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - Hugo De Bruyn
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - Stefan Vandeweghe
- Department of Periodontology, Oral Implantology, Removable and Implant Prosthetics, Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| |
Collapse
|
12
|
Abdallah MN, Badran Z, Ciobanu O, Hamdan N, Tamimi F. Strategies for Optimizing the Soft Tissue Seal around Osseointegrated Implants. Adv Healthc Mater 2017; 6. [PMID: 28960892 DOI: 10.1002/adhm.201700549] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/12/2017] [Indexed: 12/20/2022]
Abstract
Percutaneous and permucosal devices such as catheters, infusion pumps, orthopedic, and dental implants are commonly used in medical treatments. However, these useful devices breach the soft tissue barrier that protects the body from the outer environment, and thus increase bacterial infections resulting in morbidity and mortality. Such associated infections can be prevented if these devices are effectively integrated with the surrounding soft tissue, and thus creating a strong seal from the surrounding environment. However, so far, there are no percutaneous/permucosal medical devices able to prevent infection by achieving strong integration at the soft tissue-device interface. This review gives an insight into the current status of research into soft tissue-implant interface and the challenges associated with these interfaces. Biological soft/hard tissue interfaces may provide insights toward engineering better soft tissue interfaces around percutaneous devices. In this review, focus is put on the history and current findings as well as recent progress of the strategies aiming to develop a strong soft tissue seal around osseointegrated implants, such as orthopedic and dental implants.
Collapse
Affiliation(s)
- Mohamed-Nur Abdallah
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Division of Orthodontics; Faculty of Dentistry; Toronto University; Toronto M5G 1G6 ON Canada
| | - Zahi Badran
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Department of Periodontology (CHU/Rmes Inserm U1229/UIC11); Faculty of Dental Surgery; University of Nantes; Nantes 44042 France
| | - Ovidiu Ciobanu
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
| | - Nader Hamdan
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax B3H 4R2 NS Canada
| | - Faleh Tamimi
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
| |
Collapse
|
13
|
Wittneben JG, Joda T, Weber HP, Brägger U. Screw retained vs. cement retained implant-supported fixed dental prosthesis. Periodontol 2000 2016; 73:141-151. [DOI: 10.1111/prd.12168] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
14
|
Canullo L, Dehner JF, Penarrocha D, Checchi V, Mazzoni A, Breschi L. Soft Tissue Response to Titanium Abutments with Different Surface Treatment: Preliminary Histologic Report of a Randomized Controlled Trial. Biomed Res Int 2016; 2016:2952530. [PMID: 27366741 DOI: 10.1155/2016/2952530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/01/2016] [Accepted: 05/11/2016] [Indexed: 01/28/2023]
Abstract
The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups.
Collapse
|
15
|
Lemos CAA, de Souza Batista VE, Almeida DADF, Santiago Júnior JF, Verri FR, Pellizzer EP. Evaluation of cement-retained versus screw-retained implant-supported restorations for marginal bone loss: A systematic review and meta-analysis. J Prosthet Dent 2015; 115:419-27. [PMID: 26589441 DOI: 10.1016/j.prosdent.2015.08.026] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM No consensus has been reached on which retention system, cement- or screw-retained, is best to avoid bone loss around the implant of a fixed implant-supported restoration. PURPOSE The purpose of this systematic review and meta-analysis was to compare cement- and screw-retained retention systems in fixed implant-supported restorations in terms of marginal bone loss, implant survival, and prosthetic complications. MATERIAL AND METHODS A comprehensive search of studies published from January 1995 to March 2015 and listed in the PubMed/MEDLINE, Embase, Scopus and the Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The meta-analysis was based on the Mantel-Haenszel and inverse variance methods. Marginal bone loss was the continuous outcome measure evaluated by mean difference (MD), and implant survival and prosthetic complications were the dichotomous outcome measures evaluated by risk ratio (RR), both with corresponding 95% confidence intervals (CI). RESULTS The 20 studies selected for review evaluated 2139 participants, whose mean age was 47.14 years and who had received 8989 dental implants. The mean follow-up was 65.4 months (range: 12-180 months). Results of the MD for marginal bone loss showed statistically significant differences in favor of the cement-retained prosthesis (P =.04; MD: -0.19; CI: -0.37 to -0.01). The implant survival rate was higher for the cement-retained prosthesis (P =.01; RR: 0.49; CI: 0.28 to 0.85), and the prosthetic complication rate was higher for the screw-retained prosthesis (P =.04; RR: 0.52; CI: 0.28 to 0.98). Additional analysis of the mean plaque index did not show differences between retention systems (P=.58; MD: 0.13; CI: -0.32 to 0.57). CONCLUSIONS The current meta-analysis indicated that cement-retained, fixed implant-supported restorations showed less marginal bone loss than screw-retained, fixed implant-supported restorations during the follow-up period, which ranged from 12 to 180 months. However, the small difference between the mean values may not show clinical significance. The rates of prosthetic complication and implant survival also compared favorably with cement-retained prostheses.
Collapse
Affiliation(s)
| | | | | | | | - Fellippo Ramos Verri
- Assistant Professor, Aracatuba Dental School, São Paulo State University, São Paulo, Brazil
| | | |
Collapse
|
16
|
Kuhn K, Rudolph H, Graf M, Moldan M, Zhou S, Udart M, Böhmler A, Luthardt RG. Interaction of titanium, zirconia and lithium disilicate with peri-implant soft tissue: study protocol for a randomized controlled trial. Trials 2015; 16:467. [PMID: 26470711 PMCID: PMC4608119 DOI: 10.1186/s13063-015-0979-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 09/28/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Against the background of increasing use of dental implants, and thus an increasing prevalence of implant-associated complications, a deeper understanding of the biomolecular mechanisms in the peri-implant tissue is needed. Peri-implant soft tissue is in direct contact with transmucosal dental implant abutments. The aim of this trial is to distinguish the biomolecular and histological interactions of various dental abutment materials with peri-implant soft tissue. METHODS/DESIGN The study is designed as a prospective, randomized, investigator-initiated clinical pilot trial with blinded assessment. We will ultimately include 24 eligible patients who opt for implant treatment to replace a single missing posterior tooth. Three months after implantation (submerged procedure), the study begins with the second-stage surgery. Each of the 24 patients will be given three different transmucosal abutments (zirconia, lithium disilicate, titanium) consecutively. The sequence in which the three materials are used is randomized. Peri-implant crevicular fluid is sampled weekly around the respective abutment for biomolecular analyses. After one month of wearing time, the stamping press from the second-stage surgery is used to gain a narrow gingival ring biopsy around the abutment for immunohistochemical analyses. The next abutment is then inserted. The same procedure is used for all three abutments. After sampling is completed, the patients will receive a definitive crown. The primary outcome measure of the trial is biomolecular detection of specific markers in the peri-implant crevicular fluid: matrix metalloproteinase 8, interleukin- 1β, polymorphonuclear elastase, and myeloid-related protein MRP8/14 (calprotectin). Secondary outcome measures include immunohistochemical analyses and clinical parameters. DISCUSSION The study design will allow us to perform correlation analyses between the clinical indices with biomarkers' expression in the interface of the transmucosal abutments and the peri-implant soft tissue. A deeper understanding of the three abutment materials' interactions with peri-implant soft tissue will help us understand the formation mechanisms of implant-associated complications and then develop prevention strategies. TRIAL REGISTRATION The trial is registered at the German Clinical Trial Register and the International Clinical Trials Registry Platform by the WHO under DRKS00006555 (Registered on 27 October 2014).
Collapse
Affiliation(s)
- Katharina Kuhn
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Michael Graf
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Matthias Moldan
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| | - Shaoxia Zhou
- Department of Clinical Chemistry, Ulm University, Ulm, Germany.
| | - Martin Udart
- Institut für Lasertechnologien in der Medizin und Messtechnik, Ulm University, Ulm, Germany.
| | - Andrea Böhmler
- Institut für Lasertechnologien in der Medizin und Messtechnik, Ulm University, Ulm, Germany.
| | - Ralph G Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, Ulm University, Ulm, Germany.
| |
Collapse
|
17
|
Collins JR, Berg RW, Rodríguez M, Rodríguez I, Coelho PG, Tovar N. Evaluation of human periimplant soft tissues around nonsubmerged machined standard and platform-switched abutments. IMPLANT DENT 2015; 24:57-61. [PMID: 25621550 DOI: 10.1097/ID.0000000000000209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study evaluated the effect of the platform-switching phenomenon, the use of a smaller diameter abutment on a larger diameter implant platform. Clinical and histological outcomes of the periimplant mucosa around titanium abutments in a nonsubmerged implant were evaluated. MATERIALS AND METHODS Ten healthy adult patients, ranging from 27 to 65 years, participated in the study. A minimum of 2 endosseous implants with immediate abutment connection was placed per patient, 1 conventional and 1 platform-switched abutment. All sites for implant placement had an adequate zone of keratinized mucosa before surgical intervention. RESULTS No clinical signs of inflammation were observed in the periimplant soft tissue mucosa, and healing was uneventful throughout the study period. Histological findings showed abnormally thick stratified squamous epithelium for both groups with few inflammatory cells in the connective tissue and none on the surface of the epithelium. CONCLUSION Histological findings for both conventional and platform-switched implant-abutment configurations showed a similar composition of the soft tissue. These findings were in direct agreement with previous studies.
Collapse
|
18
|
Iglhaut G, Schwarz F, Winter RR, Mihatovic I, Stimmelmayr M, Schliephake H. Epithelial Attachment and Downgrowth on Dental Implant Abutments-A Comprehensive Review. J ESTHET RESTOR DENT 2014; 26:324-31. [DOI: 10.1111/jerd.12097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gerhard Iglhaut
- Oral Surgery Office; Bahnhofstrasse 20 87700 Memmingen Germany
| | - Frank Schwarz
- Department of Oral Surgery; Heinrich-Heine University; Moorenstrasse 5 40225 Düsseldorf Germany
| | | | - Ilja Mihatovic
- Department of Oral Surgery; Heinrich-Heine University; Moorenstrasse 5 40225 Düsseldorf Germany
| | | | - Henning Schliephake
- Department of Oral and Maxillofacial Surgery; George-Augusta-University Göttingen; Robert-Koch-Strasse 40 37075 Göttingen Germany
| |
Collapse
|
19
|
Abstract
Implant-supported dental restorations can be screw-retained, cement-retained, or a combination of both, whereby a metal superstructure is screwed to the implants and crowns are individually cemented to the metal frame. Each treatment modality has advantages and disadvantages. The use of computer-aided design/computer-assisted manufacture technologies for the manufacture of implant superstructures has proved to be advantageous in the quality of materials, precision of the milled superstructures, and passive fit. Maintenance and recall evaluations are an essential component of implant therapy. The longevity of implant restorations is limited by their biological and prosthetic maintenance requirements.
Collapse
Affiliation(s)
- Ghadeer Thalji
- Department of Prosthodontics, The University of Iowa College of Dentistry, 801 Newton Road, Dental Sciences Building S432, Iowa City, IA 55242, USA
| | | | | | | |
Collapse
|
20
|
Abstract
OBJECTIVE The aim of the present systematic review was to determine the peri-implant tissue response to different implant abutment materials and designs available and to assess the impact of tissue biotype. MATERIALS AND METHODS Relevant literature published between December 2009 and August 2012 was searched to identify studies dealing with different implant abutment designs and materials, as well as the response of different tissue biotypes. The search terms used, in simple or multiple conjunctions, were 'implant abutment', 'interface', 'material', 'peri-implant', 'soft tissue' and 'esthetic'. Studies were selected according to pre-determined inclusion and exclusion criteria. RESULTS The initial search yielded 2449 titles. After a subsequent filtering process, 23 studies were finally selected. The included studies revealed different factors responsible for the stability of peri-implant tissue and the esthetic outcome. These factors include tissue biotype and architecture, implant abutment material and implant abutment design. Several designs were suggested to prevent marginal bone loss and soft tissue recession. These included scalloped implants, platform-switched implants and gingivally converged or concave implant abutments. Due to the limited number of studies and the heterogeneity in their designs, it was not possible to perform a statistical analysis of the data. CONCLUSIONS The current literature provides insufficient evidence about the effectiveness of different implant abutment designs and materials in the stability of peri-implant tissues.
Collapse
Affiliation(s)
- Shaza Bishti
- Department of Prosthodontics, School of Dentistry, University Hospital , Freiburg , Germany
| | | | | |
Collapse
|
21
|
Yeo IS, Kim HY, Lim KS, Han JS. Implant surface factors and bacterial adhesion: a review of the literature. Int J Artif Organs 2012; 35:762-72. [PMID: 23138699 DOI: 10.5301/ijao.5000154] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2012] [Indexed: 12/22/2022]
Abstract
The microbiota that forms on implant surfaces placed in the human body can be highly resistant to antimicrobial agents and in some cases cause life-threatening infections. Consequently, to limit bacterial attachment to these surfaces and thereby minimize the risk of implant infection, the process of biofilm formation and bacterial attachment must be well-understood. The oral environment is considered to be an excellent model for research into biofilm formation and implant infection, accounting for many studies carried out in the field of dental medicine. Those studies show that the roughness, free energy, and material characteristics of the implant surface largely determine initial bacterial adhesion. This article reviews the relevant literature on these aspects of biofilm formation.
Collapse
|
22
|
Affiliation(s)
- Avinash S. Bidra
- Post-Graduate Prosthodontics; Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT USA
| | - Patchanee Rungruanganunt
- Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT USA
| |
Collapse
|
23
|
de Brandão ML, Vettore MV, Vidigal Júnior GM. Peri-implant bone loss in cement- and screw-retained prostheses: Systematic review and meta-analysis. J Clin Periodontol 2013; 40:287-95. [DOI: 10.1111/jcpe.12041] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 10/12/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Marcelo L. de Brandão
- Implantology Department; INOVI; Vitória ES Brazil
- Implantology Department; ABO/ES; Vitória ES Brazil
| | - Mario V. Vettore
- Institute of Studies in Public Health; Federal University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - Guaracilei M. Vidigal Júnior
- Department of Oral Implantology; School of Dentistry University of Grande Rio - UNIGRANRIO; Rio de Janeiro RJ Brazil
| |
Collapse
|
24
|
Sailer I, Mühlemann S, Zwahlen M, Hämmerle CHF, Schneider D. Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates. Clin Oral Implants Res 2012; 23 Suppl 6:163-201. [DOI: 10.1111/j.1600-0501.2012.02538.x] [Citation(s) in RCA: 192] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Irena Sailer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Switzerland
| | - Sven Mühlemann
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine; University of Bern; Bern; Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Switzerland
| |
Collapse
|
25
|
Gracis S, Michalakis K, Vigolo P, Vult von Steyern P, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2012; 23 Suppl 6:202-16. [DOI: 10.1111/j.1600-0501.2012.02556.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Gracis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Konstantinos Michalakis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Paolo Vigolo
- Department of Clinical Odontostomatology; University of Padova; Institute of Clinical Dentistry; Padova; Italy
| | | | - Marcel Zwahlen
- Institute of Social and Preventive Medicine; University of Berne; Bern; Switzerland
| | - Irena Sailer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Sciences; Center for Dental Medicine; University of Zurich; Zurich; Switzerland
| |
Collapse
|
26
|
Scala R, Ghensi P, Cucchi A, Pistoia E. Postextraction implant placement with immediate provisionalisation and finalisation, using a simplified technique: technical notes and a case report. Open Dent J 2012; 6:164-9. [PMID: 23091576 PMCID: PMC3474943 DOI: 10.2174/1874210601206010164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 06/14/2012] [Accepted: 07/04/2012] [Indexed: 11/22/2022] Open
Abstract
Trauma of maxillary teeth is a common accident. In most cases, the result is a root or crown fracture requiring tooth extraction and implant placement. Immediate postextraction implants are considered an effective option for restoring missing teeth in order to achieve successful aesthetic and functional outcomes. The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an osseointegrated implant using a simplified technique in a patient who was a smoker and presented poor oral hygiene. The technique adopted permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes.
Collapse
Affiliation(s)
- Rudy Scala
- University of Verona, Faculty of Medicine, Dentistry and Maxillofacial Surgery Clinic, Verona, Italy
| | - Paolo Ghensi
- University of Milan, Faculty of Medicine, Dentistry Clinic, Milan, Italy. Private Dentist, Trento, Italy
| | - Alessandro Cucchi
- University of Milan, Faculty of Medicine, Dentistry Clinic, Milan, Italy. Private Dentist, Trento, Italy
| | - Enrico Pistoia
- University of Verona, Faculty of Medicine, Dentistry and Maxillofacial Surgery Clinic, Verona, Italy
| |
Collapse
|
27
|
Hosseini M, Worsaae N, Schiødt M, Gotfredsen K. A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal-ceramic materials in patients with tooth agenesis. Clin Oral Implants Res 2012; 24:1078-87. [DOI: 10.1111/j.1600-0501.2012.02514.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Mandana Hosseini
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health Science; University of Copenhagen; Copenhagen; Denmark
| | - Nils Worsaae
- Department of Dental, Oral and Maxillofacial Surgery; Rigshospitalet; Copenhagen; Denmark
| | - Morten Schiødt
- Department of Dental, Oral and Maxillofacial Surgery; Rigshospitalet; Copenhagen; Denmark
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health Science; University of Copenhagen; Copenhagen; Denmark
| |
Collapse
|
28
|
Becker K, Mihatovic I, Golubovic V, Schwarz F. Impact of abutment material and dis-/re-connection on soft and hard tissue changes at implants with platform-switching. J Clin Periodontol 2012; 39:774-80. [PMID: 22676071 DOI: 10.1111/j.1600-051x.2012.01911.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the impact of abutment material and dis-/re-connection on soft and hard tissue changes at implants with platform-switching. MATERIAL & METHODS Titanium implants (n = 12), placed epicrestally in the upper jaws of three dogs, were connected with titanium (Ti) and zirconium dioxide (ZrO(2) ) abutments (horizontal mismatch of 0.4 mm) and randomly allocated in a split-mouth design either to repeated (2x) dis-/re-connection at 4 and 6 weeks (test), respectively, or left undisturbed (control). At 8 weeks, histomorphometrical measurements were made between the mucosal margin (PM), implant shoulder (IS) and the apical extension of the long junctional epithelium (aJE),-the most coronal level of bone in contact with the implant (CBI). RESULTS Repeated abutment manipulation was associated with increased mean PM-aJE and IS-CBI values at both Ti (1.82 ± 0.37-1.99 ± 0.40 mm and 0.72 ± 0.18-1.12 ± 0.60 mm) and ZrO(2) (1.90 ± 0.28-2.67 ± 0.67 mm and 0.22 ± 0.10-2.15 ± 0.77 mm) abutments at 8 weeks. These vertical dimensions were comparable at both vestibular and oral aspects. Between group comparisons, however, failed to reveal a significant difference between test and control sites. CONCLUSIONS Repeated manipulation may be associated with dimensional changes of peri-implant soft and hard tissues formed at both non-matching Ti and ZrO(2) abutments.
Collapse
Affiliation(s)
- Kathrin Becker
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany.
| | | | | | | |
Collapse
|
29
|
Cairo F, Sanz I, Matesanz P, Nieri M, Pagliaro U. Quality of reporting of randomized clinical trials in implant dentistry. A systematic review on critical aspects in design, outcome assessment and clinical relevance. J Clin Periodontol 2012; 39 Suppl 12:81-107. [DOI: 10.1111/j.1600-051x.2011.01839.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Francesco Cairo
- Department of Periodontology; University of Florence; Florence; Italy
| | - Ignacio Sanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Paula Matesanz
- Department of Periodontology; Universidad Complutense ; de; Madrid; Madrid; Spain
| | - Michele Nieri
- Department of Periodontology; University of Florence; Florence; Italy
| | - Umberto Pagliaro
- Department of Periodontology; University of Florence; Florence; Italy
| |
Collapse
|
30
|
Abstract
BACKGROUND Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients. OBJECTIVES To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review. DATA COLLECTION AND ANALYSIS Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data. MAIN RESULTS Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs. AUTHORS' CONCLUSIONS Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.
Collapse
Affiliation(s)
- Elliot Abt
- Department of Dentistry, Illinois Masonic Medical Center, Chicago, IL, USA.
| | | | | |
Collapse
|
31
|
Abstract
BACKGROUND The aim of this study was to review the literature on the restoration of single-tooth implants, and to develop evidence-based conclusions to optimize aesthetic, biologic and patient-related outcomes. METHODS An electronic and hand search was conducted using the search terms 'dental implants, single-tooth; dental restoration, temporary; dental impression materials; dental impression technique; dental prosthesis, implant-supported; dental prosthesis design; dental abutments; dental occlusion; maintenance; survival; and survival analysis'. Resultant titles were screened, and full text was obtained where relevant. The authors selected the most appropriate articles, giving preference to systematic reviews and long-term, patient-based outcome data. RESULTS Thirty-nine articles were selected and critiqued by the authors. CONCLUSIONS There was strong suggestion by several authors that peri-implant soft tissue aesthetics can be sculpted through provisional restoration contour, but there are no clinical outcome studies to define or support this claim. Laboratory studies demonstrate that pick-up type impression copings in conjunction with elastomeric impressions are the most accurate means for transferring implant position to a dental cast. Laboratory and finite-element analysis studies suggest implants with an internal-type connection show improved stress distribution, but supportive clinical data are lacking. The authors of this review favour a screw-retained prosthesis for retrievability. Clinical and histological studies show that gold, titanium and zirconia ceramic abutment materials exhibit excellent biological responses, although there is insufficient data on the clinical service provided by zirconia as an implant-substructure material. The literature does not associate any particular occlusal scheme with superior clinical outcomes. Implant-borne single crowns offer comparable clinical service to tooth-borne fixed dental prostheses. However, single-tooth implant restorations are associated with an increased incidence of biological and technical complications.
Collapse
Affiliation(s)
- M B Lewis
- Faculty of Dentistry, The University of Sydney, New South Wales, Australia
| | | |
Collapse
|
32
|
Vere J, Joshi R. Quality assessment of randomised controlled trials of dental implant surgery and prosthodontics published from 2004 to 2008: a systematic review. Clin Oral Implants Res 2011; 22:1338-45. [DOI: 10.1111/j.1600-0501.2010.02124.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
33
|
Abstract
The aim of the article is to assess the current literature in terms of the prosthetic outcome of cement-retained implant-supported fixed restorations, as well as to determine the type of cement that can be recommended for clinical application. A review of the literature published up to May 2010 was conducted to identify clinical studies about cement-retained implant-supported fixed restorations. The search strategy applied was a combination of MeSH terms and free text words, including the following keywords: implants, implant-supported fixed dental prostheses (FDPs), bridges, implant-supported single crowns (SCs), cement-retained, cement fixation, cement, cementation, cement failure, retention, and loss of retention, technical complications, mechanical complications, prosthetic complication, retrievability and maintenance. Thirty-two studies met the inclusion criteria. The studies were divided into two categories: 15 short-term clinical studies with an observation period of less than 5 years, and 17 long-term clinical studies with an observation period of 5 years and more. The most common technical complications of cement-retained implant-supported fixed restorations were loss of retention, chipping and abutment screw loosening. The results of the current review revealed no guidelines about cement or cementation procedures. It may be stated that despite the questionable retrievability of cement-retained implant-supported fixed restorations, this treatment modality is a reliable and effective option, especially for implant-supported SCs and short-span FDPs. The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability. Standardised randomised clinical trials will provide valuable information to this issue.
Collapse
Affiliation(s)
- M S Chaar
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Freiburg, Germany
| | | | | |
Collapse
|
34
|
Irinakis T, Wiebe C. Clinical evaluation of the NobelActive implant system: a case series of 107 consecutively placed implants and a review of the implant features. J ORAL IMPLANTOL 2010; 35:283-8. [PMID: 20017644 DOI: 10.1563/1548-1336-35.6.283] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this paper is to (1) introduce the features of this new implant, (2) investigate the clinical benefits as advertised by the manufacturer in comparison with traditional root form implants, and (3) provide guidelines for its use. One hundred seven NobelActive implants were placed in 67 consecutive patients with type I-IV bone within 8 months. Cases also include implants placed in sinus grafts, ridges with insufficient thickness and facial bone loss and were placed with delayed and immediate loading. Parameters were assessed to determine whether we could confirm the manufacturer's statements on this implant system. Results obtained with 107 implants of 3.5, 4.3, and 5 mm diameters with 10- to 15-mm lengths placed in different types of bone with delayed and immediate loading demonstrated a final insertion torque from 15 to 70 Ncm. All types of bone allowed "redirection" of the implant but were limited in the bone with higher density. According to the manufacturer, this new design of the NobelActive implant has high initial stability, bone condensing properties, redirecting capability, built-in platform shifting, and dual-function prosthetic connections. After investigating these 5 statements within the limits of our study, we were able to confirm these claims, but with some recommendations for the clinical use and placement of these implants.
Collapse
|
35
|
Irinakis T, Wiebe C. Initial Torque Stability of a New Bone Condensing Dental Implant. A Cohort Study of 140 Consecutively Placed Implants. J ORAL IMPLANTOL 2009; 35:277-82. [DOI: 10.1563/aaid-joi-d-09-00020.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract
The aim of this paper was to determine the torque resistance of this new implant during placement in different types of bone, immediate placement into sockets, and in grafted bone. The torque at time of placement serves as an indication of initial stability, which is accepted as an important factor for implant osseointegration and immediate loading. Within a 13-month period, 140 NobelActive implants in 84 consecutive patients were placed into types I–IV bone in fresh sockets, and into grafted bone (both in maxillary sinuses and on the facial alveolar surfaces where bone had been lost). The final torque was measured with a manual torque control wrench as manufactured by Nobel Biocare for clinical use with this type of implant. One hundred forty implants with 3.5 to 5 mm diameters and 10 to 15 mm lengths were placed in different types of bone, either as delayed or immediate implants into fresh extraction sockets. These implants demonstrated a mean torque stability value of 50.8 Ncm. The average insertion torque for delayed implants was 49.7 Ncm. For immediate implants the average torque was 52.6 Ncm. Placement into soft bone was also favorable at an average of 47.9 Ncm. Typical straight walled and tapered implants generally exhibit 10 to 35 Ncm insertion torques. The NobelActive implant consistently reaches higher torque levels. This may indicate they are more favorably suited to early provisionalization and loading. Soft bone (type IV) did not seem to decrease significantly the torque of insertion of these implants. Further longer term studies are needed to investigate whether this indeed makes these implants more suited for early provisionalization and loading than traditional root form. Long term studies are also needed to investigate maintenance of bone levels surrounding these implants.
Collapse
|
36
|
Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clin Oral Implants Res 2009; 20 Suppl 4:4-31. [DOI: 10.1111/j.1600-0501.2009.01787.x] [Citation(s) in RCA: 216] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
37
|
|
38
|
Abstract
OBJECTIVE The aim of the present study was to analyze the soft tissue barrier formed to implant abutments made of different materials. MATERIAL AND METHODS Six Labrador dogs, about 1 year old, were used. All mandibular premolars and the first, second and third maxillary premolars were extracted. Three months later four implants (OsseoSpeed, 4.5 x 9 mm, Astra Tech Dental, Mölndal, Sweden) were placed in the edentulous premolar region on one side of the mandible and healing abutments were connected. One month later, the healing abutments were disconnected and four new abutments were placed in a randomized order. Two of the abutments were made of titanium (Ti), while the remaining abutments were made of ZrO(2) or AuPt-alloy. A 5-months plaque control program was initiated. Three months after implant surgery, the implant installation procedure and the subsequent abutment shift were repeated in the contra-lateral mandibular region. Two months later, the dogs were euthanized and biopsies containing the implant and the surrounding soft and hard peri-implant tissues were collected and prepared for histological analysis. RESULTS It was demonstrated that the soft tissue dimensions at Ti- and ZrO(2) abutments remained stable between 2 and 5 months of healing. At Au/Pt-alloy abutment sites, however, an apical shift of the barrier epithelium and the marginal bone occurred between 2 and 5 months of healing. In addition, the 80-mum-wide connective tissue zone lateral to the Au/Pt-alloy abutments contained lower amounts of collagen and fibroblasts and larger fractions of leukocytes than the corresponding connective tissue zone of abutments made of Ti and ZrO(2). CONCLUSION It is suggested that the soft tissue healing to abutments made of titanium and ZrO(2) is different to that at abutments made of AuPt-alloy.
Collapse
Affiliation(s)
- Maria Welander
- Department of Periodontology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
| | | | | |
Collapse
|