1
|
Sulyhan-Sulyhan K, Barberá-Millán J, Larrazábal-Morón C, Espinosa-Giménez J, Gómez-Adrián MD. Radiographic Study of Transcrestal Sinus Floor Elevation Using Osseodensification Technique with Graft Material: A Pilot Study. Biomimetics (Basel) 2024; 9:276. [PMID: 38786485 PMCID: PMC11118885 DOI: 10.3390/biomimetics9050276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
This pilot study aimed to evaluate the level of implant success after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP) by analyzing clinical and radiographic results. Moreover, the increase in bone height was analyzed immediately after surgery, 3 months after, and before loading by taking standardized radiographic measurements. Thirteen patients, four males and nine females, with a mean age of 54.69 ± 5.86 years, requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of <8 mm and a minimum bone width of 5 mm, participated in the study. The bone gain data was obtained using cone-beam computed tomography (CBCT) immediately after surgery and twelve months after the placement. The correlation between initial and final bone height with implant stability was also assessed. The results were analyzed using SPSS 23 software (p < 0.05). The results of the study indicated a 100% implant success rate after a follow-up period of twelve months. Preoperative main bone height was 5.70 ± 0.95 mm. The osseodensification technique allowed a significant increase of 6.65 ± 1.06 mm immediately after surgery. After a twelve-month follow-up, a graft material contraction of 0.90 ± 0.49 mm was observed. No correlation was observed between the bone height at the different times of the study and the primary stability of the implant. Considering the limitations of the size sample of this study, the osseodensification technique used for transcrestal sinus lift with the additional bone graft material (β-TCP) may provide a predictable elevation of the maxillary sinus floor, allowing simultaneous implant insertion with adequate stability irrespective of bone height limitations.
Collapse
Affiliation(s)
- Khrystyna Sulyhan-Sulyhan
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - Javier Barberá-Millán
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
- Doctoral School, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Carolina Larrazábal-Morón
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - Julián Espinosa-Giménez
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| | - María Dolores Gómez-Adrián
- Department of Dentistry, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (K.S.-S.); (C.L.-M.); (J.E.-G.); (M.D.G.-A.)
| |
Collapse
|
2
|
Li R, Wu Z, Chen S, Li X, Wan Q, Xie G, Pei X. Biomechanical behavior analysis of four types of short implants with different placement depths using the finite element method. J Prosthet Dent 2023; 129:447.e1-447.e10. [PMID: 36737356 DOI: 10.1016/j.prosdent.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023]
Abstract
STATEMENT OF PROBLEM The clinical application of short implants has been increasing. However, studies on the marginal bone loss of short implants are sparse, and clinicians often choose short implants based on their own experience rather than on scientific information. PURPOSE The purpose of this finite element analysis study was to evaluate the microstrain-stress distribution in the peri-implant bone and implant components for 4 types of short implants at different placement depths of platform switching. MATERIAL AND METHODS By using short implants as prototypes, 4 short implant models were 1:1 modeled. The diameter and length of the implants were 5×5, 5×6, 6×5, and 6×6 mm. The restoration was identical for all implants. Three different depths of implant platform switching were set: equicrestal, 0.5-mm subcrestal, and 1-mm subcrestal. The models were then assembled and assigned an occlusal force of 200 N (vertical or 30-degree oblique). A finite element analysis was carried out to evaluate the maximum equivalent elastic strain and von Mises stress in the bone and the stress distribution in the implant components. RESULTS The 5×5 implant group showed the largest intraosseous strain (21.921×103 με). A 1-mm increase in implant diameter resulted in a 17.1% to 37.4% reduction in maximum intraosseous strain when loaded with oblique forces. The strain in the bone tended to be much smaller than the placement depth at the equicrestal and 0.5-mm subcrestal positions than that at the 1-mm subcrestal position, especially under oblique force loading, with an increase of approximately 37.4% to 81.8%. In addition, when the cortical bone thickness was less than 4 mm, 5×6 implants caused significantly higher intraosseous stresses than 6×6 implants. CONCLUSIONS Large implant diameters, rather than long implants, led to reduced intraosseous strain, especially under oblique loading. Regarding the implant platform switching depth, the short implant showed small intraosseous strains when the platform switching depth was equicrestal or 0.5-mm subcrestal.
Collapse
Affiliation(s)
- Ruyi Li
- Graduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Zhanglin Wu
- Graduate student, State Key Laboratory of Hydraulics and Mountain River Engineering, College of Water Resource & Hydropower, Sichuan University, Chengdu, PR China
| | - Song Chen
- Resident, Stomaological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, PR China
| | - Xiang Li
- Undergraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Qianbing Wan
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Guo Xie
- Associate Professor, State Key Laboratory of Hydraulics and Mountain River Engineering, College of Water Resource & Hydropower, Sichuan University, Chengdu, PR China
| | - Xibo Pei
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| |
Collapse
|
3
|
Tang C, Du Q, Luo J, Peng L. Simultaneous placement of short implants (≤ 8 mm) versus standard length implants (≥ 10 mm) after sinus floor elevation in atrophic posterior maxillae: a systematic review and meta-analysis. Int J Implant Dent 2022; 8:45. [PMID: 36197540 PMCID: PMC9535054 DOI: 10.1186/s40729-022-00443-1] [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: 07/29/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The objective of this meta-analysis was to compare the clinical outcomes of using short implants (≤ 8 mm) inserted with osteotome sinus floor elevation (OSFE) and standard implants (≥ 10 mm) inserted with sinus floor elevation (SFE) in atrophic posterior maxillae with insufficient residual bone height (RBH). Methods An electronic search was performed on PubMed, EMBASE, and the Cochrane Library from 1994 to July 2022, in combination with a manual search of references in relevant articles. Randomized controlled trials (RCTs) that compared the clinical results between short and standard implant placement with SFE were included. The primary outcomes were implant survival rate and marginal bone loss (MBL); the secondary outcome was complication rate. Results Three RCTs were included, totaling 138 short and 156 standard implants. The results of the meta-analysis showed no significant differences between the short and standard implant groups in survival rate (RR = 1.02, 95% CI 0.96–1.08, p = 0.570), MBL (MD = − 0.13, 95% CI − 0.32 to 0.07, p = 0.190) and complication rate (intra-surgical complication: RR = 1.14, 95% CI 0.46–2.83, p = 0.770; post-operative complication: RR = 1.34, 95% CI 0.71–2.55, p = 0.370). Conclusions Using short implants (≤ 8 mm) combined with OSFE might be an alternative to standard implants (≥ 10 mm) with SFE when the RBH of the posterior maxilla is insufficient. Based on a short-term clinical observation, short implants with OSFE show good results in terms of survival rate, MBL, and complication incidence. Graphical Abstract ![]()
Collapse
Affiliation(s)
- Chenxi Tang
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Qianhui Du
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jiaying Luo
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, Department of Implantology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.
| |
Collapse
|
4
|
Short versus standard implants at sinus augmented sites: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6681-6698. [PMID: 36070150 DOI: 10.1007/s00784-022-04628-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Short implants are proposed as a less invasive alternative with fewer complications than standard implants in combination with sinus lift. The aim of this systematic review and meta-analysis was to state the efficacy of placing short implants (≤ 6 mm) compared to standard-length implants (≥ 8 mm) performing sinus lift techniques in patients with edentulous posterior atrophic jaws. Efficacy will be evaluated through analyzing implant survival (IS) and maintenance of peri-implant bone (MBL). METHODS Screening process was done using the National Library of Medicine (MEDLINE by PubMed), EMBASE, the Cochrane Oral Health, and Web of Science (WOS). The articles included were randomized controlled trials. Risk of bias was evaluated according to The Cochrane Collaboration's tool. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). A random-effects model was applied. Secondary outcomes such as surgical time, patient satisfaction, mucositis and peri-implantitis, pain, and swelling were analyzed. RESULTS Fourteen studies (597 patients and 901 implants) were evaluated. IS was 1.02 risk ratio, ranging from 1.00 to 1.05 (CI 95%) (p = 0.09), suggesting that IS was similar when both techniques were used. MBL was higher in patients with standard-length implants plus sinus lift elevation (p = 0.03). MBL was 0.11 (0.01-0.20) mm (p = 0.03) and 0.23 (0.07-0.39) mm (p = 0.005) before and after 1 year of follow-up, respectively, indicating that the marginal bone loss is greater for standard-length implants. DISCUSSION Within the limitations of the present study, as relatively small sample size, short dental implants can be used as an alternative to standard-length implants plus sinus elevation in cases of atrophic posterior maxilla. Higher MBL was observed in the groups where standard-length implants were used, but implant survival was similar in both groups. Moreover, with short implants, it was observed a reduced postoperative discomfort, minimal invasiveness, shorter treatment time, and reduced costs. CLINICAL CLINICAL RELEVANCE The low MBL promoted by short implants does contribute to a paradigm shift from sinus grafting with long implants to short implants. Further high-quality long-term studies are required to confirm these findings.
Collapse
|
5
|
Shi JY, Montero E, Wu XY, Palombo D, Wei SM, Sanz-Sánchez I. Bone preservation or augmentation simultaneous with or prior to dental implant placement: A systematic review of outcomes and outcome measures used in clinical trials in the last 10 years. J Clin Periodontol 2022; 50 Suppl 25:67-82. [PMID: 35815430 DOI: 10.1111/jcpe.13626] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/07/2022] [Accepted: 04/03/2022] [Indexed: 11/27/2022]
Abstract
AIM To evaluate outcome measures and methods of assessment in clinical studies on bone augmentation/preservation procedures for the placement of dental implants. MATERIALS AND METHODS A systematic search was performed on three databases from January 2011 to April 2021 to identify clinical studies reporting on any type of bone augmentation/preservation procedure. The outcomes that have been used to assess efficacy or performance in each study were registered and assigned to different domains (group of outcomes). The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. RESULTS Seven-hundred and eighty-three publications were included. Only 81.8% of the papers had a clear definition of their primary outcome. The rate of complications (59.3%), implant survival (58.2%), 3D radiographic bone gain/change (30%), marginal bone level (MBL; 29%), and histological outcomes (25.5%) were the most frequently reported outcome domains. The most commonly used primary outcome was 3D radiographic bone gain/change (25.8%), followed by implant survival (13.0%). Patient-reported outcome measures (PROMs) were reported in 15.7% of studies. Differences in the reported outcomes were observed among different types of bone preservation/augmentation interventions (i.e., alveolar ridge preservation, immediate implants, horizontal and/or vertical ridge augmentation, and sinus floor augmentation). CONCLUSION Within the past decade, great heterogeneity was observed among the outcomes considered in studies evaluating bone preservation/augmentation procedures. Three-dimensional radiographic bone gain/change was the most routinely reported main outcome variable, while PROMs were rarely reported.
Collapse
Affiliation(s)
- Jun-Yu Shi
- Shanghai PerioImplant Innovation Center, Department Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,College of Stomatology, Shanghai Jiao Tong University, Shanghai, China.,National Center for Stomatology, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Eduardo Montero
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Xin-Yu Wu
- Shanghai PerioImplant Innovation Center, Department Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Palombo
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain
| | - Shi-Min Wei
- Shanghai PerioImplant Innovation Center, Department Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ignacio Sanz-Sánchez
- Section of Post-Graduate Periodontology-Faculty of Odontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| |
Collapse
|
6
|
The Mechanical Behavior of a Screwless Morse Taper Implant-Abutment Connection: An In Vitro Study. MATERIALS 2022; 15:ma15093381. [PMID: 35591715 PMCID: PMC9103680 DOI: 10.3390/ma15093381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/19/2022] [Accepted: 05/04/2022] [Indexed: 12/13/2022]
Abstract
The use of screwless Morse taper implant−abutment connections (IAC) might facilitate the clinician’s work by eliminating the mechanical complications associated with the retention screw. The aim of this study is to evaluate the effect of artificial chewing on the long-term stability of screwless Morse taper IACs. Thirty-two implant abutments restored with an upper central incisor zirconia crown were used and divided into four groups according to the implant−abutment assembling manner (C1,H: screw retained (20 Ncm); C2: tapped; or C3: torqued (20 Ncm; the screws were removed before the dynamic loading)). All specimens were subjected to a cyclic loading (98 N) for 10 million chewing cycles. The survived samples were exposed to a pull-off force until failure/disassembling of the connection. All the samples revealed a 100% survival. Regarding the pull-off test, the screw-retained internal hexagonal IAC revealed significantly higher resistance to failure/disassembling (769.6 N) than screwless conical IACs (171.6 N−246 N) (p < 0.0001). The retention forces in the Morse taper groups were not significantly different (p > 0.05). The screw-retained hexagonal IAC showed the highest retention stability. The screw preload/retention in the conical IAC was lost over time in the group where the screws were kept in place during loading. Nevertheless, the screwless Morse taper IACs were stable for an extended service time and might represent a valid form of treatment for single-tooth replacement.
Collapse
|
7
|
Mo JJ, Lai YR, Qian SJ, Shi JY, Lai HC, Tang GY. Long-term clinical outcomes of short implant (6mm) in relation to Implant Disease Risk Assessment (IDRA). Clin Oral Implants Res 2022; 33:713-722. [PMID: 35509121 DOI: 10.1111/clr.13935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the long-term survivals of short implants and to investigate the association of the Implant Disease Risk Assessment (IDRA) with the occurrence of biological complications. MATERIAL AND METHODS This study was designed as a cohort study with a median follow-up of 10.0 years. Patients who had received 6-mm implants were reviewed and assigned into low-, moderate- and high-risk groups (Group L, M and H) based on the IDRA tool. The implant survival, biological complications, soft tissue condition, hardware complications and marginal bone loss (MBL) were evaluated. Kaplan-Meier curves and Cox regression were performed for survival analysis. RESULTS A hundred and ten patients were included. The overall cumulative survival rate was 90.9% (L:100.0%, M: 93.3% and H: 80.6%). A higher risk profile was significantly associated with a decreased implant survival (hazard ratio: 4.11, 95% CI: 1.17-14.36, p<0.05). Higher risk profile (hazard ratio: 2.63, 95% CI: 1.32-5.25, p<0.05) was a potential risk factor for biological complications. At follow-up, significant differences in bleeding index, modified plaque index and peri-implant probing depth were found among groups (p<0.01). No significant difference was found in MBL. CONCLUSION Acceptable long-term clinical outcomes could be achieved after 10 years for short implants. Despite a statistically nonsignificant difference in MBL, patients with a high-risk profile of IDRA seem to be at greater risk of implant loss and biological complications.
Collapse
Affiliation(s)
- Jia-Ji Mo
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Yi-Rao Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.,Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shu-Jiao Qian
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Jun-Yu Shi
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Hong-Chang Lai
- Department of Implant Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
| | - Guo-Yao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Otolaryngology-Head and Neck Surgery, Shanghai Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
8
|
Tay JRH, Ng E, Lu XJ, Lai WMC. Healing complications and their detrimental effects on bone gain in vertical-guided bone regeneration: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:43-71. [PMID: 35048503 DOI: 10.1111/cid.13057] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Guided bone regeneration (GBR) utilizes a barrier membrane to allow osteogenic cells to populate a space by excluding epithelial and connective tissue cells. The purpose of this systematic review was to investigate the ratio of means (RoM) of vertical bone gained (Outcome) in vertical GBR procedures with healing complications (Intervention) and in vertical GBR procedures without healing complications (Comparison) in patients with vertically resorbed edentulous ridges that require dental implant placement (Population). A further aim was to investigate the incidence of complications after vertical GBR, and the influence of the timing of implant placement and regenerative devices on complications. MATERIALS AND METHODS MEDLINE (through PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched in duplicate up to, and including, November 2020 for randomized and controlled clinical trials and prospective and retrospective case series. Outcomes included patient-level and site-level RoM of vertical bone gain between healing complications and uneventful healing, and incidences of complications that occurred after vertical GBR. Random-effects and fixed-effects meta-analyses were performed where appropriate. This study was registered on PROSPERO (CRD42021226432). RESULTS A total of 31 publications were selected for the qualitative and quantitative analyses. The RoM of vertical bone gained was 0.65 [95% CI = 0.47, 0.91] and 0.62 [95% CI = 0.45, 0.85] when membrane exposure without suppuration and abscess formation without membrane exposure occurred respectively, in comparison to uneventful healing. The overall incidence proportion of healing complications occurring at the augmented site at a site- and patient-level was 11.0% [95% CI = 7.0, 15.6] and 10.8% [95% CI = 6.6, 15.7]. At a patient-level, there were no significant differences between a simultaneous or staged approach, or with the regenerative device used. The site-level incidence proportion of membrane exposure without suppuration, membrane exposure with suppuration, and with abscess formation without membrane exposure was 8.7% [95% CI = 4.2, 14.2], 0.7% [95% CI = 0.0, 2.9], and 0.5% [95% CI = 0.0, 1.7], respectively. The site-level weighted mean incidence proportion of neurologic complications occurring at the donor site was 0.8% [95% CI = 0.0, 5.3]. CONCLUSIONS There is a significant reduction in bone gain when healing complications occur. However, healing complications are relatively uncommon surgical complications after vertical GBR.
Collapse
Affiliation(s)
- John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore
| | | |
Collapse
|