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Solderer A, Hicklin SP, Aßenmacher M, Ender A, Schmidlin PR. Influence of an allogenic collagen scaffold on implant sites with thin supracrestal tissue height: a randomized clinical trial. Clin Oral Investig 2024; 28:313. [PMID: 38748295 PMCID: PMC11096242 DOI: 10.1007/s00784-024-05716-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES This randomized clinical trial focused on patients with thin peri-implant soft-tissue height (STH) (≤ 2.5 mm) and investigated the impact of an allogenic collagen scaffold (aCS) on supracrestal tissue height and marginal bone loss (MBL). MATERIAL & METHODS Forty patients received bone level implants and were randomly assigned to the test group with simultaneous tissue thickening with aCS or the control group. After three months, prosthetic restoration occurred. STH measurements were taken at baseline (T0) and reopening surgery (TR), with MBL assessed at 12 months (T1). Descriptive statistics were calculated for continuous variables, and counts for categorical variables (significance level, p = 0.05). RESULTS At T1, 37 patients were available. At T0, control and test groups had mean STH values of 2.3 ± 0.3 mm and 2.1 ± 0.4 mm. TR revealed mean STH values of 2.3 ± 0.2 mm (control) and 2.6 ± 0.7 mm (test), with a significant tissue thickening of 0.5 ± 0.6 mm in the test group (p < 0.03). At T1, control and test groups showed MBL mean values of 1.1 ± 0.8 mm and 1.0 ± 0.6 mm, with a moderate but significant correlation with STH thickening (-0.34), implant position (0.43), history of periodontitis (0.39), and smoking status (0.27). CONCLUSION The use of an aCS protocol resulted in soft tissue thickening but did not reach a threshold to reliably reduce MBL compared to the control group within the study's limitations. CLINICAL RELEVANCE Peri-implant STH is crucial for maintaining peri-implant marginal bone stability. Marginal bone stability represents a crucial factor in prevention of peri-implantitis development. German register of clinical trial registration number DRKS00033290.
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Affiliation(s)
- A Solderer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - S P Hicklin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - M Aßenmacher
- Department of Statistics, LMU Munich, Munich, Germany
- Munich Center for Machine Learning (MCML), LMU Munich, Munich, Germany
| | - A Ender
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Afrashtehfar KI, Hicklin SP, Schmidlin PR. LONG-TERM OUTCOMES OF IMPLANT PLACEMENT VERSUS TOOTH PRESERVATION IN PERIODONTALLY COMPROMISED TEETH MAY BE COMPARABLE. J Evid Based Dent Pract 2024; 24:101931. [PMID: 38448116 DOI: 10.1016/j.jebdp.2023.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Sarafidou K, Lazaridi I, Gotsis S, Kirmanidou Y, Vasilaki D, Hirayama H, Michalakis K. Tooth preservation vs. extraction and implant placement in periodontally compromised patients: A systematic review and analysis of studies. J Prosthodont. 2022 Oct;31(8):e87-e99. doi:10.1111/jopr.13560. Epub 2022 Aug 2. PMID: 35794083 SOURCE OF FUNDING: No external funding was received for this research. TYPE OF STUDY/DESIGN Systematic review (without meta-analysis).
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Hicklin SP, Sailer I, Todorovic A, Mojon P, Worni A, Strasding M. Immediately versus early placed bone-level-tapered implants supporting all-ceramic crowns on titanium base abutments: 1-year radiographic and pink esthetic outcomes of a multicenter pilot RCT. J ESTHET RESTOR DENT 2024. [PMID: 38334315 DOI: 10.1111/jerd.13206] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES Aim of this study was to assess survival rates, radiographic, and pink esthetic outcomes of a bone-level-tapered (BLT) implant following immediate or early implant placement. MATERIALS AND METHODS Patients in need of tooth extraction and one implant in the anterior or premolar area were recruited in five centers. Patients were randomly assigned to the immediate or early placement protocol. Implants were restored with all-ceramic crowns cemented to titanium-base-abutments. Radiographic bone levels, implant stability quotient (ISQ), and pink esthetic outcomes were assessed. Data were analyzed descriptively. Level of significance was set at 0.05. Differences between groups were tested using Wilcoxon-signed-rank and Mann-Whitney-U test as nonparametric tests. RESULTS A total of 60 patients received 60 BLT implants (Institut Straumann). At 12-months, 59 implants (98.3%) were osseointegrated. The mean distance from implant shoulder to first bone-to-implant contact was 0.15 ± 0.59 mm without significant differences between the groups. Median ISQ values increased from 75.5 to 78.5. A mean buccal recession of 0.1 ± 0.70 mm occurred with no difference between groups. The mean papilla height gain in both groups was 0.5 ± 1.47 mm mesially and 0.4 ± 1.36 mm distally. CONCLUSIONS After 1 year, immediately and early placed BLT implants exhibit similar bone level changes, ISQ values, and pink esthetic outcomes. CLINICAL SIGNIFICANCE The present research contributes to the knowledge on clinical outcomes of immediately and early placed BLT implants restored with buccally microveneered ceramic single crowns out of two different ceramic materials. The research shows that similar esthetic and radiographic outcomes can be reached by means of immediate implant placement compared to the conventional early placement protocol. The improvement of esthetic soft-tissue parameters over time was shown for both implant placement protocols.
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Affiliation(s)
- Stefan P Hicklin
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Ana Todorovic
- Division of Prosthodontics, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Philippe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Solderer A, Widmer N, Gubler A, Fischer KR, Hicklin SP, Schmidlin PR. Properties of three collagen scaffolds in comparison with native connective tissue: an in-vitro study. Int J Implant Dent 2023; 9:36. [PMID: 37819469 PMCID: PMC10567619 DOI: 10.1186/s40729-023-00504-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023] Open
Abstract
PURPOSE To evaluate collagen scaffolds (CS) in terms of their in vitro resorption behavior, surface structure, swelling behavior, and mechanical properties in physiologically simulated environments, compared with porcine native connective tissue. MATERIALS AND METHODS Three test materials-one porcine collagen matrix (p-CM), two acellular dermal matrices (porcine = p-ADM, allogenic = a-ADM)-and porcine native connective tissue (p-CTG) as a control material were examined for resorption in four solutions using a high-precision scale. The solutions were artificial saliva (AS) and simulated body fluid (SBF), both with and without collagenase (0.5 U/ml at 37 °C). In addition, the surface structures of CS were analyzed using a scanning electron microscope (SEM) before and after exposure to AS or SBF. The swelling behavior of CS was evaluated by measuring volume change and liquid absorption capacity in phosphate-buffered saline (PBS). Finally, the mechanical properties of CS and p-CTG were investigated using cyclic compression testing in PBS. RESULTS Solutions containing collagenase demonstrated high resorption rates with significant differences (p < 0.04) between the tested materials after 4 h, 8 h and 24 h, ranging from 54.1 to 100% after 24 h. SEM images revealed cross-linked collagen structures in all untreated specimens. Unlike a-ADM, the scaffolds of p-CM and p-ADM displayed a flake-like structure. The swelling ratio and fluid absorption capacity per area ranged from 13.4 to 25.5% among the test materials and showed following pattern: p-CM > a-ADM > p-ADM. P-CM exhibited higher elastic properties than p-ADM, whereas a-ADM, like p-CTG, were barely compressible and lost structural integrity under increasing pressure. CONCLUSIONS AND CLINICAL IMPLICATIONS Collagen scaffolds vary significantly in their physical properties, such as resorption and swelling behavior and elastic properties, depending on their microstructure and composition. When clinically applied, these differences should be taken into consideration to achieve the desired outcomes.
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Affiliation(s)
- Alex Solderer
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Nicole Widmer
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Andrea Gubler
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Kai R Fischer
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Stefan P Hicklin
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Patrick R Schmidlin
- Division for Periodontology and Peri-Implant Diseases, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. Materials (Basel) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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Hicklin SP, Bindl A, Schmidlin PR. Radiographic results of osteotome-driven maxillary sinus floor elevation without grafting materials after 17.5 years radiographic evaluation of minimally-invasive sinus grafting. J Dent 2022; 126:104318. [PMID: 36202279 DOI: 10.1016/j.jdent.2022.104318] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND There is growing evidence that minimally invasive sinus augmentation works without the use of filler materials. This study assessed the bone integration and sinus projection of single-unit implants in the maxilla, which were placed approximately 18 years ago using a modified filler-free osteotome technique. METHODS Sixteen of the 24 treated patients of a former publication (treatment was performed between 2001 and 2004) were reassessed after a mean implant loading period of 17.5 years. The treated posterior areas were evaluated using cone-beam computed tomography (CBCT), and as a primary outcome parameter, sinus projection was determined in sectional views at the mesial, distal, buccal, and oral sites. Additionally, the percentage of alveolar bone contact was determined with respect to the implant length. Conventional radiographs were used to determine marginal bone levels. Additionally, plaque, bleeding on probing, and probing pocket depth were measured. The reconstructions were checked for chipping and other technical complications such as loss of retention, screw loosening, and screw fracture. RESULTS The mean age of the included patients was 72.8 ± 8.5 years. Two implants were lost. Therefore, fourteen implants were available for CBCT evaluation. The highest sinus projection of 2.1 ± 1.7 mm was observed in the distal aspect, while it was 1.1 ± 1.5, 0.9 ± 1.2, and 0.9 ± 1.1 mm at the mesial, buccal, and oral sites, respectively. The maximal sinus projection in one case was 6.7 mm. The percentage calculation of osseous implant integration (in mm ± standard deviations) with respect to the selected implant length at the mesial, distal, buccal, and oral sites showed values ranging from, 87.9 ± 16.0, 78.4 ± 20.3, 91.0 ± 12.5, and 90.5 ± 11.1%, respectively. Five implants displayed probing pocket depths of more than 4 mm with bleeding; all implants had less than 1 mm of bone loss in the observation period, that is, implants had mucositis. Six of 14 crowns showed small chippings within the ceramic veneering. One case of screw loosening was reported in medical history. DISCUSSION This study showed that implant placement in non-augmented sinuses resulted in good clinical results. The sinus projection, even if persistent and present, leads to no functional impairments. Given adequate maintenance, marginal bone levels remain constant and peri‑implant health can be observed. Moreover, these results represent only a small cohort; and therefore, should be interpreted with caution. However, in view of the existing literature, these highly promising results are in line with other findings. CLINICAL SIGNIFICANCE To the best of our knowledge, this dataset is the report with the longest follow-up. Overall, implants placed in the sinus without fillers represent a valuable alternative for tooth replacement in a minimally interventional manner.
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Affiliation(s)
- Stefan P Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Andreas Bindl
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Kölliker R, Hicklin SP, Hirsiger C, Liu CC, Janett F, Schmidlin PR. In Vitro Evaluation of the Permeability of Different Resorbable Xenogeneic Membranes after Collagenolytic Degradation. Membranes (Basel) 2022; 12:787. [PMID: 36005702 PMCID: PMC9415831 DOI: 10.3390/membranes12080787] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
In this in vitro study, we compare the penetration of cells through different resorbable collagen membranes, which were collagenolytically degraded over different time periods. Three different resorbable collagen membranes were evaluated, including two non-cross-linked (NCL) membranes-namely, a porcine (NCL-P) and an equine (NCL-E) membrane-and an enzymatically cross-linked porcine (ECL-B) membrane. A special two-chamber model was fabricated, allowing for the placement of separating membranes, and a non-porous polyester membrane was used as a negative control (C), in order to verify the impermeability of the experimental chamber device. Round membrane samples with a diameter of 16 mm were fabricated. Eighteen membranes of each type were punched and placed on polyethylene nets as carriers. The membranes were then biodegraded-each on its carrier-in 12-well polystyrene plates: three samples of each membrane type were degraded for 1.5, 3, 6, or 12 h in 2 mL of a buffered collagenase solution, at 37 °C. For control purposes, three samples of each membrane type were not degraded, but only immersed in buffer solution for 1.5, 3, 6, or 12 h, at 37 °C. Another three samples of each type of membrane were degraded until complete dissolution, in order to determine the full hydroxyproline content for comparison. Liquid-preserved boar semen (containing at least 120 million sperm cells per milliliter) was used to test the cell occlusivity of the degraded membranes. At baseline and initial degradation, all tested membranes were tight, and no penetration was observed with up to 30 min of incubation time (results not shown). After 1.5 h, cells were partially capable of penetrating the NCL-E membrane only. One sample showed leakage, with a sperm volume of 1.7 million cells/mL over all samples. No penetration occurred in the test, NCL-P, and ECL-B groups. After a degradation time of 3 h, the NCL-P and ECL-B membranes remained occlusive to cells. All the membranes and measurements indicated leakage in the NCL-E group. After 6 h, four NCL-P measurements showed the first signs of cell penetration, as boar spermatozoa were detectable in the lower chamber (64 million cells/mL). The ECL-B membranes remained completely cell occlusive. After 12 h, four NCL-P measurements were cell penetration positive (14.6 million cells/mL), while the ECL-B group remained tight and showed no cell penetration. As the findings of our study are well in accordance with the results of several previous animal studies, it can be concluded that the surrogate model is capable of performing rapid and cheap screening of cell occlusivity for different collagen membranes in a very standardized manner. In particular, claims of long degradation resistance can be easily proven and compared. As the boar spermatozoa used in the present report had a size of 9 × 5 μm, smaller bacteria are probably also able to penetrate the leaking membranes; in this regard, our proposed study set-up may provide valuable information, although it must be acknowledged that sperm cells show active mobility and do not only translocate by growth.
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Affiliation(s)
- Ramona Kölliker
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Constanze Hirsiger
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Fredi Janett
- Clinic of Reproductive Medicine, Vetsuisse-Faculty, University of Zurich, Winterthurerstrasse 204, 8057 Zurich, Switzerland
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
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Cantarella J, Pitta J, Mojon P, Hicklin SP, Fehmer V, Sailer I. Mechanical Stability of Restorations Supported by Titanium Base, Zirconia, and Polyetherketoneketone Abutments on One- and Two-Piece Zirconia Implants. Int J Oral Maxillofac Implants 2021; 36:313-321. [PMID: 33909721 DOI: 10.11607/jomi.8798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate survival, complication rates, and bending moments of one- and two-piece zirconia implants restored with different abutment materials and lithium disilicate crowns after aging, compared to titanium implants restored with titanium base-supported lithium disilicate crowns. MATERIALS AND METHODS Sixty anterior crowns were either screwretained on two-piece titanium implants (C) and two-piece zirconia implants (T1, T2, T3) or cemented on one-piece zirconia implants (T4), resulting in 5 groups with 12 specimens each. For the screw-retained crowns, different abutment materials and implant connections were tested: titanium base with internal conical connection and horizontal joint component (C and T2), zirconia with internal hexagonal connection and horizontal joint component (T1), and polyetherketoneketone with internal hexagonal connection and horizontal joint component (T3). After artificial aging with thermocycling (5°C to 50°C) and chewing simulation (1,200,000 cycles, 49 N, 1.67 Hz), the surviving specimens were loaded until fracture, and the bending moments were calculated. Survival rates and respective differences during aging were analyzed with the Kaplan-Meier log-rank test, while complication rates were compared with chi-square tests. Bending moment data were evaluated using the Kruskal-Wallis test (α = .05). RESULTS Survival rates after artificial aging ranged from 75% (T1) to 100% (C and T4) without significant differences between the groups (P > .05). Only 41.5% of the surviving specimens were free of complications, while the remaining presented screw-loosening, loss of retention of crowns, or cracks on the crown or implant level. The complication rates varied significantly among the groups (P < .05). The mean bending moments were 173.7 × 20.1 (C), 114.5 × 20.1 (T1), 171.1 × 46.1 (T2), 258.1 × 147.4 (T3), and 194.7 × 30.9 Ncm (T4), and group T1 exhibited significantly lower median bending moment values than the other groups (P < .001). CONCLUSION The zirconia one- and two-piece implants presented high survival rates after aging, yet the number of technical complications was high. New prosthetic solutions, such as titanium bases or polyetherketoneketone abutments, may offer a comparable treatment option to restore two-piece zirconia implants.
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Salvi GE, Moëne R, Wallkamm B, Hicklin SP, Bischof M, Nedir R, Mombelli A, Sculean A. Clinical and radiographic changes at tissue level implants with either a machined or a modified transmucosal neck surface: A 3-year multicentre randomized controlled proof-of-concept study. J Clin Periodontol 2020; 47:500-508. [PMID: 31912523 DOI: 10.1111/jcpe.13249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/19/2019] [Revised: 12/03/2019] [Accepted: 01/04/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Surface modification may yield enhanced soft tissue adhesion to transmucosal titanium implant necks. AIM To evaluate and compare changes in soft tissues around implants with a modified hydrophilic sandblasted and acid-etched neck (mSLA; test) to those with a machined neck (M; control). MATERIALS AND METHODS Implants with a diameter of 4.1 mm and a neck height of 1.8 mm were randomly inserted in healed sites with pristine bone of the posterior maxilla or mandible. The modified Sulcus Bleeding Index (mSBI) (primary outcome) was assessed at baseline (BL) and 6, 12 and 36 months. Secondary outcomes included the assessment of pocket probing depth (PPD), mucosal recession (REC) and clinical attachment level (CAL). Standardized radiographs were taken at time of implant placement, at BL and after 12 and 36 months. RESULTS Of the 43 randomized subjects, 38 (19 test and 19 controls) completed the 36-month follow-up. Implant survival rates amounted to 95.5% (test) and 100% (control) (p > .05). At 36 months, 77.6% of test implants and 78.9% of control implants were without any bleeding sites (mSBI = 0; p > .05). The 36-month success rate was 86.4% in the test and 85.7% in the control group, respectively (p > .05). At 36 months, the mean radiographic bone level change from BL was 0.33 ± 0.69 mm at test implants and 0.12 ± 0.3 mm at control implants (p > .05). CONCLUSION Tissue level implants with a hydrophilic mSLA transmucosal neck failed to yield clinical and radiographic benefits compared with implants with a machined neck up to 3 years.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Raphaël Moëne
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Beat Wallkamm
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Private Practice, Langenthal, Switzerland
| | - Stefan P Hicklin
- Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mark Bischof
- Swiss Dental Clinics Group, Ardentis Clinique Dentaire, Lausanne, Switzerland
| | - Rabah Nedir
- Swiss Dental Clinics Group, Ardentis Clinique Dentaire, Lausanne, Switzerland
| | - Andrea Mombelli
- Division of Periodontology, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Pitta J, Fehmer V, Sailer I, Hicklin SP. Monolithic zirconia multiple-unit implant reconstructions on titanium bonding bases. Int J Comput Dent 2018; 21:163-171. [PMID: 29967907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The development of titanium bonding bases allows for the use of implant-supported monolithic reconstructions in a digital workflow. Different base configurations are available according to each clinical indication. In this case report, the selection of titanium bonding bases for crowns was considered for a multiple-unit fixed dental prosthesis (FDP).
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Schneebeli E, Brägger U, Scherrer SS, Keller A, Wittneben JG, Hicklin SP. Quality Evaluation of Zirconium Dioxide Frameworks Produced in Five Dental Laboratories from Different Countries. J Prosthodont 2015; 26:399-409. [DOI: 10.1111/jopr.12391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 11/26/2022] Open
Affiliation(s)
- Esther Schneebeli
- Department of Reconstructive Dentistry and Gerontology; University of Bern; Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerontology; University of Bern; Switzerland
| | - Susanne S. Scherrer
- Division of Fixed Prosthodontics and Biomaterials; University Clinics of Dental Medicine; Geneva Switzerland
| | - Andrea Keller
- Department of Reconstructive Dentistry and Gerontology; University of Bern; Switzerland
| | - Julia G. Wittneben
- Department of Reconstructive Dentistry and Gerontology; University of Bern; Switzerland
| | - Stefan P. Hicklin
- Department of Reconstructive Dentistry and Gerontology; University of Bern; Switzerland
- Division of Fixed Prosthodontics and Biomaterials; University Clinics of Dental Medicine; Geneva Switzerland
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Abstract
Implant therapy has evolved into an important part of daily dental practice. Appropriate knowledge of diagnostic and therapeutic options with dental implant therapy is, therefore, mandatory for dental students. The present consensus paper describes the theoretical knowledge as a foundation to the teaching of implant dentistry at the undergraduate level. Students need a solid basic knowledge about biological prerequisites and clinical procedures leading to successful implant treatment and, in particular, an understanding of the importance of embedding implants into the overall treatment concept. Among others this includes aspects of bone and soft tissue integration of dental implants, as well as aspects of materials that are used in implant dentistry. The students should also be able to differentiate between low, medium and high-risk situations, which assumes that they have knowledge about a proper clinical examination. Furthermore, the students need to be able to inform the patient about the different treatment options and their advantages and disadvantages. Frequently, a choice has to be made between an FDP anchored on teeth and an implant-borne reconstruction. This is highly influenced by the long-term prognosis of the different treatment options. In order to perform implant placement in uncomplicated cases and to give appropriate patient information, adequate knowledge of surgical procedure and surgical complications is mandatory. Furthermore, the dentist needs to be competent in evaluating clinical situations and in advising patients about the suitability of the different options, e.g. removable or fixed reconstructions. It is possible that peri-implant tissue destruction may be a more common finding during long-term service of implant-borne reconstructions than was previously believed. The dentist needs knowledge about etiology and pathogenesis of peri-implantitis and should know how to provide an effective maintenance care programme. In cases of peri-implantitis the student should be knowledgeable regarding suitable interventions.
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Affiliation(s)
- S P Hicklin
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zürich, Zürich, Switzerland
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